Iodide Transport Defect: Functional Characterization of a Novel Mutation in the Na(+)/I(-) Symporter 5 `-Untranslated Region in a Patient with Congenital Hypothyroidism

Context: Iodide transport defect (ITD) is an autosomal recessive disorder caused by impaired Na(+)/I(-) symporter (NIS)-mediated active iodide accumulation into thyroid follicular cells. Clinical manifestations comprise a variable degree of congenital hypothyroidism and goiter, and low to absent radioiodide uptake, as determined by thyroid scintigraphy. Hereditary molecular defects in NIS have been shown to cause ITD. Objective: Our objective was to perform molecular studies on NIS in a patient with congenital hypothyroidism presenting a clinical ITD phenotype. Design: The genomic DNA encoding NIS was sequenced, and an in vitro functional study of a newly identified NIS mutation was performed. Results: The analysis revealed the presence of an undescribed homozygous C to T transition at nucleotide -54 (-54C>T) located in the 5`-untranslated region in the NIS sequence. Functional studies in vitro demonstrated that the mutation was associated with a substantial decrease in iodide uptake when transfected into Cos-7 cells. The mutation severely impaired NIS protein expression, although NIS mRNA levels remained similar to those in cells transfected with wild-type NIS, suggesting a translational deficiency elicited by the mutation. Polysome profile analysis demonstrated reduced levels of polyribosomes-associated mutant NIS mRNA, consistent with reduced translation efficiency. Conclusions: We described a novel mutation in the 5`-untranslated region of the NIS gene in a newborn with congenital hypothyroidism bearing a clinical ITD phenotype. Functional evaluation of the molecular mechanism responsible for impaired NIS-mediated iodide concentration in thyroid cells indicated that the identified mutation reduces NIS translation efficiency with a subsequent decrease in protein expression and function. (J Clin Endocrinol Metab 96: E1100-E1107, 2011)

TRPV1 receptors modulate retinal development

We investigated the possible participation of TRPV1 channels in retinal apoptosis and overall development. Retinas from newborn, male albino rats were treated in vitro with capsazepine, a TRPV1 antagonist. The expression of cell cycle markers was not changed after TRPV1 blockade, whereas capsazepine reduced the number of apoptotic cells throughout the retina,increased ERK1/2 and p38 phosphorylation and slightly reduced JNK phosphorylation. The expression of BAD, Bcl-2, as well as integral and cleaved capsase-3 were similar in all experimental conditions. Newborn rats were kept for 2 months after receiving high doses of capsazepine. In their retinas, calbindin and parvalbumin protein levels were upregulated, but only the number of amacrine-like, parvalbumin-positive cells was increased. The numbers of calretinin, calbindin, ChAT, vimentin, PKC-alpha and GABA-positive cells were similar in both conditions. Protein expression of synapsin Ib was also increased in the retinas of capsazepine-treated rats. Calretinin, vimentin, GFAP, synapsin Ia, synaptophysin and light neurofilament protein levels were not changed when compared to control values. Our results indicate that TRPV1 channels play a role in the control of the early apoptosis that occur during retinal development, which might be dependent on MAPK signaling. Moreover, it seems that TRPV1 function might be important for neuronal and synaptic maturation in the retina. (C) 2011 ISDN. Published by Elsevier Ltd. All rights reserved.

The allergic inflammatory reaction in neonatal streptozotocininduced diabetic rats: evidence of insulin resistance and microvascular dysfunction

To investigate the allergic reaction in neonatal streptozotocin (nSTZ)-induced diabetes mellitus. Male newborn Wistar rats were made diabetic by the injection of streptozotocin (160 mg/kg, i. p.) and used 8 weeks thereafter. Animals were sensitized against ovalbumin (OA, 50 mu g and Al(OH)3, 5 mg, s. c.) and challenged 14 or 21 days thereafter. OA-induced airway inflammation and OA-induced pleurisy models were used to investigate leukocyte migration (total and differential leukocyte counts) and lung vascular permeability (Evans blue dye extravasation). nSTZ-diabetic rats presented glucose intolerance and insulin resistance. Relative to controls, nSTZ rats exhibited a 30% to 50% reduction in lung vascular permeability. Leukocyte infiltration in both models of allergen-induced inflammation, and number of pleural mast cells did not differ between groups. Data suggest that the reduction of allergic inflammatory reactions in nSTZ rats is restricted to microvascular dysfunctions and associated, probably, with insulin resistance in lung microvascular endothelium.

Transfer of antibodies across the placenta and in breast milk from mothers on intravenous immunoglobulin

We studied the levels of immunoglobulins in colostrum, milk and sera from two common variable immunodeficiency (CVID) mothers (M1 and M2), and in sera from their newborn infants. During pregnancy they continued intravenous immunoglobulin therapy (IVIG). Antibody levels from maternal and cord blood collected at delivery and colostrum and milk, collected on the 3rd and 7th post-partum days, respectively, were analyzed. Although cord/maternal blood ratios of total immunoglobulins and subclasses, as well as specific antibodies differed between M1 and M2, both showed good placental transfer of anti-protein and anti-polysaccharide antibodies, despite lower cord/maternal blood ratios in M2. Anti-Streptococcus pneumoniae antibody avidity indexes were similar between paired maternal and cord serum. Both mothers` colostrum and milk samples showed only traces of IgA, and IgM and IgG levels in colostrum were within normal range in M1, whereas M2 presented elevated IgG and low IgM levels, when compared with healthy mothers. The study of colostrum and milk activity showed that they strongly inhibited enteropathogenic Escherichia coli adhesion in vitro. CVID patients must be informed about the relevance of regular IVIG administration during pregnancy, not only for their own health but also for their immune immature offspring. Breast-feeding should be encouraged as colostra from these CVID patients strongly inhibited E. coli adhesion to human epithelial cells thus providing immunological protection plus nutritional and psychological benefits for the infant.

Boosting systemic and secreted antibody responses in mice orally immunized with recombinant Bacillus subtilis strains following parenteral priming with a DNA vaccine encoding the enterotoxigenic Escherichia coli (ETEC) CFA/I fimbriae B subunit

Recombinant Bacillus subtilis strains, either spores or vegetative cells, may be employed as safe and low cost orally delivered live vaccine vehicles. In this study, we report the use of an orally delivered B. subtilis vaccine strain to boost systemic and secreted antibody responses in mice i.m. primed with a DNA vaccine encoding the structural subunit (CfaB) of the CFA/I fimbriae encoded by enterotoxigenic Escherichia coli (ETEC), an important etiological agent of diarrhea among travelers and children living in endemic regions. DBA/2 female mice submitted to the prime-boost immunization regimen developed synergic serum (IgG) and mucosal (IgA) antibody responses to the target CfaB antigen. Moreover, in contrast to mice immunized only with one vaccine formulation, sera harvested from prime-boosted vaccinated individuals inhibited adhesion of ETEC cells to human red blood cells. Additionally, vaccinated dams conferred full passive protection to suckling newborn mice challenged with a virulent ETEC strain. Taken together the present results further demonstrate the potential use of recombinant B. subtilis strains as an alternative live vaccine vehicle. (C) 2008 Elsevier Ltd. All rights reserved.

Household survey of hepatitis B vaccine coverage among Brazilian children

We conducted a multi-stage household cluster survey to calculate hepatitis B vaccine coverage among children 18-30 months of age in 27 Brazilian cities. Hepatitis B vaccine is administered at birth, 1 month and 6 months of age by Brazil`s national immunization program. Among 17,749 children surveyed, 40.2% received a birth dose within one day of birth, 94.8% received at least one dose of hepatitis B vaccine, and 86.7% completed the three-dose series by 12 months of age. Increased coverage with the birth dose and administration of hepatitis B in combination with diphtheria-tetanus-pertussis-Haemophilus influenzae type b antigens could improve protection against hepatitis B. (C) 2009 Elsevier Ltd. All rights reserved.

Delivery care in Quang Ninh province, Northern Vietnam : resources and access to safe care.

Every mother and child has the right to survive childbirth which requires skilled birth attendants together with referral and available emergency obstetric care (EmOC). The objective of the study was to describe delivery care routines at different levels in the health care system in Quang Ninh province, Northern Vietnam. The design was cross sectional using a structured questionnaire. Two districts in Quang Ninh province with 40 Community Health Centres (CHC), three district hospitals and one region hospital was included in the study, in total 138 (CHC n=105 and hospitals n=33) health care providers participated. In our study 20% (CHC) of the health care providers assisting deliveries at CHC were midwives and health care provider’s in our study further report to have assisted at less then 10 deliveries/year (81% of respondents at CHC). Findings show that the health care provider’s routines and care for women during labour and delivery vary and that there is a need for re-training and that women in labour should be cared for by health care providers with adequate training like midwifery. In our study CHC had poor resources to provide basic or comprehensive EmOC. Our findings indicate that there is a need for re-training in delivery care among health care providers and since the number of deliveries at CHC is few they should be handled by someone who is a skilled birth attendant. Our findings also show a variation in care routines during labour and delivery among health care providers at CHC and hospital levels and this also show the need for re-training and support from proper authorities in order to improve maternal and newborn health.

Sockerlösningens smärtlindrande effekt -avseende nyfödda En systematisk litteraturstudie

Syftet med denna litteraturstudie var att beskriva vilken aktuell vetenskap som lett till rekommendationen av att administrera sockerlösning till nyfödda barn i smärtlindrande syfte, i samband med hälstick/venpunktion. Litteraturstudien var av kvantitativ, deskriptiv art. Data analyserades med hjälp av Forsberg och Wengströms granskningsmall för randomiserade kontrollerade studier. De studier som granskades i denna uppsats visade genomgående att sockerlösningen har betydelse för smärtlindringen hos det nyfödda barnet som genomgått någon form av procedursmärta. Vad gäller styrkan på sockerlösningarna kunde konstateras att högre styrka gav bättre effekt. Utöver sockerlösningen vidtogs i studierna även andra omvårdnadsmässiga strategier för att reducera stress och smärta. Det är viktigt ur ett sjuksköterskeperspektiv att tänka på att till exempel hålla barnet varmt och bara klä av den extremitet som ska stickas i. Det anses att ett tryggt, lugnt och mätt barn visar mindre smärtreaktioner än ett hungrigt och irriterat. Författarna till denna litteraturstudie anser att man inte bara ska förlita sig på som i det här fallet sockerlösningen i smärtlindringssyfte utan se helheten då planering och eftertanke också är viktiga bitar vid provtagningar av spädbarn. Sockerlösningen skall ses som ett bra komplement i smärtlindringssyfte.

Mother’s experiences and perceptions of a continuous caring model with fathers after caesarean section : a qualitative study

Background: In Chile, mothers and newborns are separated after caesarean sections. The caesarean section rate in Chile is approximately 40%. Once separated, newborns will miss out on the benefits of early contact unless a suitable model of early newborn contact after caesarean section is initiated. Aim: To describe mothers experiences and perceptions of a continuous parental model of newborn care after caesarean section during mother-infant separation. Methods: A questionnaire with 4 open ended questions to gather data on the experiences and perceptions of 95 mothers in the obstetric service of Sótero Del Rio Hospital in Chile between 2009 and 2012. Data were analyzed using qualitative content analysis. Results: One theme family friendly practice after caesarean section and four categories. Mothers described the benefits of this model of caring. The fathers presence was important to mother and baby. Mothers were reassured that the baby was not left alone with staff. It was important for the mothers to see that the father could love the baby as much as the mother. This model of care helped create ties between the father and newborn during the period of mother-infant separation and later with the mother. Conclusions: Family friendly practice after caesarean section was an important health care intervention for the whole family. This model could be stratified in the Chilean context in the case of complicated births and all caesarean sections. Clinical Implications: In the Chilean context, there is the potential to increase the number of parents who get to hold their baby immediately after birth and for as long as they like. When the mother and infant are separated after birth, parents can be informed about the benefits of this caring model. Further research using randomized control trials may support biological advantages.

The development of a Defense System against Coxsackievirus B5 Infection in Suckling Mice

There are many viruses that are able to infect the alimentary tract of man. Little is known, however, about the mechanism of infection itself or the pathophysiology of the gut during infection. 'The research reported here is concerned with the differences in susceptibility among suckling mice of various ages inoculated by the intraperitoneal and intragastric routes. Since the normal mode of entry of many viruses to the gut is via the oral route, Coxsackievirus B5, a human enterovirus which does attack this way, was utilized. It is a non-tumor producing RNA virus that has been shown to act similarly in the mouse and human. The virus was pooled in HeLa cell cultures and titered by a plaquing assay in the same cell cultures. CD-l mice, 10, 14, 18, and 22 days old , were infected either orally or intraperitoneally with 5.0 x 10^10 (10 day old animals) and 1.0 x10^9 plaque forming units per animal. Dissections were done at 1 and 3 days post infection with samples of the blood, heart, liver, and gut being taken from each animal. Each sample was titered individually and the data presented as an average of six samples. As a result of previous work, it is known that the gut of a newborn mouse isn't able to decrease the concentration of the infecting dose and therefore provides no defense against an enteric infection with Coxsackievirus B5. In contrat, mature mice are able to reduce the amount of viral dissemination across the gut as well as inhibit replication after absorption has occurred. The results of this study indicate that there is a double barrier system developing in suckling mice that is involved with and directly related to the gastrointestinal tract The first part of this defense is the inhibition of penetration of virus across the gut when the primary site of' infection is the intestinal mucosa. This mechanism develops sometime around 20 to 22 days after birth. At about 16-18 days of age, suckling mice that were challenged intragastrically are able to stop active replication and initiate clearance of virus from the systemic circulation. There are many factors that might contribute to the marked decrease in susceptibility with age of suckling mice. Some of these or possibly a combination of these factors might explain the defense mechanisms described above, but to date, the chemistry or mechanical functioning of the gastrointestinal barrier to enteric viral infection is unknown.

Desenvolvimento neurológico e resposta apendicular ao movimento do tronco de crianças prematuras, durante o primeiro ano de vida

A ausência de estudos de acompanhamento do desenvolvimento neurológico de crianças nascidas prematuras, em nosso meio, motivou a realização desta pesquisa. Com o intuito de estabelecer marcos desse desenvolvimento e de verificar as respostas apendiculares ao movimento do tronco e a uniformidade entre as funções motoras, perceptivas e de linguagem, foram avaliados prematuros aos 3, 6, 9 e 12 meses de idade corrigida, em um estudo de coorte não controlado, com enfoque prognóstico. As respostas apendiculares ao movimento do tronco foram estudadas por meio das reações de paraquedismo e de apoio lateral. A amostra foi constituída de 40 recém-nascidos (RN) prematuros, nascidos no Hospital de Clínicas de Porto Alegre, que foram acompanhados no ambulatório do hospital aos 3, 6, 9 e 12 meses de idade corrigida. Foram incluídos no estudo RN com idade gestacional até 36 semanas e 6 dias, com 2.000g ou menos de peso no nascimento. Foram excluídos os RN com índices de Apgar <7 no 5o minuto, hemorragia cerebral, crises convulsivas, alterações no estado de consciência, infecção do sistema nervoso central (SNC), infecções congênitas, síndromes genéticas e intoxicações pré-natais. Também foram excluídos os RN que apresentaram intercorrências capazes de interferir no desenvolvimento neurológico e os que apresentaram exame neurológico alterado. As reações de paraquedismo e de apoio lateral estavam ambas presentes em 8,1% das crianças aos 6 meses de idade corrigida. Aos 9 meses de idade corrigida, a reação de paraquedismo estava presente em 87% das crianças e a reação de apoio lateral, em 90%. Aos 12 meses de idade corrigida, 100% dos casos apresentaram as reações posturais. Estes resultados não foram semelhantes aos encontrados em RN de termo de 6 e 9 meses de idade. O desenvolvimento do RN prematuro foi uniforme em relação às funções perceptivas e de linguagem para as idades corrigidas de 3, 6, 9 e 12 meses de idade corrigida. O desenvolvimento do equilíbrio estático foi o aspecto motor em desacordo com o esperado para cada idade corrigida. A evolução dos reflexos primitivos coincidiu com o esperado para cada idade corrigida; e o reflexo cutâneo-plantar se tornou flexor simultaneamente ao desaparecimento da preensão plantar.

Hiperecogenicidade dos vasos talâmicos no recém-nascido prematuro internado no Hospital de Clínicas de Porto Alegre

O presente estudo procura avaliar as possíveis patologias que se manifestam como hiperecogenicidade dos vasos talâmicos (HEVT) à ultra-sonografia cerebral (USC) e observar a freqüência com que ocorrem. A amostra foi constituída de 206 recém-nascidos (RNs) prematuros nascidos no Hospital de Clínicas de Porto Alegre (HCPA) no período de julho de 1998 a maio de 1999. Todos os RNs realizaram a USC na primeira semana de vida. Foram incluídos no estudo aqueles prematuros que necessitaram de internação hospitalar e que tiveram o termo de consentimento informado assinado por um dos responsáveis. Foram excluídos aqueles cuja USC evidenciava sangramento cerebral e/ou malformações congênitas associadas e os que evoluíram para óbito antes da realização do exame. A USC levou à identificação de 65 RNs prematuros com HEVT e 141 RNs prematuros sem HEVT. A forma de apresentação do tipo pélvica ao nascimento, a maior idade gestacional, o maior peso do RN ao nascimento e a classificação grande para a idade gestacional foram fatores de risco para a ocorrência de HEVT. A presença de hipertensão materna durante o período de gestação tendeu a ser fator de proteção para HEVT. Os RNs que apresentaram crises convulsivas durante o período de internação hospitalar tiveram risco 3,2 vezes maior de ter HEVT quando comparados com os RNs que não apresentaram crises convulsivas.

Relação da proteína S100B com a hipóxia neontal

A participação de marcadores bioquímicos na avaliação de quadros de asfixia neonatal é cada vez mais relevante. A proteína S100B tem um papel destacado nestas pesquisas. O objetivo deste estudo foi procurar destacar a importância da proteína S100B na avaliação de recém-nascidos a termo com quadros de encefalopatia hipóxico-isquêmica, assim como correlacionar com outras substâncias que também participam do processo isquêmico. Foram analisados 21 casos de recém-nascidos a termo que desenvolveram quadro de encefalopatia hipóxico-isquêmica, no período de setembro de 2003 a outubro de 2004. Realizadas coletas no 1º e 4º dia de vida e dosadas, por método imunocitoquímico, a proteína S100B e o lactato. Foi possível detectar uma correlação positiva entre as 2 substâncias, assim como, quando comparadas entre si, observou-se também significância estatística.

Avaliação da suplementação materna com megadose de vitamina a sobre os níveis de retinol e alfa-tocoferol no colostro

The vitamins A and E are recognizably important in the initial stages of life and the newborn depends on nutritional adequacy of breast milk to meet their needs. These vitamins share routes of transport to the tissues and antagonistic effects have been observed in animals after supplementation with vitamin A. This study aimed to verify the effect of maternal supplementation with vitamin A megadose (200,000 UI) in the immediate post-partum on the concentration of alpha-tocopherol in colostrum. Healthy parturient women attended at a public maternity natalensis were recruited for the study and divided into two groups: control (n = 37) and supplemented (n = 36). Blood samples of colostrum and milk were collected until 12 hours after delivery. The women of the supplemented group was administered a retynil palmitate capsule and 24 hours after the first collection was obtained the 2nd sample of colostrum in two groups for analysis of retinol and alpha-tocopherol in milk. The mean retinol concentration of 50,7 ± 14,4 μg/dL (Mean ± standard deviation) and alpha-tocopherol of 1217.4 ± 959 mg/dL in the serum indicate the nutritional status biochemical appropriate. Supplementation with retynil palmitate resulted in increase not only retinol levels in the colostrum of the supplemented group (p = 0.002), but also the concentration of alpha-tocopherol (p = 0.04), changing from 1456.6 ± 1095.8 mg/dL to 1804.3 ± 1432.0 mg/dL (milk 0 and 24 respectively) compared to values in the control group, 984.6 ± 750.0 mg/dL and 1175.0 ± 730.8 mg/dL. The women had different responses to supplementation, influenced by baseline levels of retinol in colostrum. Those with previous by low levels of retinol in colostrum (<60 mg/dL) had increased the concentration of alpha-tocopherol in milk, whereas those with adequate levels (> 60 mg/dL), showed a reduction after supplementation. Supplementation with retinol palmitate is an important intervention in situations of high risk for vitamin A deficiency, when considering the need to maternal supplementation, since the excess vitamin can offer unfavorable interactions between nutrients essential for the mother-child group

Influência do estado nutricional materno em vitamina A sobre os níveis de imunoglobulina A no colostro humano

Mothers with good vitamin A nutritional status during gestation and lactation are better able to nourish and protect their infant with maternal milk. Our hypothesis is that women with more serum retinol have more retinol and secretory immunoglobulin A in colostrum. 190 healthy puerperal women from a Brazilian public maternity were recruited and divided according to the cutoff point for serum retinol (30 μg/dL). A number of the women was supplemented with 200000 UI (60 mg) of retinyl palmitate in the immediate postpartum. Serum and colostrum were collected on the 1st day postpartum and colostrum again on the following day. Retinol (serum and colostrum) was analyzed by HPLC and SIgA (colostrum) by turbidimetry. The mothers presented with adequate biochemical indicators of nutritional status, according to serum retinol (44.6 μg/dL). There were significant differences (p= 0.0017 and p= 0.043, respectively) in retinol and SIgA levels in the colostrum of mothers with serum retinol > 30 μg/dL and < 30 μg/dL. The concentration of SIgA in the colostrum of non-supplemented mothers on the 1st day postpartum was 822.6 mg/dL, decreasing after 24 hours to 343.7 mg/dL. Supplemented mothers showed levels of SIgA in colostrum of 498.9 mg/dL on the 2nd day postpartum (p= 0.00006). The colostrum of women with good vitamin A nutritional status had more retinol and SIgA. Additionally, maternal supplementation increases the levels of SIgA in colostrum. The higher levels of SIgA on the 1st day postpartum showed the importance of early breastfeeding, given that it provides considerable immunological benefits to newborn infants