Brazilian network of COVID-19 during pregnancy (REBRACO: a multicentre study protocol).

INTRODUCTION: The aim of this study was to evaluate the clinical, epidemiological and laboratory aspects of SARS-CoV-2 infection during pregnancy and postpartum in 16 maternity hospitals. METHODS AND ANALYSIS: A prospective multicentre study, with five axes. First, the prevalence of SARS-CoV-2 infection among women admitted for childbirth will be described in a cross-sectional study. Second, maternal and perinatal outcomes will be assessed in a prospective cohort study including pregnant or postpartum women with suspected COVID-19. Third, a cohort of positive COVID-19 cases with sampling of a variety of biological material. Histopathological and viral analysis of biological maternal and neonatal samples will be performed, and the assessment of nutritional variables to evaluate the association between vitamin D and severity of infection. Fourth, a monitoring and evaluation committee to collect relevant healthcare information and plan actions in centres facing the pandemic. Furthermore, qualitative studies will be performed to study pregnant women, their families and health professionals. Fifth, an ecological study will monitor the number of live births, stillbirths and other outcomes to explore any trend among the periods before, during and after the pandemic. Data will systematically be collected in an electronic platform following standardised operational procedures. For quantitative study components, an appropriate statistical approach will be used for each analysis. For qualitative data, in-depth interviews recorded in audio will be transcribed, checking the text obtained with the recording. Subsequently, thematic analysis with the aid of the NVivo programme will be performed. ETHICS AND DISSEMINATION: Ethical approval was obtained (letters of approval numbers 4.047.168, 4.179.679 and 4.083.988). All women will be fully informed to sign the consent form before enrolment in the study. Findings will be disseminated through peer-reviewed journals and scientific conferences.

Obesity increases eosinophil activity in asthmatic children and adolescents.

BACKGROUND: A clear relationship between asthma and obesity has been reported, but the mechanisms remain unclear. The aim of this study was to evaluate the influence of obesity on eosinophil activity (chemotaxis and adhesion) in asthmatic children and adolescents compared with cells from healthy volunteers. METHODS: Asthmatic obese (AO), asthmatic non-obese (ANO), non-asthmatic obese (NAO) and non-asthmatic non-obese (NANO) individuals were included in the present study. The chemotaxis of eosinophils after stimulation with eotaxin (300 ng/ml), platelet-activating factor (10 µM; PAF) and RANTES (100 ng/ml) was performed using a microchemotaxis chamber. The eosinophil peroxidase activity was measured to determine the adhesion activity of eosinophils cultivated on fibronectin-coated plates. The serum leptin, adiponectin, TNF-α and IgE levels were quantified using ELISA assays. RESULTS: The serum IgE levels and eosinophil counts were significantly higher in asthmatic (obese and non-obese) individuals compared with non-asthmatic individuals (obese and non-obese). Spontaneous eosinophil chemotaxis was greater in the AO group compared with either the ANO or NANO groups. The activation of eosinophils using eotaxin and PAF increased eosinophil chemotaxis in the AO group. RANTES treatment increased eosinophil chemotaxis in the NAO group compared with the NANO or ANO groups. The activation of eosinophils using eotaxin significantly increased eosinophil adhesion in the AO group compared with other groups. The serum leptin and TNF-α levels were higher in obese subjects (asthmatic and non-asthmatic), whereas the levels of adiponectin did not significantly differ among these groups. CONCLUSION: This study is the first to show increased eosinophilic activity (chemotaxis and adhesion) associated with high serum leptin and TNF-α levels in atopic asthmatic obese children and adolescents compared with non-obese healthy volunteers.

Determining the C-reactive protein level in patients with different clinical forms of chagas disease.

Chagas disease is caused by Trypanosoma cruzi and remains a health problem in the developing countries of South America. The condition leads to cardiac conduction disturbances and chronic heart failure. In this study, 136 individuals were evaluated by the Chagas Disease Study Group of the Hospital de la Universidad Estatal de Campinas in Brazil to determine the relationship between chronic heart failure and the serum C-reactive protein (CRP) level. When patients were stratified according to the different clinical presentations of Chagas disease, it was found that the CRP levels in those with severe heart disease and non-Chagasic cardiopathy were significantly higher than in controls or those with mild heart disease (P< .05), even when participants were stratified by age (i.e. <40 and > or =40 years). There was a direct linear correlation between age and CRP level, such that the older the individual, the higher the CRP level. These data provide further evidence for an association between chronic inflammation and the development of heart failure. Although CRP elevations are not exclusively related to Chagas disease, the CRP level may be a useful marker for the progression of Chagas disease to a more advanced phase.

Determinación de la concentración plasmática de proteína C reactiva en pacientes con diferentes formas clínicas de la enfermedad de Chagas / Determining the C-reactive protein level in patients with different clinical forms of Chagas disease

La enfermedad de Chagas (EC) es una infección causada por Trypanosoma cruzi que aún hoy constituye un problema de salud en los países en desarrollo de Sudamérica y causa trastornos de la conducción e insuficiencia cardiaca crónica. En este trabajo, el Grupo de Estudios de Enfermedad de Chagas del Hospital de la Universidad Estatal de Campinas ha analizado a 136 individuos para investigar la relación entre insuficiencia cardiaca crónica y concentración sérica de proteína C reactiva (PCR). La PCR estratificada según diferentes apariciones clínicas de la EC reveló que los pacientes con cardiopatía grave y cardiopatía no chagásica tenían estadísticamente concentraciones de PCR mayores que los otros grupos de control y cardiopatía leve (p < 0,05), incluso estratificando por edad ( < 40 y ≥ 40 años). Hubo una correlación lineal positiva entre edad y PCR, de manera que cuanto mayores los individuos, más altos los valores de PCR. Estos datos refuerzan la asociación entre inflamación crónica y aparición de insuficiencia cardiaca. Aunque la elevaciones de PCR no están exclusivamente relacionadas con la EC, serían un marcador asequible de la evolución de la EC hacia fases avanzadas (AU)

Chagas disease is caused by Trypanosoma cruzi and remains a health problem in the developing countries of South America. The condition leads to cardiac conduction disturbances and chronic heart failure. In this study, 136 individuals were evaluated by the Chagas Disease Study Group of the Hospital de la Universidad Estatal de Campinas in Brazil to determine the relationship between chronic heart failure and the serum C-reactive protein (CRP) level. When patients were stratified according to the different clinical presentations of Chagas disease, it was found that the CRP levels in those with severe heart disease and non-Chagasic cardiopathy were significantly higher than in controls or those with mild heart disease (P < .05), even when participants were stratified by age (i.e. <40 and 8805 40 years there was a direct linear correlation between age crp level such that the older individual higher these data provide further evidence for an association chronic inflammation development of heart failure although elevations are not exclusively related to chagas disease may be useful marker progression more advanced phase (AU)