Determinantes socio-económicas de la desnutrición global infantil en la Localidad de Ciudad Bolívar (Bogotá, Colombia) en el año 2011

La desnutrición infantil y la pobreza se encuentran asociadas y estas a su vez con el progreso de los países. Conocer las determinantes sociales y económicas de la niñez que padece de bajo peso es necesario para crear escenarios propicios para el adecuado desarrollo de la primera infancia y de esta manera contribuir con la superación de la pobreza en el marco de sistemas sanitarios equitativos. Se realiza una descripción de las características socio-económicas y un análisis de posibles asociaciones entre estas y el bajo peso infantil de una muestra de infantes de uno de los sectores de mayor vulnerabilidad y pobreza de Bogotá (Colombia). La tasa del bajo peso infantil en la muestra del estudio en más alta a la presentada en Bogotá y Colombia (8.5%, 2.9% y 3.4% respectivamente). Al realizar el análisis de las posibles asociaciones entre el bajo peso y las variables de estudio, se evidencia que las relaciones son débiles entre la primera y las segundas, siendo la condición de desplazamiento la que mayor asociación positiva presenta con la deficiencia nutricional seguido del rango de edad entre los 25 y 36 meses. La situación que presenta mayor independencia con respecto al bajo peso infantil es contar con vivienda propia seguida del sexo. La desnutrición infantil se presenta en niveles importantes en sectores de mayor vulnerabilidad con implicaciones para el adecuado desarrollo de los infantes y para las intenciones de reducción de los índices de pobreza en el país. El fortalecimiento de las políticas públicas que favorezca el desarrollo infantil, la superación de la pobreza y las inequidades en los sistemas de salud deben contemplar acciones integrales dirigidas a los más vulnerables, con la participación de la sociedad civil y los sectores públicos y privados, el compromiso político y económico de los gobiernos y reglas claras que contribuyan a la solución estructural de la pobreza y que promueva el adecuado desarrollo infantil.

Yellow fever vaccination coverage among children in Brazilian capitals

Brazil recommends universal yellow fever (YF) vaccination for children who reside in or travel to endemic areas. We conducted a household survey to calculate YF vaccine coverage among children 18-30 months of age in 27 capital cities. A total of 9285 children were surveyed in the 15 cities with YF fever universal vaccination; 7290(79%) had documented evidence of YF vaccination by 12 months of age, 7996 (86%) by 18 months of age, and 8479 (91%) prior to the survey. In 12 cities with selective YF vaccination coverage was only 1% by 18 months of age. YF fever vaccination can be improved to reach all children where vaccine is recommended. (C) 2010 Elsevier Ltd. All rights reserved.

Human regulatory protein Ki-1/57 has characteristics of an intrinsically unstructured protein

The human protein Ki-1/57 was first identified through the cross reactivity of the anti-CD30 monoclonal antibody Ki-1; in Hodgkin lymphoma cells. The expression of Ki-1/57 in diverse cancer cells and its phosphorylation in peripheral blood leukocytes after mitogenic activation suggested its possible role in cell signaling. Ki-1/57 interacts with several other regulatory proteins involved in cellular signaling, transcriptional regulation and RNA metabolism, suggesting it may have pleiotropic functions. In a previous spectroscopic analysis, we observed a low content of secondary structure for Ki-1/57 constructs. Here, Circular dichroism experiments, in vitro RNA binding analysis, and limited proteolysis assays of recombinant Ki-1/57(122-413) and proteolysis assays of endogenous full length protein from human HEK293 cells suggested that Ki-1/57 has characteristics of an intrinsically unstructured protein. Small-angle X-ray scattering (SAXS) experiments were performed with the C-terminal fragment Ki-1/57(122-413). These results indicated an elongated shape and a partially unstructured conformation of the molecule in solution, confirming the characteristics of an intrinsically unstructured protein. Experimental curves together with ab initio modeling approaches revealed an extended and flexible molecule in solution. An elongated shape was also observed by analytical gel filtration. Furthermore, sedimentation velocity analysis suggested that Ki-1/57 is a highly asymmetric protein. These findings may explain the functional plasticity of Ki-1/57, as suggested by the wide array of proteins with which it is capable of interacting in yeast two-hybrid interaction assays.

Forskning med juridiska förvecklingar : Om tolkningsflexibilitet i kontroversen om mässlingsvaccination och autism

Medical research with jurisdictional consequences: interpretative flexibility in the controversy over MMR vaccination and autism Based on the empirical case of the controversy of MMR vaccination and autism around the turn of the millennium, this paper argues for the analytical importance of the concept of “interpretative flexibility”. As shown, this concept is useful not only for the small subfield of sociology of scientific knowledge (SSK) but also for the broader social sciences. First we analyse, by reference to interpretative flexibility, the initial dispute within medical research concerning evidence for and against a possible link between the measles component of the MMR vaccine and autism. In a second step we move beyond this traditional application of the concept, showing how the interpretative flexibility of the research results remains in society although consensus has been reached in the medical community. This further step is exemplified by two legal events, in Sweden and the US respectively. In both these cases the difficulties in providing uncontested evidence affected institutions and practices at great distance and with different outcomes. Our findings suggest the importance of not only applying the concept of interpretative flexibility to classical scientific laboratory disputes, but also connecting it to its societal manifestations.

Soroprevalência de anticorpos contra o sarampo de uma determinada população infantil de Botucatu, SP

Esta pesquisa trata-se de um estudo de soroprevalência de anticorpos contra o sarampo, de uma determinada população infantil residente em Botucatu, SP, com o objetivo de avaliar o estado imunólogico, induzido quer por infecção natural, quer por meio de vacinação. Foram estudadas 101 crianças, sendo que todas receberam a vacina contra o sarampo. Os exames laboratoriais utilizados para avaliar a presença de anticorpos, nas amostras de sangue coletadas, foram o teste de Inibição de Hemaglutinação (IH) e o Ensaio imunoenzimático (ELISA). Os resultados do teste de IH, mostraram que 92,1% das amostras apresentavam anticorpos contra o sarampo. As amostras com títulos < que 1:4, quando estudadas pela IH, foram retestadas no mesmo laboratório por meio do ELISA, e somente duas mantiveram-se negativas para anticorpos contra o sarampo. Portanto, em 98% das amostras de soro das crianças estudadas os anticorpos contra o sarampo estavam presentes.

Situação vacinal infantil e características individuais e familiares do interior de São Paulo

The aim of this study was to describe and analyze individual and family characteristics of children and those of health services, as well as their relationship with the immunization status for different kinds of vaccines and doses. Three sources of information were used: records from the Municipal Health Information System, immunization charts, and interviews using closed-ended questions. The families interviewed still had one or two growing children; caretakers were usually young unemployed mothers with easy access to health services. Around 30% of them were not instructed on the vaccine being given, its reactions or when to return for the next shot. The greatest levels of tardiness occurred with the vaccines against measles (6.3%) and Haemophilus influenzae B (4.2%). It was possible to observe that tardiness or absence of vaccinations seem to have a stronger relationship with service characteristics than with population characteristics.

As doenças infectocontagiosas em cidades de médio porte: uma abordagem qualitativa da Aids em Piracicaba/SP

Pós-graduação em Geografia - IGCE

Achados audiológicos pós-doenças infecciosas em crianças matriculadas em um centro especializado nos distúrbios da audição

Pós-graduação em Pediatria - FMB

Rights of urban children

Urban children in Latin AmericaThis issue of Challenges addresses a topic deserving of special attention: the high proportion of children and adolescents in the region's urban areas who live in precarious conditions. Their disparate living conditions are examined with a look at the moderate deprivation (housing deficiencies, monetary poverty or low level of education) and severe deprivation (a combination of two or more of the aforementioned deficits) affecting urban dwellers. It is estimated that about 29.0% of children and adolescents in these areas live in conditions of severe deprivation and 27.6% experience moderate deprivation for an average of eight countries.In severely deprived rural and urban areas a higher proportion of children are not immunized against measles, and a greater percentage of adolescents are neither studying nor economically active, and are already parents.These disparities call for differentiated policies with a strong local focus and the potential to improve living conditions, lower the risk of infant morbidity and mortality, and reduce rates of adolescent pregnancy and school dropout. Significant initiatives and policies designed to produce healthy and inclusive environments have already been put in place in some of the most vulnerable areaswith a view to improving the quality of life among these groups.In addition to the featured article, the issue includes information on relevant meetings and conferences held in the region over the year, children's and adolescents' testimonies, and expert opinion.

Situação vacinal de crianças atendidas em uma unidade de saúde na cidade de Porto Velho

Foi analisada a situação vacinal de 173 crianças de 0 a 2 anos de idade atendidas na Policlínica Hamilton Raulino Gondin situada num bairro periférico da cidade de Porto Velho, Rondônia. Os dados foram colhidos de maio a setembro de 2001 e obtidos através de entrevistas realizadas com o acompanhante da criança mediante a aplicação de formulário padronizado. Através deste instrumento foram analisadas as carteiras de vacina das crianças, tendo como critério o aprazamento das doses e colhidas informações referentes aos aspectos sócio-econômicos e culturais da família onde a criança está inserida. Os resultados mostraram que os maiores percentuais de atrasos encontrados foram 6,4% para a vacina contra a febre amarela e 5,8% para as vacinas contra sarampo (1ª e 2ª dose) e contra o Haemophilus influenza tipo b-Hib 3ª dose. Dentre os motivos de atrasos vacinais pesquisados o de maior relevância foi à falta de informação da mãe ou responsáveis. Estudando os fatores sócio-econômicos e culturais da família das crianças da amostra, evidenciou-se predominância de mães jovens, com idade entre 19 e 25 anos. Em relação ao grau de escolaridade do acompanhante das crianças, detectamos o percentual de 63,0% para o I grau incompleto. Analisando a renda das famílias das crianças do estudo observou-se que 29,5% vivem com rendimento compreendidos entre 1 e 2 salários mínimos.

'Formidável contágio': epidemias, trabalho e recrutamento na Amazônia colonial (1660-1750)

Analisa em que medida epidemias de varíola e de sarampo ensejaram transformações nas formas de aquisição e uso de força de trabalho na Amazônia colonial, de meados do século XVII a meados do século XVIII, com o incremento de descimentos privados de índios e a tentativa de organização de uma rota de tráfico negreiro para a região. Trata igualmente de entender como a mortandade de indígenas significou, no fim do século XVII, uma preocupação com a defesa da região e motivou o recrutamento de soldados da Madeira.

Antibody responses in Plasmodium falciparum malaria and their relation to protection against the disease

Protective immunity against Plasmodium falciparum may be obtained after repeated exposure to infection. Several studies indicate that immunity against the blood stages of the P. Falciparum infection is mainly antibody mediated. Protective antibodies may act either on their own, mediate antibody-dependent phagocytosis and/or cell-mediated neutralization of parasites. This thesis describes several aspects of humoral immune responses to P. falciparum infection in individuals of different age groups, different genetic background and with different degrees of malaria exposure. Several target antigens for antibody-mediated inhibition of parasite growth or invasion have been identified. One such antigen is Pf332, which appears on the surface of parasitized erythrocytes at late trophozoite and schizont stage. This surface exposure makes the antigen a possible target for opsonizing antibodies. We optimized an in vitro assay for studying cellmediated parasite neutralization in the presence of Pf332-reactive antibodies. Our data demonstrate that, Pf332 specific antibodies are able to inhibit parasite growth on their own and in cooperation with human monocytes. The P. falciparum parasites have evolved several mechanisms to evade the host neutralizing immune responses. In this thesis, we show that freshly isolated P. falciparum parasites from children living in a malaria endemic area of Burkina Faso were less sensitive for growth inhibition in vitro by autologous immunoglobulins (Ig) compared with heterologous ones. Analyses of two consecutive isolates taken 14 days apart, with regard to genotypes and sensitivity to growth inhibition in vitro, did not give any clear-cut indications on possible mechanisms leading to a reduced inhibitory activity in autologous parasite/antibody combinations. The frequent presence of persisting parasite clones in asymptomatic children indicates that the parasite possesses as yet undefined mechanisms to evade neutralizing immune responses. Transmission reducing measures such insecticide treated nets (ITNs) have been shown to be effective in reducing morbidity and mortality from malaria. However, concerns have been raised that ITNs usage could affect the acquisition of malaria immunity. We studied the effect of the use of insecticide treated curtains (ITC) on anti-malarial immune responses of children living in villages with ITC since birth. The use of ITC did neither affect the levels of parasite neutralizing immune responses nor the multiplicity of infection. These results indicate that the use of ITC does not interfere with the acquisition of anti-malarial immunity in children living in a malaria hyperendemic area. There is substantial evidence that the African Fulani tribe is markedly less susceptible to malaria infection compared to other sympatrically living ethnic tribes. We investigated the isotypic humoral responses against P. falciparum asexual blood stages in different ethnic groups living in sympatry in two countries exhibiting different malaria transmission intensities, Burkina Faso and Mali. We observed higher levels of the total malaria-specific-IgG and its cytophilic subclasses in individuals of the Fulani tribe as compared to non-Fulani individuals. Fulani individuals also showed higher levels of antibodies to measles antigen, indicating that the intertribal differences are not specific for malaria and might reflect a generally activated immune system in the Fulani.

Canine distemper virus infects canine keratinocytes and immune cells by using overlapping and distinct regions located on one side of the attachment protein

The morbilliviruses measles virus (MeV) and canine distemper virus (CDV) both rely on two surface glycoproteins, the attachment (H) and fusion proteins, to promote fusion activity for viral cell entry. Growing evidence suggests that morbilliviruses infect multiple cell types by binding to distinct host cell surface receptors. Currently, the only known in vivo receptor used by morbilliviruses is CD150/SLAM, a molecule expressed in certain immune cells. Here we investigated the usage of multiple receptors by the highly virulent and demyelinating CDV strain A75/17. We based our study on the assumption that CDV-H may interact with receptors similar to those for MeV, and we conducted systematic alanine-scanning mutagenesis on CDV-H throughout one side of the beta-propeller documented in MeV-H to contain multiple receptor-binding sites. Functional and biochemical assays performed with SLAM-expressing cells and primary canine epithelial keratinocytes identified 11 residues mutation of which selectively abrogated fusion in keratinocytes. Among these, four were identical to amino acids identified in MeV-H as residues contacting a putative receptor expressed in polarized epithelial cells. Strikingly, when mapped on a CDV-H structural model, all residues clustered in or around a recessed groove located on one side of CDV-H. In contrast, reported CDV-H mutants with SLAM-dependent fusion deficiencies were characterized by additional impairments to the promotion of fusion in keratinocytes. Furthermore, upon transfer of residues that selectively impaired fusion induction in keratinocytes into the CDV-H of the vaccine strain, fusion remained largely unaltered. Taken together, our results suggest that a restricted region on one side of CDV-H contains distinct and overlapping sites that control functional interaction with multiple receptors.

N-(3-Cyanophenyl)-2-phenylacetamide, an effective inhibitor of morbillivirus-induced membrane fusion with low cytotoxicity

Based on the structural similarity of viral fusion proteins within the family Paramyxoviridae, we tested recently described and newly synthesized acetanilide derivatives for their capacity to inhibit measles virus (MV)-, canine distemper virus (CDV)- and Nipah virus (NiV)-induced membrane fusion. We found that N-(3-cyanophenyl)-2-phenylacetamide (compound 1) has a high capacity to inhibit MV- and CDV-induced (IC(50) muM), but not NiV-induced, membrane fusion. This compound is of outstanding interest because it can be easily synthesized and its cytotoxicity is low [50 % cytotoxic concentration (CC(50)) >/= 300 muM], leading to a CC(50)/IC(50) ratio of approximately 100. In addition, primary human peripheral blood lymphocytes and primary dog brain cell cultures (DBC) also tolerate high concentrations of compound 1. Infection of human PBMC with recombinant wild-type MV is inhibited by an IC(50) of approximately 20 muM. The cell-to-cell spread of recombinant wild-type CDV in persistently infected DBC can be nearly completely inhibited by compound 1 at 50 muM, indicating that the virus spread between brain cells is dependent on the activity of the viral fusion protein. Our findings demonstrate that this compound is a most applicable inhibitor of morbillivirus-induced membrane fusion in tissue culture experiments including highly sensitive primary cells.

Canine distemper virus infection of primary hippocampal cells induces increase in extracellular glutamate and neurodegeneration

The canine distemper virus (CDV) belongs to the Morbillivirus genus which includes important human pathogens like the closely related measles virus. CDV infection can reach the nervous system where it causes serious malfunctions. Although this pathology is well described, the molecular events in brain infection are still poorly understood. Here we studied infection in vitro by CDV using a model of dissociated cell cultures from newborn rat hippocampus. We used a recombinant CDV closely related to the neurovirulent A75/17 which also expresses the enhanced green fluorescent protein. We found that infected neurons and astrocytes could be clearly detected, and that infection spreads only slowly to neighboring cells. Interestingly, this infection causes a massive cell death of neurons, which includes also non-infected neurons. Antagonists of NMDA-type or alpha-amino-3-hydroxy-5-methylisoxazole-4-propinate (AMPA)-type glutamate receptors could slow down this neuron loss, indicating an involvement of the glutamatergic system in the induction of cell death in infected and non-infected cells. Finally, we show that, following CDV infection, there is a steady increase in extracellular glutamate in infected cultures. These results indicate that CDV infection induces excitotoxic insults on neurons via glutamatergic signaling.