The resurgence of cases of Zika virus (ZIKV) infection, accompanied by epidemic of microcephaly in Brazil, has aroused worldwide interest in understanding the biological mechanisms of the virus that allow patient management and the viral dissemination control. Colostrum and human milk are possible sources of virus spread. Therefore, the objective of this study was to analyze the repercussions of ZIKV infection on rheological parameters and inflammatory cytokines of colostrum. The prospective cohort study included 40 puerperal donors of colostrum, divided into 2 groups: control (without ZIKV infection, n = 20) and a group infected with ZIKV during the gestational period (n = 20). Analyses were performed for the detection of ZIKV by polymerase chain reaction (PCR). In addition to obtaining the rheological parameters and quantification of IL-10 and IL-6 cytokines by flow cytometry, ZIKV and other flaviviruses were not detected in colostrum. However, maternal infection reflected increased viscosity, decreased levels of IL-10, and elevated levels of IL-6. The higher viscosity may represent a mechanical barrier that hinders the spread of the virus. The lower levels of anti-inflammatory mediators and higher inflammatory cytokines may possibly alter the viscosity, and it seems the higher viscosity represents a possible mechanism of adaptation of breastfeeding against a response to ZIKV.

Resumo: O Serviço de Atendimento Móvel de Urgência (SAMU) que atende pelo telefone 192, é um serviço oferecido pelo Governo Federal desde 2003, com finalidade de prestar assistência aos casos de urgência e emergência no Brasil. Os atendimentos são diversos, e envolvem desde causas clínicas, psiquiátricas, pediátricas, obstétricas, cirúrgicas e traumáticas. Dessa forma, o presente artigo tem como objetivo analisar a importância do atendimento pré-hospitalar para paciente politraumatizado no Brasil. Para isso, realizou-se uma revisão integrativa da literatura, feita a partir do levantamento de artigos nos portais Pubmed e BVS Brasil, entre os meses de julho de 2018 a agosto de 2019. A qualidade da reabilitação do paciente vítima de politrauma envolve todos os cuidados, desde o momento da triagem, até sua evolução, transporte e cuidados intra-hospitalares. O manejo precoce e adequado por uma equipe capacitada é de suma importância para o desfecho do paciente.Descritores: Serviços médicos de emergência; Assistência pré-hospitalar; Traumatismo múltiplo; Equipe de assistência ao paciente. Abstract:The Mobile Emergency Care Service (SAMU) that answers by phone 192, is a service offered by the Federal Government since 2003, with the purpose of providing assistance to urgent cases in Brazil. The services are diverse, and involve from clinical, psychiatric, pediatric, obstetric, surgical and traumatic causes. Thus, this article aims to analyze the importance of prehospital care for polytrauma patients in Brazil. For this, an integrative literature review was performed, based on the survey of articles in the Pubmed and VHL Brazil portals, from July 2018 to August 2019. The quality of the rehabilitation of the patient suffering from polytrauma involves all patients. care, from the moment of screening, until its evolution, transportation and in-hospital care. Early and appropriate management by a trained team is of paramount importance to the patient's outcome.

Background and objectives: Breastfeeding promotion is an important public health strategy for counter-balancing the negative effects of maternal overweight and obesity. Colostrum contains melatonin, which can attenuate the impacts of excessive maternal weight and boost the infant’s immune system. Therefore, the objective of this study was to analyze the effects of melatonin on mononuclear (MN) phagocytes from the colostrum of women with pre-gestational obesity. Materials and Methods: Colostrum samples were collected postpartum from 100 women at a public hospital in São Paulo, Brazil. The donors were divided into two groups: the control group and the high body mass index (BMI) group. Melatonin levels in the colostrum were determined by an ELISA Kit, and the functional activity of MN cells was assessed using the phagocytosis assay by flow cytometry, and reactive oxygen species (ROS), intracellular calcium, and apoptosis were assessed by fluorimetry using a microplate reader. Results: The colostrum of mothers with pre-gestational high BMI exhibited higher melatonin levels (p < 0.05) and lower phagocytosis (p < 0.05) and ROS release (p < 0.05). Superoxide release was similar between the normal and high BMI groups (p > 0.05). Intracellular calcium release and apoptosis were also higher in the high BMI group (p < 0.05). Melatonin levels likely increased the phagocytosis rate and reduced intracellular calcium release and the apoptosis index (p < 0.05). Conclusions: The results suggest that melatonin is a possible mechanism for maternal–infant protection against obesity and restores the functional activity of colostrum phagocytes in obese mothers.

Adiponectin and leptin play roles in the hunger response, and they can induce the inflammatory process as the initial mechanism of the innate immune response. It is possible for alterations in the levels of these adipokines to compromise the functional activity of human colostrum phagocytes. Therefore, the objective of this study is to analyze the effects of adiponectin and leptin on colostrum mononuclear (MN) cells. Colostrum was collected from 80 healthy donors, who were divided into two groups: the control group and the high body mass index (BMI) group. MN cells were used to analyze phagocytosis by flow cytometry, and reactive oxygen species (ROS), intracellular calcium, and apoptosis were assessed by fluorimetry using a microplate reader. Adipokines restored the levels of phagocytosis to the high BMI group (p < 0.05), with a mechanism that is action-dependent on the release of ROS and intracellular calcium. However, adiponectin and leptin simultaneously contributed to better microbicidal activity, thus reflecting an increase in the apoptosis level (p < 0.05) in the high BMI group. Probably, the maintenance of the balance between adiponectin and leptin levels enhances the protection and decreases the indices of neonatal infection in the breastfeeding infants of women with high BMI values. Therefore, policies that support pre-gestational weight control should be encouraged.

Pregnancy causes intense changes, both physical and psychological, in women's lives and hypertension was found to be a factor of high interference in pregnant woman's QoL, causing lower scores in all QoL domains of hypertensive pregnant women, compared with pregnant woman without complications.

Introdução: O diabetes pode ser compreendido como um importante problema de saúde pública, sobretudo pela alta prevalência e incidência entre a população. Pode se fazer presente em indivíduos de todas as idades, incluindo os casos de diabetes gestacional. O diabetes gestacional é uma síndrome do metabolismo energético de origem múltipla, cuja causa não foi cientificamente definida com precisão até o momento, caracterizada pelo aumento do índice glicêmico detectado pela primeira vez durante a gravidez, e o diabetes ocorre porque o pâncreas não consegue insulina suficiente, isto é, sem ser produzida em quantidades adequadas para atender às necessidades do organismo. Tendo em vista o enfrentamento da questão, aponta-se a atuação do enfermeiro, uma vez que os cuidados de enfermagem em gestantes com diabetes gestacional se apresentam como de grande valia para proporcionar mais qualidade de vida no referido período. Objetivo: Avaliar a efetividade dos cuidados de enfermagem em pacientes com diabetes gestacional. Método: Trata-se de uma revisão integrativa de literatura, com a seguinte pergunta norteadora: Os cuidados de enfermagem são efetivos no enfrentamento do diabetes gestacional? O corpus da pesquisa foi estruturado em consultas realizadas em bases de dados online: SciELO, MEDLINE e LILACS. A amostra foi formada a partir dos seguintes critérios de inclusão: artigos que tratem sobre o tema enfermagem e diabetes gestacional; artigos disponíveis em português inglês e espanhol publicados entre 2012 e 2022. Resultados e discussão: A busca na literatura culminou em 06 artigos, nos quais foi observado que o enfermeiro é um profissional de muita relevância na assistência à gestante com diabetes gestacional, promovendo as condições favoráveis no âmbito da promoção de saúde, prevenção, diagnóstico e educação em saúde. Conclusão: Ante ao estudo realizado, avaliando-se a efetividade dos cuidados de enfermagem em pacientes com diabetes gestacional, evidenciou-se que tais profissionais atuam de forma significativa na prevenção, manejo e controle da problemática abordada, em articulação com outros profissionais que prestam assistência às gestantes. Portanto, enfermeiros são profissionais ímpares na elaboração de diagnósticos que contribuem para efetivar o tratamento, a prevenção de agravos, bem como no fornecimento de orientações fundamentais para as grávidas com diabetes gestacional. Palavras-chave: Cuidados de enfermagem; Diabetes gestacional; e Enfermagem. ABSTRACT: Introduction: Diabetes can be understood as an important public health problem, mainly due to its high prevalence and incidence among the population. It can be present in individuals of all ages, including cases of gestational diabetes. Gestational diabetes is a syndrome of energy metabolism of multiple origin, whose cause has not been scientifically precisely defined so far, characterized by an increase in the glycemic index detected for the first time during pregnancy, and diabetes occurs because the pancreas does not get enough insulin, that is, without being produced in adequate amounts to meet the body's needs. With a view to tackling the issue, the role of the nurse is highlighted, since nursing care for pregnant women with gestational diabetes is of great value to provide better quality of life in that period. Objective: To evaluate the effectiveness of nursing care in patients with gestational diabetes. Method: This is an integrative literature review, with the following guiding question: Are nursing care effective in coping with gestational diabetes? The research corpus was structured in consultations carried out in online databases: SciELO, MEDLINE and LILACS. The sample was formed based on the following inclusion criteria: articles dealing with the topic of nursing and gestational diabetes; articles available in Portuguese, English and Spanish published between 2012 and 2022. Results and discussion: The search in the literature culminated in 06 articles, in which it was observed that the nurse is a very relevant professional in the assistance to pregnant women with gestational diabetes, promoting the conditions favorable in the field of health promotion, prevention, diagnosis and health education. Conclusion: In view of the study carried out, evaluating the effectiveness of nursing care in patients with gestational diabetes, it was evidenced that such professionals act significantly in the prevention, management and control of the problem addressed, in conjunction with other professionals who provide assistance to pregnant women. Therefore, nurses are unique professionals in the elaboration of diagnoses that contribute to the effective treatment, prevention of injuries, as well as in providing fundamental guidelines for pregnant women with gestational diabetes. Keywords: Nursing care; Gestational diabetes; e Nursing.

Introduction: Congenital malformations, also called Congenital Anomalies (CA) or birth defects are morphological and/or functional changes evident at birth or that are manifested at later stages of life. The origin of most CA is still unknown, but the causes may be related to genetic and environmental factors. Objetive: Identify the prevalence of congenital malformations in the city of Sousa, Paraíba, between 2012 and 2014. Method: This is a cross-sectional and descriptive study conducted in the city of Sousa, Paraíba, Brazil, based on data extracted from the Computing Department of the Unified Health System (DATASUS) and the Live Birth declarations (DNVs) supplied by the Department of Epidemiological Surveillance of the Municipal Secretary of Health from the above-mentioned city. Data were tabulated in Microsoft Office Excel 2013 software. Furthermore, a database in SPSS (version 21) was built. We used descriptive analysis of frequency and percentage and as inferential technique, we used logistic regression and the level of statistical significance set at 5% with 95% confidence intervals for each independent variable analyzed. Results: It was evident that there was a prevalence of 0.48% of Congenital Malformations cases. Among the abnormalities, the most frequent were the ones in the osteomuscular system (35.7%), followed by abnormalities of the nervous system (28.6%). The groups that showed statistical significance in relation to the presence of abnormality were: considered late mothers and had an odds ratio of 5.50, mothers who

Objective: analyze the prevalence of recurrent wheezing and its risk factors. Method: systematic literature review, guided by the research question "what is the prevalence of recurrent wheezing and its risk factors?". The search was performed in the databases MedLine and LILACS, in April and May 2013. The inclusion criteria were: scientific study, fully available, published between 2002 and 2013, with free access. Results: wheezing presents a higher prevalence in developing countries, possibly due to poor socioeconomic conditions. Among its risk factors, we find heredity, mother's education level, attendance of day nursery, smoking during pregnancy, breastfeeding for < 3 months, animals in the household of children, among others. Conclusion: in Latin America, the prevalence of wheezing shows to be high and the use of non-standardized instruments hampers its treatment.