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Biomedical subjects

S M Jorge

Publications and source records attributed to S M Jorge.

At least 19 recordsLinked to original sources

Amino acid composition of parturient plasma, the intervillous space of the placenta and the umbilical vein of term newborn infants.

The objective of the present study was to determine the levels of amino acids in maternal plasma, placental intervillous space and fetal umbilical vein in order to identify the similarities and differences in amino acid levels in these compartments of 15 term newborns from normal pregnancies and deliveries. All amino acids, except tryptophan, were present in at least 186% higher concentrations in the intervillous space than in maternal venous blood, with the difference being statistically significant. This result contradicted the initial hypothesis of the study that the plasma amino acid levels in the placental intervillous space should be similar to those of maternal plasma. When the maternal venous compartment was compared with the umbilical vein, we observed values 103% higher on the fetal side which is compatible with currently accepted mechanisms of active amino acid transport. Amino acid levels of the placental intervillous space were similar to the values of the umbilical vein except for proline, glycine and aspartic acid, whose levels were significantly higher than fetal umbilical vein levels (average 107% higher). The elevated levels of the intervillous space are compatible with syncytiotrophoblast activity, which maintain high concentrations of free amino acids inside syncytiotrophoblast cells, permitting asymmetric efflux or active transport from the trophoblast cells to the blood in the intervillous space. The plasma amino acid levels in the umbilical vein of term newborns probably may be used as a standard of local normality for clinical studies of amino acid profiles.

Amino Acids↗

Usefulness of blood and urine samples collected on filter paper in detecting cytomegalovirus by the polymerase chain reaction technique.

A rapid test for the diagnosis of congenital CMV infection is still needed. This study evaluated the usefulness of dried blood and urine samples collected on filter paper for detecting cytomegalovirus (CMV) by the polymerase chain reaction (PCR) assay compared with the use of liquid urine. Samples were obtained from 332 infants aged 1-7 days. Liquid urine samples were collected into bags, cultured in human fibroblasts, and processed using a multiplex PCR technique. Dried urine samples were obtained by placing a piece of filter paper in contact with the infant's genitals. The heels of neonates were punctured and capillary blood was blotted onto filter paper and dried. Dried blood and urine specimens were analyzed by multiplex PCR and nested-PCR assays. A diagnosis of congenital CMV infection was established by isolating the virus, and by detecting viral DNA in the liquid urine. Of the 332 liquid urine samples collected from 332 neonates, seven (2.1%) were positive for CMV and 325 were negative, by both cell culture and PCR assay. In dried samples, CMV DNA was detectable only with a nested PCR assay. Compared with known CMV infection status, 5/7 (71.4%) neonates were positive for congenital CMV infection using dried blood samples. All 325 uninfected neonates were negative. In the dried urine samples, 4/4 CMV-infected infants gave positive tests, and all 262 uninfected infants were negative. Although further improvements in sample collection and/or processing are still needed, PCR testing on dried urine or blood collected on filter paper is a promising approach in the diagnosis of neonatal CMV infection.

Blood Specimen Collection↗

Congenital cytomegalovirus infection in preterm and full-term newborn infants from a population with a high seroprevalence rate.

BACKGROUND: Cytomegalovirus (CMV) is the most frequent cause of congenital infections in humans. Prematurity occurs in as many as 34% of infants with symptomatic congenital CMV infection. OBJECTIVE: To determine the clinical presentation and frequency of congenital CMV infection among preterm infants and full-term infants from a population with a high seroprevalence rate. DESIGN/METHODS: A total of 289 preterm infants (median gestational age, 34 weeks; median birth weight, 1,757 g) and 163 term infants (median gestational age, 39 weeks; median birth weight, 3,150 g) sequentially born were included in the study. Serum IgG antibodies to CMV were measured in all mothers. One urine sample was collected within the first 7 days of age from all newborns. Virus isolation in urine samples was performed by tissue culture, and viral DNA was detected by a multiplex PCR. CMV infection was diagnosed in infants with virus excretion detected by both methods on at least two occasions within the first 3 weeks of life. RESULTS: Maternal CMV seropositivity rate was 95.7%. Congenital CMV infection was detected in 6 of 289 (2.1%) (95% confidence interval, 0.84 to 4.68) preterm infants and in 3 of 163 term infants (1.8%) (95% confidence interval, 0.48 to 5.74) (P > 0.05). Four of 6 preterm infants with congenital CMV infection were symptomatic, but none of the term infants was symptomatic (P = 0.16). CONCLUSION: The frequency of congenital CMV infection in preterm newborn infants from mothers with a high seropositive rate was similar to that found in term infants. No significant difference was found between the proportion of symptomatic infants among preterm and term infants. Our finding of symptomatic congenital CMV infection underscores the need of further evaluation of correlates of congenital symptomatic infection in highly immune populations.

Adult↗

Cutaneous application of vegetable oil as a coadjutant in the nutritional management of preterm infants.

BACKGROUND: The cutaneous application of vegetable oil as a therapeutic practice and dietary coadjuvant has been described mainly in adult patients at risk for essential fatty acid deficiency. In the current study, the effects of cutaneous soybean oil application on somatic growth and plasma linoleic and arachidonic acid levels were examined in enterally fed preterm newborns. METHODS: Sixty consecutive preterm infants were chosen from patients admitted to the nursery. Infants were randomly assigned to one of two groups: the oil group, which was treated cutaneously with soybean oil, or the control group, which received no cutaneous treatment. RESULTS: After 30 days, a significant increase in anthropometric parameters was observed in infants who received cutaneous oil, mainly in infants small for gestational age. An increase in linoleic acid level and a decrease in arachidonic acid level were seen in both groups but do not justify the difference found in growth rates in the control and oil groups. CONCLUSIONS: Preterm infants treated cutaneously with soy oil showed better somatic growth than the control group. The factors leading to the present results, especially the response of the infants who were small for gestational age merit further evaluation.

Administration, Cutaneous↗

The emergence of salivary cortisol circadian rhythm and its relationship to sleep activity in preterm infants.

OBJECTIVE: The circadian rhythm of cortisol is established at between 8 and 12 postnatal weeks in term infants. However, there is limited information about the effect of prematurity on this rhythm. We evaluated the emergence of the salivary cortisol circadian rhythm in premature infants and its relationship to the onset of sleep daily rhythm. DESIGN AND PATIENTS: A longitudinal study of a group of nine premature infants (gestational age 31-34 weeks) was performed. Salivary samples were obtained in the morning and at night at 2, 4, 8, 12, 16, 20 and 24 postnatal weeks and the babies' sleeping periods were recorded by their mothers. MEASUREMENTS: Cortisol was determined by RIA in 25-microl salivary samples. Two techniques based on assay coefficients of variation were used to characterize the circadian pattern of cortisol. RESULTS: Five infants (55%) established and maintained their cortisol rhythm at 2 and 8 postnatal weeks. In the remaining four infants the age of appearance was 12 and 16 weeks. This rhythm emerged in the group as a whole between 8 and 12 postnatal weeks. The circadian rhythm of sleep was detected starting from the eighth postnatal week. CONCLUSIONS: Our data suggest that in this group of premature infants the circadian maturation of the hypothalamic-pituitary-adrenal axis occurred at the same postnatal age as reported for term infants and that there was a parallelism between the appearance of such rhythm and the onset of sleep rhythm.

Circadian Rhythm↗

Simultaneous high-performance liquid chromatographic determination of retinol by fluorometry and of tocopherol by ultraviolet absorbance in the serum of newborns.

The simultaneous determination of retinol and tocopherol by isocratic HPLC in 100 microl serum from preterm newborns is described. Retinol (tR 2.02+/-0.04 min) and retinyl acetate were detected fluorometrically, and were baseline-resolved in 4 min. Tocopherol (tR 8.4+/-0.16 min) and tocopheryl acetate were detected by UV absorbance. Intra- and inter-assay RSD were: retinol, 5.6 and 8.1, and tocopherol, 3.6 and 6.7, respectively. This method is fast, selective and highly sensitive for retinol. It permits the measurement of serum concentrations of retinol and tocopherol with good accuracy and precision.

Chromatography, High Pressure Liquid↗

Plasma fatty acids in children with grade III protein-energy malnutrition in its different clinical forms: marasmus, marasmic kwashiorkor, and kwashiorkor.

Plasma fatty acid patterns were analysed in 15 children aged 2 to 42 months (median = 12 months) admitted to the University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, suffering from grade III protein-energy malnutrition in its different clinical forms: marasmus (n = 5), marasmic kwashiorkor (n = 5), and kwashiorkor (n = 5). A control group of eight children from the same population aged 3 to 22 months (median = 12 months) was also studied. Plasma fatty acids were analysed by gas liquid chromatography. The plasma fatty acid patterns detected in grade III protein-energy malnutrition indicated changes characteristic of essential fatty acid deficiency, with lower linoleic acid (C18:2) levels in the three groups (p < 0.05). The major metabolite of linoleic acid, arachidonic acid (C20:4), was lower in the kwashiorkor group than in the control group (p < 0.05). Linoleic acid (C18:2) levels were lower in the marasmus group than in the kwashiorkor group (p < 0.05). Several factors may have contributed to these changes, such as a decreased content of linoleic acid in the diet, plus malabsorption and/or poor utilization of fats, and changes in the synthesis or degradation of these fatty acids. Although many questions remain unanswered, we suggest that an adequate amount of linoleic acid be added to the rehabilitation diet of these children in the form of vegetable fat.

Brazil↗

Hepatic capillariasis in children: report of 3 cases in Brazil.

Capillaria hepatica is a helminth that may cause an extremely rare condition of parasitic hepatitis. Only 29 cases have been published, 2 of them in Brazil. We report here 3 cases of children in Brazil with massive hepatic capillariasis who presented the characteristic triad of this type of infection, i.e., persistent fever, hepatomegaly, and eosinophilia. The diagnosis was made by liver biopsy. All children responded well after treatment with thiabendazole (case 1), albendazole (case 3), and albendazole in combination with a corticoid (case 2). Case 1 has been followed-up for 24 years, an event not previously reported in the literature.

Albendazole↗

Spondyloepimetaphyseal dysplasia with joint laxity (SEMDJL): a Brazilian case.

This is a report on a Brazilian patient with spondyloepimetaphyseal dysplasia with joint laxity (SEMDJL; MIM 271640), a rare autosomal recessive skeletal dysplasia characterized by dwarfism, articular hypermobility, progressive intractable spinal malalignment, a typical facies and a propensity to joint dislocation and subluxation. The condition has been described only in 20 children of Afrikaans-speaking parents in South Africa. This is the first report of a non-Afrikaans patient with this genetic entity.

Brazil↗

Longitudinal evaluation of the development of salivary cortisol circadian rhythm in infancy.

OBJECTIVE: Although an outstanding characteristic of the adrenocortical function of children and adults is its circadian rhythm, little information is available about the age of appearance of such rhythm in infancy. The main obstacle has been the ethical difficulty in obtaining serial blood samples from healthy infants. We monitored the development of cortisol daily rhythm using noninvasive salivary cortisol determination. DESIGN AND PATIENTS: A longitudinal study of a group of 9 healthy infants was performed. Salivary samples were obtained in the morning, afternoon and night at 2, 4, 8, 12, 16, 20 and 24 post-natal weeks from all infants. MEASUREMENTS: Cortisol was determined by RIA in 25-microl salivary samples. Two techniques based on assay coefficients of variation were employed to characterize a normal circadian pattern of cortisol. RESULTS: Five infants (55%) established and maintained their cortisol rhythm as early as at 2, 4 and 8 weeks of age. In the remaining 4 infants the age of appearance was 12 and 20 weeks. This rhythm emerged in the group as a whole at a mean age of 8 weeks. CONCLUSIONS: Our data suggest that, in most normal infants, the development of hypothalamic-pituitary-adrenal axis circadian maturation may occur at a much earlier age than previously described.

Circadian Rhythm↗

Feeding premature infants banked human milk homogenized by ultrasonic treatment.

Premature neonates fed ultrasonically homogenized human milk had better weight gain and triceps skin-fold thickness than did a control group given untreated human milk (p < 0.01) and also had lower fat loss during tube feeding (p < 0.01). Ultrasonic homogenization of human milk appears to minimize loss of fat and thus allows better growth of premature infants.

Food Handling↗

[Prevalence of breast feeding in low birth weight infants].

The present situation regarding the breast feeding of children born with a weight of 2,500 grammes or less (LWB) at the Hospital das Clínicas of the Medical School of the Universidade de S. Paulo in Ribeirão Preto (Brazil) was studied. The study was descriptive and the data were obtained through a longitudinal follow-up carried over the period from October 1985 to September 1986 inclusive. Of the 222 children included in the study, 30 (13.5%) infants were not breastfed. Thus the incidence of breast feeding among this population was of 86.5%. At 3 months 62.5% of these infants were still being breastfed. At 6 months this figure fell to 38.5% and only 25.0% were still being breast-fed at the end of 12 months. The average duration of breast feeding for the 192 children that had started it was of 4 months. An association was found between the level of literacy of the mothers and the duration of breast feeding. Birthweight was found to be associated with the incidence and duration of breast feeding in general, as well as with the incidence of exclusive breast feeding. These data are considerably lower than recent figures obtained from the populations of well-developed countries, especially than those of Finnish infants born with a weight of less than 1.500 g. Action programmes involving the community and/or the Institution must be implemented in order to improve these figures.

Adult↗

Total nitrogen and electrolyte levels in colostrum and transition human milk.

The objective of this research was to study the composition of human milk in terms of protein levels and levels of the electrolytes sodium, potassium, calcium, magnesium, phosphorus and chloride in colostrum 48-72 hours post-partum, and in the transition milk (96 +/- 9 hours, 120 +/- 9 hours and 144 +/- 9 hours post-partum) of mothers who had fullterm and pre-term deliveries. The mothers were kept in the hospital with the objective to control a few important lactation parameters such as exercising or resting conditions, sleep, nutrition and suckling stimulation. Only low socioeconomic level mothers took part in the study. The initial period of lactation was studied because this is the time when secretion suffers rapid changes, going from colostrum to transition milk, and then to mature milk. The results observed for the different times and for the two groups were compared both within and between groups. No significant differences were obtained for any of the comparisons, except for transitory oscillations in potassium, calcium, chloride and phosphorus levels observed within groups. In general, it can be said that there was no variation between colostrum and transition milk for the mothers who delivered at full term or pre-term. No differences were found either when the groups were compared at the different times post-partum. This means that, under the conditions used in this study, milk did not vary as its type naturally changed (from colostrum to transition milk) for the two groups and that the levels of the constituents studied also remained unchanged when studied as a function of full-term or pre-term delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Colostrum↗

Serum vitamin B12 levels in parturients, in the intervillous space of the placenta and in full-term newborns and their interrelationships with folate levels.

Serum vitamin B12 levels were determined in a group of 51 parturients as well as in their babies and placentas. The results obtained showed that newborns had 2.3 times higher vitamin B12 levels than their mothers and that the concentrations of this vitamin in the intervillous space of the placenta was 1.3- and 3.2-fold those encountered in the blood of newborns and mothers, respectively. These findings indicate that vitamin B12 accumulation by the placenta may represent an important factor in providing sufficient amount of this essential nutrient to the fetus. The relationship between folate and vitamin B12 concentration in the maternal, fetal and placental sera was also investigated. The highly significant correlation coefficient encountered and significantly higher serum folate concentrations in the group of parturients who received vitamin B12 supplementation during pregnancy indicate a close metabolic interrelationship between vitamin B12 and folate.

Female↗

Serum and red blood cell folate levels in parturients, in the intervillous space of the placenta and in full-term newborns.

Folates, essential nutrients for man, are especially important during gestation. Serum and red blood cell folate levels were measured in 51 parturients and in their respective placentas and concepts, with the objective to further elucidate the mechanisms of folate transfer from mother to fetus. The interrelationships between the three compartments with respect to folate levels were also studied (Tab. I). Serum and red blood cell folates were measured by radioimmunoassay in samples of venous blood from the mother, from the intervillous space of the placenta, and from the umbilical cord. Higher folate levels were detected in newborns than in their mothers both in serum (3.9 times) and red blood cells (2.3 times). Serum folate levels were higher in the intervillous space of the placenta than in newborns (1.3 times) or mothers (4.5 times) Fig. 1, 2). These data suggest that the placenta concentrates folates, thus offering high concentrations of this vitamin to the fetus. It is possible that folate-binding proteins existing in the placenta participate in the mechanism of folate concentration in this organ. However, despite the existence of a transfer mechanism that benefits the fetus, a significant positive correlation was observed between serum folate levels of mothers, newborns and placentas.

Chorionic Villi↗

Evaluation of plasma tocopherols in relation to hematological indices of Brazilian infants on human milk and cows' milk regime from birth to 1 year of age.

A study was carried out to evaluate the effects of a human milk and cows' milk regime on plasma tocopherols and hematological status of 176 Brazilian infants from birth to 12 months of age. Plasma total tocopherols and the ratio of tocopherols/total lipids were significantly higher (p less than 0.01) for breast-fed infants than for cows' milk-fed infants at all ages. Hydrogen peroxide-stimulated erythrocyte hemolysis was greater for cows' milk-fed infants than breast-fed infants; the difference was statistically significant (p less than 0.01) at 3, 6, and 9 months of age. Among the hematological indices examined, Hb levels were significantly higher (p less than 0.01) for the breast-fed infants at 3 and 12 months, while the reticulocyte counts were significantly higher for the cows' milk-fed infants at all ages; hematocrit values more or less remained similar for both groups. It is concluded from these results that although a human milk regime is ideal as compared to a cow's milk regime for maintaining adequate vitamin E status during the 1st year of early life, there may be other influencing factors besides vitamin E to explain such differences in the hematological indices of the breast-fed and cows' milk fed-Brazilian infants.

Animals↗