Abstract

Diesel exhaust is the major source of ultrafine particles released during traffic-related pollution. Subjects with chronic respiratory diseases are at greater risk for exacerbations during exposure to air pollution. This study evaluated the effects of subchronic exposure to a low-dose of diesel exhaust particles (DEP). Sixty male BALB/c mice were divided into two groups: (a) Saline: nasal instillation of saline (n = 30); and (b) DEP: nasal instillation of 30 microg of DEP/10 microl of saline (n = 30). Nasal instillations were performed 5 days a week, over 30 and 60 days. Animals were anesthetized with pentobarbital sodium (50 mg/kg intraperitoneal [i.p.]) and sacrificed by exsanguination. Bronchoalveolar lavage (BAL) fluid was performed to evaluate the inflammatory cell count and the concentrations of the interleukin (IL)-4, IL-10, and IL-13 by enzyme-linked immunosorbent assay (ELISA). The gene expression of oligomeric mucus/gel-forming (Muc5ac) was evaluated by real-time polymerase chain reaction (PCR). Histological analysis in the nasal septum and bronchioles was used to evaluate the bronchial and nasal epithelium thickness as well as the acidic and neutral nasal mucus content. The saline group (30 and 60 days) did not show any changes in any of the parameters. However, the instillation of DEP over 60 days increased the expression of Muc5ac in the lungs and the acid mucus content in the nose compared with the 30-day treatment, and it increased the total leukocytes in the BAL and the nasal epithelium thickness compared with saline for 60 days. Cytokines concentrations in the BAL were detectable, with no differences among the groups. Our data suggest that a low-dose of DEP over 60 days induces respiratory tract inflammation.

The objective of this study was to evaluate and compare symptoms of anxiety and depression before and after psychological intervention in mothers of babies born preterm with very low birth weight, hospitalized in the Neonatal Intensive Care Unit. Fifty nine mothers, without psychiatric antecedents, were distributed into two groups according to the type of psychological intervention received. Group G1 included 36 mothers who received routine psychological treatment associated with initial structured intake using support materials (video and guidance manual). Group G2 included 23 mothers who received routine psychological intervention without support material. The STAI and BDI, respectively, were used to evaluate maternal indicators of anxiety and depression. The results revealed that both groups showed a reduction in levels of state or trait anxiety and depression after psychological intervention and discharge of the baby from the hospital. In regard to the emotional symptoms at a clinical level, a statistically significant reduction in the level of state-anxiety was verified in G1. The findings confirmed the need for psychological support for mothers of preterm infants and the use of materials focusing on «prematurity» for reduction of the situational anxiety on a clinical level.

ResumoO presente estudo comparou a história de desenvolvimento, aprendizagem e comportamento de 20 crianças de 8 a 10 anos nascidas pré-termo < 1500g (MBP) emparelhadas a 20 crianças controle nascidas a termo. Foram realizadas entrevistas e foi aplicada a Escala Comportamental de Rutter nas mães e o Raven nas crianças. Verificou-se sinais de atraso na aquisição de comportamentos psicomotores iniciais e lateralidade manual canhestra no MBP em relação ao controle. Na fase escolar, a maioria das crianças de ambos os grupos apresentou nível intelectual médio e estava freqüentando escola regular. As crianças MBP apresentaram mais repetência escolar do que as controles e reuniram uma parcela de 20% de crianças com déficit auditivo. Embora em ambos os grupos tivesse indicação de problemas comportamentais na Rutter, as crianças MBP apresentaram mais problemas respiratórios, enurese noturna, recusa escolar, agitação, impaciência, inquietude e agarramento à mãe em comparação a escolares de Ribeirão Preto. Palavras-chave: Pré-termo; muito baixo peso; desenvolvimento cognitivo; comportamento; aprendizagem. Developmental History and Behavior of Pre-Term and Low Birth-Weight Children (<1.500g) AbstractThe aim of this study is to compare the developmental history, learning and behavior of 20 pre-term and very low birth-weight children (VLB) and 20 full-term children at eight-ten years old. Data collection included interviews and the Child Behavioral Scale administered to the mothers and the Raven test to the children. Signs of delay in psychomotor behaviors acquisitions and predominance of the left hand use in the VLB compared to the control group were detected. In the school phase, most of the children of both groups presented average intellectual level and were attending regular schools. In the VLB group there was a significantly higher proportion of school failure than in the control group and there were 20% of children with hearing impairment. Authough both groups had signs of behavior problems, the VLB group showed more respiratory problems, enuresis, school-refuse, agitation, impatience and attachment to the mother than school children from Ribeirão Preto.

RESUMO:O objetivo do presente estudo consistiu em avaliar o impacto do nascimento de bebês extremamente prematuros (<1500g). Foram estudadas duas amostras de sujeitos: uma constituída por mães de recém-nascidos pré-termo e com muito baixo peso, hospitalizados em UTI-Neonatal e outra com 34 crianças de oito a dez anos nascidas pré-termo e com peso <1500g e 20 crianças nascidas a termo e com peso > 2500g. Os efeitos precoces da prematuridade foram identificados na análise de conteúdo das verbalizações maternas em 20 sessões de grupo de apoio durante a internação do bebê na UTIN. As crianças da fase escolar foram avaliadas pelos testes de Raven, Desenho da Figura Humana, Escala Comportamental Infantil A2 de Rutter e um questionário (mães). Os resultados mostraram as mães preocupadas com a sobrevivência e evolução dos bebês, com a separação devido à internação na UTIN e sentimento de incompetência em desempenhar seu papel. 49% das crianças da fase escolar evidenciaram inteligência média ou acima e 42% limítrofes; 18% apresentou deficiência auditiva; 82% estavam em escola regular. Problemas comportamentais verificados: agitação, impaciência, inquietude e agarramento à mãe Palavras chave: Pré-termo; Baixo peso; Risco ao desenvolvimento. PRETERM AND LOW BIRTHWEIGHT AS A RISK FOR THE DEVELOPMENT OF CHILDREN ABSTRACT:The aim of the present study consisted of assessing the impact of extremely pre-term low birth weight (<1500g). It were studied two samples of subjects: one of pre-term newborn mothers (with very low weight committed on ICU-Neonatal of HCFMRP-USP) and other made up of 34 children from eight to ten years old that were born pre-term and with <1500g of weight and 20 children born full term and with >2500g. Early effects of prematurity were identified through analysis of mothers verbalizations' content in 20 group support sessions during the babies' commitment on ICU. The assessment phase of school children included Raven's and Human Figure Draw Tests, Child Behavioral Scale A2 of Rutter and a questionnaire to the mothers. It was verified a high mother's preoccupation with babies' survival, evolution, mother's separation, and incompetence sense to perform their role. 49% of school age children showed average intelligence and 42% were borderline; 18% presented aural deficiency; 82% were attending regular school. There appeared behavioral problems as agitation, impatience, and attachment to the mother.

ResumoO objetivo do estudo foi avaliar indicadores de desenvolvimento de crianças nascidas pré-termo e comparar o desempenho nas faixas de 5 a 7 e 10 a 14 meses de idade corrigida. Foram relacionados indicadores do desenvolvimento com variáveis neonatais e do ambiente familiar e sexo. Trinta crianças foram avaliadas pelo Denver-II. As cuidadoras responderam à entrevista e o prontuário médico foi analisado. Na faixa de 5 a 7 meses, 20 % das crianças apresentaram risco para problemas de desenvolvimento e 27% de 10 a 14 meses. Houve diferença significativa entre as fases com mais risco na linguagem na faixa de 10 a 14 meses. As crianças nascidas com menor peso e idade gestacional, que permaneceram mais tempo hospitalizadas e com situações familiares adversas apresentaram mais problemas de desenvolvimento. Palavras-chave: Pré-termo; Muito baixo peso; Desenvolvimento; Saúde. AbstractThe aim of the study was to assess the development of children born preterm and to compare the performance in the ranges of 5-7 and 10-14 months of corrected age. The children's development indicators and the variables of neonatal period and familial environment were correlated. Thirty children were assessed by Denver-II. The caregivers were interviewed and the medical chart was examined. Twenty per cent of children presented risk for developmental problems at 5-7 months, and 27% at 10-14 months. There was statistical significant difference between ages in language, with high risk at 10-14. The children with lower birthweight, lower gestational age, longer time stay in the hospital, and with adverse family situations showed higher risk for developmental problems.

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Resumo O presente estudo objetivou avaliar indicadores do desenvolvimento psicológico na fase escolar de crianças nascidas pré-termo com muito baixo peso e compará-los aos de crianças nascidas a termo, quanto às áreas intelectual, emocional e comportamental. A amostra foi composta por 40 crianças de 8 a 10 anos, subdivididas em 2 grupos: Pré-termo (PT), 20 crianças nascidas <37 semanas de idade gestacional e peso <1.500 g e A Termo (AT), 20 crianças nascidas a termo com peso >2.500g. Foram utilizados o Raven, o Desenho da Figura Humana e a Escala Comportamental Infantil. As crianças PT apresentaram mais freqüentemente nível intelectual inferior à média e problemas comportamentais em comparação às AT. Não houve diferença entre os grupos quanto aos aspectos emocionais. Os problemas de enurese, medo, tiques, impaciência e dificuldade de permanência nas atividades foram significativamente mais freqüentes no PT do que no AT. Verificou-se que, no grupo PT, quanto menor o nível intelectual das crianças, mais problemas de comportamento elas apresentavam. Palavras-chave: Pré-termo; muito baixo peso de nascimento; desenvolvimento; inteligência; comportamento.