Objective: To determine the safety, immunogenicity and efficacy of two doses of rotavirus vaccine in healthy Brazilian infants. Methods: A randomized, multicenter, double-blind, placebo-controlled trial was conducted in Brazil, Mexico and Venezuela. Infants received two oral doses of vaccine or placebo at 2 and 4 months of age, concurrently with routine immunizations, except for oral poliomyelitis vaccine (OPV). This paper reports results from Belém, Brazil, where the number of subjects per group and the viral vaccine titers were: 194 (10 4.7 focus forming units-FFU), 196 (10 5.2 FFU), 194 (10 5.8 FFU) and 194 (placebo). Anti-rotavirus (anti-RV) antibody response was assessed in 307 subjects. Clinical severity of gastroenteritis episodes was measured using a 20-point scoring system with a score of ≥ 11 defined as severe GE. Results: The rates of solicited general symptoms were similar in vaccine and placebo recipients. At 2 months after the second dose, a serum IgA response to RV occurred in 54.7 to 74.4% of vaccinees. No interference was seen in the immunogenicity of routine vaccines. Vaccine efficacy against any rotavirus gastroenteritis (RVGE) was 63.5% (95%CI 20.8-84.4) for the highest concentration (10 5.8 FFU). Efficacy was 81.5% (95%CI 44.5-95.4) against severe RVGE. At its highest concentration (10 5.8 FFU), RIX4414 provided 79.8% (95%CI 26.4-96.3) protection against severe RVGE by G9 strain. Conclusions: RIX4414 was highly immunogenic with a low reactogenicity profile and did not interfere with seroresponse to diptheria, tetanus, pertussis, hepatitis B and Hib antigens. Two doses of RIX4414 provided significant protection against severe GE caused by RV. J Pediatr (Rio J). 2007;83(3):217-224: Rotavirus, gastroenteritis, vaccine, efficacy.

Obesity promotes a significant reduction in plasma dapsone trough levels of subjects with multibacillary leprosy with a weak association between drug levels and BMI.

BackgroundThe role of repeated episodes of malaria on the cognitive development of children is a relevant issue in endemic areas since it can have a long-lasting impact on individual lifespan. The aim of the current paper was to investigate whether the history of malaria can impair the verbal and performance skills of children living in an endemic area with low transmission of Plasmodium vivax malaria.MethodsA cross-sectional study was conducted with children living in an endemic area of P. vivax malaria in Brazilian Amazon basin. The history of episodes of malaria was used as criteria for inclusion of children in the groups. The cognitive performance was assessed by the Wechsler intelligence scale for children-III edition (WISC-III), which was applied to the participants of study by two trained psychologists.ResultsA total of 17 cases and 26 controls was included in the study. A significant low score of verbal quotient was found in the cases (p = 0.005), however, the performance IQ was similar in both groups (p = 0.304). The full-scale IQ was significantly lower in the cases when compared to the controls (p = 0.042). The factorials index showed significant difference only in the subtest of verbal comprehension with the lower values in the cases (p = 0.0382), compared to the controls. The perceptual organization (p = 0.363), freedom from distractability (p = 0.180) and processing speed (p = 0.132) were similar in both groups.ConclusionsChildren with a history of vivax malaria has a significant impairment of verbal and full-scale quotients as well as a significant low index of verbal comprehension. These findings are likely due to the absenteeism caused by malaria and by the low parental education, which impairs an adequate response to the environmental stimulus.

Objective: To determine the safety, immunogenicity and efficacy of two doses of rotavirus vaccine in healthy Brazilian infants. Conclusions: RIX4414 was highly immunogenic with a low reactogenicity profile and did not interfere with seroresponse to diptheria, tetanus, pertussis, hepatitis B and Hib antigens. Two doses of RIX4414 provided significant protection against severe GE caused by RV.J Pediatr (Rio J). 2007;83(3):217-224: Rotavirus, gastroenteritis, vaccine, efficacy.

ResumoObjetivo: Verificar a incidência de sífilis congênita em neonatos, em maternidade de hospital público.Métodos: A pesquisa foi realizada na maternidade do Hospital Fundação Santa Casa de Misericórdia do Pará, no período de maio a setembro de 1996. Foram entrevistadas 361 puérperas e realizados os exames físicos de seus recém-nascidos. Ambos foram submetidos a 3 exames sorológicos: VDRL, FTA -Abs, ELISA IgM. Para o diagnóstico de sífilis congênita, empregaram-se os critérios indicados pelo Ministério da Saúde em 1993.Resultados: A incidência de sífilis congênita foi de 9,1% (33); em 14 casos, houve um ou mais sinais indicativos da doença: prematuridade, hepatomegalia, natimortalidade, esplenomegalia, neomortalidade, distensão abdominal, obstrução nasal, icterícia, recém-nascido pequeno para a idade gestacional. A maioria das mães com sífilis estava na faixa de 20 a 35 anos de idade (81,8%); 60,6% eram casadas; 63,6% haviam realizado o pré-natal; 48,5% referiram abortos espontâneos e 12,1% episódios de natimortalidade, em gestações anteriores; 12,1% confessaram consumir drogas. Bissexualidade paterna foi registrada em 9,1% dos casos.Conclusão: Os programas de controle da sífilis e os cuidados pré-natais não estão conseguindo prevenir a incidência expressiva da moléstia.J. pediatr. (Rio J.). 1999; 75(2):119-125: sífilis congênita, recém-nascido. AbstractObjective: To determine the incidence of congenital syphilis among newborns at the maternity of a public hospital.Methods: The study was conducted at the maternity of Fundação Santa Casa de Misericórdia do Pará, from May to September 1996; 361 mothers were interviewed, and physical examination was performed in their newborns. Serum samples from both, mothers and neonates, were tested using three methods: VDRL, FTA -Abs, ELISA IgM. The diagnosis of congenital syphilis was established according to the criteria defined by Ministério da Saúde in 1993.Results: The rate of congenital syphilis was of 9.1% (33); in 14 cases, there were one or more signs of the disease: prematurity, hepatomegaly, stillbirth, splenomegaly, perinatal death, abdominal distention, nasal stuffiness, jaundice, newborn small for gestational age. The majority of the infected mothers belonged to the age group of 20-35 years (81.8%); 60.6% were married; 63.6% received prenatal care; 48.5% reported previous spontaneous abortion, and 12.1% previous stillbirth. The rate of bisexuality among fathers was of 9.1%. Conclusion:The syphilis control measures and the prenatal care, have not been sufficient to prevent the high rate of the disease.J. pediatr. (Rio J.). 1999; 75(2):119-125: congenital syphilis, newborn. IntroduçãoCom o advento da penicilina, diminuiu muito a incidência de sífilis. Porém, o número de casos relatados aumentou a partir de 1980 nos EUA 1 e, atualmente, a sífilis representa sério problema de saúde pública em muitos países, inclusive no Brasil 2 .A sífilis pode ser transmitida ao concepto em qualquer fase da gravidez. A OMS estima em 85,0% a taxa média de transmissão vertical em ges...