Reduction of infant mortality in Latin America and the Caribbean: uneven progress requiring a variety of responses

Infant mortality has unquestionably declined throughout Latin America over the last decade, even under conditions of low and unstable economic growth and a meagre overall reduction of poverty in the region. The declines in infant mortality vary from one country to another. The persistence of high infant mortality rates is related to low income, teenage pregnancy and lack of access to basic services, as well as to the lack of appropriate health care infrastructure. At the same time, both the rural population as a whole, and the indigenous and Afro-descendent population in particular, has fallen markedly behind, with overall infant mortality rates much higher than among the rest of the population. Moreover, the cause and incidence of death in this age group have been changing according with the changes in neonatal and post-neonatal deaths. Our editorial line-up has created space for opinions from adolescents and youth, as well as from policy experts on the problem, its causes, and approaches to dealing with infant mortality. We also offer succinct information on a broad range of programmes—utilizing various interventions—in different countries of the region regarding maternal and infant care, in an attempt to bring about a reduction in mortality.

Effect of ambulatory versus hospital treatment for gestational diabetes or hyperglycemia on infant mortality rates: a systematic review

CONTEXTO E OBJETIVO:Gestações complicadas pelo diabetes estão associadas com aumento das complicações neonatais e maternas. A complicação mais grave materna é o risco de desenvolver diabetes tipo 2 após 10-12 anos do parto. Para o controle rigoroso da glicose no sangue, as mulheres grávidas são tratadas de forma ambulatorial ou com internações hospitalares. O objetivo deste estudo é avaliar a efetividade do tratamento ambulatorial versus hospitalização em gestações complicadas por diabetes ou hiperglicemia.TIPO DE ESTUDO E LOCAL:Revisão sistemática conduzida em hospital universitário público.MÉTODOS:Uma revisão sistemática da literatura foi realizada e as principais bases de dados eletrônicas foram pesquisadas. A data da pesquisa mais recente foi 4 de setembro de 2011. Dois autores selecionaram independentemente os ensaios clínicos relevantes, avaliaram a qualidade metodológica e extraíram os dados.RESULTADOS:Apenas três estudos foram selecionados, com tamanho de amostra pequeno. Não houve diferença estatisticamente significativa entre o tratamento ambulatorial versus hospitalização em relação à mortalidade em nenhuma das subcategorias analisadas: mortes perinatais e neonatais, (risco relativo [RR] 0,65; 95% de intervalo de confiança [IC] 0,11-3,84, P = 0,63); morte neonatal (RR 0,29, IC 95% 0,01-6,07, P = 0,43), e óbitos infantis (RR 0,29, IC 95% 0,01-6,07, P = 0,43).CONCLUSÕES:Com base em estudos com risco de viés alto ou moderado, esta revisão demonstrou que não há diferença estatisticamente significante entre o tratamento ambulatorial comparado com o hospitalar na redução das taxas de mortalidade em gestações complicadas por diabetes ou hiperglicemia. Esta revisão sistemática também sugere a necessidade de mais ensaios clínicos randomizados sobre o assunto.

Validation of an HPLC Method for the Determination of Dibucaine Encapsulated in Solid Lipid Nanoparticles and Nanostructured Lipid Carriers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Producing xylan/Eudragit (R) S100-based microparticles by chemical and physico-mechanical approaches as carriers for 5-aminosalicylic acid

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Spin-dependent beating patterns in thermoelectric properties: Filtering the carriers of the heat flux in a Kondo adatom system

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Nanostructured Lipid Carriers as a Strategy to Improve the In Vitro Schistosomiasis Activity of Praziquantel

Praziquantel (PZQ) is a pyrazinoisoquinoline anthelmintic that was discovered in 1972 by Bayer Germany. Currently, due to its efficacy, PZQ is the drug of choice against all species of Schistosoma. Although widely used, PZQ exhibits low and erratic bioavailability because of its poor water solubility. Nanostructured lipid carriers (NLC), second-generation solid lipid nanoparticles, were developed in the 1990s to improve the bioavailability of poorly water soluble drugs. The aim of this study was to investigate nanostructured lipid carriers as a strategy to improve the efficacy. of PZQ in S. mansoni treatment. We prepared NLC2 and NLC4 by adding seventy percent glycerol monostearate (GMS) as the solid lipid, 30% oleic acid (OA) as the liquid lipid and two surfactant systems containing either soybean phosphatidylcholine/poloxamer (PC/P-407) or phosphatidylcholine/Tween 60 (PC/T60), respectively. The carriers were characterized by nuclear magnetic resonance, differential scanning calorimetry, thermogravimetric analysis and Fourier transform-infrared spectroscopy. The safety profile was evaluated using red cell hemolysis and in vitro cytotoxicity assays. The results showed that the encapsulation of PZQ in NLC2 or NLC4 improved the safety profile of the drug. Treatment efficacy was evaluated on the S. mansoni BH strain. PZQ-NLC2 and PZQ-NLC4 demonstrated an improved efficacy in comparison with free PZQ. The results showed that the intestinal transport of free PZQ and PZQ-NLC2 was similar. However, we observed that the concentration of PZQ absorbed was smaller when PZQ was loaded in NLC4. The difference between the amounts of absorbed PZQ could indicate that the presence of T60 in the nanoparticles (NLC4) increased the rigid lipid matrix, prolonging release of the drug. Both systems showed considerable in vitro activity against S. mansoni, suggesting that these systems may be a promising platform for the administration of PZQ for treating schistosomiasis.

Reuse of Cyclodextrin Glycosyltransferase through Immobilization on Magnetic Carriers

National Council for Scientific and Technological Development (CNPq)

Highlights in peptide nanoparticle carriers intended to oral diseases

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Recent advances in nanoparticle carriers for coordination complexes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Fluoride concentrations of milk, infant formulae, and soy-based products commercially available in Brazil

To assess the fluoride (F) content in commercially available milk formulae in Brazil and to estimate the F intake in children from this source in the first year of life. Samples of cow's milk (n = 51), infant formulae (n = 15), powdered milk (n = 13), and soy-based products (n = 4) purchased in Araçatuba (Brazil) had their F content measured using an ion-specific electrode, after hexamethyldisiloxane-facilitated diffusion. Powdered milk and infant formulae were reconstituted with deionized water, while ready-to-drink products were analyzed without any dilution. Using average infant body masses and suggested volumes of formula consumption for infants 1-12 months of age, possible F ingestion per body mass was estimated. Data were analyzed by descriptive analysis. Mean F content ranged from 0.02 to 2.52 mg/L in all samples. None of the cow's milk provided F intake higher than 0.07 mg/kg. However, two infant formulae, one powdered milk, and one soy-milk led to a daily F intake above the suggested threshold for fluorosis when reconstituted with deionized water. Assuming reconstitution of products with tap water at 0.7 ppm F, two infant formulae, five powdered milk, and four soymilks led to daily F intake ranging from 0.108 to 0.851 mg/kg. The results suggest that the consumption of some brands of infant formulae, powdered milk, and soy-based milk in the first year of age could increase the risk of dental fluorosis, reinforcing the need for periodic surveillance of the F content of foods and beverages typically consumed by young children.

Effects of probiotic Lactobacillus gasseri strains of breast-fed infant in a murine model

The ingestion of probiotic lactic acid bacteria has been evaluated and noted that it has an effect on the balance of desirable microbiota in the gastrointestinal tract. Lactobacillus gasseri demonstrates good survival in the gastrointestinal tract, and it has been associated with a variety of probiotic activities and roles, including the reduction of fecal mutagenic enzymes, the production of bacteriocins and the stimulation of macrophages immunomodulation. The aim of the study was to evaluate the effects of a pool of L. gasseri strains isolated from the feces of breastfed infants added in the human milk of healthy women. The milk was both pasteurized and unpasteurized, to verify the cell cytotoxicity of macrophages and to quantify the production of immunologic mediators such as IL-4, IL-6, IFN-g, TNF-a, NO and oxygen intermediary compounds (H2O2). The administration of raw human milk and pasteurized human milk to infants is a regular, encouraged practice in units of intensive therapy (UITs) and our present investigation verified the beneficial effect of addition of a pool of L. gasseri to pasteurized human milk (PHML). Our results show that probiotic supplementation helped to maintain cell viability, reduced IL-6 and IFN-γ production and stimulated TNF-α, NO, H2O2, IL-4 production. Nevertheless, the results indicate that the addition of lactobacillus to human milk was not a determinant in the production of TNF-α. L. gasseri added to breast milk did not present a cytotoxic risk, and the addition of L. gasseri to pasteurized milk of human milk bank would benefit newborns that depend on milk banks for the colonization of more desirable microbiota.