The etiology of respiratory distress syndrome (RDS) is multifactorial and multigenic. Studies have suggested that polymorphisms and mutations in the surfactant protein B (SP-B) gene are associated with the pathogenesis of RDS. The objectives of this study were to determine and compare the frequencies of SP-B gene polymorphisms in preterm babies with and without RDS. We studied 151 neonates: 79 preterm babies without RDS and 72 preterm newborns with RDS. The following four SP-B gene polymorphisms were analyzed: A/C at -18, C/T at 1580, A/G at 9306, and G/C at nucleotide 8714. The polymorphisms were detected by PCR amplification of genomic DNA and genotyping. The genotypes were determined using PCR-based converted restriction fragment length polymorphisms. The control group consisted of 42 (53%) girls and 37 (47%) boys. Weight ranged from 1170 to 3260 g and mean gestational age (GA) was 33.9 weeks (range: 29 to 35 weeks and 6 days). The RDS group consisted of 31 (43%) girls and 41 (57%) boys. Weight ranged from 614 to 2410 g and mean GA was 32 weeks (range: 26 to 35 weeks). The logistic regression model showed that GA was the variable that most contributed to the occurrence of RDS. The AG genotype of the A/G polymorphism at position 9306 of the SP-B gene was a protective factor in this population (OR = 0.1681; 95%CI = 0.0426-0.6629). We did not detect differences in the frequencies of the other polymorphisms between the two groups of newborns.

Polymorphisms and mutations in the surfactant protein B (SP-B) gene have been associated with the pathogenesis of respiratory distress syndrome (RDS). The objective of the present study was to compare the frequencies of SP-B gene polymorphisms between preterm babies with RDS and healthy term newborns. We studied 50 preterm babies with RDS (inclusion criteria - newborns with RDS and gestational age between 28 and 33 weeks and 6 days), and 100 healthy term newborns. Four SP-B gene polymorphisms were analyzed: A/C at nucleotide -18, C/T at nucleotide 1580, A/G at nucleotide 9306, and G/C at nucleotide 8714, by PCR amplification of genomic DNA and genotyping by cRFLP. The healthy newborns comprised 42 female and 58 male neonates; 39 were white and 61 non-white. The RDS group comprised 21 female and 29 male preterm neonates; 28 were white and 22 non-white. Weight ranged from 640 to 2080 g (mean: 1273 g); mean gestational age was 31 weeks and 2 days (range: 28-33 weeks and 6 days). When white children were analyzed separately, a statistically significant difference in the G/C polymorphism at 8714 was observed between groups (P = 0.028). All other genotype frequencies were similar for both groups when sex and race were analyzed together. Analysis of the SP-B polymorphism G/C at nucleotide 8714 showed that among white neonates the GG genotype was found only in the RDS group at a frequency of 17% and the GC genotype was more frequently found in healthy term newborns. These data demonstrate an association of GG genotype with RDS.

A infecção por C. trachomatis é adquirida pelo recém-nascido (RN) principalmente durante sua passagem pelo canal do parto; 25% a 50% destes deverão desenvolver conjuntivite e 10% a 20% pneumonia. OBJETIVOS: Verificar a incidência de infecção ocular por C. trachomatis nos RN internados com diagnóstico de conjuntivite, num período de 10 anos. - Observar a associação entre infecção ocular é pneumonia intersticial - Estudar os aspectos epidemiológicos e os métodos utilizados para o diagnóstico laboratorial. CASUÍSTICA E METODOLOGIA: Foram analisados os RN internados com diagnóstico de conjuntivite e/ou pneumonia intersticial internados na UCINE no período de 1987-1998. Os métodos de diagnóstico utilizados foram: a pesquisa direta do agente etiológico em raspado de conjuntiva, radiografia de tórax, sorologia para C. trachomatis no sangue pelo método de imunofluorescência para anticorpos IgG e IgM. RESULTADOS: Estudamos as características de 20 RN que apresentaram infecção por C. trachomatis : 15 eram de termo (75%) e cinco, pré-termos (25%); houve predominância da infecção no sexo feminino (60%); a pneumonia esteve presente em 15 dos 20 RN (75%) e 12 apresentaram associação de conjuntivite e pneumonia. Não houve relação significante entre tipo de parto, idade materna, número de parceiros e a infecção, sendo que o antecedente materno de leucorreia esteve presente em 50% dos casos. O diagnóstico sorológico esteve relacionado com a presença de pneumonia e a pesquisa direta com a conjuntivite. A incidência de conjuntivite por C. trachomatis entre os RN internados com esse diagnóstico durante o período de estudo foi de 17/100 (17%). CONCLUSÕES: A C. trachomatis é um importante agente patogênico e sua pesquisa é muito importante em RN com conjuntivite e/ou pneumonia intersticial mesmo na ausência de fatores de risco para doença sexualmente transmissível. A pesquisa direta em raspado de conjuntiva e o exame sorológico se mostraram importantes como métodos auxiliares do diagnóstico.

Chlamydia trachomatis infection is adquired by the newborn infant during the delivery, 25 to 50 % of them may develop conjunctivitis and 10 to 20 % pneumonia. BACKGROUND: To verify the incidence of ocular infection by C. trachomatis in the newborn infants with conjunctivitis. To observe the association between ocular infection and intersticial pneumonia.-Study the epidemiological aspects and laboratorial methods of criterial diagnosis. CASUISTICS AND METHODS: We studied the newborn infants admitted in the intensive neonatal care with diagnostic of conjunctivitis and/or interstitial pneumonia during the period of ten years. The diagnostic methods were direct exam of etiologic agent in conjunctival material, X ray chest and serologic test by imunofluorescence method for IgG and IgM antibodies. RESULTS: We studied the clinical characteristics of 20 newborns infants with chlamydial trachomatis infection: 15 (75%) were terms newborns and 5 (25%) pre-terms. We observed the predominance of infection in females (60%); pneumonia was observed in 15/20 (75%) and 12 of them had both: conjunctivitis and pneumonia. we did not observe significant association among type of delivery, age of the mother, number of partner and infection. Leukorrhea was present em 50% of the mothers The serologic test was positive in 100% of the newborn with pneumonia and none with conjunctivitis alone,and the direct exam in conjuntival material was positive in newborns with conjunctivitis. The incidence of C. trachomatis in the newborns admitted in this period with conjunctivitis were 17/100 (17%). CONCLUSION: Chlamydia trachomatis is an important pathogenical agent and the research of it is essential in newborn infants with conjunctivitis and/or interstitial pneumonia even there were not risk factors for sexually transmitted diseases. The direct exam of conjunctival material and serologic test are very important to diagnosis.

OBJETIVO: Comparar o consumo de hemocomponentes entre recém-nascidos (RN) de termo (RNT) e pré-termo (RNPT) e correlacionar esse consumo ao tipo de tratamento dispensado à sua patologia: clínico ou cirúrgico; acidentes hemorrágicos e sobrevida. CASUÍSTICA E METODOLOGIA: 48 RNs classificados em dois grupos: 26 RNT e 22 RNPT receberam 251 unidades de hemocomponentes: 177 unidades de concentrado de hemácias (CH), 36 de concentrado de plaquetas (CP), 30 de plasma fresco congelado (PFC) e oito de sangue total (ST), no período de 186 dias. Foi analisado o consumo de hemocomponentes em cada grupo, e na razão do número de RNs vivos por dia, até o 120º dia. RESULTADOS: O consumo médio de hemocomponentes foi de 7,31 unidades para RNPT e 3,46 para RNT. A análise de consumo diário revelou que a maior parte ocorreu em RNs sob tratamento clínico antes do 60º dia de vida (d.v.) e que um aumento após o 86º d.v. pode ser atribuído a um aumento de cirurgias nessa fase. Os acidentes hemorrágicos predominaram em RNPT com plaquetometria inferior a 60.000/mm³. Foi constatada uma tendência inversamente proporcional entre o número de transfusões e a sobrevida. CONCLUSÕES: Os RNPT consumiram mais hemocomponentes que os RNT. Esse consumo estava ligado à patologia de base. Foi sugerido que a transfusão profilática de CP em RNPT poderia reduzir o número de hemorragias, além do consumo de CH nesse grupo. Mais de dez transfusões de hemocomponentes nos primeiros 120 d.v., em ambos os grupos, parece constituir marcador de mau prognóstico.

BACKGROUND: Blood transfusion requirements for preterm infants are greater than for newborn ones. We compare blood transfusion requirements for newborn and premature infants and their pathology: clinical or surgical; hemorragic accidents and survival. METHODS: 48 newborns classified in 2 groups: 26 newborn and 22 preterm infants received 251 units of blood components: 177 units of red cell concentrates, 36 of platelet concentrates, 30 of fresh frozen plasma and 8 of total blood in a 186 days period. We analyzed total requirements of components in each group and daily, under a live-infant/day rate until 120 days. RESULTS: The all-components median requirements were 7.31 units for premature and 3.46 for newborn infants. Daily requirements analyzes reveal that requirements were greater before 60th day of life (d.l.) on clinical patients and after 86th d.l. may be caused by surgical acts. Hemorragic accidents happen on premature with less than 60.000 platelets/mm³. The survival wave by number of transfusions, until 186 d.l., shows an inversely proportional trend between the number of transfusions done and the hope of life. CONCLUSIONS: Blood requirements for preterm infants are greater than for term ones. Those requirements are related to their pathology. Prophylatic platelet transfusions may reduce hemorrhagic accidents then red blood cell transfusions in preterm infants group. The number of transfusions over 10 is a surrogate marker of bad prognosis for both groups up to 120 d.l.