Browsing by Author "Nunes, S"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
- Determinantes da colonização materna e da infecção neonatal por Streptococcus do grupo BPublication . Areal, A; Moreira, M; Nunes, S; Faustino, MA; Cardoso, L; Sá, CAim and Objective: During the past three decades, group B Streptococcus (GBS) neonatal infection has been the subject of little research. The aim of this study was to evaluate the association between maternal risk factors, as established by the Center for Disease Control and Prevention (CDC), and maternal colonization. We also analysed the association between risk factors present in newborns and early-onset GBS disease. Study design: Cross-sectional study. Population: All pregnant women admitted for delivery in our institution and their newborns, between 1st February and 31st July 2005. Methods: Maternal and neonatal characteristics were collected from hospital clinical data, including information on risk factors established by the CDC. Descriptive statistics was used to characterize the study sample. Qui-square and Mantel-haenszel tests were applied to compare proportions and to measure the strength of associations, respectively, setting significance at p < 0,05. Results: In this sample only 47% of women were screened for GBS colonization in suitable time and 34,9% of these women were colonized. The incidence of early neonatal infection by SGB was 9/1000 neonates. Significant associations between GBS maternal colonization ant the following parameters were observed: maternal age [p=0,012; OR=1,659 (IC a 95%, 1,218-2,260)], gestational age at labour [p=0,001; OR= 2,621 (IC a 95%, 1,641- 4,188)], and urinary GBS infection during pregnancy (p<0,001). Maternal colonization occurred in women without CDC defined risk factors. Early neonatal infection by SGB was strongly associated with unscreened women (p=0,014). Conclusion: In this study, maternal GBS colonization occurred in the absence of CDC defined risk factors and varied according to maternal age and gestational week. Neonatal GBS infection was more frequent in unscreened women.
- Edema hemorrágico agudo infantilPublication . Pereira, T; Nunes, S; Vieira, AP; Sá, C; Pereira, A; Sousa-Basto, AO edema hemorrágico agudo infantil é uma forma rara de vasculite leucocitoclásica cutânea, que ocorre em crianças com menos de 4 anos de idade. As principais manifestações são lesões cutâneas purpúricas, edema periférico e febre. Apesar dos achados clínicos serem dramáticos, quer na aparência das lesões, quer na rapidez de instalação, o prognóstico permanece excelente, com recuperação espontânea em poucas semanas. A sua origem está pouco esclarecida, mas infecções subjacentes, fármacos e vacinas têm sido referidas como possíveis factores etiológicos. Descrevemos uma criança de 7 meses com quadro clínico e histológico típicos de edema hemorrágico agudo infantil que surgiu na sequência de uma infecção do tracto urinário, em tratamento com amoxicilina e ácido clavulâmico.
- Ghrelin and obestatin: Different role in fetal lung development?Publication . Nunes, S; Nogueira-Silva, C; Dias, E; Moura, RS; Correia-Pinto, JGhrelin and obestatin are two proteins that originate from post-translational processing of the preproghrelin peptide. Various authors claim an opposed role of ghrelin and obestatin in several systems. Preproghrelin mRNA is significantly expressed in airway epithelium throughout lung development, predominantly during the earliest stages. The aim of this study was to evaluate the role of ghrelin and obestatin in fetal lung development in vitro. Immunohistochemistry studies were performed at different gestational ages in order to clarify the expression pattern of ghrelin, GHS-R1a, obestatin and GPR39 during fetal lung development. Fetal rat lung explants were harvested at 13.5 days post-conception (dpc) and cultured during 4 days with increasing doses of total ghrelin, acylated ghrelin, desacyl-ghrelin, ghrelin antagonist (D-Lys(3)-GHRP-6) or obestatin. Immunohistochemistry studies demonstrated that ghrelin, GHS-R1a, obestatin and GPR39 proteins were expressed in primitive rat lung epithelium throughout all studied gestational ages. Total and acylated ghrelin supplementation significantly increased the total number of peripheral airway buds, whereas desacyl-ghrelin induced no effect. Moreover, GHS-R1a antagonist significantly decreased lung branching. Finally, obestatin supplementation induced no significant effect in the measured parameters. The present study showed that ghrelin has a positive effect in fetal lung development through its GHS-R1a receptor, whereas obestatin has no effect on lung branching.
- A infecção peri-natal por Streptococcus agalactiae pode ser evitada: prevalência da colonização em parturientes no Hospital de S. Marcos, factores de risco e sua relação com a infecção peri-natalPublication . Areal, A; Nunes, S; Moreira, M; Faustino, MA; Cardoso, L; Sá, Cntrodução: O Streptococcus agalactiae (SGB) é o agente mais frequente de infecção neonatal precoce, sendo possível a sua prevenção. Em Portugal é desconhecida a prevalência de mulheres colonizadas por SGB. O estudo da Unidade de Vigilância Pediátrica refere uma prevalência nacional de infecção neonatal por SGB de 0,5:1000 nados-vivos. Objectivo: Determinar a prevalência da colonização materna e da infecção perinatal por SGB no Hospital de S. Marcos, Braga (HSM), de modo a avaliar a importância da implementação do rastreio universal e o uso de medidas profiláticas. Método: De 1 de fevereiro a 31 de julho de 2005 foi realizado um estudo transversal com análise de coortes anichada, avaliando todas as grávidas assistidas para trabalho de parto no HSM e respectivos recém-nascidos. Os dados foram submetidos a análise estatística bi-variada pelo teste do qui-quadrado, com um nível de significância de 5% (p<0,05). Resultados: A prevalência da colonização nas grávidas rastreadas na região de Braga foi de 34,9 % [intervalo de confiança a 95% (IC95%), 31,5-38,3%]. No HSM o diagnóstico de infecção neonatal precoce por SGB ocorreu em 9:1000 recém-nascidos. O risco relativo de ocorrência de infecção perinatal entre os recém-nascidos dos grupos de mães rastreadas e não rastreadas foi de 0,3 [IC95% 0,2,7-0,32]. Conclusão: O rastreio bacteriológico positivo para colonização materna por SGB associado à adequada profilaxia intra-parto reduziu significativamente a infecção neonatal precoce, em relação ao grupo de gestantes não rastreadas (p=0,014). Consideramos que é recomendável a instituição do rastreio universal das grávidas e a profilaxia adequada quando indicada.
- Local Fetal Lung Renin-Angiotensin System as a Target to Treat Congenital Diaphragmatic HerniaPublication . Nogueira-Silva, C; Carvalho-Dias, E; Piairo, P; Nunes, S; Baptista, MJ; Moura, RS; Correia-Pinto, JAntenatal stimulation of lung growth is a reasonable approach to treat congenital diaphragmatic hernia (CDH), a disease characterized by pulmonary hypoplasia and hypertension. Several evidences from the literature demonstrated a possible involvement of renin-angiotensin system (RAS) during fetal lung development. Thus, the expression pattern of renin, angiotensin-converting enzyme, angiotensinogen, type 1 (AT(1)) and type 2 (AT(2)) receptors of angiotensin II (ANGII) was assessed by immunohistochemistry throughout gestation, whereas the function of RAS in the fetal lung was evaluated using fetal rat lung explants. These were morphometrically analyzed and intracellular pathway alterations assessed by Western blot. In nitrofen-induced CDH model, pregnant rats were treated with saline or PD-123319. In pups, lung growth, protein/DNA ratio, radial saccular count, epithelial differentiation and lung maturation, vascular morphometry, right ventricular hypertrophy and overload molecular markers, gasometry and survival time were evaluated. Results demonstrated that all RAS components were constitutively expressed in the lung during gestation and that ANGII had a stimulatory effect on lung branching, mediated by AT(1) receptor, through p44/42 and Akt phosphorylation. This stimulatory effect on lung growth was mimicked by AT(2)-antagonist (PD-123319) treatment. In vivo antenatal PD-123319 treatment increased lung growth, ameliorated indirect parameters of pulmonary hypertension, improved lung function and survival time in non-ventilated CDH pups, without maternal or fetal deleterious effects. Therefore, this study demonstrated a local and physiologically active RAS during lung morphogenesis. Moreover, selective inhibition of AT(2) receptor is presented as a putative antenatal therapy for CDH.