Maternal and congenital infections arising from Zika, dengue and Chikungunya arboviruses in Salvador, Brazil.

BACKGROUND: Salvador was one of the Brazilian cities most affected during the 2015 Zika virus (ZIKV) outbreak. METHODS: A cross-sectional study was performed with enrolment of parturients and their newborns. RESULTS: Positive IgM antibodies for ZIKV, dengue (DENV) and Chikungunya (CHIKV) were present in 6.9, 11.9 and 22.8% of the parturients, and IgG antibodies were detected in 72.3, 92.3 and 38.6%, respectively. No cases of DENV congenital infection were identified. ZIKV and CHIKV congenital infections were observed in 16.5 and 13% of newborns, respectively. CONCLUSIONS: High exposure rates to the three arboviruses and the identification of newborns with ZIKV and CHIKV congenital infections reinforces the necessity of ZIKV and CHIKV prenatal and neonatal screening in endemic regions.

Neonatal surveillance for congenital Zika infection during the 2016 microcephaly outbreak in Salvador, Brazil: Zika virus detection in asymptomatic newborns.

OBJECTIVE: To identify newborns with congenital Zika infection (CZI) at a maternity hospital in Salvador, Brazil, during the 2016 microcephaly outbreak. METHODS: A prospective study enrolled microcephalic and normocephalic newborns with suspected CZI between January and December 2016. Serology (immunoglobulins IgM and IgG) and quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) for the Zika virus were performed. Demographic and clinical characteristics of newborns with and without microcephaly were compared. RESULTS: Of the 151 newborns enrolled, 32 (21.2%) were classified as microcephalic. The majority of these cases were born between January and May 2016. IgM and IgG Zika virus antibodies were detected in 5 (23.8%) and 17 (80.9%) microcephalic newborn blood samples, respectively. Six (24%) microcephalic newborns tested positive for Zika virus by RT-qPCR in urine or placenta samples. Thirteen (11.8%) normocephalic newborns also tested positive for Zika virus by PCR in urine, plasma, or placenta samples, while IgM antibodies against Zika were detected in 4 (4.2%) others. CONCLUSIONS: Identification of 17 normocephalic CZI cases, confirmed by IgM serology or RT-qPCR for Zika virus, provides evidence that CZI can present asymptomatically at birth. This finding highlights the need for prenatal and neonatal screening for Zika virus in endemic regions.

First case reports of bloodstream infection by Candida magnoliae in two neonates with low birth weight.

Invasive candidiasis is a serious neonatal sepsis with high morbidity and mortality despite the correct treatment. Candida albicans and Candida parapsilosis are the most common pathogens causing these events; however, a new emergent pathogen has evolved with time. Herein, we describe two cases of Candida magnoliae infection in neonates with a fatal outcome. This microorganism is commonly used in the food industry given its high capacity to produce erythritol and mannitol. This report is important to gain more information about this pathogen and manage it in a more effective way.

Changes in morphology of long bone marrow tissue of rats submitted to cryotherapy with liquid nitrogen.

PURPOSE: To study the main effects of local use of liquid nitrogen on bone marrow tissue in rats. METHODS: The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for one or two minutes, intercalated with periods of five minutes of passive thawing. The animals were sacrificed after one, two, four and 12 weeks and the specimens obtained were analyzed histomorphologically. RESULTS: In the second experimental week of one-minute protocol, histological degree of inflammation obtained a mean score of one (mild), ranging from 0 (absent or scarce) and two (moderate) (Kruskal-Wallis test p=0.01). In the second experimental week of two-minute protocol, degree of inflammation to the medullar tissue obtained an average score of two (Kruskal-Wallis test p=0.01). CONCLUSION: The degree of inflammation of the bone marrow tissue was higher in protocol of three applications of two minutes compared to protocol of three applications of one minute.

Histomorphometric assessment of bone necrosis produced by two cryosurgery protocols using liquid nitrogen: an experimental study on rat femurs.

OBJECTIVE: The aim of this study was to evaluate the effects of liquid nitrogen cryosurgery on the femoral diaphysis of rats. MATERIAL AND METHODS: The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for 1 or 2 min, intercalated with periods of 5 min of passive thawing. The animals were sacrificed after 1, 2, 4 and 12 weeks and the specimens obtained were processed and analyzed histomorphometrically. RESULTS: The depth and extent of peak bone necrosis were 124.509 µm and 2087.094 µm for the 1-min protocol, respectively, and 436.424 µm and 12046.426 µm for the 2-min protocol. Peak necrosis was observed in the second experimental week with both cryotherapy protocols. CONCLUSIONS: The present results indicate that the 2-min protocol produced more marked bone necrosis than the 1-min protocol. Although our results cannot be entirely extrapolated to clinical practice, they contribute to the understanding of the behavior of bone tissue submitted to different cycles of liquid nitrogen freezing and may serve as a basis for new studies.

Changes in morphology of long bone marrow tissue of rats submitted to cryotherapy with liquid nitrogen / Alterações na morfologia do tecido medular de ossos longos de ratos submetido à crioterapia com nitrogênio líquido

PURPOSE: To study the main effects of local use of liquid nitrogen on bone marrow tissue in rats. METHODS: The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for one or two minutes, intercalated with periods of five minutes of passive thawing. The animals were sacrificed after one, two, four and 12 weeks and the specimens obtained were analyzed histomorphologically. RESULTS: In the second experimental week of one-minute protocol, histological degree of inflammation obtained a mean score of one (mild), ranging from 0 (absent or scarce) and two (moderate) (Kruskal-Wallis test p=0.01). In the second experimental week of two-minute protocol, degree of inflammation to the medullar tissue obtained an average score of two (Kruskal-Wallis test p=0.01). CONCLUSION: The degree of inflammation of the bone marrow tissue was higher in protocol of three applications of two minutes compared to protocol of three applications of one minute.

OBJETIVO: Investigar os principais efeitos do uso local de nitrogênio líquido sobre o tecido medular ósseo em ratos. MÉTODOS: As diáfises femorais de 42 ratos Wistar foram expostas a três aplicações sequenciais locais de nitrogênio líquido por um ou dois minutos, intercaladas por períodos de cinco minutos de degelo espontâneo. Os animais foram sacrificados após uma, duas, quatro e 12 semanas e os espécimes obtidos foram analisados histomorfologicamente. RESULTADOS: Na segunda semana experimental do protocolo de um minuto, o grau histológico de inflamação obteve um escore médio de um (leve) variando entre 0 (ausente ou escarço) a dois (moderado) (Teste de Kruskal-Wallis p=0.01). Na segunda semana experimental do protocolo de dois minutos, o grau histológico de inflamação do tecido medular obteve um escore máximo de dois (moderado) (Teste de Kruskal-Wallis p=0.01). CONCLUSÃO: O grau de inflamação do tecido medular ósseo foi maior no protocolo de três aplicações de dois minutos comparado ao protocolo de três aplicações de um minuto.

Changes in morphology of long bone marrow tissue of rats submitted to cryotherapy with liquid nitrogen / Alterações na morfologia do tecido medular de ossos longos de ratos submetido à crioterapia com nitrogênio líquido

PURPOSE: To study the main effects of local use of liquid nitrogen on bone marrow tissue in rats. METHODS: The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for one or two minutes, intercalated with periods of five minutes of passive thawing. The animals were sacrificed after one, two, four and 12 weeks and the specimens obtained were analyzed histomorphologically. RESULTS: In the second experimental week of one-minute protocol, histological degree of inflammation obtained a mean score of one (mild), ranging from 0 (absent or scarce) and two (moderate) (Kruskal-Wallis test p=0.01). In the second experimental week of two-minute protocol, degree of inflammation to the medullar tissue obtained an average score of two (Kruskal-Wallis test p=0.01). CONCLUSION: The degree of inflammation of the bone marrow tissue was higher in protocol of three applications of two minutes compared to protocol of three applications of one minute.(AU)

OBJETIVO: Investigar os principais efeitos do uso local de nitrogênio líquido sobre o tecido medular ósseo em ratos. MÉTODOS: As diáfises femorais de 42 ratos Wistar foram expostas a três aplicações sequenciais locais de nitrogênio líquido por um ou dois minutos, intercaladas por períodos de cinco minutos de degelo espontâneo. Os animais foram sacrificados após uma, duas, quatro e 12 semanas e os espécimes obtidos foram analisados histomorfologicamente. RESULTADOS: Na segunda semana experimental do protocolo de um minuto, o grau histológico de inflamação obteve um escore médio de um (leve) variando entre 0 (ausente ou escarço) a dois (moderado) (Teste de Kruskal-Wallis p=0.01). Na segunda semana experimental do protocolo de dois minutos, o grau histológico de inflamação do tecido medular obteve um escore máximo de dois (moderado) (Teste de Kruskal-Wallis p=0.01). CONCLUSÃO: O grau de inflamação do tecido medular ósseo foi maior no protocolo de três aplicações de dois minutos comparado ao protocolo de três aplicações de um minuto.(AU)

Histomorphometric assessment of bone necrosis produced by two cryosurgery protocols using liquid nitrogen: an experimental study on rat femurs

OBJECTIVE: The aim of this study was to evaluate the effects of liquid nitrogen cryosurgery on the femoral diaphysis of rats. MATERIAL AND METHODS: The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for 1 or 2 min, intercalated with periods of 5 min of passive thawing. The animals were sacrificed after 1, 2, 4 and 12 weeks and the specimens obtained were processed and analyzed histomorphometrically. RESULTS: The depth and extent of peak bone necrosis were 124.509 µm and 2087.094 µm for the 1-min protocol, respectively, and 436.424 µm and 12046.426 µm for the 2-min protocol. Peak necrosis was observed in the second experimental week with both cryotherapy protocols. CONCLUSIONS: The present results indicate that the 2-min protocol produced more marked bone necrosis than the 1-min protocol. Although our results cannot be entirely extrapolated to clinical practice, they contribute to the understanding of the behavior of bone tissue submitted to different cycles of liquid nitrogen freezing and may serve as a basis for new studies.

Soroprevalência para Zika, Dengue e Chikungunya em puerperas que apresentaram doença exantematica durante a gestação e incidência de infecções congênitas em uma maternidade de referência de Salvador-Bahia

Epidemias concomitantes de Dengue, Chikungunya e Zika vem ocorrendo no Brasil. Em maio de 2015 os primeiros casos de infecção por vírus Zika (ZIKV) foram confirmados no Brasil e após seis meses um surto de recém-nascidos com microcefalia foi notificado no Nordeste, sendo confirmada a associação com a infecção por ZIKV em gestantes e infecção congênita.