ABSTRACT
Na faixa etária de 0 a 5 anos, considera-se a transmissão vertical o indicador da infecção pelo vírus da imunodeficiência humana (HIV). A principal via de exposição pós-natal ocorre pelo aleitamento materno. Quando a infecção aguda materna se dá no período puerperal, há maior risco de infecção infantil, devido à elevada carga viral materna. Objetivo: Avaliar as formas de infecção pediátrica pelo HIV no serviço de Infectologia Pediátrica do Complexo do Hospital de Clínicas da Universidade Federal do Paraná (UFPR), com ênfase na transmissão vertical tardia via aleitamento materno. Métodos: Estudo transversal e analítico, com coleta de dados retrospectiva, avaliando pacientes de 0 a 16 anos infectados pelo vírus HIV, acompanhados de 2010 a 2015. Realizada análise da categoria de exposição por protocolo geral, seguida de protocolo específico para casos sugestivos de transmissão vertical tardia via aleitamento materno, objetivando compreender as características maternas e pediátricas. Resultados: Dos 122 pacientes incluídos, 95,0% foram infectados via transmissão vertical. Desses, 11 (9,5%) casos foram de infecção tardia possível ou confirmada via aleitamento materno. Ao diagnóstico da criança, 72,7% apresentaram sintomas decorrentes da infecção pelo HIV. Em 45,4% desses casos, mães e filhos foram diagnosticados concomitantemente e 72,7% das mães apresentaram categoria de exposição sexual. Conclusão: A transmissão vertical confirmou-se como a principal forma de contaminação pelo vírus HIV, com importante prevalência da infecção tardia pelo aleitamento materno. Essa observação, a gravidade dos sintomas pediátricos, o momento do diagnóstico e categoria de exposição maternos destacam a importância da busca de medidas profiláticas e avanços científicos que objetivem a redução da transmissão do HIV via leite materno
Vertical transmission is considered an indication of human immunodeficiency virus (HIV) infection in children aged below five years. The main postnatal category of exposure is through breastfeeding. When maternal infection occurs in early postnatal period, the risk of infant infection is even higher, due to a high maternal viral rate in this period. Objective: To evaluate HIV infection in infants assisted by the Pediatric Infectology Service of Hospital de Clínicas da Universidade Federal do Paraná, emphasizing the cases where vertical transmission occurred postnatally through breastfeeding. Methods: Transversal, analytical and descriptive study, with quantitative and qualitative approach, analyzing all HIV-infected patients aged 0 to 16 years, assisted between 2010 and 2015. The analysis of category of exposure was carried out by a general protocol, followed by a specific protocol for cases where transmission was suspected to have occurred due to late postnatal transmission through breastfeeding, aiming at understanding pediatric and maternal characteristics. Results: Records from 122 patients were analyzed, with 95.0% of mother-to-child-transmission cases. Between these cases, 11 (9.5%) were considered possible or confirmed late postnatal transmission through breastfeeding, having the presence of breastfeeding as a requirement. By the time of diagnosis, 72.7% presented symptoms of HIV infection. In 45.4% of these cases, mother and children were diagnosed at the same time, and 72.7% of mothers were infected sexually. Conclusion: Mothertochildtransmission was the main responsible for infant infection and there was a significant prevalence of late postnatal transmission through breastfeeding in our sample. Moreover, the severity of infant symptoms, the moment of diagnosis and mother's category of exposure highlight a gap on HIV prevention, and the importance of finding prophylactic measures and scientific improvement in order to reduce HIV transmission through breastfeeding
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Breast Feeding , HIV Infections , Infectious Disease Transmission, Vertical , Pregnancy , Cross-Sectional StudiesABSTRACT
Objective To summarize the clinical experience of patient diagnosed with Niemaoh-Pick disease being pregnant after liver transplantation. Methods Clinical data of one case of type B Niemaoh-Pick disease being pregnant after liver transplantation were retrospectively analyzed. Results The patient successfully underwent liver transplantation combined with splenic artery ligation on July 8, 2011. She was well recovered postoperatively. After surgery, she received conventional anti-rejection treatment, and gradually switched to use of tacrolimus at a dosage of 2.5 mg/d. The serum drug concentration was maintained at 2 ng/mL. In September 2015, she was successfully pregnant. On June 2, 2016, she delivered a male infant through cesarean section. She could breastfeed the infant in a low quantity early after delivery. Both the mother and infant were followed up until submission date. The mother was physically stable and the infant grew normally. Conclusions Patients diagnosed with Niemaoh-Pick disease can obtain favorable clinical outcomes of pregnancy and delivery after liver transplantation.
ABSTRACT
Toxocariasis is a widespread zoonosis and is considered an important worldwide public health problem. The aim of this study was to investigate the frequency of trans-mammary Toxocara canis infection in newborn BALB/c mice nursed by females experimentally infected with 1,200 eggs after delivery. After 50 days of age, the presence of larvae in different organs of the offspring was investigated. Trans-mammary infection was confirmed in 73.9% of the mice that had been nursed by infected females. These data show a high trans-mammary transmission of T. canis and confirm the significance of this transmission route in paratenic hosts.
A toxocaríase é zoonose amplamente difundida e considerada importante problema de saúde pública. O objetivo deste estudo foi avaliar a frequência da transmissão transmamária de Toxocara canis em camundongos BALB/c neonatos amamentados por fêmeas experimentalmente infectadas com 1.200 ovos logo após o parto. Após 50 dias de idade, foi avaliada a presença de larvas em diferentes órgãos dos neonatos. A infecção por via transmamária foi confirmada em 73,9% dos camundongos amamentados por fêmeas infectadas. Estes dados demonstram elevada transmissão transmamária de T. canis e confirmam a importância desta via de transmissão em hospedeiros paratênicos.
Subject(s)
Animals , Female , Infectious Disease Transmission, Vertical , Lactation , Toxocara canis , Toxocariasis/transmission , Disease Models, Animal , Mice, Inbred BALB CABSTRACT
El abordaje y defensa de la lactancia materna exige al Pediatra, su participación activa en la implementación de su práctica. Su rol como guía es fundamental para que los infantes reciban una nutrición adecuada, que les garantice un comienzo óptimo en la vida y el derecho al más alto nivel posible de salud, así como también para que las madres dispongan de la información oportuna y veraz, que les permita decidir el modo de alimentar a sus hijos e hijas. Implica que debe ser más que un simple promotor, conocer todos los aspectos de la lactancia para brindar su apoyo a las madres en su desempeño y convertirse en defensores de la misma. Es de suma importancia el conocimiento de los instrumentos legales de protección a la lactancia materna además de la capacitación en habilidades de consejería en lactancia y alimentación infantil. En el presente artículo se revisa la Normativa Legal de Protección a la Lactancia Materna, vigente en el país.
The addressing and defense of breastfeeding demands the pediatrician´s active participation on the implementation of its practice. His (her) guide role is fundamental for the infants to receive an appropiate nutrition that guarantee an optimum beginning in life and the right to the highest possible health level, as for the mothers to dispose of the opportune and truthful information that allows them to chose the way of feeding their sons and daughters. The Pediatrician has to be more than a simple promoter and know all the aspects of breastfeeding to defend it and to bring a support to mother´s occupy. Its highly important to have the knowledge of the legal instruments of breastfeeding protection and the training in breastfeeding and child feeding counseling skills. In this article, the Legal Normative of Breastfeeding Protection that is valid in the country is reviewed.