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1.
Spec Care Dentist ; 40(1): 3-9, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31794083

RESUMO

INTRODUCTION: Deciduous teeth eruption is connected to children's growth and development. In Brazil, with the increase in the occurrence of children born with microcephaly associated to exposure to Zika virus, studies about orofacial alterations were necessary. OBJECTIVE: Describe the chronology and sequence of deciduous teeth in children with microcephaly due to the fetal exposure to Zika virus. METHODOLOGY: A cross-sectional study involving 74 children of a neuropediatric reference unit in Salvador, Bahia, in 2017 was conducted. Through use of secondary data, interviews with mothers and children's exam, the population was characterized, the chronology and sequence of deciduous teeth eruption was registered, and the analysis of the variables was proceeded. RESULTS: The first eruption happened between 4 and 17 months of age and 52.70% had a delay in the eruption of incisors. The average eruption time for the maxilla varies from 17.92 (16.56-19.28; 95% CI) to 20.43 (19.35-21.51; 95% CI) months, and the jaw from 11.57 (6.85-18.99; 95% CI) to 20.20 (19.09-21.31; 95% CI) months. In 77.94% of population, the eruption of the first teeth was in the lower arch and in 33.82%, molars and/or canines erupted before the incisors. CONCLUSIONS: There were alteration in the chronology and sequence of deciduous teeth eruption.


Assuntos
Microcefalia , Infecção por Zika virus , Zika virus , Brasil , Criança , Estudos Transversais , Humanos , Erupção Dentária , Dente Decíduo
2.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 36(12): 1203-1205, 2019 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-31813148

RESUMO

OBJECTIVE: To explore the genetic basis for a fetus featuring increased nuchal thickness. METHODS: Routine G-banding karyotyping and single nucleotide polymrophism array were carried out to detect genomic copy number variations (CNVs) in the fetus. RESULTS: The fetus was found to harbor a heterozygous 3.8 Mb deletion in the 2q22.2-q22.3 region encompassing the ZEB2 gene, which is closely associated with Mowat-Wilson syndrome (MWS). CONCLUSION: Haploinsufficiency of the ZEB2 gene may predispose to MWS. Lack of knowledge regarding to the ultrasonographic features of MWS may lead to misdiagnosis of the syndrome.


Assuntos
Variações do Número de Cópias de DNA , Doença de Hirschsprung/diagnóstico , Deficiência Intelectual/diagnóstico , Microcefalia/diagnóstico , Facies , Feminino , Feto , Doença de Hirschsprung/genética , Humanos , Deficiência Intelectual/genética , Microcefalia/genética , Gravidez , Diagnóstico Pré-Natal , Deleção de Sequência , Homeobox 2 de Ligação a E-box com Dedos de Zinco/genética
3.
Rev Fac Cien Med Univ Nac Cordoba ; 76(4): 217-221, 2019 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-31833744

RESUMO

Introduction: We present temporal and spatial variation of deaths from microcephaly in children under 1 year of age is analyzed at regional, state, and municipal level in the pre-Zika period in Brazil. Materials and Methods: Data on births and deaths of infants with microcephaly was obtained from DATASUS from 1996 to 2013. Infant mortality rate from microcephaly (IMR-M) was estimated at Region, Federative Unit (UF), and Municipality level. Secular trend (ST) and risk of death variation were estimated using a Poisson regression model. Satscan software was used to obtain a statistic spatial scan for the Poisson model. Results: IMR-M shows a non-significant negative ST in the Southeast, South and Central West Regions of Brazil. A greater IMR-M risk of death variation is found in the North and Northeast Regions. Most UFs in the Southeast, South and Central West Regions showed a negative ST, in contrast to what occurs in the UFs of the North and Northeast Regions showed a positive ST. Six high risk significant clusters were found: 3 in the North-Northeast and 3 in the South-SouthWest-Center-West. Conclusions: The North and Northeast Regions showed positive ST for IRM-M and higher death risk, which was not observed in the other regions. Cluster distribution for higher IMR-M and risk resembles the distribution of the microcephaly and Zika cases in the outbreak period.


Assuntos
Mortalidade Infantil , Microcefalia/mortalidade , Microcefalia/virologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/mortalidade , Brasil/epidemiologia , Surtos de Doenças , Humanos , Lactente , Recém-Nascido , Análise Espaço-Temporal
4.
Rev. Esc. Enferm. USP ; 53: e03491, Jan.-Dez. 2019. graf
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020389

RESUMO

RESUMO Objetivo Relatar as experiências educativas das mães ou cuidadoras de crianças com microcefalia, desenvolvidas por equipe acadêmica na temática da promoção da saúde dessas crianças. Método Trata-se de relato de experiência vivenciado por alunos do curso de graduação em enfermagem, discentes e docentes do programa de Pós-Graduação em Saúde e Ambiente da Universidade Tiradentes sobre intervenções educativas realizadas em três unidades de referência no atendimento à criança com microcefalia no estado de Sergipe. A amostra do estudo foi de conveniência. Resultados Participaram da pesquisa 70 mães ou cuidadoras principais de crianças com diagnóstico confirmado de microcefalia, durante os meses de setembro a dezembro. Os eixos temáticos-teóricos selecionados para descrever as atividades foram promoção da alimentação saudável, importância do vínculo mãe e filho e estimulação precoce de crianças com microcefalia. Conclusão A experiência relatada demostrou a importância das estratégias educativas na promoção da saúde de crianças com microcefalia, proporcionando capacitação adicional às mães/cuidadoras para que estas ofereçam um cuidado holístico e humanizado a essas crianças.


RESUMEN Objetivo Relatar las experiencias educativas de las madres o cuidadoras de niños con microcefalia, desarrolladas por equipo académico en la temática de la promoción de la salud de esos niños. Método Se trata de relato de experiencia vivida por alumnos de la carrera universitaria de enfermería, discentes y docentes del programa de Posgrado en Salud y Ambiente de la Universidad Tiradentes acerca de intervenciones educativas realizadas en tres unidades de referencia en la atención al niño con microcefalia en el Estado de Sergipe. La muestra del estudio fue de conveniencia. Resultados Participaron en la investigación 70 madres o cuidadoras principales de niños con diagnóstico de microcefalia, durante los meses de septiembre a diciembre. Los ejes temáticos-teóricos seleccionados para describir las actividades fueron promoción de la alimentación sana, importancia del vínculo madre e hijo y estimulación precoz de niños con microcefalia. Conclusión La experiencia relatada demostró la importancia de las estrategias educativas en la promoción de la salud de niños con microcefalia, proporcionando capacitación adicional a las madres/cuidadoras a fin de que estas proporcionen un cuidado holístico y humanizado a esos niños.


ABSTRACT Objective To report the educational experiences of mothers or caregivers of children with microcephaly, as developed by an academic team with the theme of promoting these children's health. Method This is an experience report by undergraduate nursing students and Health and Environment Post-Graduation students and professors of Tiradentes University on educational interventions carried out in three reference units for the care of children with microcephaly in the state of Sergipe. The study sample was taken by convenience. Results A total of 70 mothers or primary caregivers of children with a confirmed diagnosis of microcephaly during the months of September to December participated in the study. The thematic-theoretical axes selected to describe the activities were promotion of healthy eating, importance of the mother and child bond, and early stimulation of children with microcephaly. Conclusion The experience reported demonstrates the importance of educational strategies in promoting the health of children with microcephaly, providing additional training to mothers/caregivers to provide holistic and humanized care to these children.


Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Educação em Saúde , Cuidadores , Promoção da Saúde , Microcefalia/terapia , Mães , Entrevista , Enfermagem Familiar , Pesquisa Qualitativa
5.
PLoS Genet ; 15(10): e1008460, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31671093

RESUMO

Malfunction of pre-mRNA processing factors are linked to several human diseases including cancer and neurodegeneration. Here we report the identification of a de novo heterozygous missense mutation in the SNRPE gene (c.65T>C (p.Phe22Ser)) in a patient with non-syndromal primary (congenital) microcephaly and intellectual disability. SNRPE encodes SmE, a basal component of pre-mRNA processing U snRNPs. We show that the microcephaly-linked SmE variant is unable to interact with the SMN complex and as a consequence fails to assemble into U snRNPs. This results in widespread mRNA splicing alterations in fibroblast cells derived from this patient. Similar alterations were observed in HEK293 cells upon SmE depletion that could be rescued by the expression of wild type but not mutant SmE. Importantly, the depletion of SmE in zebrafish causes aberrant mRNA splicing alterations and reduced brain size, reminiscent of the patient microcephaly phenotype. We identify the EMX2 mRNA, which encodes a protein required for proper brain development, as a major mis-spliced down stream target. Together, our study links defects in the SNRPE gene to microcephaly and suggests that alterations of cellular splicing of specific mRNAs such as EMX2 results in the neurological phenotype of the disease.


Assuntos
Processamento Alternativo , Proteínas de Homeodomínio/genética , Deficiência Intelectual/genética , Microcefalia/genética , Mutação de Sentido Incorreto , Fatores de Transcrição/genética , Proteínas Centrais de snRNP/genética , Animais , Linhagem Celular , Modelos Animais de Doenças , Feminino , Células HEK293 , Humanos , Linhagem , Processamento de RNA , RNA Mensageiro/genética , Ribonucleoproteínas Nucleares Pequenas/metabolismo , Sequenciamento Completo do Exoma , Peixe-Zebra , Proteínas Centrais de snRNP/química , Proteínas Centrais de snRNP/metabolismo
6.
Rev Assoc Med Bras (1992) ; 65(10): 1249-1253, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31721956

RESUMO

OBJECTIVE: In this study, we intend to identify the prevalence of clinical variables in children with microcephaly. METHODS: This is a cross-sectional and observational study with data collected from medical records of patients admitted to the microcephaly outpatient clinic of a referral center in Teresina-PI. Demographic (gender and age) and clinical data (presence of epilepsy, dysphagia, irritability, and associated comorbidities) were collected. The frequency of Zika virus as a probable etiology was determined from computed tomography patterns and the exclusion of other etiologies by serological tests. RESULTS: A total of 67 patient records were evaluated, of which 31 were male and 36 were female, with a mean age of 1 year and 10 months. The most prevalent clinical variables were epilepsy, present in 47 children (70.2%), and irritability in 37 (55.2%). Also with a high frequency, 22 had dysphagia (32.8%), and 13 had musculoskeletal comorbidities (19.4%). Only three patients in the sample had cardiac abnormalities (4.5%), and no endocrine comorbidity was found. A total of 38 children in the sample (56.7%) presented ZIKV as a probable etiology and, in these cases, there was a higher frequency of epilepsy and dysphagia compared to other etiologies, although not statistically significant. CONCLUSION: Epilepsy, irritability, dysphagia, and musculoskeletal comorbidities were the most frequent clinical variables in children with microcephaly. There was a high prevalence of congenital ZIKV microcephaly syndrome in this sample.


Assuntos
Epilepsia/epidemiologia , Microcefalia/virologia , Anormalidades Musculoesqueléticas/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Infecção por Zika virus/epidemiologia , Brasil/epidemiologia , Pré-Escolar , Comorbidade , Anormalidades Congênitas/epidemiologia , Anormalidades Congênitas/etiologia , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Registros Médicos , Microcefalia/reabilitação , Gravidez , Complicações Infecciosas na Gravidez/etiologia , Prevalência , Centros de Reabilitação , Estudos Retrospectivos , Infecção por Zika virus/congênito , Infecção por Zika virus/reabilitação
7.
Clinics (Sao Paulo) ; 74: e798, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644665

RESUMO

OBJECTIVE: To describe the nutritional profile of newborns with microcephaly and factors associated with worse outcomes during the first 14 days of life. METHODS: This investigation is a longitudinal, descriptive study carried out in 21 full-term neonates exposed vertically to the Zika virus and hospitalized in a neonatal intensive care unit from February to September 2016. Patients receiving parenteral nutrition were excluded. Data analysis was performed using a generalized estimating equation model and Student's t-test to evaluate the association between worsening weight-for-age z-scores and independent clinical, sociodemographic and nutritional variables during hospitalization, with p<0.05 indicating significance. RESULTS: During hospitalization, there was a decrease in the mean values of the weight-for-age z-scores. The factors associated with worse nutritional outcomes were symptomatic exposure to the Zika virus, low maternal schooling, absence of maternal income and consumption of infant formula (p<0.05). Calcification and severe microcephaly were also associated with poor nutritional outcomes. Energy and macronutrient consumption remained below the recommendations and had an upward trend during hospitalization. CONCLUSION: The presence of cerebral calcification, the severity of microcephaly and symptomatic maternal exposure to Zika virus affected the nutritional status of newborns. In terms of nutritional factors, human milk intake had a positive impact, reducing weight loss in the first days of life. Other known factors, such as income and maternal schooling, were still associated with a poor nutritional status.


Assuntos
Microcefalia/fisiopatologia , Estado Nutricional/fisiologia , Infecção por Zika virus/complicações , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Microcefalia/virologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores Socioeconômicos , Adulto Jovem
8.
Yi Chuan ; 41(10): 905-918, 2019 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-31624053

RESUMO

Brain development diseases refer to a group of diseases that affect the development of the brain or the central nervous system. Autosomal recessive primary microcephaly (MCPH) is a typical neurodevelopmental disorder characterized by a decreased brain size, mental retardation and abnormal behaviors. To date, at least 25 genes have been discovered to cause MCPH when mutated. These genes were named MCPH1-25 according to the discovery order. MCPH proteins play important roles in regulating brain developmental signaling pathways. Here, we provide a timely review of the expression patterns, cellular localization, molecular functions, phenotypes, as well as animal models of these 25 MCPH proteins that will expedite our understanding of the pathogenesis of brain disorders at both molecular and cellular levels.


Assuntos
Proteínas de Ciclo Celular/genética , Peptídeos e Proteínas de Sinalização Intracelular/genética , Microcefalia/genética , Proteínas do Tecido Nervoso/genética , Animais , Encéfalo , Humanos , Microcefalia/patologia , Mutação , Fenótipo
9.
Pediatr Phys Ther ; 31(4): 370-372, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31568386

RESUMO

The outbreak of Zika in Brazil almost 3 years ago had harmful medical, financial, and social consequences for children and their families. It also significantly increased the statistics of Brazilian children with disabilities being followed up in rehabilitation centers. Actions promoting the use of the International Classification of Functioning, Disability and Health (ICF) framework are encouraged in view of the complex health needs identified in this population, which cover all areas of functioning, and gain special relevance when it comes to a vulnerable context. This perspective article discusses the challenges related to the implementation of the ICF in rehabilitation services for children with congenital syndrome.


Assuntos
Avaliação da Deficiência , Crianças com Deficiência/reabilitação , Microcefalia/reabilitação , Reabilitação/classificação , Reabilitação/métodos , Infecção por Zika virus/reabilitação , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino
10.
PLoS Negl Trop Dis ; 13(9): e0007768, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31568478

RESUMO

BACKGROUND: Zika virus (ZIKV) infection in pregnancy can cause microcephaly and a wide spectrum of severe adverse outcomes, collectively called "Congenital Zika Syndrome" (CZS). Parenting a child with disabilities can have adverse mental health impacts, but these associations have not been fully explored in the context of CZS in Brazil. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was undertaken in Recife and Rio de Janeiro, including 163 caregivers of a child with CZS (cases) and 324 caregivers with an unaffected child (comparison subjects), identified from existing studies. The primary caregiver, almost always the mother, was interviewed using a structured questionnaire to collect information on: depression, anxiety, and stress (Depression, Anxiety, and Stress Scale-DASS-21), social support (Medical Outcomes Study Social Support Scale-MOS-SSS), and socio-demographic data. Data was collected May 2017-January 2018. Ethical standards were adhered to throughout the research. A high proportion of mothers reported experiencing severe or extremely severe levels of depression (18%), anxiety (27%) and stress (36%). Mothers of children with CZS were more likely to experience symptoms of depression, anxiety andstress, compared to mothers of comparison children. These associations were more apparent among mothers living in Rio de Janeiro. These differences were reduced after adjustment for socio-economic status and social support. Among mothers of children with CZS, low social support was linked to higher levels of depression, anxiety and stress, but there was no association with socio-economic status. CONCLUSIONS/SIGNIFICANCE: Depression, anxiety and stress were very common among mothers of young children in Brazil, regardless of whether they were parenting a child with disabilities. Mothers of children with CZS may be particularly vulnerable to poor mental health, and this association may be buffered through better social support.


Assuntos
Ansiedade/epidemiologia , Mães/psicologia , Estresse Psicológico/epidemiologia , Infecção por Zika virus/congênito , Adulto , Ansiedade/etiologia , Brasil , Cuidadores/psicologia , Estudos de Casos e Controles , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Feminino , Humanos , Lactente , Masculino , Microcefalia , Classe Social , Apoio Social , Estresse Psicológico/etiologia , Inquéritos e Questionários
11.
Yi Chuan ; 41(9): 801-815, 2019 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-31549679

RESUMO

Development of the human brain is a strictly complex and precisely regulated process. Brain development includes the proliferation and differentiation of neural progenitor cells, migration and maturation of neurons, myelination of neuronal axons, synaptogenesis and organization of the neural circuits. Abnormalities of these developmental processes can lead to severe malformation and dysfunction of the brain, which may result in brain developmental diseases which have a high medical burden and have attracted global attention. Brain developmental diseases are typically divided into two categories according to abnormal brain morphology and dysfunction: malformation of cortical development (MCD) and neuropsychopathy. Microcephaly and autism spectrum disorder (ASD) are representative disorders of MCD and neuropsychopathy respectively. In this review, we summarize the progresses of these two typical and relevant brain developmental diseases including the mechanism and etiology of their development, gene expression, symptoms, and related to provide theoretical guidance for basic research and management and treatment.


Assuntos
Encéfalo/fisiopatologia , Deficiências do Desenvolvimento/fisiopatologia , Doenças do Sistema Nervoso/patologia , Doenças do Sistema Nervoso/psicologia , Transtorno do Espectro Autista/fisiopatologia , Humanos , Microcefalia/fisiopatologia , Neurogênese , Neurônios
12.
Nat Commun ; 10(1): 3967, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481669

RESUMO

N6-threonyl-carbamoylation of adenosine 37 of ANN-type tRNAs (t6A) is a universal modification essential for translational accuracy and efficiency. The t6A pathway uses two sequentially acting enzymes, YRDC and OSGEP, the latter being a subunit of the multiprotein KEOPS complex. We recently identified mutations in genes encoding four out of the five KEOPS subunits in children with Galloway-Mowat syndrome (GAMOS), a clinically heterogeneous autosomal recessive disease characterized by early-onset steroid-resistant nephrotic syndrome and microcephaly. Here we show that mutations in YRDC cause an extremely severe form of GAMOS whereas mutations in GON7, encoding the fifth KEOPS subunit, lead to a milder form of the disease. The crystal structure of the GON7/LAGE3/OSGEP subcomplex shows that the intrinsically disordered GON7 protein becomes partially structured upon binding to LAGE3. The structure and cellular characterization of GON7 suggest its involvement in the cellular stability and quaternary arrangement of the KEOPS complex.


Assuntos
Adenosina/análogos & derivados , Proteínas de Ligação ao GTP/genética , Hérnia Hiatal/genética , Proteínas Intrinsicamente Desordenadas/genética , Microcefalia/genética , Nefrose/genética , Proteínas Nucleares/genética , RNA de Transferência/genética , Proteínas de Ligação a RNA/genética , Adenosina/genética , Criança , Feminino , Proteínas de Ligação ao GTP/química , Proteínas de Ligação ao GTP/metabolismo , Humanos , Proteínas Intrinsicamente Desordenadas/metabolismo , Masculino , Complexos Multiproteicos/química , Complexos Multiproteicos/genética , Complexos Multiproteicos/metabolismo , Mutação , Proteínas Nucleares/química , Proteínas Nucleares/metabolismo , Proteínas de Ligação a RNA/química , Proteínas de Ligação a RNA/metabolismo
13.
Rev Panam Salud Publica ; 43, September 2019
Artigo em Português | PAHO-IRIS | ID: phr-51551

RESUMO

[RESUMO]. Em 2015, o Brasil enfrentou uma epidemia de infecção pelo vírus Zika que se propagou por países do mundo. Posteriormente, recomendações acerca dos critérios de notificação de casos de síndrome congênita do Zika (SCZ) foram divulgadas através de protocolos. As mudanças frequentes nessas recomendações podem ter afetado o gerenciamento clínico e o acesso a suporte pós-diagnóstico por crianças afetadas mas não identificadas. No presente estudo, 39 casos de SCZ notificados no estado do Espírito Santo no período de 2015 a 2016 foram reclassificados quanto ao seu diagnóstico de acordo com o protocolo atualmente vigente, diferente daquele que vigorava em 2015. Pela reclassificação, apenas oito dos 36 casos seriam confirmados, respeitando o critério de dois ou mais sinais ou sintomas da SCZ com ou sem microcefalia e confirmação sorológica. Ainda, pela diminuição no perímetro cefálico que define microcefalia, 17 casos passaram a não se enquadrar nessa condição. Apesar de o protocolo vigente não utilizar somente o perímetro cefálico como critério para notificação e confirmação da SCZ, cabe ressaltar que este achado ainda é o maior sinalizador para as equipes de saúde, indicando um risco da não detecção precoce da SCZ. Seria prudente uma revisão dos casos “descartados” no momento de transição entre protocolos, a fim de avaliar se foram corretamente classificados.


[ABSTRACT]. In 2015, Brazil faced a Zika virus epidemic that spread to other countries in the world. As a result, recommendations regarding reporting criteria for congenital Zika syndrome (CZS) were issued in the form of protocols. The frequent changes in these recommendations may have affected clinical management and the access to post-diagnostic support by children who were affected by CZS, but who ended up not being identified. In the present study, 39 cases of CZS reported in the state of Espírito Santo, Brazil, from 2015 to 2016 were re-classified in terms of diagnosis using the current protocol, which is different from the protocol used in 2015. According to this re-classification, only eight out of 36 cases would be confirmed, based on the criterion of two or more signs or symptoms of CZS with or without microcephaly plus positive serologic results. Also, considering the decrease in the head circumference cut-off point defining microcephaly, 17 cases would no longer meet the definition for this condition. Even though the current protocol does not rely on head circumference alone for CZS reporting and confirmation, it should be noted that this is still the main sign considered by health care teams, and therefore the decrease in the cut-off point might have compromised early CZS detection. A review of “ruled out” cases would be advisable in moments of protocol transition to determine whether these cases have been correctly classified.


[RESUMEN]. En el 2015, Brasil enfrentó una epidemia de infección por el virus del Zika que se propagó por varios países del mundo. Posteriormente, se divulgaron recomendaciones acerca de los criterios de notificación de casos del síndrome congénito por el virus del Zika (SCZ) por medio de protocolos. Los cambios frecuentes de esas recomendaciones podrían haber afectado el manejo clínico y el acceso al apoyo posterior al diagnóstico de los niños afectados, pero no identificados. En el presente estudio, se reclasificó el diagnóstico de 39 casos del SCZ notificados en el estado de Espírito Santo en el período 2015-2016, de acuerdo con el protocolo vigente en la actualidad, que es distinto del que regía en el 2015. Por causa de la reclasificación, se confirmaron únicamente ocho de los 36 casos, con observancia del criterio de dos o más signos o síntomas del SCZ acompañados o no de microcefalia y con confirmación serológica. Además, por la disminución del perímetro cefálico que define la microcefalia, 17 casos no correspondieron a esa afección. A pesar de que en el protocolo vigente no se utiliza solamente el perímetro cefálico como criterio para la notificación y confirmación del SCZ, cabe resaltar que este hallazgo es, con todo, la mayor señal para los equipos de salud, puesto que indica un riesgo de falta de detección temprana del SCZ. Convendría examinar los casos “descartados” en el momento de la transición entre protocolos, con el fin de determinar si se clasificaron correctamente.


Assuntos
Zika virus , Microcefalia , Doenças Transmissíveis , Saúde Pública , Brasil , Zika virus , Microcefalia , Doenças Transmissíveis , Saúde Pública , Brasil , Zika virus , Doenças Transmissíveis , Saúde Pública
14.
BMJ Case Rep ; 12(8)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31413053

RESUMO

Mandibulofacial dysostosis with microcephaly (MFDM) is a rare condition that causes abnormalities of the head and face. Other major extracranial malformations may also be found. The authors present a case of an MFDM in a 35 weeks newborn with antenatal growth restriction. The patient required resuscitation at birth and was diagnosed with oesophageal atresia with tracheoesophageal fistula at day 1. At physical examination he presented multiple congenital malformations including prominent forehead, plagiocephaly, low-set ears, malformed auricles, hypertelorism, downward-slanting eyes, micrognathia, everted lower lip, short neck, wide-spaced nipples and inguinal hernia. Imaging investigation showed dysplasia of the inner ear with agenesis of the vestibular-cochlear nerves and global cerebral atrophy. Analysis of the EFTUD2 gene revealed that the patient was a heterozygous carrier of a pathogenic mutation (c.831_832del[p.Lys277Asnsf*7]), which has not been previously described. This case illustrates the challenges faced in diagnosing and treating MFDM patients.


Assuntos
Atresia Esofágica/diagnóstico , Disostose Mandibulofacial/diagnóstico , Microcefalia/diagnóstico , Anormalidades Múltiplas , Diagnóstico Diferencial , Atresia Esofágica/complicações , Atresia Esofágica/diagnóstico por imagem , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Imagem por Ressonância Magnética , Masculino , Disostose Mandibulofacial/complicações , Disostose Mandibulofacial/diagnóstico por imagem , Disostose Mandibulofacial/genética , Microcefalia/complicações , Microcefalia/diagnóstico por imagem , Microcefalia/genética , Fatores de Alongamento de Peptídeos/genética , Ribonucleoproteína Nuclear Pequena U5/genética , Síndrome
15.
Rev Esc Enferm USP ; 53: e03491, 2019 Aug 19.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31433020

RESUMO

OBJECTIVE: To report the educational experiences of mothers or caregivers of children with microcephaly, as developed by an academic team with the theme of promoting these children's health. METHOD: This is an experience report by undergraduate nursing students and Health and Environment Post-Graduation students and professors of Tiradentes University on educational interventions carried out in three reference units for the care of children with microcephaly in the state of Sergipe. The study sample was taken by convenience. RESULTS: A total of 70 mothers or primary caregivers of children with a confirmed diagnosis of microcephaly during the months of September to December participated in the study. The thematic-theoretical axes selected to describe the activities were promotion of healthy eating, importance of the mother and child bond, and early stimulation of children with microcephaly. CONCLUSION: The experience reported demonstrates the importance of educational strategies in promoting the health of children with microcephaly, providing additional training to mothers/caregivers to provide holistic and humanized care to these children.


Assuntos
Cuidadores/psicologia , Microcefalia/terapia , Relações Mãe-Filho , Mães/psicologia , Brasil , Bacharelado em Enfermagem , Feminino , Promoção da Saúde/métodos , Humanos , Estudantes de Enfermagem
16.
Estilos clín ; 24(2): 276-290, maio-ago. 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1039854

RESUMO

Este artigo busca analisar a relação entre a epidemia de Zika, ocorrida no Brasil entre 2015 e 2017, e o cenário social fóbico estabelecido entre as gestantes e seus familiares a espera de um bebê. O objetivo é fazer uma exploração teórica, com base numa perspectiva psicanalítica, ou seja, que considera os processos inconscientes na constituição do sujeito psicológico, impulsionado pela sexualidade no cenário edípico, o que implica, nesse cenário da epidemia de Zika, a reorganização das identidades paternas e maternas impregnadas pelo medo de trazer ao mundo um bebê com necessidades especiais ou, ainda, com complicações consideradas incompatíveis com a vida.


Este artículo busca analizar la relación entre la epidemia de Zika, ocurrida en Brasil entre 2015 y 2017, y el escenario social fóbico establecido entre las gestantes y sus familiares durante la espera de un bebé. El objetivo es hacer una exploración teórica, con base en una perspectiva psicoanalítica, o sea, que considera los procesos inconscientes en la constitución del sujeto psicológico, impulsado por la sexualidad en el escenario edípico, lo que implica, en ese escenario de la epidemia de Zika, la reorganización de las identidades paternas y maternas impregnadas por el miedo de traer al mundo un bebé con necesidades especiales o, aún, con complicaciones consideradas incompatibles con la vida.


This paper aims to analyze the relationship between the Zika epidemic that occured in Brazil from 2015 to 2017 and the phobic social scenario established between pregnant women and their relatives who will receive a baby in the family. The objective is to make a theoretical exploration, based on a psychoanalytical perspective, which considers the unconscious processes in the constitution of the psychological subject, driven by sexuality in the Oedipal scenario and therefore result, in this scenario of Zika virus, the reorganization of the paternal and maternal identities impregnated by the fear to bring to the world a baby with special needs or even with complications that are considered incompatible with life.


Assuntos
Gestantes/psicologia , Fatores Sociológicos , Infecção por Zika virus/epidemiologia , Fobia Social , Microcefalia/psicologia , Inconsciente (Psicologia)
17.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46660

RESUMO

Microcefalia é uma malformação congênita em que o cérebro não se desenvolve de maneira adequada. Essa malformação pode ser efeito de uma série de fatores de diferentes origens, como substâncias químicas e infecciosas, além de bactérias, vírus e radiação. Em relação ao aleitamento materno, como não há evidência científica que demonstre a transmissão do vírus Zika pelo leite, o Ministério da Saúde recomenda que seja mantida a amamentação contínua até os dois anos ou mais, sendo ele exclusivo até os seis primeiros meses de vida da criança.


Assuntos
Zika virus , Leite Humano , Infecção por Zika virus , Microcefalia , Recém-Nascido , Gestantes , Sistema Único de Saúde , Saúde da Criança
19.
Rev Assoc Med Bras (1992) ; 65(6): 909-913, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340324

RESUMO

INTRODUCTION: The Zika virus (ZIKV) is an arbovirus isolated for the first time in 1947 and transmitted to humans by the Aedes aegypti mosquito. In Brasil, it was first detected in May 2015. Since then, ZIKV has been identified as the etiological agent of acute exanthematous disease in Brasil, and Neuropediatricians of the Recife warned about an epidemic of microcephaly, and the Brazilian Ministry of Health confirmed the association between ZIKV and Congenital malformations and neurological syndromes. The eye, as an extension of the developing brain, has been examined in patients with microcephaly and maternal history of ZIKV infection. METHODS: Twenty newborn patients with microcephaly, whose mothers had presumed Zika virus during pregnancy, were analyzed through medical records. The nonparametric chi-square statistic was used to verify the association between head circumference and ocular alteration at a significance level of 0.0001. RESULTS: The significance of P = 0.000 in the value of non-parametric chi-square statistics was lower than the value of α = 0.0001, demonstrating that, at a level of 0.0001, there is an association between head circumference and ocular alteration. CONCLUSION: Although the knowledge of the natural evolution of the disease is still scarce, the current evidence is strong enough to establish a causal relationship between ZIKV infection during pregnancy and the increased incidence of the microcephaly and serious eye alterations that lead to the severe lower vision of these children.


Assuntos
Cefalometria , Oftalmopatias/virologia , Microcefalia/virologia , Infecção por Zika virus/complicações , Brasil , Oftalmopatias/patologia , Feminino , Cabeça/patologia , Humanos , Lactente , Masculino , Microcefalia/patologia , Valores de Referência
20.
Rev Soc Bras Med Trop ; 52: e20190105, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340371

RESUMO

INTRODUCTION: Clinical and epidemiological data on suspected congenital Zika syndrome (CZS) cases from southern Mato Grosso (MT) in Brazil during the Zika virus (ZIKV) outbreak in 2015-2016 were evaluated. METHODS: This is a descriptive case series study of newborns whose mothers were suspected cases of ZIKV infections during their pregnancies. The medical records of all the suspected CZS cases (mothers and newborns) treated by the specialized ambulatory service from June 2015 to August 2016 were analyzed. RESULTS: Twenty suspected CZS cases were included in these analyses. They were categorized into four groups based on the clinical and laboratory findings: confirmed cases (n=1), highly probable cases (n=13), moderately probable cases (n=5), and somewhat probable cases (n=1). The mothers tested negative for STORCH (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex) and other important congenital infections; however, specific ZIKV tests were not performed during the study period. Microcephaly was observed in the majority of these newborns, and all the patients showed altered cranial computed tomography image findings. Extracranial abnormalities such as arthrogryposis, and otological and ophthalmological manifestations were also observed. CONCLUSIONS: Although ZIKV was not confirmed to cause the congenital malformations, this study demonstrated that the clinical and epidemiological findings associated with a STORCH exclusion strengthened the CZS diagnosis. The suspected cases in MT occurred simultaneously with the first CZS cases reported in Brazil, suggesting ZIKV circulation in the study region during the same period.


Assuntos
Microcefalia/virologia , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia , Zika virus/isolamento & purificação , Adolescente , Adulto , Brasil/epidemiologia , Surtos de Doenças , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Fatores Socioeconômicos , Adulto Jovem , Infecção por Zika virus/complicações , Infecção por Zika virus/congênito
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