Suporte informacional como elemento para orientação de pais de pré-termo: um guia para o serviço de acompanhamento do desenvolvimento no primeiro ano de vida / Information support as an element for advising parents of preterm infants: a guide for development follow-up services during the first year of life

INTRODUÇÃO: A literatura aponta o alto risco de distúrbios biológicos e psicossociais aos quais o bebê pré-termo está susceptível, necessitando de atenção diferenciada daquela dada ao bebê a termo. OBJETIVO: Elaborar um guia de orientação e acompanhamento do desenvolvimento no primeiro ano de vida para pais que freqüentam um serviço de acompanhamento do desenvolvimento de bebês. MÉTODO: Os critérios para inclusão dos participantes foram: ser pais de bebê pré-termo de zero a seis meses de idade corrigida que não apresentavam doença neurológica e não necessitaram de intervenção fisioterápica. O presente estudo, de caráter qualitativo, empregou, na etapa de coleta de dados, a observação direta e a entrevista, efetivadas com as mães e profissionais deste serviço de acompanhamento do desenvolvimento de bebês. A elaboração do Guia baseou-se nas análises das observações dos atendimentos no serviço, na freqüência das respostas das entrevistas com profissionais e mães sobre necessidades e dúvidas no manuseio e cuidado com o bebê e a associação com a literatura. RESULTADOS: Obteve-se um guia contendo informações sobre o desenvolvimento do bebê, distribuído nos quatro primeiros trimestres de vida, e o alerta sobre a importância de calcular a idade corrigida para o acompanhamento adequado dos marcos do desenvolvimento. CONCLUSÃO: A utilização deste guia pode ser feita por diferentes profissionais da saúde e por aqueles que desenvolvem atividades educativas para pais.

INTRODUCTION: The literature shows that preterm infants are at high risk of biological and psychological disorders and consequently require a higher level of care than is provided for full-term infants. OBJECTIVE: To draw up a guide advising on development follow-up during the first year of life, for parents who attend a child development follow-up service. METHOD: The inclusion criteria were that participants should be parents of preterm infants with a corrected age between zero and six months that did not present neurological diseases and did not require physiotherapeutic intervention. This study was of qualitative nature. Data collection was by means of direct observation and interviews with mothers and with the professionals at this infant development follow-up service. The guide was produced based on analysis of the observations on attendance at the service, frequency of responses in the interviews with professionals and mothers regarding needs and doubts about handling and caring for infants, and associations with the literature. RESULTS: A guide was produced containing information on infant development, divided into the first four trimesters of life. It draws attention to the importance of calculating corrected ages in order to adequately follow up development markers. CONCLUSIONS: This guide may be used by a variety of health professionals and by professionals who develop educational activities for parents.

Influence of the Th2 immune response established by Nippostrongylus brasiliensis infection on the protection offered by different vaccines against Chlamydophila abortus infection.

Chlamydophila abortus is the aetiological agent of enzootic abortion in small ruminants in which it infects the placenta to cause abortion during the last trimester of gestation. In a mouse model, a Th1 immune response involving IFN-gamma production and CD8+ T cells is necessary for the infection to be resolved. The authors previously demonstrated that infection with Nippostrongylus brasiliensis, a rodent gastrointestinal nematode extensively used in experimental models to induce Th2 responses, alters the specific immune response against C. abortus infection, increasing bacterial multiplication in liver and reducing specific IFN-gamma production. The aim of the present work was to clarify whether a Th2 immune response has any influence on the success of vaccination using both inactivated and attenuated vaccines. The results showed that the Th2 response established prior to vaccination did not influence the induction of protection offered by the vaccines. However, the effectiveness of this protective response can be altered, depending on the adjuvant employed in the inactivated vaccines, when the Th2 response is established after vaccination, just before challenge with C. abortus.

An outbreak of fulminant hepatitis delta in the Waorani, an indigenous people of the Amazon basin of Ecuador.

An outbreak of delta hepatitis occurred during 1998 among the Waorani of the Amazon basin of Ecuador. Among 58 people identified with jaundice, 79% lived in four of 22 Waorani communities. Serum hepatitis B surface antigen (HBsAg) was found in the sera of 54% of the jaundiced persons, and 14% of asymptomatic persons. Ninety-five percent of 105 asymptomatic Waorani had hepatitis B core (HBc) IgG antibody, versus 98% of 51 with jaundice. These data confirm that hepatitis B virus (HBV) infection is highly endemic among the Waorani. Sixteen of 23 (70%) HBsAg carriers identified at the onset of the epidemic had serologic markers for hepatitis D virus (HDV) infection. All 16 were jaundiced, where as only two of seven (29%) with negative HDV serology were jaundiced (P = .0006). The delta cases clustered in families, 69% were children and most involved superinfection of people chronically infected with HBV. The data suggest that HDV spread rapidly by a horizontal mode of transmission other than by the sexual route.

[Chemokines, a new family of cytokines in inflammatory cell recruitment]. / Las quimiocinas, una nueva familia de citocinas en el reclutamiento de células inflamatorias.

Cell recruitment is a crucial event in the establishment of both acute and chronic inflammatory responses, including acute and delayed type hypersensitivity reactions. Among other significant factors like adhesion molecules, chemokines and its receptors are crucial elements that lead leukocyte migration to the tissues. Chemokines are a large group of peptidic cytokines which have a conserved motif of 4 cisteins. These cistein residues form pairs which permit to classify them in two groups, the alpha and beta subfamilies. In general terms, alpha subfamily has preferential chemotactic activity on granulocytes, and beta subfamily attracts mainly lymphocytes and macrophages. Besides their chemotactic activity, chemokines also participate in some other important biological processes like hematopoiesis, angiogenesis, and anti-tumoral activity. Chemokines also play an important role in certain pathological conditions, for instance in some allergic processes they have an essential role in the pathogenesis. In autoimmune and infectious diseases, this cytokine family is also important as is suggested by the presence of chemokine receptors in rheumatoid arthritis inflammed synovia or the HIV receptor activity that chemokine receptors display which apparently play a significant role in the natural resistance against this infectious agent. Preferential leukocyte recruitment mediated by chemokines is a potential target for pharmacological modulation, which in turn may lead to a novel and efficient types of therapeutic control of inflammatory diseases with diverse etiology.