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1.
Rev Gaucha Enferm ; 42(spe): e20200370, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34037187

RESUMO

OBJECTIVE: To comprehend the daily rites of child-mothers with congenital Zika virus syndrome for the prevention of COVID-19 during the pandemic. METHOD: Study with a qualitative-exploratory approach, in the light on the comprehensive sociology of Michel Maffesoli, carried out in WhatsApp groups of associations of families of children with the syndrome. 44 mothers answered the online questionnaire between April and May 2020. Lexical and similarity analyzes were used through IRaMuTeQ. RESULTS: Mothers encourage exercises for child development and help the children's school activities, watch television, sew, cook, support other mothers on social networks and find satisfaction in not meeting previously established schedules. To prevent COVID-19, mothers adopt physical distance, try to consume healthy foods and intensify hygiene measures. FINAL CONSIDERATIONS: Child-mothers experience, in physical distance being closer to their children and other mothers through the networks, and adopt preventive care to COVID-19, with care overload.


Assuntos
Atividades Cotidianas , Mães , Infecção por Zika virus/congênito , Adulto , Cuidado da Criança/métodos , Desenvolvimento Infantil , Pré-Escolar , Humanos , Microcefalia/virologia , Pandemias , Pesquisa Qualitativa , Grupos de Autoajuda , Mídias Sociais , Inquéritos e Questionários , Adulto Jovem , Infecção por Zika virus/terapia
2.
BMC Pregnancy Childbirth ; 21(1): 214, 2021 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-33731027

RESUMO

BACKGROUND: Prevalence of neonatal microcephaly in populations without Zika-epidemics is sparse. The study aimed to report baseline prevalence of congenital microcephaly and its relationship with prenatal factors in an area at risk of Zika outbreak. METHODS: This study included singletons born after 24 gestational weeks in 2017-2018 at four hospitals in Guangzhou, China. Microcephaly was defined as a head circumference at birth >3SD below the mean for sex and gestational age. Prevalence of microcephaly was estimated by binomial exact method. Multivariable logistic regression was used to examine the associations of microcephaly with prenatal factors. The population attributable fraction (PAF) for associated risk factors was calculated. RESULTS: Of 46,610 live births included, 154 (3.3, 95% CI 2.8-3.9 per 1000 live births) microcephalies were identified. Maternal hepatitis B virus carriers (HBV, OR 1.80, 95% CI 1.05-3.10) and primipara (OR 2.68, 95% CI 1.89-3.81) had higher risk of having a microcephalic baby. Higher prevalence of microcephaly was observed in women who had premature labor (OR 1.98, 95% CI 1.17-3.34) and had a baby with fetal growth restriction (OR 16.38, 95% CI 11.81-22.71). Four identified factors (HBV, primiparity, preterm labor, and fetal growth restriction) contributed to 66.4% of the risk of microcephaly. CONCLUSIONS: The prevalence of microcephaly in Guangzhou was higher than expected. This study identified four prenatal risk factors that, together, contributed to two-thirds of the increased risk of microcephaly. This is the first reported association between maternal HBV carrier status and microcephaly.


Assuntos
Hepatite B/epidemiologia , Doenças do Recém-Nascido , Microcefalia , Complicações Infecciosas na Gravidez , Infecção por Zika virus/epidemiologia , Adulto , China/epidemiologia , Feminino , Retardo do Crescimento Fetal/diagnóstico , Retardo do Crescimento Fetal/epidemiologia , Idade Gestacional , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/epidemiologia , Doenças do Recém-Nascido/etiologia , Microcefalia/diagnóstico , Microcefalia/epidemiologia , Microcefalia/virologia , Paridade , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/diagnóstico , Nascimento Prematuro/epidemiologia , Prevalência , Medição de Risco , Fatores de Risco , Zika virus/isolamento & purificação , Zika virus/patogenicidade
3.
Int J Infect Dis ; 105: 595-597, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33713818

RESUMO

Zika virus (ZIKV) is a Flavivirus transmitted by Aedes mosquitoes, and was responsible for a worldwide outbreak between 2013 and 2016. However, no ZIKV outbreak has been described in Southeast Asia since 2017. In this study, we report the first microcephaly case with probable ZIKV infection during pregnancy in Lao People's Democratic Republic.


Assuntos
Aedes/virologia , Surtos de Doenças , Microcefalia/diagnóstico , Infecção por Zika virus/diagnóstico , Zika virus/isolamento & purificação , Adulto , Animais , Ásia Sudeste/epidemiologia , Feminino , Humanos , Recém-Nascido , Laos/epidemiologia , Masculino , Microcefalia/epidemiologia , Microcefalia/virologia , Gravidez , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/virologia
4.
Viruses ; 13(1)2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-33466404

RESUMO

Upper respiratory obstruction is a common sequela in children with Zika-related microcephaly (ZRM). As a cross-sectional analysis nested in a cohort study, this study aims to investigate the prevalence of adenoid hypertrophy (AH) in children with ZRM and symptoms of respiratory obstruction. The data were collected in the first three years of life from children with ZRM who were followed in two reference centers for otorhinolaryngological care of patients with congenital Zika syndrome. Out of 92 children with confirmed ZRM, 57 were evaluated by nasopharyngoscopy after presenting with upper respiratory obstruction symptoms. In this study, 31 of the 57 (54%) children with ZRM who were evaluated had obstructive AH. Thirteen children with obstructive AH were submitted to surgery, which resulted in the complete resolution of symptoms for 11, partial resolution in 1, and no improvement in 1. No evidence of direct involvement by Zika virus (ZIKV) infection in the adenoid tissues was demonstrated by histology or immunohistochemistry. Our results suggest that there is a high prevalence and early presentation of AH in children with ZRM, with consequent upper airway obstruction causing upper airway obstructive disorder, secretory otitis media, and dysphagia.


Assuntos
Tonsila Faríngea/patologia , Microcefalia/epidemiologia , Infecção por Zika virus/epidemiologia , Brasil , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Hipertrofia/complicações , Hipertrofia/epidemiologia , Lactente , Masculino , Microcefalia/patologia , Microcefalia/virologia , Prevalência , Infecção por Zika virus/patologia
5.
PLoS Negl Trop Dis ; 15(1): e0008893, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33395421

RESUMO

OBJECTIVE: To analyze adverse fetal and neonatal outcomes of Zika virus infection by the timing of infection during pregnancy. Method: Cohort study of 190 pregnancies with 193 offspring with a positive RT-PCR test for Zika virus (March/2016 to April/2017). RESULTS: Death or defects related to congenital Zika virus infection were identified in 37.3% of fetuses and newborns, and microcephaly in 21.4% of the newborns. The proportion of small for gestational age newborns was 21.9%. Maternal symptoms in the first trimester were significantly associated with the birth of newborns with microcephaly/cerebral atrophy, small for gestational age and with the deaths (one abortion, one stillbirth and the two neonatal deaths). Maternal infection during the second trimester was further associated with asymptomatic newborns at birth. The study showed that 58.5% of the offspring with microcephaly and / or cortical atrophy were small for gestational age, with an evident decrease in symptomatic offspring without microcephaly, 24.1%, and with only 9.1% in the asymptomatic group. CONCLUSION: This study showed that the earlier the symptoms appear during gestation, the more severe the endpoints. We found a higher percentage of small for gestational age newborns exposed to Zika virus early in gestation. We also found a group of apparently asymptomatic newborns with proven Zika infection, which highlights the importance of follow up studies in this population.


Assuntos
Doenças Fetais/patologia , Doenças do Recém-Nascido/patologia , Complicações Infecciosas na Gravidez/patologia , Infecção por Zika virus/patologia , Adulto , Brasil/epidemiologia , Estudos de Coortes , Estudos Transversais , Feminino , Doenças Fetais/diagnóstico , Doenças Fetais/virologia , Feto , Seguimentos , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/virologia , Microcefalia/virologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Zika virus , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/virologia
6.
Proc Natl Acad Sci U S A ; 117(38): 23869-23878, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32907937

RESUMO

Mounting evidence has associated Zika virus (ZIKV) infection with congenital malformations, including microcephaly, which raises global alarm. Nonetheless, mechanisms by which ZIKV disrupts neurogenesis and causes microcephaly are far from being understood. In this study, we discovered direct effects of ZIKV on neural progenitor cell development by inducing caspase-1- and gasdermin D (GSDMD)-mediated pyroptotic cell death, linking ZIKV infection with the development of microcephaly. Importantly, caspase-1 depletion or its inhibitor VX-765 treatment reduced ZIKV-induced inflammatory responses and pyroptosis, and substantially attenuated neuropathology and brain atrophy in vivo. Collectively, our data identify caspase-1- and GSDMD-mediated pyroptosis in neural progenitor cells as a previously unrecognized mechanism for ZIKV-related pathological effects during neural development, and also provide treatment options for ZIKV-associated diseases.


Assuntos
Encefalopatias , Células-Tronco Neurais , Piroptose/fisiologia , Infecção por Zika virus , Zika virus , Animais , Encéfalo/citologia , Encéfalo/metabolismo , Encéfalo/virologia , Encefalopatias/metabolismo , Encefalopatias/virologia , Células Cultivadas , Humanos , Camundongos , Microcefalia/metabolismo , Microcefalia/virologia , Células-Tronco Neurais/metabolismo , Células-Tronco Neurais/virologia , Infecção por Zika virus/metabolismo , Infecção por Zika virus/virologia
7.
Value Health ; 23(7): 969-976, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32762999

RESUMO

OBJECTIVES: In this systematic review, we synthesize the current evidence on health-related quality of life (HRQoL) for the two of the most relevant outcomes of Zika virus infection in humans, microcephaly and Guillain-Barré Syndrome (GBS). METHODS: We searched the following databases: MEDLINE, Embase, CINAHL, LILACS, WHO's ICTRP clinical trials registries database and PROSPERO. Search terms included quality of life, microcephaly, and Guillain-Barré Syndrome. We included primary studies where HRQoL was quantitatively assessed for microcephaly and GBS using validated instruments. We used the Joanna Briggs Institute Critical Appraisal Tools to assess the risk of bias of individual studies. RESULTS: From a total of 1,657 abstracts screened and 66 full texts reviewed, 21 studies met the eligibility criteria; one study for microcephaly and 20 for GBS. Adjusted disutilities for microcephaly compared to a normative childhood utility ranged from -0.745 to -0.820. For GBS, time traded-off the expected lifetime ranged from 16 days to 3 years. HRQoL follows the clinical course of GBS, with lower scores in the first months, recovery within the first year post onset, and stabilization after one year. CONCLUSIONS: Included studies reported a wide range of HRQoL for GBS, due in part to a high level of heterogeneity in methods, inclusion criteria, follow-up and reporting of results. Opportunities exist for primary studies assessing the longitudinal HRQoL over the entire course of the diseases to inform clinical practice, economic evaluations and health policy.


Assuntos
Qualidade de Vida , Infecção por Zika virus/complicações , Criança , Síndrome de Guillain-Barré/epidemiologia , Síndrome de Guillain-Barré/virologia , Humanos , Microcefalia/epidemiologia , Microcefalia/virologia , Fatores de Tempo , Infecção por Zika virus/epidemiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-32844907

RESUMO

This study analyzed possible associations between the trimester of maternal Zika virus infection (ZIKV) in pregnancy, severity of brain computed tomography (CT) findings and the presence of microcephaly at birth in children with Congenital Zika Syndrome (CZS). It was an analytical study in a cohort of children with CZS. Symptoms of maternal infection were dichotomized into the 1st trimester of pregnancy and other trimesters. Head circumference (HC) at birth was used to calculate the z-score. Mild microcephaly was defined as HC between 2 and ≥3 standard deviations (SD) below the mean for each gestational age and sex, and severe microcephaly when HC <3 SD below average. Brain CT images were evaluated by two radiologists and classified, according to the severity, into mild, moderate and severe. Fisher's exact, Mann-Whitney and Kruskal-Wallis tests were used to verify the associations between variables. In 108 children, maternal infection in the 1st trimester of pregnancy was associated with more severe brain CT abnormalities (p=0.038), greater severity of microcephaly at birth (p=0.013) and lower HC z-scores at birth (p=0.021). The severity of brain CT lesions was also associated with lower HC z-scores at birth (p<0.001). Maternal ZIKV infection during the first trimester of pregnancy proved to be an important risk factor for a more severe spectrum of CZS, as it is associated with more severe brain CT abnormalities and, consequently, with lower HC z-scores at birth.


Assuntos
Encéfalo/diagnóstico por imagem , Microcefalia/virologia , Primeiro Trimestre da Gravidez , Tomografia Computadorizada por Raios X/métodos , Infecção por Zika virus/diagnóstico , Zika virus , Adulto , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Trimestres da Gravidez , Índice de Gravidade de Doença , Infecção por Zika virus/congênito , Infecção por Zika virus/epidemiologia
10.
Am J Trop Med Hyg ; 103(4): 1656-1659, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32723426

RESUMO

We report the case of an infant born with congenital Zika syndrome (CZS). During the largest Zika virus (ZIKV) outbreak in Peru, the mother presented with fever and rash that were confirmed to be due to ZIKV by real-time PCR. The infant was born with severe microcephaly. Imaging revealed corpus callosum dysgenesis, lissencephaly, ventriculomegaly, and calcifications. Mild hypertrophic cardiomyopathy with diastolic dysfunction was reported in the echocardiogram. Valgus deviation of the lower extremities and a left clubfoot were diagnosed at birth. The hip ultrasound showed incipient signs of Graf type II dysplasia. The findings confirm that CZS is a multiorgan phenotype in which microcephaly is merely the tip of the iceberg. A multidisciplinary approach is needed for the evaluation of these children.


Assuntos
Hidrocefalia/diagnóstico por imagem , Microcefalia/diagnóstico por imagem , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Infecção por Zika virus/diagnóstico por imagem , Zika virus/isolamento & purificação , Adulto , Feminino , Humanos , Hidrocefalia/congênito , Hidrocefalia/virologia , Recém-Nascido , Microcefalia/virologia , Parto , Peru , Gravidez , Complicações Infecciosas na Gravidez/virologia , Zika virus/genética , Infecção por Zika virus/congênito , Infecção por Zika virus/virologia
11.
PLoS One ; 15(7): e0235010, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32634152

RESUMO

Since 2015 Brazil has experienced the social repercussions of the Zika virus epidemic, thus raising a debate about: difficulties of diagnosis; healthcare access for children with Zika Congenital Syndrome (ZCS); the search for benefits by affected families; social and gender inequalities; and a discussion on reproductive rights, among others. The objective of this article is to analyse access to specialized health services for the care of children born with ZCS in three North-eastern states of Brazil. This is an exploratory cross-sectional study which analyses recorded cases of microcephaly at the municipal level between 2015 and 2017. Most of the cases of ZCS were concentrated on the Northeast coast. Rio Grande do Norte and Paraiba had the highest incidence of microcephaly in the study period. The states of Bahia, Paraiba and Rio Grande do Norte were selected for their high incidence of microcephaly due to the Zika Virus. Socio-territorial vulnerability was stratified using access to microcephaly diagnosis and treatment indicators. The specialized care network was mapped according to State Health Secretaries Protocols. A threshold radius of 100 km was stablished as the maximum distance from municipalities centroids to specialised health care for children with microcephaly. Prenatal coverage was satisfactory in most of the study area, although availability of ultrasound equipment was uneven within states and health regions. Western Bahia had the lowest coverage of ultrasound equipment and lacked health rehabilitation services. ZCS's specialized health services were spread out over large areas, some of which were outside the affected patients' home municipalities, so displacements were expensive and very time consuming, representing an extra burden for the affected families. This study is the first to address accessibility of children with microcephaly to specialised health care services and points to the urgent need to expand coverage of these services in Brazil, especially in the northeastern states, which are most affected by the epidemic.


Assuntos
Acesso aos Serviços de Saúde , Microcefalia/virologia , Zika virus/patogenicidade , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Epidemias/estatística & dados numéricos , Feminino , Geografia Médica , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Lactente , Masculino , Microcefalia/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Fatores Socioeconômicos , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/terapia
12.
Arq Neuropsiquiatr ; 78(7): 403-411, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32627805

RESUMO

BACKGROUND: The congenital Zika syndrome involves structural brain changes, including ventriculomegaly, thin cerebral cortices, abnormal gyral pattern, cortical malformations, hypoplasia of the corpus callosum, myelination delay, subcortical diffuse calcifications, brainstem hypoplasia, and microcephaly in newborns. OBJECTIVE: This study aimed to describe the clinical characteristics of children with congenital Zika syndrome; to compare the outcomes of infants infected in the first (1T, n=20) and second trimesters of pregnancy (2T, n=11); to investigate correlations between birth weight, birth and follow-up head circumference, birth gestational age, and gross motor scores. METHODS: Participants were evaluated with Alberta Infant Motor Scale (AIMS) and part A of the Gross Motor Function Measure (GMFM-A). ANOVA compared head circumference, birth gestational age, birth weight, and gross motor performance of 1T and 2T. RESULTS: The correlations were investigated by Pearson correlation coefficients. ANOVA showed differences in birth and follow-up head circumferences. Head circumference was smaller in 1T, compared to 2T. Motor performance was classified as below the fifth percentile in AIMS in all children and 1T showed lower scores in prone, sitting, and total AIMS score, compared to 2T. Children ranged from 8 to 78% on GMFM-A and there was a poorer motor performance of 1T. Nineteen children showed hypertonia, six showed normal tone and six showed hypotonia. Birth head circumference was correlated with AIMS prone postural control. Follow-up head circumference was correlated to prone, supine and total AIMS scores. Smaller head circumference at birth and follow-up denoted poorer postural control. DISCUSSION: Children with congenital Zika syndrome showed microcephaly at birth and follow-up. Smaller head circumferences and poorer motor outcomes were observed in 1T. Infants showed poor visual and motor outcomes. Moderate positive correlations between birth and follow-up head circumference and gross motor function were found.


Assuntos
Microcefalia/virologia , Infecção por Zika virus/diagnóstico , Zika virus/isolamento & purificação , Encéfalo , Cefalometria , Criança , Feminino , Humanos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Microcefalia/diagnóstico , Destreza Motora , Gravidez , Complicações Infecciosas na Gravidez , Infecção por Zika virus/complicações , Infecção por Zika virus/congênito
13.
PLoS Negl Trop Dis ; 14(7): e0008413, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32628667

RESUMO

Global Zika virus (ZIKV) outbreaks and their link to microcephaly have raised major public health concerns. However, the mechanism of maternal-fetal transmission remains largely unknown. In this study, we determined the role of yolk sac (YS) microglial progenitors in a mouse model of ZIKV vertical transmission. We found that embryonic (E) days 6.5-E8.5 were a critical window for ZIKV infection that resulted in fetal demise and microcephaly, and YS microglial progenitors were susceptible to ZIKV infection. Ablation of YS microglial progenitors significantly reduced the viral load in both the YS and the embryonic brain. Taken together, these results support the hypothesis that YS microglial progenitors serve as "Trojan horses," contributing to ZIKV fetal brain dissemination and congenital brain defects.


Assuntos
Feto/patologia , Microcefalia/patologia , Microglia/virologia , Complicações Infecciosas na Gravidez/patologia , Infecção por Zika virus/patologia , Zika virus/isolamento & purificação , Animais , Encéfalo/virologia , Modelos Animais de Doenças , Feminino , Feto/virologia , Humanos , Transmissão Vertical de Doenças Infecciosas , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microcefalia/embriologia , Microcefalia/virologia , Microglia/metabolismo , Gravidez , Complicações Infecciosas na Gravidez/virologia , Carga Viral , Zika virus/fisiologia , Infecção por Zika virus/transmissão , Infecção por Zika virus/virologia
14.
Int J Infect Dis ; 98: 359-365, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32619757

RESUMO

OBJECTIVES: This study aimed to describe the demographic and clinical parameters of women infected by Zika virus who had infants with stigmata of Congenital Zika Syndrome (CZS) versus those who had normal-appearing infants at birth, thereby providing further details on the clinical caveats of neonatal ZIKV infection. METHODOLOGY: This cross-sectional study was performed in the state of Mato Grosso do Sul, Central-West region of Brazil, and included 117 mother-infant pairs who were interviewed and 120 gestational outcomes. All mothers had laboratory confirmation by qRT-PCR of ZIKV infection during pregnancy. RESULTS: The prevalence of congenital abnormalities related to ZIKV was 2.69 cases per 10,000 live births during this period. Exanthem was the main clinical finding, observed in 92.5% of the mothers in this study. Regarding the timing of ZIKV infection, the first trimester was the most frequent time of infection among mothers of infants with CZS (54.55%) (p=0.0007). The case fatality rate was 5% (n=6). Among the 23 children who were classified as having CZS, 13 (56.52%) of them presented with microcephaly. Only 13 (56.52%) children with CZS were tested by qRT-PCR for ZIKV infection at birth, five (38%) were positive. CONCLUSIONS: This study highlights the congenital alterations of ZIKV infection during pregnancy in an epidemic burst, demonstrating that the alterations found in other studies are similar to the present research.


Assuntos
Microcefalia/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Exantema/diagnóstico , Exantema/epidemiologia , Exantema/fisiopatologia , Exantema/virologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Microcefalia/diagnóstico , Microcefalia/fisiopatologia , Microcefalia/virologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/fisiopatologia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez , Estudos Retrospectivos , Adulto Jovem , Zika virus/genética , Zika virus/isolamento & purificação , Zika virus/fisiologia
15.
Arq. neuropsiquiatr ; 78(7): 403-411, July 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1131733

RESUMO

ABSTRACT Background: The congenital Zika syndrome involves structural brain changes, including ventriculomegaly, thin cerebral cortices, abnormal gyral pattern, cortical malformations, hypoplasia of the corpus callosum, myelination delay, subcortical diffuse calcifications, brainstem hypoplasia, and microcephaly in newborns. Objective: This study aimed to describe the clinical characteristics of children with congenital Zika syndrome; to compare the outcomes of infants infected in the first (1T, n=20) and second trimesters of pregnancy (2T, n=11); to investigate correlations between birth weight, birth and follow-up head circumference, birth gestational age, and gross motor scores. Methods: Participants were evaluated with Alberta Infant Motor Scale (AIMS) and part A of the Gross Motor Function Measure (GMFM-A). ANOVA compared head circumference, birth gestational age, birth weight, and gross motor performance of 1T and 2T. Results: The correlations were investigated by Pearson correlation coefficients. ANOVA showed differences in birth and follow-up head circumferences. Head circumference was smaller in 1T, compared to 2T. Motor performance was classified as below the fifth percentile in AIMS in all children and 1T showed lower scores in prone, sitting, and total AIMS score, compared to 2T. Children ranged from 8 to 78% on GMFM-A and there was a poorer motor performance of 1T. Nineteen children showed hypertonia, six showed normal tone and six showed hypotonia. Birth head circumference was correlated with AIMS prone postural control. Follow-up head circumference was correlated to prone, supine and total AIMS scores. Smaller head circumference at birth and follow-up denoted poorer postural control. Discussion: Children with congenital Zika syndrome showed microcephaly at birth and follow-up. Smaller head circumferences and poorer motor outcomes were observed in 1T. Infants showed poor visual and motor outcomes. Moderate positive correlations between birth and follow-up head circumference and gross motor function were found.


RESUMO Introdução: A síndrome congênita do zika envolve alterações estruturais do cérebro, incluindo ventriculomegalia, córtices finos do cérebro, padrão giral anormal, malformações corticais, hipoplasia do corpo caloso, atraso de mielinização, calcificações difusas subcorticais, hipoplasia do tronco cerebral e microcefalia em recém-nascidos. Objetivo: Este estudo teve como objetivo descrever as características clínicas de crianças com síndrome congênita do zika; comparar os resultados de bebês infectados no primeiro (1T, n=20) e no segundo trimestres da gravidez (2T, n=11); investigar correlações entre peso ao nascer, perímetro cefálico ao nascer e acompanhamento, idade gestacional ao nascer e escores motores brutos. Método: Os participantes foram avaliados com a Escala Motora Infantil de Alberta (Alberta Infant Motor Scale - AIMS) e a parte A da Medida da Função Motora Grossa (Gross Motor Function Measure - GMFM-A). A ANOVA comparou a circunferência da cabeça, a idade gestacional ao nascer, o peso ao nascer e o desempenho motor bruto de 1T e 2T. As correlações foram investigadas pelos coeficientes de correlação de Pearson. A ANOVA mostrou diferenças no perímetro cefálico ao nascimento e acompanhamento. A circunferência da cabeça foi menor no 1T, em comparação ao 2T. Resultados: O desempenho motor foi classificado como abaixo do quinto percentil na AIMS para todas as crianças e o 1T apresentou escores mais baixos na posição de bruços, sentado e no escore total da AIMS, em comparação ao 2T. As crianças variaram de 8 a 78% no GMFM-A e houve um desempenho motor pior de 1T. Dezenove crianças apresentaram hipertonia, seis apresentaram tônus normal e seis apresentaram hipotonia. A circunferência da cabeça no nascimento foi correlacionada com o controle postural em posição de bruços à AIMS. Discussão: O perímetro cefálico de acompanhamento foi correlacionado aos escores AIMS em posição de bruços, em supino e no escore total. Menor perímetro cefálico ao nascimento e acompanhamento indicaram pior controle postural. Crianças com síndrome congênita do zika apresentaram microcefalia ao nascimento e acompanhamento. Circunferências da cabeça menores e piores resultados motores foram observados no 1T. Os bebês apresentaram maus resultados visuais e motores. Foram encontradas correlações moderadas positivas entre o nascimento e a circunferência da cabeça de acompanhamento, e a função motora grossa.


Assuntos
Humanos , Feminino , Gravidez , Recém-Nascido , Lactente , Criança , Zika virus/isolamento & purificação , Infecção por Zika virus/diagnóstico , Microcefalia/virologia , Complicações Infecciosas na Gravidez , Encéfalo , Imageamento por Ressonância Magnética , Cefalometria , Infecção por Zika virus/complicações , Infecção por Zika virus/congênito , Microcefalia/diagnóstico , Destreza Motora
16.
Rev Fac Cien Med Univ Nac Cordoba ; 77(2): 100-105, 2020 04 07.
Artigo em Espanhol | MEDLINE | ID: mdl-32558512

RESUMO

Introduction: Microcephaly and brain abnormalities may be due to multiple etiologies, one of them is the congenital infection by Zika virus (ZIKV). From 2016 to the present, there has been a series of ZIKV outbreaks in Argentina. Methods: National Network of Congenital Anomalies (RENAC) and the National Institute of Viral Diseases (INEVH), under the National Administration of Laboratories and Health Institutes "Carlos Malbrán" (ANLIS), carry out the intensified surveillance of newborns with microcephaly and brain abnormalities. This article presents the clinical characteristics and laboratory testof patients detected with congenital infection by ZIKV between April 2016 to March 2018, Results: 10 cases with embryopathy were detected, six autochthonous and four imported; in two cases, the mothers were asymptomatic during pregnancy; all the cases presented microcephaly and cranial facial disproportion, ventriculomegaly in seven cases and in six cerebral calcifications. The diagnosis of congenital infection by Zika in the newborn was made by antigen-specific Immunoglobulin M (MAC-ELISA) and plaque-reduction neutralization test (PRNT90 ). PCR was negative in all cases. Conclusion: the patients presented clinical features that were consistent with those reported in other countries. The need for serological studies that allow confirmation is emphasized, ruling out cross-reactivity with other Flaviviruses.


Assuntos
Microcefalia/virologia , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/complicações , Argentina/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , Microcefalia/diagnóstico , Microcefalia/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Infecção por Zika virus/epidemiologia
17.
PLoS Pathog ; 16(5): e1008204, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32357162

RESUMO

Zika virus (ZIKV) can infect and cause microcephaly and Zika-associated neurological complications in the developing fetal and adult brains. In terms of pathogenesis, a critical question is how ZIKV overcomes the barriers separating the brain from the circulation and gains access to the central nervous system (CNS). Despite the importance of ZIKV pathogenesis, the route ZIKV utilizes to cross CNS barriers remains unclear. Here we show that in mouse models, ZIKV-infected cells initially appeared in the periventricular regions of the brain, including the choroid plexus and the meninges, prior to infection of the cortex. The appearance of ZIKV in cerebrospinal fluid (CSF) preceded infection of the brain parenchyma. Further the brain infection was significantly attenuated by neutralization of the virus in the CSF, indicating that ZIKV in the CSF at the early stage of infection might be responsible for establishing a lethal infection of the brain. We show that cells infected by ZIKV in the choroid plexus were pericytes. Using in vitro systems, we highlight the possibility that ZIKV crosses the blood-CSF barrier by disrupting the choroid plexus epithelial layer. Taken together, our results suggest that ZIKV might exploit the blood-CSF barrier rather than the blood-brain barrier to invade the CNS.


Assuntos
Plexo Corióideo/patologia , Pericitos/patologia , Infecção por Zika virus/patologia , Animais , Barreira Hematoencefálica/patologia , Encéfalo/patologia , Sistema Nervoso Central/patologia , Chlorocebus aethiops , Plexo Corióideo/metabolismo , Plexo Corióideo/virologia , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microcefalia/complicações , Microcefalia/virologia , Doenças do Sistema Nervoso , Pericitos/metabolismo , Pericitos/virologia , Cultura Primária de Células , Células Vero , Zika virus/fisiologia , Infecção por Zika virus/virologia
18.
PLoS Pathog ; 16(5): e1008521, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32392268

RESUMO

Zika virus (ZIKV) infection may lead to congenital microcephaly and pregnancy loss in pregnant women. In the context of pregnancy, folic acid (FA) supplementation may reduce the risk of abnormal pregnancy outcomes. Intriguingly, FA may have a beneficial effect on the adverse pregnancy outcomes associated with ZIKV infection. Here, we show that FA inhibits ZIKV replication in human umbilical vein endothelial cells (HUVECs) and a cell culture model of blood-placental barrier (BPB). The inhibitory effect of FA against ZIKV infection is associated with FRα-AMPK signaling. Furthermore, treatment with FA reduces pathological features in the placenta, number of fetal resorptions, and stillbirths in two mouse models of in utero ZIKV transmission. Mice with FA treatment showed lower viral burden and better prognostic profiles in the placenta including reduced inflammatory response, and enhanced integrity of BPB. Overall, our findings suggest the preventive role of FA supplementation in ZIKV-associated abnormal pregnancy and warrant nutritional surveillance to evaluate maternal FA status in areas with active ZIKV transmission.


Assuntos
Ácido Fólico/farmacologia , Placenta , Complicações Infecciosas na Gravidez , Infecção por Zika virus/prevenção & controle , Zika virus/metabolismo , Animais , Modelos Animais de Doenças , Feminino , Células Endoteliais da Veia Umbilical Humana , Humanos , Camundongos , Microcefalia/metabolismo , Microcefalia/patologia , Microcefalia/prevenção & controle , Microcefalia/virologia , Placenta/metabolismo , Placenta/patologia , Placenta/virologia , Gravidez , Complicações Infecciosas na Gravidez/metabolismo , Complicações Infecciosas na Gravidez/patologia , Complicações Infecciosas na Gravidez/prevenção & controle , Infecção por Zika virus/metabolismo , Infecção por Zika virus/patologia
19.
BMC Infect Dis ; 20(1): 332, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32393198

RESUMO

BACKGROUND: Between 2016 and 2019, 265 cases of Zika virus (ZIKV) infection were reported in Vietnam, predominantly in southern Vietnam. In 2016, a case of ZIKV-associated microcephaly was confirmed in the Central Highlands, and several members of the infant's family were confirmed to be infected with ZIKV. The study aims to determine the level of immunity to ZIKV in the general population of the ZIKV epidemic region. METHODS: A total of 879 serum samples were collected from 801 participants between January 2017 and July 2018, during and after the ZIKV epidemic in Vietnam. The samples were tested for anti-ZIKV immunoglobulin M (IgM) and immunoglobulin G (IgG), and anti-dengue virus (DENV) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Plaque-reduction neutralization test (PRNT) for ZIKV was performed on all samples, and for DENV on the samples that ZIKV neutralizing antibody positive. RESULTS: A total of 83 (10.3%) participants had anti-ZIKV IgM. Of the 83, 6 were confirmed to be ZIKV antibodies positive using PRNT and anti-ZIKV IgG ELISA. Of the 718 participants who were anti-ZIKV IgM negative, a further 3 cases were confirmed as positive for antibodies against ZIKV. Of the 9 participants with ZIKV infection, 5 lived in the same village as the infant with ZIKV-associated microcephaly and the other 4 lived in 2 neighboring communes. Repeat samples were collected from the 83 ZIKV IgM positive participants 1.5 years after the first collection. No new cases of ZIKV infection were detected. In addition, 2 of 3 participants with anti-ZIKV NS1 IgG demonstrated a 4- to 8-fold increase in ZIKV neutralizing antibody titer. CONCLUSIONS: ZIKV was present in the area around Krong Buk, with the rate of ZIKV-specific antibodies was 1.1% in the community since at least 2016. While the low levels of circulation together with low seroprevalence suggests a limited outbreak in the region, the results also reflect on low levels of protective immunity to Zika within the population. These results provide a better understanding of the current ZIKV epidemic status in the region and demonstrate a need for implementation of more effective ZIKV infection control measures.


Assuntos
Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Epidemias , Infecção por Zika virus/epidemiologia , Zika virus/imunologia , Adolescente , Adulto , Criança , Pré-Escolar , Vírus da Dengue/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Microcefalia/virologia , Pessoa de Meia-Idade , Testes de Neutralização , Prevalência , Estudos Soroepidemiológicos , Vietnã/epidemiologia , Adulto Jovem , Infecção por Zika virus/virologia
20.
J Pediatr ; 222: 112-119.e3, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32417080

RESUMO

OBJECTIVE: To estimate the prevalence of microcephaly and central nervous system (CNS) defects during the Zika virus (ZIKV) epidemic in Colombia and proportion attributable to congenital ZIKV infection. STUDY DESIGN: Clinical and laboratory data for cases of microcephaly and/or CNS defects reported to national surveillance between 2015 and 2017 were reviewed and classified by a panel of clinical subject matter experts. Maternal and fetal/infant biologic specimens were tested for congenital infection and chromosomal abnormalities. Infants/fetuses with microcephaly and/or CNS defects (cases) were classified into broad etiologic categories (teratogenic, genetic, multifactorial, and unknown). Cases classified as potentially attributable to congenital ZIKV infection were stratified by strength of evidence for ZIKV etiology (strong, moderate, or limited) using a novel strategy considering birth defects unique or specific to ZIKV or other infections and laboratory evidence. RESULTS: Among 858 reported cases with sufficient information supporting a diagnosis of microcephaly or CNS defects, 503 were classified as potentially attributable to congenital ZIKV infection. Of these, the strength of evidence was considered strong in 124 (24.7%) cases; moderate in 232 (46.1%) cases; and limited in 147 (29.2%). Of the remaining, 355 (41.4%) were attributed to etiologies other than ZIKV infection (syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes 1 and herpes 2 viruses only, n = 32 [3.7%]; genetic, n = 16 [1.9%]; multifactorial, n = 42 [4.9%]; unknown, n = 265 [30.9%]). CONCLUSIONS: Fifty-eight percent of cases of microcephaly and/or CNS defects were potentially attributable to congenital ZIKV infection; however, the strength of evidence varied considerably. This surveillance protocol might serve as a model approach for investigation and etiologic classification of complex congenital conditions.


Assuntos
Sistema Nervoso Central/anormalidades , Microcefalia/epidemiologia , Microcefalia/virologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/congênito , Infecção por Zika virus/epidemiologia , Colômbia/epidemiologia , Anormalidades Congênitas/epidemiologia , Anormalidades Congênitas/virologia , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Prevalência
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