Sudden infant death syndrome - a community intervention project.

OBJECTIVE: To capacitate pregnant women to comply with measures designed to prevent sudden infant death syndrome. METHODS: A quasi-experimental study was conducted before and after the intervention that included pregnant women attending the Course of Preparation for Childbirth and Parenthood of Health Centers Cluster. Six training sessions were given in the context of preventing this syndrome. Three questionnaires were applied, one to evaluate the knowledge of pregnant women before classes, other was submitted after the sessions, and another, one month after the birth of the babies, to identify what skills were acquired and which were practiced. RESULTS: Among 77 studied pregnant women, 70 answered pre-session questionnaire and the proportion of correct answers varied from from 60.0% to 84.3%. After the intervention, 64 women answered the questionnaire and the proportion of correct answers varied between 79.7% and 100% . Prior to the intervention, the most wrong answers were related to the role of smoking as a risk factor for sudden infant death syndrome and to the use of pacifiers as a protective measure. After the sessions, all women answered correctly to the questions concerning where the baby should sleep and the safest way to lay the baby in the cradle. CONCLUSIONS: Health education with the aim of establishing measures may have a significant impact in terms of care delivery and mortality rate caused by sudden infant death syndrome.

Birth in Brazil II: a postpartum maternal, paternal and child health research protocol. / Nascer no Brasil II: protocolo de investigação da saúde materna, paterna e da criança no pós-parto.

Pregnancy, parturition and birth bring major changes to the lives of mothers and fathers. This article presents a research protocol for estimating the prevalence of postpartum mental health outcomes in mothers and fathers, abuse and satisfaction in delivery/abortion care, and the correlations between them and socioeconomic, obstetric, and child health factors. As a 2-component research, it consists of a prospective cohort study with all postpartum women interviewed in the 465 maternity hospitals included at the Birth in Brazil II baseline survey conducted from 2021 to 2023, and a cross-sectional study with the newborns' fathers/partners. Interviews will be conducted via telephone or self-completion link sent by WhatsApp with the mother at 2 and 4 months after delivery/abortion. Partners will be approached three months after birth (excluding abortions, stillbirths and newborn death) using the telephone number informed by the mother at the maternity ward. Postpartum women will be inquired about symptoms of depression, anxiety and post-traumatic stress disorder, abuse during maternity care and quality of the mother-newborn bond. Maternal and neonatal morbidity, use of postnatal services, and satisfaction with maternity care are also investigated. Fathers will be asked to report on symptoms of depression and anxiety, and the quality of the relationship with the partner and the newborn. The information collected in this research stage may help to plan and improve care aimed at the postpartum health of the mother-father-child triad.

A gravidez, o parto e o nascimento são momentos de grandes mudanças na vida das mães e dos pais. Este artigo tem como objetivo apresentar o protocolo da pesquisa para estimar a prevalência dos desfechos em saúde mental nas mães e pais no pós-parto, dos maus tratos e satisfação na atenção ao parto/abortamento, e as inter-relações entre eles e fatores socioeconômicos, obstétricos e da saúde da criança. A pesquisa tem dois componentes: estudo de coorte prospectiva com todas as puérperas entrevistadas nas 465 maternidades incluídas na linha de base da pesquisa Nascer no Brasil II realizada entre 2021 e 2023, e estudo seccional com os companheiros/pais dos bebês. As entrevistas são realizadas por ligação telefônica ou link de autopreenchimento enviado por WhatsApp com as puérperas aos 2 e 4 meses após o parto/aborto. Os companheiros são abordados três meses após o nascimento (excluídos os abortos, natimortos e neomortos), a partir do telefone informado pela puérpera na maternidade. As entrevistas abordam, entre as puérperas, sintomas de depressão, ansiedade e transtorno de estresse pós-traumático, maus-tratos na atenção na maternidade e qualidade do vínculo mãe-bebê. São investigados também a presença de morbidade materna e neonatal, utilização de serviços pós-natais, e satisfação com o atendimento na maternidade. Entre os pais, é abordada a ocorrência de sintomas de depressão e ansiedade, e a qualidade do relacionamento com a esposa/companheira e o bebê. As informações coletadas nessa etapa da pesquisa poderão subsidiar o planejamento e melhoria do cuidado voltado para a saúde da tríade mãe-pai-filho após o nascimento.

El embarazo, el parto y el nacimiento son momentos de grandes cambios en la vida de madres y padres. Este artículo tiene como objetivo presentar el protocolo de investigación para estimar la prevalencia de los resultados de la salud mental en madres y padres en el posparto, maltratos y la satisfacción durante la atención del parto/aborto, y las interrelaciones entre ellos y los factores socioeconómicos, obstétricos y de salud infantil. La investigación tiene dos componentes: un estudio de cohorte prospectivo con todas las puérperas entrevistadas en las 465 maternidades incluidas en la línea de base de la encuesta Nacer en Brasil II realizada entre 2021 y 2023, y un estudio seccional con las parejas/padres de los bebés. Las entrevistas se efectúan mediante llamada telefónica o enlace de autocumplimentación enviado vía WhatsApp a las puérperas a los 2 y 4 meses después del parto/aborto. El contacto con la pareja se hace a los tres meses del nacimiento (excluyendo abortos, mortinatos y muertes de recién nacidos), a través del teléfono facilitado por la puérpera en la sala de maternidad. Las entrevistas abordan, entre las puérperas, los síntomas de depresión, ansiedad y trastorno de estrés postraumático, maltrato durante la atención en la maternidad y la calidad del vínculo madre-bebé. También se investiga la presencia de morbilidad materna y neonatal, uso de servicios posnatales y satisfacción con la atención en la maternidad. Entre los padres, se aborda la ocurrencia de síntomas de depresión y ansiedad, y la calidad de la relación con la esposa/pareja y el bebé. La información recopilada en esta etapa de la investigación puede apoyar la planificación y mejora de la atención dirigida a la salud de la tríada madre-padre-hijo después del nacimiento.

Increased consumption of ultra-processed foods during pregnancy is associated with sociodemographic, behavioral, and obstetric factors: A cohort study.

A diet based on ultra-processed food (UPF) does not meet nutritional needs, especially during pregnancy. The aim of this study is to assess the change in UPF consumption from preconception to pregnancy and associated factors. Our hypothesis is that women tend to adopt a healthier eating pattern during pregnancy, decreasing the intake of UPF and increasing the intake of unprocessed/minimally processed foods. A prospective cohort study with 326 participants was carried out from 2016 to 2019 in 2 health units in Rio de Janeiro, Brazil. Pregestational food consumption assessed using the food frequency questionnaire in the prenatal interview in women up to 20 gestational weeks and gestational consumption in the interview 2 months after delivery. Food items classified according to the NOVA system. For the mean variation from preconception to gestational UPF consumption, we used the generalized estimating equations model with linear distribution. Control of confounding variables was based on the literature on factors associated with UPF consumption, using a 3-level hierarchical model. The proportion of UPF energy consumption was 28.9% in preconception and 33% during pregnancy. Older and more educated women had a lower mean variation in the consumption of UPF during the pregnancy. A higher average consumption of UPF observed among women physically inactive before pregnancy, who smoked during pregnancy, were multiparous, and with had a low pregestational weight. These results reflect similar behavior to that of the general population, aggravated by a significant increase during pregnancy. However, older and more educated women and those with healthy behaviors showed lower UPF intake in pregnancy.

Nascer no Brasil II: protocolo de investigação da saúde materna, paterna e da criança no pós-parto / Nacer en Brasil II: protocolo de investigación en salud materna, paterna e infantil posparto / Birth in Brazil II: a postpartum maternal, paternal and child health research protocol

Resumo: A gravidez, o parto e o nascimento são momentos de grandes mudanças na vida das mães e dos pais. Este artigo tem como objetivo apresentar o protocolo da pesquisa para estimar a prevalência dos desfechos em saúde mental nas mães e pais no pós-parto, dos maus tratos e satisfação na atenção ao parto/abortamento, e as inter-relações entre eles e fatores socioeconômicos, obstétricos e da saúde da criança. A pesquisa tem dois componentes: estudo de coorte prospectiva com todas as puérperas entrevistadas nas 465 maternidades incluídas na linha de base da pesquisa Nascer no Brasil II realizada entre 2021 e 2023, e estudo seccional com os companheiros/pais dos bebês. As entrevistas são realizadas por ligação telefônica ou link de autopreenchimento enviado por WhatsApp com as puérperas aos 2 e 4 meses após o parto/aborto. Os companheiros são abordados três meses após o nascimento (excluídos os abortos, natimortos e neomortos), a partir do telefone informado pela puérpera na maternidade. As entrevistas abordam, entre as puérperas, sintomas de depressão, ansiedade e transtorno de estresse pós-traumático, maus-tratos na atenção na maternidade e qualidade do vínculo mãe-bebê. São investigados também a presença de morbidade materna e neonatal, utilização de serviços pós-natais, e satisfação com o atendimento na maternidade. Entre os pais, é abordada a ocorrência de sintomas de depressão e ansiedade, e a qualidade do relacionamento com a esposa/companheira e o bebê. As informações coletadas nessa etapa da pesquisa poderão subsidiar o planejamento e melhoria do cuidado voltado para a saúde da tríade mãe-pai-filho após o nascimento.

Resumen: El embarazo, el parto y el nacimiento son momentos de grandes cambios en la vida de madres y padres. Este artículo tiene como objetivo presentar el protocolo de investigación para estimar la prevalencia de los resultados de la salud mental en madres y padres en el posparto, maltratos y la satisfacción durante la atención del parto/aborto, y las interrelaciones entre ellos y los factores socioeconómicos, obstétricos y de salud infantil. La investigación tiene dos componentes: un estudio de cohorte prospectivo con todas las puérperas entrevistadas en las 465 maternidades incluidas en la línea de base de la encuesta Nacer en Brasil II realizada entre 2021 y 2023, y un estudio seccional con las parejas/padres de los bebés. Las entrevistas se efectúan mediante llamada telefónica o enlace de autocumplimentación enviado vía WhatsApp a las puérperas a los 2 y 4 meses después del parto/aborto. El contacto con la pareja se hace a los tres meses del nacimiento (excluyendo abortos, mortinatos y muertes de recién nacidos), a través del teléfono facilitado por la puérpera en la sala de maternidad. Las entrevistas abordan, entre las puérperas, los síntomas de depresión, ansiedad y trastorno de estrés postraumático, maltrato durante la atención en la maternidad y la calidad del vínculo madre-bebé. También se investiga la presencia de morbilidad materna y neonatal, uso de servicios posnatales y satisfacción con la atención en la maternidad. Entre los padres, se aborda la ocurrencia de síntomas de depresión y ansiedad, y la calidad de la relación con la esposa/pareja y el bebé. La información recopilada en esta etapa de la investigación puede apoyar la planificación y mejora de la atención dirigida a la salud de la tríada madre-padre-hijo después del nacimiento.

Abstract: Pregnancy, parturition and birth bring major changes to the lives of mothers and fathers. This article presents a research protocol for estimating the prevalence of postpartum mental health outcomes in mothers and fathers, abuse and satisfaction in delivery/abortion care, and the correlations between them and socioeconomic, obstetric, and child health factors. As a 2-component research, it consists of a prospective cohort study with all postpartum women interviewed in the 465 maternity hospitals included at the Birth in Brazil II baseline survey conducted from 2021 to 2023, and a cross-sectional study with the newborns' fathers/partners. Interviews will be conducted via telephone or self-completion link sent by WhatsApp with the mother at 2 and 4 months after delivery/abortion. Partners will be approached three months after birth (excluding abortions, stillbirths and newborn death) using the telephone number informed by the mother at the maternity ward. Postpartum women will be inquired about symptoms of depression, anxiety and post-traumatic stress disorder, abuse during maternity care and quality of the mother-newborn bond. Maternal and neonatal morbidity, use of postnatal services, and satisfaction with maternity care are also investigated. Fathers will be asked to report on symptoms of depression and anxiety, and the quality of the relationship with the partner and the newborn. The information collected in this research stage may help to plan and improve care aimed at the postpartum health of the mother-father-child triad.

Sudden infant death syndrome — a community intervention project / Síndrome da morte súbita do lactente — projeto de intervenção na comunidade

ABSTRACT Objective: To capacitate pregnant women to comply with measures designed to prevent sudden infant death syndrome. Methods: A quasi-experimental study was conducted before and after the intervention that included pregnant women attending the Course of Preparation for Childbirth and Parenthood of Health Centers Cluster. Six training sessions were given in the context of preventing this syndrome. Three questionnaires were applied, one to evaluate the knowledge of pregnant women before classes, other was submitted after the sessions, and another, one month after the birth of the babies, to identify what skills were acquired and which were practiced. Results: Among 77 studied pregnant women, 70 answered pre-session questionnaire and the proportion of correct answers varied from from 60.0% to 84.3%. After the intervention, 64 women answered the questionnaire and the proportion of correct answers varied between 79.7% and 100% . Prior to the intervention, the most wrong answers were related to the role of smoking as a risk factor for sudden infant death syndrome and to the use of pacifiers as a protective measure. After the sessions, all women answered correctly to the questions concerning where the baby should sleep and the safest way to lay the baby in the cradle. Conclusions: Health education with the aim of establishing measures may have a significant impact in terms of care delivery and mortality rate caused by sudden infant death syndrome.

RESUMO Objetivo: Capacitar as grávidas para o cumprimento de medidas de prevenção da síndrome de morte súbita do lactente. Métodos: Realizou-se um estudo quase-experimental pré- e pós-intervenção que integrou as grávidas que frequentavam o Curso de Preparação para o Parto e Parentalidade do Agrupamento de Centros de Saúde. Foram ministradas seis sessões formativas no âmbito da prevenção desta síndrome. Três questionários foram aplicados, um para avaliar os conhecimentos das gestantes antes das aulas, outro foi submetido após as sessões, e outro, um mês após o nascimento dos bebês para identificar que conhecimentos foram adquiridos e quais foram praticados. Resultados: Da amostra de 77 grávidas, relativamente ao questionário pré-sessão (n=70), obteve-se uma proporção de respostas corretas entre 60,0-84,3%. Posteriormente à intervenção (n=64), verificou-se um incremento dos conhecimentos com 79,7-100% de acertos. Previamente à intervenção, as respostas mais erradas às questões eram inerentes ao papel do tabagismo como fator de risco para síndrome de morte súbita do lactente e ao uso da chupeta como medida protetora. Após as sessões, todas as mulheres responderam corretamente às questões relativas ao local onde o bebê deve dormir e à forma mais segura de colocar o bebê no berço. Conclusões: Este projeto demonstrou que a educação para a saúde com o intuito de instituir medidas pode ter um impacto significativo em termos de prestação de cuidados e taxa de mortalidade por síndrome de morte súbita do lactente.

Transcriptomic and physiological shade avoidance responses in potato (Solanum tuberosum) plants.

Plants detect competitors in shaded environments by perceiving a reduction in photosynthetically active radiation (PAR) and the reduction between the red and far-red light (R:FR) ratio and blue photons. These light signals are detected by phytochromes and cryptochromes, which trigger shade avoidance responses such as shoot and petiole elongation and lead to increased susceptibility to pathogen attack. We studied morphological, anatomical, and photosynthesis differences in potato plants (Solanum tuberosum var. Spunta) exposed to sunlight or simulated shade in a greenhouse. We found that simulated shade strongly induced stem and internode elongation with a higher production of free auxin in stems and a lower production of tubers. The mesophyll thickness of the upper leaves of plants grown in simulated shade was lower, but the epidermis was wider compared with the leaves of plants cultivated in sunlight. In addition, the photosynthesis rate was lower in the upper leaves exposed to nonsaturated irradiances and higher in the basal leaves at saturated irradiances compared with control plants. RNA-seq analysis showed that 146 and 155 genes were up- and downregulated by shade, respectively. By quantitative reverse transcription polymerase chain reaction, we confirmed that FLOWERING LOCUS T (FT), WRKY-like, and PAR1b were induced, while FLAVONOL 4-SULFOTRANSFERASE was repressed under shade. In shaded plants, leaves and tubers were more susceptible to the necrotrophic fungus Botrytis cinerea attack. Overall, our work demonstrates configurational changes between growth and defense decisions in potato plants cultivated in simulated shade.

Factors associated with ultra-processed foods consumption in a cohort of Brazilian pregnant women.

Nutrition during pregnancy is essential for the health of the pregnant woman, the development of the fetus, and the prevention of complications related to pregnancy and the postpartum period. This study described the factors associated with high consumption of ultra-processed foods among pregnant women. This prospective cohort study was performed from February 2016 to November 2019 in two health units in the city of Rio de Janeiro, Brazil, with data from 344 pregnant women. The first interview was conducted in the prenatal visit at less than 20 gestational weeks, the second at 34 gestational weeks, and the third at two months postpartum. Diet was assessed in the last interview using a food frequency questionnaire, and food items were classified according to NOVA. The percentage of ultra-processed foods consumption was estimated by tertile distribution, and the third tertile represented the highest consumption. Based on the hierarchical analysis model, the associations between ultra-processed foods consumption and sociodemographic, reproductive health, pregestational, behavioral, and pregnancy variables were assessed using a multinomial logistic regression model. Older women had lower ultra-processed foods consumption (OR = 0.33; 95%CI: 0.15-0.71). Few years of schooling (up to 7 years; OR = 5.58; 95%CI: 1.62-19.23), history of a previous childbirth (OR = 2.48; 95%CI: 1.22-5.04), history of two or more previous childbirths (OR = 7.53; 95%CI: 3.02-18.76), and no history of regular physical activity before pregnancy (OR = 2.40; 95%CI: 1.31-4.38) were risk factors. The identification of risk and protection factors allows for the establishment of control measures and encouragement of healthy practices during prenatal care.

AtBBX29 integrates photomorphogenesis and defense responses in Arabidopsis.

Light is an environmental signal that modulates plant defenses against attackers. Recent research has focused on the effects of light on defense hormone signaling; however, the connections between light signaling pathways and the biosynthesis of specialized metabolites involved in plant defense have been relatively unexplored. Here, we show that Arabidopsis BBX29, a protein that belongs to the B-Box transcription factor (TF) family, integrates photomorphogenic signaling with defense responses by promoting flavonoid, sinapate and glucosinolate accumulation in Arabidopsis leaves. AtBBX29 transcript levels were up regulated by light, through photoreceptor signaling pathways. Genetic evidence indicated that AtBBX29 up-regulates MYB12 gene expression, a TF known to induce genes related to flavonoid biosynthesis in a light-dependent manner, and MYB34 and MYB51, which encode TFs involved in the regulation of glucosinolate biosynthesis. Thus, bbx29 knockout mutants displayed low expression levels of key genes of the flavonoid biosynthetic pathway, and the opposite was true in BBX29 overexpression lines. In agreement with the transcriptomic data, bbx29 mutant plants accumulated lower levels of kaempferol glucosides, sinapoyl malate, indol-3-ylmethyl glucosinolate (I3M), 4-methylsulfinylbutyl glucosinolate (4MSOB) and 3-methylthiopropyl glucosinolate (3MSP) in rosette leaves compared to the wild-type, and showed increased susceptibility to the necrotrophic fungus Botrytis cinerea and to the herbivore Spodoptera frugiperda. In contrast, BBX29 overexpressing plants displayed increased resistance to both attackers. In addition, we found that AtBBX29 plays an important role in mediating the effects of ultraviolet-B (UV-B) radiation on plant defense against B. cinerea. Taken together, these results suggest that AtBBX29 orchestrates the accumulation of specific light-induced metabolites and regulates Arabidopsis resistance against pathogens and herbivores.

Factors associated with ultra-processed foods consumption in a cohort of Brazilian pregnant women / Fatores associados ao consumo de alimentos ultraprocessados em uma coorte de gestantes brasileiras / Factores asociados al consumo de alimentos ultraprocesados en una cohorte de gestantes brasileñas

Nutrition during pregnancy is essential for the health of the pregnant woman, the development of the fetus, and the prevention of complications related to pregnancy and the postpartum period. This study described the factors associated with high consumption of ultra-processed foods among pregnant women. This prospective cohort study was performed from February 2016 to November 2019 in two health units in the city of Rio de Janeiro, Brazil, with data from 344 pregnant women. The first interview was conducted in the prenatal visit at less than 20 gestational weeks, the second at 34 gestational weeks, and the third at two months postpartum. Diet was assessed in the last interview using a food frequency questionnaire, and food items were classified according to NOVA. The percentage of ultra-processed foods consumption was estimated by tertile distribution, and the third tertile represented the highest consumption. Based on the hierarchical analysis model, the associations between ultra-processed foods consumption and sociodemographic, reproductive health, pregestational, behavioral, and pregnancy variables were assessed using a multinomial logistic regression model. Older women had lower ultra-processed foods consumption (OR = 0.33; 95%CI: 0.15-0.71). Few years of schooling (up to 7 years; OR = 5.58; 95%CI: 1.62-19.23), history of a previous childbirth (OR = 2.48; 95%CI: 1.22-5.04), history of two or more previous childbirths (OR = 7.53; 95%CI: 3.02-18.76), and no history of regular physical activity before pregnancy (OR = 2.40; 95%CI: 1.31-4.38) were risk factors. The identification of risk and protection factors allows for the establishment of control measures and encouragement of healthy practices during prenatal care.

A nutrição durante a gravidez é essencial para a saúde da gestante, o desenvolvimento do bebê e a prevenção de complicações relacionadas à gravidez e ao pós-parto. Este estudo descreveu os fatores associados ao alto consumo de alimentos ultraprocessados entre gestantes. Trata-se de uma coorte prospectiva realizada de fevereiro de 2016 a novembro de 2019, em duas unidades de saúde do Município do Rio de Janeiro, Brasil, que analisou dados de 344 gestantes. A primeira entrevista foi realizada na consulta pré-natal com menos de 20 semanas de gestação, a segunda com 34 semanas de gestação e a terceira dois meses após o parto. A dieta foi avaliada na última entrevista por meio de um questionário de frequência alimentar e os itens alimentares foram classificados de acordo com a classificação NOVA. O percentual de consumo de alimentos ultraprocessados foi calculado em tercis de distribuição, dos quais o terceiro tercil representou o maior consumo. Com base no modelo de análise hierárquica, as associações entre o consumo de alimentos ultraprocessados e variáveis sociodemográficas, de saúde reprodutiva, pré-gestacionais, comportamentais e gestacionais foram investigadas usando um modelo de regressão logística multinomial. Mulheres mais velhas apresentaram menor consumo de alimentos ultraprocessados (OR = 0,33; IC95%: 0,15-0,71). Os fatores de risco foram baixa escolaridade (até sete anos; OR = 5,58; IC95%: 1,62-19,23), histórico de parto anterior (OR = 2,48; IC95%: 1,22-5,04), histórico de dois ou mais partos anteriores (OR = 7,53; IC95%: 3,02-18,76) e ausência de histórico de atividade física regular antes da gestação (OR = 2,40; IC95%: 1,31-4,38). A identificação de fatores de risco e proteção permite o estabelecimento de medidas de controle e o incentivo a práticas saudáveis durante o pré-natal.

La nutrición durante el embarazo es esencial para la salud de la futura madre, el desarrollo del bebé y la prevención de complicaciones relacionadas con el embarazo y el posparto. Este estudio describió los factores asociados con el alto consumo de alimentos ultraprocesados entre las mujeres embarazadas. Se trata de una cohorte prospectiva realizada entre febrero de 2016 y noviembre de 2019, en dos unidades de salud de la ciudad de Río de Janeiro, Brasil, que analizó datos de 344 gestantes. La primera entrevista se realizó en la visita prenatal a las 20 semanas de gestación, la segunda a las 34 semanas de gestación y la tercera dos meses después del parto. La dieta se evaluó en la última entrevista mediante un cuestionario de frecuencia de alimentos y los alimentos se clasificaron de acuerdo con la clasificación NOVA. El porcentaje de consumo de alimentos ultraprocesados se calculó en terciles de distribución, de los cuales el tercer tercil representó el mayor consumo. Con base en el modelo de análisis jerárquico, se investigaron las asociaciones entre el consumo de alimentos ultraprocesados y las variables sociodemográficas, de salud reproductiva, previas al embarazo, conductuales y gestacionales mediante un modelo de regresión logística multinomial. Las mujeres mayores presentaron menor consumo de alimentos ultraprocesados (OR = 0,33; IC95%: 0,15-0,71). Los factores de riesgo fueron bajo nivel educativo (hasta siete años; OR = 5,58; IC95%: 1,62-19,23), antecedentes de parto previo (OR = 2,48; IC95%: 1,22-5,04), antecedentes de dos o más partos previos (OR = 7,53; IC95%: 3,02-18,76) y sin antecedentes de actividad física regular antes del embarazo (OR = 2,40; IC95%: 1,31-4,38). La identificación de factores de riesgo y protección permite el establecimiento de medidas de control y el fomento de prácticas saludables durante la atención prenatal.

Establishing a mass spectrometry-based system for rapid detection of SARS-CoV-2 in large clinical sample cohorts.

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is pressing public health systems around the world, and large population testing is a key step to control this pandemic disease. Here, we develop a high-throughput targeted proteomics assay to detect SARS-CoV-2 nucleoprotein peptides directly from nasopharyngeal and oropharyngeal swabs. A modified magnetic particle-based proteomics approach implemented on a robotic liquid handler enables fully automated preparation of 96 samples within 4 hours. A TFC-MS system allows multiplexed analysis of 4 samples within 10 min, enabling the processing of more than 500 samples per day. We validate this method qualitatively (Tier 3) and quantitatively (Tier 1) using 985 specimens previously analyzed by real-time RT-PCR, and detect up to 84% of the positive cases with up to 97% specificity. The presented strategy has high sample stability and should be considered as an option for SARS-CoV-2 testing in large populations.

HLA-B*51 and its main subtypes in Brazilian patients with Behçet's disease.

OBJECTIVES: This study aimed to evaluate the frequency of HLA-B*51 and its subtypes in Brazilian patients with Behçet's disease (BD) and healthy controls (HC) and to assess possible associations with disease manifestations. METHODS: A cross-sectional study with sequential BD patients and HC. HLAB*51 presence was determined by sequence-specific polymerase chain reaction (SSP-PCR) and HLA-B*51 subtypes by the Sanger sequencing method. RESULTS: Eighty-three BD patients and 258 HC were evaluated. HLA-B*51 was found in 30.1% of DB patients and in 15.5% of HC (p=0.003). The most prevalent subtypes in DB patients were HLA-B*51:01 (60.0%), HLA-B*51:08 (20.0%), HLA-B*51:22 (8.0%), HLAB* 51:29 (8.0%) and HLA-B*51:02 (4.0%), while HLA-B*51:01 (77.5%) and HLA-B*51:55 (7.5%) were the most prevalent in HC. HLA-B*51 was less frequently found in patients with neurologic involvement (8.0% vs. 29.3%; p=0.034) while HLAB*51:01 was more observed in patients with ocular involvement (93.3% vs. 60.3%; p=0.014). No BD patient with neurologic or vascular involvement presented HLA-B*51:01. HLAB*51:08 was more frequent in patients with vascular manifestations (60.0% vs. 15.4%; p=0.012). In multivariate analysis, HLA-B*51 was an independent risk factor for BD (OR=2.410; 95%CI: 1.332-4.361; p=0.004) and HLA-B*51:08 had an independent association with vascular manifestations of BD (OR = 14.843; 95%CI: 1.550 - 142.115; p=0.019). CONCLUSIONS: The prevalence of HLAB*51 is higher in Brazilian BD patients compared to HC, and it is a risk factor for BD. The HLA-B*51:08 subtype was independently associated with vascular manifestations of BD.

Pregestational overweight and obesity and symptoms of postpartum depression: Data from the Birth in Brazil Study.

BACKGROUND: Relationship between pregestational overweight and obesity and symptoms of postpartum depression (PPD) has been documented in developed countries. In middle and low-income countries the studies are scarce and the pattern of findings is more mixed. Our objective is to assess the effect of pregestational overweight and obesity on development symptoms of PPD in a nationwide Brazilian study. METHODS: The study included 23,894 puerperal women, from 2011 to 2012. The Edinburgh Postnatal Depression Scale (EPDS) was applied from 6 to 18 months postpartum, with ≥13 points as the cutoff. Classification of pregestational nutritional status followed the method recommended by the Institute of Medicine. Confounding variables were identified using directed acyclic graph (DAG), and propensity score estimated the effect of nutritional status on PPD symptoms. RESULTS: Prevalence of PPD was 26.3%. Women with excess weight represented nearly 32% of the sample. In the crude analysis, women with pregestational obesity showed 23% higher odds of developing symptoms of PPD when compared to those with normal weight (OR=1.23 CI 95% 1.04-1.45). There was a loss of statistical significance after propensity score analysis (OR=1.14 CI 95% 0.91-1.42). LIMITATIONS: The symptoms of PPD were measured in a single moment, and sensitivity analysis revealed the existence of omitted or non-measured variables potentially modifying these estimates. CONCLUSIONS: Although we did not find a relationship between pregestational nutritional status and depressive symptoms, the results are important because of the problem's magnitude. Future studies should aim at a more comprehensive understanding of the complex relationship between the variables.

Rib osteomyelitis: a rare complication of varicella / Osteomielite de arco costal: uma complicação rara de varicela

ABSTRACT Objective: To report a case of varicella complicated by acute osteomyelitis in order to remind of a rare and potentially serious complication of a very common pediatric disease. Case description: A previously healthy 3-month-old female infant with 10-day history of varicella was admitted to the hospital for fever, groan and prostration. The initial laboratorial evaluation was compatible with bacterial sepsis. By the third day after admission, a swelling of the seventh left rib had developed. The ultrasound and scintigraphy evaluation suggested rib osteomyelitis. Blood cultures were negative. The patient completed six weeks of antibiotics with favorable clinical, laboratorial and imaging evolution. Comments: Varicella is one of the most frequent exanthematic diseases of childhood and it is usually self-limited. The most frequent complication is bacterial infection of cutaneous lesions. Osteoarticular complications are rare, and rib osteomyelitis is described in less than 1% of cases. The main route of dissemination is hematogenic, and the most frequent etiological agent is Staphylococcus aureus. The prognosis is generally good and depends on early detection and antibiotic initiation.

RESUMO Objetivo: Descrever um caso de varicela complicada de osteomielite aguda a fim de alertar para a complicação rara e potencialmente grave de uma doença muito frequente em idade pediátrica. Descrição do caso: Lactente de três meses, previamente saudável, internada por um quadro de febre, prostração e gemido, num contexto de varicela com cerca de dez dias de evolução, com avaliação inicial compatível com sepse de etiologia bacteriana. No terceiro dia de internação, observou-se uma tumefação na sétima costela esquerda. A avaliação ecográfica e cintilográfica mostraram alterações sugestivas de osteomielite de arco costal. As hemoculturas foram negativas. Recebeu antibioticoterapia por seis semanas e evoluiu favoravelmente do ponto de vista clínico, laboratorial e ecográfico. Comentários: A varicela é uma das doenças exantemáticas mais frequentes da infância, sendo habitualmente autolimitada. A complicação mais frequente é a infecção bacteriana secundária das lesões cutâneas, sendo raras as complicações osteoarticulares. O arcabouço costal é uma localização excepcional de osteomielite, descrita em menos de 1% dos casos. A principal via de disseminação é a hematogênica, e o agente mais frequente, o Staphylococcus aureus. O prognóstico é geralmente bom, quando a antibioticoterapia se institui precocemente.

RIB OSTEOMYELITIS: A RARE COMPLICATION OF VARICELLA.

OBJECTIVE: To report a case of varicella complicated by acute osteomyelitis in order to remind of a rare and potentially serious complication of a very common pediatric disease. CASE DESCRIPTION: A previously healthy 3-month-old female infant with 10-day history of varicella was admitted to the hospital for fever, groan and prostration. The initial laboratorial evaluation was compatible with bacterial sepsis. By the third day after admission, a swelling of the seventh left rib had developed. The ultrasound and scintigraphy evaluation suggested rib osteomyelitis. Blood cultures were negative. The patient completed six weeks of antibiotics with favorable clinical, laboratorial and imaging evolution. COMMENTS: Varicella is one of the most frequent exanthematic diseases of childhood and it is usually self-limited. The most frequent complication is bacterial infection of cutaneous lesions. Osteoarticular complications are rare, and rib osteomyelitis is described in less than 1% of cases. The main route of dissemination is hematogenic, and the most frequent etiological agent is Staphylococcus aureus. The prognosis is generally good and depends on early detection and antibiotic initiation.

Thiol oxidation of hemolymph proteins in oysters Crassostrea brasiliana as markers of oxidative damage induced by urban sewage exposure.

Urban sewage is a concerning issue worldwide, threatening both wildlife and human health. The present study investigated protein oxidation in mangrove oysters (Crassostrea brasiliana) exposed to seawater from Balneário Camboriú, an important tourist destination in Brazil that is affected by urban sewage. Oysters were exposed for 24 h to seawater collected close to the Camboriú River (CAM1) or 1 km away (CAM2). Seawater from an aquaculture laboratory was used as a reference. Local sewage input was marked by higher levels of coliforms, nitrogen, and phosphorus in seawater, as well as polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), linear alkylbenzenes (LABs), and fecal steroid in sediments at CAM1. Exposure of oysters to CAM1 caused marked bioaccumulation of LABs and decreased PAH and PCB concentrations after exposure to both CAM1 and CAM2. Protein thiol oxidation in gills, digestive gland, and hemolymph was evaluated. Lower levels of reduced protein thiols were detected in hemolymph from CAM1, and actin, segon, and dominin were identified as targets of protein thiol oxidation. Dominin susceptibility to oxidation was confirmed in vitro by exposure to peroxides and hypochlorous acid, and 2 cysteine residues were identified as potential sites of oxidation. Overall, these data indicate that urban sewage contamination in local waters has a toxic potential and that protein thiol oxidation in hemolymph could be a useful biomarker of oxidative stress in bivalves exposed to contaminants. Environ Toxicol Chem 2017;36:1833-1845. © 2016 SETAC.

Factors associated with unintended pregnancy in Brazil: cross-sectional results from the Birth in Brazil National Survey, 2011/2012.

BACKGROUND: Unintended pregnancy, a pregnancy that have been either unwanted or mistimed, is a serious public health issue in Brazil. It is reported for more than half of women who gave birth in the country, but the characteristics of women who conceive unintentionally are rarely documented. The aim of this study is to analyse the prevalence and the association between unintended pregnancy and a set of sociodemographic characteristics, individual-level variables and history of obstetric outcomes. METHODS: Birth in Brazil is a cross-sectional study with countrywide representation that interviewed 23,894 women after birth. The information about intendedness of pregnancy was obtained after birth at the hospital and classified into three categories: intended, mistimed or unwanted. Multinomial regression analysis was used to estimate the associations between intendedness of a pregnancy, and sociodemographic and obstetric variables, calculating odds ratios and 95 % confidence intervals. All significant variables in the bivariate analysis were included in the multinomial multivariate model and the final model retaining variables that remained significant at the 5 % level. RESULTS: Unintended pregnancy was reported by 55.4 % of postpartum women. The following variables maintained positive and significant statistical associations with mistimed pregnancy: maternal age < 20 years (OR = 1.89, 95 % CI: 1.68-2.14); brown (OR = 1.15, 95 % CI: 1.04-1.27) or yellow skin color (OR = 1.56, 95 % CI: 1.05-2.32); having no partner (OR = 2.32, 95 % CI: 1.99-2.71); having no paid job (OR = 1.15, 95 % CI: 1.04-1.27); alcohol abuse with risk of alcoholism (OR = 1.25, 95 % CI: 1.04-1.50) and having had three or more births (OR = 2.01, 95 % CI: 1.63-2.47). The same factors were associated with unwanted pregnancy, though the strength of the associations was generally stronger. Women with three or more births were 14 times more likely to have an unwanted pregnancy, and complication in the previous pregnancies and preterm birth were 40 % and 19 % higher, respectively. Previous neonatal death was a protective factor for both mistimed (OR = 0.61, 95 % CI: 0.44-0.85) and unwanted pregnancy (OR = 0.44, 95 % CI: 0.34-0.57). CONCLUSIONS: This study confirms findings from previous research about the influence of socioeconomic and individual risk factors on unintended pregnancy. It takes a new approach to the problem by showing the importance of previous neonatal death, preterm birth and complication during pregnancy as risk factors for unintended pregnancy.

Puberty beginning in lambs from hairless ewe submitted to caloric or protein restriction / Início da puberdade de cordeiros provenientes de ovelhas deslanadas submetidas à restrição calórica ou proteica

This study was carried out to evaluate if caloric or protein restriction in lactation ewe affect puberty beginning of its lambs. Had been used 21 lambs, two females and five males per type of treatment. During 60 days the mothers received the treatment for which its lamb was sort out: Control Treatment (TC, maintenance), Energy Restriction Treatment (TRC, ½ of the energy of the TC) and Protein Restriction Treatment (TRP, 1/3 of the protein of the TC). The lambs were weaned and received a diet composed by corn silage and concentrate, weighed and evaluated fortnightly. In males, the ejaculate was collected, scrotal circumference and testicular size measured. In females, it was realized ultrasound to measure the ovaries and verify the corpus luteum presence. For males was considered in puberty if produced ejaculation with at least: motility of 50%, sperm concentration of 50 x 106espermatozoa/mL and maximum of 50% total sperm abnormalities, and females if exhibit corpus luteum. An interaction was found between evaluation period and treatment for scrotum circumference (p=0.0019), testicular volume (p=0.0025) sperm motility (p0.05) were found about follicles characteristics, however that was difference in the presence of corpous luteum (p=0.0179). The TC females showed corpus luteum from the 10th week, TRC 11th and 13th for TRP. It was concluded that mother protein restriction during the lactation delays the beginning of the puberty of its lambs.

O estudo foi realizado para avaliar se a restrição calórica ou proteica em fêmeas lactantes influencia o início da puberdade de seus cordeiros. Foram utilizados 21 cordeiros, sendo duas fêmeas e cinco machos por tratamento. Durante sessenta dias as mães receberam o tratamento aleatoriamente escolhido para o seu cordeiro: controle (TC, mantença), restrição calórica (TRC, ½ da energia do TC) e restrição proteica (TRP, 1/3 da proteína do TC). Após o desmame, os cordeiros receberam uma dieta composta por silagem de milho e concentrado, sendo pesados e avaliados quinzenalmente. Nos machos, coletava-se o ejaculado, mensurava-se circunferência escrotal e as dimensões testiculares. Nas fêmeas, realizava-se ultrassonografia para medir os ovários e verificar presença de corpo lúteo. Os machos eram considerados púberes se apresentassem ejaculado com, no mínimo: motilidade de 50%, concentração do ejaculado de 50 x 106espermatozóides/mL e, no máximo, 50% de anormalidades espermáticas totais, e as fêmeas, se apresentassem corpo lúteo. Foi encontrada interação entre período de avaliação e tratamento para circunferência escrotal (p=0,0019), volume testicular médio (p=0,0025), motilidade (p0,05) entre os tratamentos quanto às características foliculares, porém houve quanto ao corpo lúteo (p=0,0179). Notou-se que as fêmeas do TC apresentaram corpo lúteo a partir da 10a semana, TRC da 11a e o TRP da 13a. Concluiu-se que a restrição proteica materna durante a lactação atrasa o início da puberdade de seus cordeiros.

Início da puberdade de cordeiros provenientes de ovelhas deslanadas submetidas à restrição calórica ou proteica

AbstractThis study was carried out to evaluate if caloric or protein restriction in lactation ewe affect puberty beginning of its lambs. Had been used 21 lambs, two females and five males per type of treatment. During 60 days the mothers received the treatment for which its lamb was sort out: Control Treatment (TC, maintenance), Energy Restriction Treatment (TRC, ½ of the energy of the TC) and Protein Restriction Treatment (TRP, 1/3 of the protein of the TC). The lambs were weaned and received a diet composed by corn silage and concentrate, weighed and evaluated fortnightly. In males, the ejaculate was collected, scrotal circumference and testicular size measured. In females, it was realized ultrasound to measure the ovaries and verify the corpus luteum presence. For males was considered in puberty if produced ejaculation with at least: motility of 50%, sperm concentration of 50 x 106espermatozoa/mL and maximum of 50% total sperm abnormalities, and females if exhibit corpus luteum. An interaction was found between evaluation period and treatment for scrotum circumference (p=0.0019), testicular volume (p=0.0025) sperm motility (p 0.0001) and concentration (p=0.027), TRP was later than TRC and TC in all variable. In female no treatment effect (p>0.05) were found about follicles characteristics, however that was difference in the presence of corpous luteum (p=0.0179). The TC females showed corpus luteum from the 10th week, TRC 11th and 13th for TRP. It was concluded that mother protein restriction during the lactation delays the beginning of the puberty of its lambs.

ResumoO estudo foi realizado para avaliar se a restrição calórica ou proteica em fêmeas lactantes influencia o início da puberdade de seus cordeiros. Foram utilizados 21 cordeiros, sendo duas fêmeas e cinco machos por tratamento. Durante sessenta dias as mães receberam o tratamento aleatoriamente escolhido para o seu cordeiro: controle (TC, mantença), restrição calórica (TRC, ½ da energia do TC) e restrição proteica (TRP, 1/3 da proteína do TC). Após o desmame, os cordeiros receberam uma dieta composta por silagem de milho e concentrado, sendo pesados e avaliados quinzenalmente. Nos machos, coletava-se o ejaculado, mensurava-se circunferência escrotal e as dimensões testiculares. Nas fêmeas, realizava-se ultrassonografia para medir os ovários e verificar presença de corpo lúteo. Os machos eram considerados púberes se apresentassem ejaculado com, no mínimo: motilidade de 50%, concentração do ejaculado de 50 x 106espermatozóides/mL e, no máximo, 50% de anormalidades espermáticas totais, e as fêmeas, se apresentassem corpo lúteo. Foi encontrada interação entre período de avaliação e tratamento para circunferência escrotal (p=0,0019), volume testicular médio (p=0,0025), motilidade (p 0,0001) e concentração espermática (p=0,027), sendo o TRP, mais tardio do que TRC e TC em todas variáveis. Nas borregas não houve diferença (p>0,05) entre os tratamentos quanto às características foliculares, porém houve quanto ao corpo lúteo (p=0,0179). Notou-se que as fêmeas do TC apresentaram corpo lúteo a partir da 10a semana, TRC da 11a e o TRP da 13a. Concluiu-se que a restrição proteica materna durante a lactação atrasa o início da puberdade de seus cordeiros.

Puberty beginning in lambs from hairless ewe submitted to caloric or protein restriction / Início da puberdade de cordeiros provenientes de ovelhas deslanadas submetidas à restrição calórica ou proteica

This study was carried out to evaluate if caloric or protein restriction in lactation ewe affect puberty beginning of its lambs. Had been used 21 lambs, two females and five males per type of treatment. During 60 days the mothers received the treatment for which its lamb was sort out: Control Treatment (TC, maintenance), Energy Restriction Treatment (TRC, ½ of the energy of the TC) and Protein Restriction Treatment (TRP, 1/3 of the protein of the TC). The lambs were weaned and received a diet composed by corn silage and concentrate, weighed and evaluated fortnightly. In males, the ejaculate was collected, scrotal circumference and testicular size measured. In females, it was realized ultrasound to measure the ovaries and verify the corpus luteum presence. For males was considered in puberty if produced ejaculation with at least: motility of 50%, sperm concentration of 50 x 106espermatozoa/mL and maximum of 50% total sperm abnormalities, and females if exhibit corpus luteum. An interaction was found between evaluation period and treatment for scrotum circumference (p=0.0019), testicular volume (p=0.0025) sperm motility (p<0.0001) and concentration (p=0.027), TRP was later than TRC and TC in all variable. In female no treatment effect (p>0.05) were found about follicles characteristics, however that was difference in the presence of corpous luteum (p=0.0179). The TC females showed corpus luteum from the 10th week, TRC 11th and 13th for TRP. It was concluded that mother protein restriction during the lactation delays the beginning of the puberty of its lambs.(AU)

O estudo foi realizado para avaliar se a restrição calórica ou proteica em fêmeas lactantes influencia o início da puberdade de seus cordeiros. Foram utilizados 21 cordeiros, sendo duas fêmeas e cinco machos por tratamento. Durante sessenta dias as mães receberam o tratamento aleatoriamente escolhido para o seu cordeiro: controle (TC, mantença), restrição calórica (TRC, ½ da energia do TC) e restrição proteica (TRP, 1/3 da proteína do TC). Após o desmame, os cordeiros receberam uma dieta composta por silagem de milho e concentrado, sendo pesados e avaliados quinzenalmente. Nos machos, coletava-se o ejaculado, mensurava-se circunferência escrotal e as dimensões testiculares. Nas fêmeas, realizava-se ultrassonografia para medir os ovários e verificar presença de corpo lúteo. Os machos eram considerados púberes se apresentassem ejaculado com, no mínimo: motilidade de 50%, concentração do ejaculado de 50 x 106espermatozóides/mL e, no máximo, 50% de anormalidades espermáticas totais, e as fêmeas, se apresentassem corpo lúteo. Foi encontrada interação entre período de avaliação e tratamento para circunferência escrotal (p=0,0019), volume testicular médio (p=0,0025), motilidade (p<0,0001) e concentração espermática (p=0,027), sendo o TRP, mais tardio do que TRC e TC em todas variáveis. Nas borregas não houve diferença (p>0,05) entre os tratamentos quanto às características foliculares, porém houve quanto ao corpo lúteo (p=0,0179). Notou-se que as fêmeas do TC apresentaram corpo lúteo a partir da 10a semana, TRC da 11a e o TRP da 13a. Concluiu-se que a restrição proteica materna durante a lactação atrasa o início da puberdade de seus cordeiros.(AU)