Papers by Claudete Aparecida Araujo Cardoso
IMPORTANCE: Noninvasive techniques for obtaining ocular surface cells (neuroepithelial) from babi... more IMPORTANCE: Noninvasive techniques for obtaining ocular surface cells (neuroepithelial) from babies with Congenital Zika Syndrome CZS - resulting from infection by zika virus (ZIKV) during gestational period (malformations include ocular abnormalities and microcephaly) - remain to be determined. OBJECTIVES: The aim of this study was to describe an optimized impression cytology method for the isolation of viable cells from babies with CZS in satisfactory amounts and quality to enable the application in the context of genome approaches well as morphological and molecular evaluations. DESIGN, SETTINGS AND PARTICIPANTS: In this observational study, ocular surface samples were obtained with a hydrophilic nitrocellulose membrane (through optimized impression cytology method) from twelve babies referred to the Pediatric Service of the Antonio Pedro Hospital, Universidade Federal Fluminense (UFF), Niteroi, Rio de Janeiro, Brazil. Samples were collected with an authorized informed consent fr...
Ciência & Saúde Coletiva
The objective of this study was to describe if the victims of the Zika have access to essential p... more The objective of this study was to describe if the victims of the Zika have access to essential public policies to guarantee social rights. Methods: We used a cross-sectional study of a historical cohort of children with congenital Zika syndrome (CZS) in a reference hospital. CZS diagnosis was based on the Ministry of Health protocol. The variables analyzed were sociodemographic and social rights of children. Results: Of the 161 children seen from April 2016 to July 2018, 42 were diagnosed with CZS. Of these, 37 children participated in the study and 75.7% of them had severe neurological disorders. Anticonvulsants were used by 73% of the children, with 81% paid by families. The families were also responsible for purchasing nutritional formulas and diapers in, respectively, 79% and 100% of cases, and 89% of the children had access to rehabilitation therapy, although 70% of them faced several barriers to do it. Of the 24 working mothers, 83% did not return to the labor market after th...
PLoS neglected tropical diseases, 2017
, during the height of the Ebola virus disease (EVD) epidemic in West Africa, we wrote, "EVD is o... more , during the height of the Ebola virus disease (EVD) epidemic in West Africa, we wrote, "EVD is only the beginning and only one disease; even if we are to control the current epidemic, the future introduction of this and other highly contagious and virulent microbes to and from global slums is inevitable" [1]. Fast forward to late 2015: another epidemic of another virus-Zika-together with its major neurological complication-microcephaly-explodes in Brazil. Again, as with the EVD epidemic, the world's attention is focused on issues such as where the virus originated, the need to control vectors, how quickly we can develop a vaccine, and how long the epidemic will continue. While these are important discussions to have, they are irrelevant if the world does not recognize and address a crucial reason why these explosive epidemics continue to occur in the first place: the world must talk about urban slums. Zika is, and will continue to be, a disease of the urban poor. Slum-defining characteristicspoor water and sanitation infrastructure, crowding, and poor structural quality of housingoffer ample opportunities for mosquitoes to breed and spread the Zika virus. It was recently estimated that 1.6 million childbearing women and 93 million people will be infected in the Americas' first epidemic wave [2]. From this reservoir of infections, the world is witnessing the largest epidemic ever of a congenital complication-microcephaly. Except for sporadic reports, largely absent from discussion is the fact that the greatest proportion of Zika infections and its complications have occurred, and will continue to occur, among residents of the large, densely packed informal human settlements of Latin America and the Caribbean. The Aedes aegypti mosquito-the species that most commonly transmits Zika-will, on average, travel a mere 100 meters in its lifetime [3]. In the densely populated favelas, or slums of Brazil and elsewhere in the region, a single 100 square meter space could contain more than 100 housing structures, 2-3 stories high, with a resident population upwards of 1,000. These residents can be infected multiple times by mosquitoes circulating in such neighborhoods. Wealthy residents of high-rise apartment buildings with screened windows, air conditioning, and regular spraying of insecticides, even if located adjacent to these favelas, are less likely to be exposed to such mosquitoes. The burden of symptomatic dengue, another mosquito-borne disease, has been shown to be greater among the neighborhoods with the lowest socioeconomic status within a slum [4]. In a study of successive dengue epidemics in Rio de Janeiro that occurred in 2007 and 2008, Rosa-Freitas et. al demonstrated that dengue incidence positively correlated with
Revista do Instituto de Medicina Tropical de São Paulo
This is an open-access article distributed under the terms of the Creative Commons Attribution Li... more This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Viruses
Low levels of parvovirus B19 (B19V) DNA can be detected in the circulation and in different tissu... more Low levels of parvovirus B19 (B19V) DNA can be detected in the circulation and in different tissue of immunocompetent individuals for months or years, which has been linked to inflammatory diseases such as cardiomyopathy, rheumatoid arthritis, hepatitis, and vasculitis. However, the detection of B19V DNA does not necessarily imply that infectious virions are present. This study aimed to evaluate the method based on the Benzonase® treatment for differentiation between the infectious virions from “naked” DNA in serum and bone marrow (BM) samples to be useful for the B19V routine diagnosis. In addition, we estimated the period of viremia and DNAemia in the sera and bone marrow of nonhuman primates experimentally infected with B19V. Serum samples from ten patients and from four cynomolgus monkeys experimentally infected with B19V followed up for 60 days were used. Most of the human serum samples became negative after pretreatment; however, only decreased viral DNA loads were observed in...
Pathogens, 2022
Over the past 15 years, and despite many difficulties, significant progress has been made to adva... more Over the past 15 years, and despite many difficulties, significant progress has been made to advance child and adolescent tuberculosis (TB) care. Despite increasing availability of safe and effective treatment and prevention options, TB remains a global health priority as a major cause of child and adolescent morbidity and mortality—over one and a half million children and adolescents develop TB each year. A history of the global public health perspective on child and adolescent TB is followed by 12 narratives detailing challenges and progress in 19 TB endemic low and middle-income countries. Overarching challenges include: under-detection and under-reporting of child and adolescent TB; poor implementation and reporting of contact investigation and TB preventive treatment services; the need for health systems strengthening to deliver effective, decentralized services; and lack of integration between TB programs and child health services. The COVID-19 pandemic has had a significant n...
Viruses, 2022
High levels of T helper 17 cell (Th17)-related cytokines have been shown in acute Zika virus (ZIK... more High levels of T helper 17 cell (Th17)-related cytokines have been shown in acute Zika virus (ZIKV) infection. We hypothesized that the high levels of Th17-related cytokines, associated with a regulatory environment during pregnancy, create a favorable milieu for the differentiation of CD4+Th17 cells. We present data from a cross-sectional study on mothers who confirmed ZIKV infection by qRT-PCR and their children. We also recruited non-pregnant women infected with ZIKV in the same period. ZIKV infection occurred between 2015 and 2017. We collected samples for this study between 2018 and 2019, years after the initial infection. We highlight that, after in vitro stimulation with ZIKV CD4 megapool (ZIKV MP), we found a lower frequency of IL-17-producing CD4+ T cells (Th17), especially in the mothers, confirmed by the decrease in IL-17 production in the supernatant. However, a higher frequency of CD4+ IL-17+ IFN-γ+ T cells (Th1Th17) responding to the ZIKV MP was observed in the cells o...
Residência Pediátrica, 2017
In this article, we review the concept of biomarkers and biosignature and their potential use in ... more In this article, we review the concept of biomarkers and biosignature and their potential use in pediatric tuberculosis, with application in the development of new vaccines and new laboratory methods that allow a more accurate diagnosis and evaluation of the response to treatment. Emphasis is also given to methods which include the dosage of antibodies, cytokines, transcriptomics, proteomics and metabolomics.
This article analyzes the interface between epidemiology and historical-cultural psychology in a ... more This article analyzes the interface between epidemiology and historical-cultural psychology in a research project in an urban slum: Morro do Preventório, located in the Charitas neighborhood of the city of Niterói, in the state of Rio de Janeiro, Brazil. From the outset, the study sought to assess the clinical burden of disease due to diabetes mellitus, iteratively integrating findings into clinical practice, a strict separation between diagnosis and intervention. However, during the course of the project, it began to shift away from the traditional medical model as all stakeholders became engaged in the dialogic process. This process – known as researchintervention – brought to light the constructive nature of knowledge, producing “zones of senses”. These senses, and the lessons learned via their analysis, engender the development of new research and medical practice. In the process of these analyses we highlight several intersecting epistemological paths as we explore the historic...
Objetivo: Estudar prevalência de colonização nasal e infecção por Staphylococcus aureus (S. aureu... more Objetivo: Estudar prevalência de colonização nasal e infecção por Staphylococcus aureus (S. aureus) e S. aureus resistente à meticilina associado à comunidade (CA-MRSA) em crianças com varicela atendidas em nível hospitalar, avaliando a presença de infecção secundária e o desfecho clínico. Métodos: Trata-se de um estudo de corte transversal, em que se aplicaram questionários acerca dos fatores de risco para colonização e infecção por S. aureus, bem como se coletou suabe nasal. A resistência à meticilina foi confirmada pela detecção do gene mecA pela técnica de reação em cadeia da polimerase (PCR). Adicionalmente, a gravidade dos casos foi estimada por meio do Pediatric Risk of Mortality score (PRISM), e avaliou-se o desfecho clínico dos pacientes internados. As variáveis categóricas foram comparadas por meio do teste do qui-quadrado ou do exato de Fisher. Considerou-se p-valor < 0,05 estatisticamente significativo. Resultados: Foram incluídos 55 pacientes. A prevalência da coloni...
Viruses, 2021
There have been reports of neurological abnormalities associated with the Zika virus (ZIKV), such... more There have been reports of neurological abnormalities associated with the Zika virus (ZIKV), such as congenital Zika syndrome (CZS) in children born to mothers infected during pregnancy. We investigated how the immune response to ZIKV during pregnancy is primed and conduct a thorough evaluation of the inflammatory and cytotoxic profiles as well as the expression of CCR5 and CX3CR1. We compared the reactivity of T cells to ZIKV peptides in convalescent mothers infected during pregnancy. The child’s clinical outcome (i.e., born with or without CZS) was taken to be the variable. The cells were stimulated in vitro with ZIKV peptides and evaluated using the ELISPOT and flow cytometry assays. After in vitro stimulation with ZIKV peptides, we observed a tendency toward a higher Interferon gamma (IFN-γ)-producing T cell responses in mothers who had asymptomatic children and a higher CD107a expression in T cells in mothers who had children with CZS. We found a higher frequency of T cells exp...
Introduction: In Brazil, practices of medical students have been interrupted due to COVID-19 to m... more Introduction: In Brazil, practices of medical students have been interrupted due to COVID-19 to meet emergency demands. Aim: To describe a strategy for a controlled return to the presential practices for medical students. Methods: We developed a standardized protocol to be applied before and during the return of the practical classes in medical students of Universidade Federal Fluminense, in the follow months after COVID-19 pandemic beginning. The protocol was comprised in three parts: Remote training on COVID-19 prevention; Face-to-face training focused in COVID-19 prevention, handwashing and personal protective equipment use; Investigation of students COVID-19 status before starting practical activities and weekly monitoring for COVID-19 during seven weeks. The training was done by medical teachers in small groups for medical students of the last lective semester. Results: The classes were interrupted on March 12, 2020 and returned in August 10, 2020. Seventy-one students were tra...
Revista da Sociedade Brasileira de Medicina Tropical, 2019
Listeria is an unusual pathogen that causes neonatal infection with high morbidity and mortality.... more Listeria is an unusual pathogen that causes neonatal infection with high morbidity and mortality. We present the case of a premature newborn whose mother had a rash during pregnancy; the newborn had severe early sepsis because of Listeria monocytogenes and histopathologically suggestive findings of the placenta. Obstetricians and neonatologists should suspect listeriosis in cases with compatible epidemiological history, clinical features, and examination findings of the placenta.
BMC Infectious Diseases, 2019
Background: Staphylococcus aureus and beta-hemolytic streptococci (BHS) diseases disproportionate... more Background: Staphylococcus aureus and beta-hemolytic streptococci (BHS) diseases disproportionately affect populations in middle/low-income countries. To assess if this disparity is reflected in colonization by these organisms, we compared their colonization frequency among children from different socioeconomic status (SES) communities in a city with high income inequality. Methods: Between May-August 2014, we collected nasal and throat swabs to investigate S. aureus and BHS colonization among children who attended private and public pediatric clinics. Patients were classified as high SES, middle/low SES, and slum residents. We investigated the antimicrobial resistance profile, the SCCmec types and the presence of PVL genes among methicillin-resistant S. aureus (MRSA). We also examined the antimicrobial resistance profile and serogroups of BHS. Results: Of 598 children, 221 (37%) were colonized with S. aureus, of which 49 (22%) were MRSA. MRSA colonization was higher in middle/low SES (n = 18; 14%) compared with high SES (n = 17; 6%) and slum (n = 14; 8%) residents (p = 0.01). All MRSA strains were susceptible to clindamycin, nitrofurantoin, and rifampin. The highest nonsusceptibility frequency (42.9%) was observed to erythromycin. SCCmec type V was only found in isolates from high SES children; types I and II were found only in middle/low SES children. Ten (20%) MRSA isolates carried PVL genes. Twenty-four (4%) children were BHS carriers. All BHS (n = 8) found in high SES children and six (67%) isolates from slum patients belonged to group A. All group B streptococci were from middle/low SES children, corresponding to five (71%) of the seven BHS isolated in this group. BHS isolates were susceptible to all drugs tested. Conclusions: Children from different SES communities had distinct bacterial colonization profiles, including MRSA carriage. Public health officials/researchers should consider SES when assessing disease transmission and control measures.
Journal of Tropical Pediatrics, 2019
Objective To better understand the clinical spectrum and course of congenital Zika syndrome (CZS)... more Objective To better understand the clinical spectrum and course of congenital Zika syndrome (CZS) during the first 18 months of life of children whose mothers had rash during pregnancy. Methods This longitudinal observational study evaluated the clinical progress from birth until 18 months of life of children of mothers who developed rash during or up to 3 months before gestation. Maternal rash occurred from November 2015 to May 2017. The study subjects were divided into three groups: children whose mothers tested positive by RT-qPCR for Zika virus (ZIKV) (Group 1), children whose mothers tested negative by RT-qPCR for ZIKV (Group 2), and children whose mothers did not undergo any testing for ZIKV (Group 3) but tested negative for other congenital infections. Results Between April 2016 and July 2018, we studied 108 children: 43 in Group 1, 26 in Group 2 and 39 in Group 3. The majority of children were admitted into the study within 6 months of life. CZS was diagnosed in 26 children,...
Fractal : Revista de Psicologia, 2016
Resumo Este artigo analisa o desenvolvimento de uma pesquisa no campo da Epidemiologia, na interf... more Resumo Este artigo analisa o desenvolvimento de uma pesquisa no campo da Epidemiologia, na interface com a psicologia histórico- cultural, que teve como cenário uma comunidade urbana. A pesquisa pretendia comparar a carga das doenças relacionadas ao diabetes mellitus, a fim de, posteriormente, promover uma prática em saúde, o que significa uma divisão entre diagnóstico e intervenção. Entretanto, durante o processo, uma pesquisa, alternativa a este modelo diagnóstico, foi sendo produzida no processo dialógico entre os envolvidos. Esta prática - nomeada de pesquisa-intervenção - trouxe à cena o caráter construtivo do conhecimento e produziu “zonas de sentido”, que engendraram formas novas para a pesquisa e para a prática em saúde. Estas transformações exigiram também novos percursos epistemológicos, o que nos aproximou da psicologia histórico-cultural de Vigotski, da pedagogia de Freire e da filosofia da linguagem de Bakhtin
Revista Práxis, 2013
Desde os primeiros casos de resistência a penicilina e depois meticilina,o Staphylococcus aureuss... more Desde os primeiros casos de resistência a penicilina e depois meticilina,o Staphylococcus aureusse tornou degrande importância no ambiente hospitalar e atualmente também na comunidade. Glicopeptídeos são a primeiralinha de tratamento para infecções graves por MRSA, porém a alta toxicidade dos mesmos e, resistência,fazem com que as outras alternativas terapêuticas sejam adotadas na prática clínica para o tratamento de infecçõescausadas por S. aureus. Esta revisão pretende abordar as principais opções de tratamento antiestafilocócicos.
International journal of environmental research and public health, Jun 21, 2016
Challenges to the adherence to combination antiretroviral therapy among the pediatric population ... more Challenges to the adherence to combination antiretroviral therapy among the pediatric population should be understood in the context of the trajectories of families, their interaction with healthcare services, and their access to material and symbolic goods. The present study analyzed individual, institutional and social factors that might be associated with the caregivers' role in the treatment adherence of children and adolescents living with HIV (CALHIV). Based on semi-structured interviews and questionnaires applied to 69 caregivers seen at pediatric AIDS services of five Brazilian macro-regions, we observed that adherent caregivers had better acceptance of diagnosis and treatment, were less likely to face discrimination and social isolation secondary to AIDS-related stigma and tended to believe in the efficacy of treatment, and to be more optimistic about life perspectives of CALHIV. Interventions aiming to improve adherence and to promote the health of CALHIV should take i...
Genome announcements, Jan 20, 2015
The sequence of methicillin-resistant Staphylococcus aureus strain B6 (sequence type 30 [ST30], s... more The sequence of methicillin-resistant Staphylococcus aureus strain B6 (sequence type 30 [ST30], spa type t433, staphylococcal chromosomal cassette mec element [SCCmec] type IVc, Panton-Valentine leukocidin [PVL] positive), isolated from a pediatric patient with a lung infection in Niterói, Rio de Janeiro, Brazil, is described here. The draft genome sequence includes a 2.8-Mb chromosome, accompanied by a 20-kb plasmid containing blaZ and two small cryptic plasmids.
World Journal of Virology, 2015
during the last decades has transformed human immunodeficiency virus (HIV) infection into a chron... more during the last decades has transformed human immunodeficiency virus (HIV) infection into a chronic disease. Children that were diagnosed during the first months or years of life and received treatment, are living longer and better and are presently reaching adolescence and adulthood. Perinatally HIV-infected adolescents (PHIV) and young adults may present specific clinical, behavior and social characteristics and demands. We have performed a literature review about different aspects that have to be considered in the care and follow-up of PHIV. The search included papers in the MEDLINE database via PubMed, located using the keywords "perinatally HIV-infected" AND "adolescents". Only articles published in English or Portuguese from 2003 to 2014 were selected. The types of articles included original research, systematic reviews, and quantitative or qualitative studies; case reports and case series were excluded. Results are presented in the following topics: "Puberal development and sexual maturation", "Growth in weight and height", "Bone metabolism during adolescence", "Metabolic complications", "Brain development, cognition and mental health", "Reproductive health", "Viral drug resistance" and "Transition to adult outpatient care". We hope that this review will support the work of pediatricians, clinicians and infectious diseases specialists that are receiving these subjects to continue treatment.
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Papers by Claudete Aparecida Araujo Cardoso