Protective effect of exclusive breastfeeding and effectiveness of maternal vaccination in reducing pertussis-like illness

Abstract Objective: To assess the protective effect of exclusive breastfeeding and the effectiveness of maternal vaccination in reducing pertussis-like illness. Method: This was a case-control study conducted in sentinel hospitals for pertussis in Recife between July 2016 and July 2018. Cases included children aged under six months with symptoms compatible with pertussis (pertussis-like illness). Controls included children aged under six months, living in the metropolitan region of Recife with no diagnosis of pertussis-like illness and matched by the same hospital and birth date. Results: Seventy-three cases and 194 controls were included. The diagnosis of pertussis-like illness was predominantly clinical (97,2%). Amongst the main symptoms, paroxysmal cough was observed in 95.89% of cases and vomiting in 53.4%. There were 29 hospitalized cases and no deaths. Out of the 73 cases, 47 were born to mothers vaccinated against pertussis during pregnancy, and the mothers of 144 of the 194 controls had been vaccinated. The protective effect of breastfeeding was of 74% (95% CI;38%, 89%). Children younger than six months, who were exclusively breastfed and with mothers vaccinated against pertussis during pregnancy were 5 times less likely to develop pertussis-like illness, corresponding to a protection of 79% (95% CI;31%, 94%). The effectiveness of maternal vaccination against pertussis-like illness in children under six months was low (27%) and not statistically significant (CI 95%; −34% a 60%). Conclusions: Exclusive breastfeeding protects children under six months from pertussis-like illness and may be enhanced when associated with maternal vaccination. These strategies should be encouraged because they also protect against pertussis-like illnesses.

Protective effect of exclusive breastfeeding and effectiveness of maternal vaccination in reducing pertussis-like illness.

OBJECTIVE: To assess the protective effect of exclusive breastfeeding and the effectiveness of maternal vaccination in reducing pertussis-like illness. METHOD: This was a case-control study conducted in sentinel hospitals for pertussis in Recife between July 2016 and July 2018. Cases included children aged under six months with symptoms compatible with pertussis (pertussis-like illness). Controls included children aged under six months, living in the metropolitan region of Recife with no diagnosis of pertussis-like illness and matched by the same hospital and birth date. RESULTS: Seventy-three cases and 194 controls were included. The diagnosis of pertussis-like illness was predominantly clinical (97,2%). Amongst the main symptoms, paroxysmal cough was observed in 95.89% of cases and vomiting in 53.4%. There were 29 hospitalized cases and no deaths. Out of the 73 cases, 47 were born to mothers vaccinated against pertussis during pregnancy, and the mothers of 144 of the 194 controls had been vaccinated. The protective effect of breastfeeding was of 74% (95% CI;38%, 89%). Children younger than six months, who were exclusively breastfed and with mothers vaccinated against pertussis during pregnancy were 5 times less likely to develop pertussis-like illness, corresponding to a protection of 79% (95% CI;31%, 94%). The effectiveness of maternal vaccination against pertussis-like illness in children under six months was low (27%) and not statistically significant (CI 95%; -34% a 60%). CONCLUSIONS: Exclusive breastfeeding protects children under six months from pertussis-like illness and may be enhanced when associated with maternal vaccination. These strategies should be encouraged because they also protect against pertussis-like illnesses.

Combined genotypes of the MBL2 gene related to low mannose-binding lectin levels are associated with vaso-occlusive events in children with sickle cell anemia

Abstract Sickle cell anemia (SCA) presents heterogenous clinical manifestations that cannot be explained solely by alterations to hemoglobin (Hb); other components such as endothelial adhesion, thrombosis and inflammation may be involved. The mannose-binding lectin (MBL) has an important role in innate immunity and inflammatory diseases. In this report, we describe an association between MBL2 polymorphism related to low production of serum MBL and the frequency of vasoocclusive events (FVOE) in children ≤ 5 years old with SCA (p = 0.0229; OR 5.55; CI 1.11-27.66). Further studies are needed to explore the role of low MBL2 in the pathophysiology of vasoocclusive events in SCA.

Combined genotypes of the MBL2 gene related to low mannose-binding lectin levels are associated with vaso-occlusive events in children with sickle cell anemia.

Sickle cell anemia (SCA) presents heterogenous clinical manifestations that cannot be explained solely by alterations to hemoglobin (Hb); other components such as endothelial adhesion, thrombosis and inflammation may be involved. The mannose-binding lectin (MBL) has an important role in innate immunity and inflammatory diseases. In this report, we describe an association between MBL2 polymorphism related to low production of serum MBL and the frequency of vasoocclusive events (FVOE) in children ≤ 5 years old with SCA (p = 0.0229; OR 5.55; CI 1.11-27.66). Further studies are needed to explore the role of low MBL2 in the pathophysiology of vasoocclusive events in SCA.

Leucemia mieloide aguda (lma):: as condições psicológicas do paciente adulto / Acute myeloid leukemia (aml): the psychological conditions of the adult patient / Leucemia mieloide aguda (lma): las condiciones psicológicas del paciente adulto

Este estudo objetivou caracterizar a condição psicológica vivenciada por pacientes adultos em relação à leucemia mieloide aguda (LMA). Para tanto, utilizou-se de uma investigação qualitativa, de natureza descritiva e exploratória, da qual, segundo o critério de saturação do conteúdo, participaram 16 mulheres atendidas num serviço de referência da cidade do Recife-PE, em 2012. Os dados evidenciaram um conhecimento correto e errôneo, baseado, respectivamente, em informações do senso comum e científico. Mostraram, ainda, que os pacientes, ao receberem o diagnóstico, podem apresentar uma condição de desajustamento emocional, por exemplo, recorrendo à negação. Durante o tratamento, todavia, é possível que evoluam para uma condição de ajustamento emocional. Permitiu também observar que o adoecimento induz ao desenvolvimento de atitudes positivas para o estilo e a qualidade de vida. Os dados reforçam a necessidade de que os profissionais de saúde, contrapondo-se a uma perspectiva biomédica, assistam, de forma humanizada, o paciente e seus familiares

This study aimed to characterize the psychological condition presented by the adult patients towards the Acute Myeloid Leukemia (AML). For that, a qualitative, descriptive and exploratory investigation was used. According to the saturation of the content, 16 women who assisted at a service of reference by the city of Recife, Pernambuco in 2002, participated in the study. The data detached a conscious knowledge of right and wrong, based, respectively, on information of both common and scientific knowledge. They have also shown that the patients, when became aware of their diagnose, may present a condition of an emotional maladjustment, leaning towards, for instance, denial. Nevertheless, during the treatment it is possible for them to evolve to a condition of an emotional adjustment. The study allowed, also, the observation of the fact that an illness leads to the development of positive attitudes of life. The data reinforced the urgency of a humanized assistance for both the patient and their family to be implemented by the professionals of health, who should be against the biomedical perspective.

Este estudio tuvo por fin caracterizar la condición psicológica vivenciada por pacientes adultos respecto a la leucemia mieloide aguda (LMA). Para esto, se desarrolló una investigación cualitativa, de naturaleza descriptiva y exploratoria, de la cual, según el criterio de saturación del contenido, participaron 16 mujeres atendidas en un servicio de referencia de la ciudad de Recife-PE, en 2012. Los datos evidenciaron un conocimiento correcto y erróneo, basado, respectivamente, en informaciones del sentido común y científico. Mostraron, también, que los pacientes, al recibir el diagnóstico, pueden presentar una condición de desajuste emocional, por ejemplo, recurriendo a la negación. Sin embargo, durante el tratamiento, es posible que evolucionen hacia una condición de ajuste emocional. Permitió, aún, observar que el proceso de enfermarse induce al desarrollo de actitudes positivas para el estilo y la calidad de vida. Los datos refuerzan la necesidad de que los profesionales de salud, contraponiéndose a una perspectiva biomédica, cuiden al paciente y a sus familiares de forma humanizada