https://repositorio.ufu.br/handle/123456789/5474 2026-10-05T18:51:48Z https://repositorio.ufu.br/handle/123456789/50354 Title: Identificação da displasia broncopulmonar em recém-nascidos pré-termos de muito baixo peso por meio de biomarcadores urinários: aplicações não-invasivas com plataformas metabolômica e ATR-FTIR Abstract: Introduction: Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants, characterized by impaired alveolar and vascular development, resulting in compromised gas exchange and prolonged oxygen dependency. The high incidence of prematurity and the morbidity and mortality associated with BPD highlight the limitations of a diagnosis that remains largely based on late clinical outcomes, which fail to reflect the early immunoinflammatory alterations underlying the disease. This limitation hinders risk stratification and timely intervention, underscoring the need for the development of non-invasive biomarkers integrated with artificial intelligence to improve the prediction and management of BPD in very low birth weight preterm infants. Objective: To develop and evaluate non-invasive platforms based on urinary biomarkers integrated with artificial intelligence algorithms for the early prediction of BPD in very low birth weight preterm infants (VLBW-PTIs). Materials and Methods: A longitudinal study was conducted in a neonatal intensive care unit between January 2015 and September 2019, including preterm infants with gestational age <30 weeks and very low birth weight (<1,500 g). Infants were classified into two groups: BPD and non-BPD. Urine samples collected on the second day of life were analyzed using attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR) and high-resolution mass spectrometry (MS) coupled with high-performance liquid chromatography (HPLC) for metabolite identification. Spectral data generated by both platforms were subsequently analyzed using artificial intelligence algorithms to assess diagnostic predictive performance (accuracy, sensitivity, and specificity). Statistical analyses included parametric and nonparametric tests for group comparisons, principal component analysis (PCA) of spectral data, machine learning-based classification algorithms, metabolomic analysis, univariable and multivariable logistic regression, internal bootstrap validation, receiver operating characteristic (ROC) curve analysis, and decision curve analysis. Results: In the ATR-FTIR analysis of 42 urine samples from very low birth weight (VLBW) preterm infants, including 20 with bronchopulmonary dysplasia (BPD) and 22 without BPD, the AdaBoost algorithm combined with second-derivative preprocessing demonstrated a sensitivity of 73%, a specificity of 81%, and an accuracy of 78% in classifying infants who did or did not develop BPD. The most relevant vibrational markers were associated with lipids, carbohydrates, and proteins. HPLC-MS metabolomic analysis of 88 urine samples from VLBW preterm infants, including 33 with BPD and 55 without BPD, identified two metabolites with significantly different abundances between the groups. The final multivariable model (M2), which combined sex, birth weight, gestational age, mechanical ventilation on the second day of life, and urinary Cys-Ser-Met, showed good discriminatory performance, yielding an AUC of 0.862 (bootstrap 95% CI, 0.775–0.937). At a cutoff of 0.347, the model achieved 80.7% sensitivity, 83.9% specificity, and 81.8% accuracy, with a positive predictive value of 90.2% and a negative predictive value of 70.3%. Conclusions: The results highlight the potential of a portable ATR-FTIR platform combined with artificial intelligence algorithms for the diagnostic screening of BPD using a non-invasive biological matrix such as urine. The urinary metabolomic approach identified Cys-Ser-Met and creatinine as differentially abundant metabolites in preterm infants with BPD, and the incorporation of Cys-Ser-Met into clinical variables improved model discrimination. However, these findings still require external validation in larger, multicenter cohorts. Together with our previous results obtained via ATR-FTIR, these data suggest that spectroscopic and metabolomic platforms can provide complementary biochemical signatures for the early identification of BPD, though their diagnostic and clinical utility must be prospectively confirmed prior to implementation in neonatal practice. 2026-08-25T00:00:00Z https://repositorio.ufu.br/handle/123456789/50200 Title: Perfil sorológico e evolução dos neonatos de mães com toxoplasmose aguda na gestação Abstract: Introduction: Congenital Toxoplasmosis is an infectious disease that resultsfrom transplacental transfer of Toxoplasma gondii to the fetus, resulting from primary infection of the mother during pregnancy. Serological tests are the most widely used and both the diagnosis. However, these antibodies may not be present at birth and there is also the possibility of false positive results in the first days of life. The aim of this study was to evaluate the profile of mothers with serological diagnosis of toxoplasmosis during pregnancy and their children Methods: We evaluated the results of serological tests IgM and IgA of 79 pairs of mothers-infants who were diagnosed with acute toxoplasmosis during pregnancy, and its correlation with congenital toxoplasmosis diagnosis. The medical records were obtained data for clinical symptoms, diagnosis and management. Differences in continuous variables between groups were compared by t test or Mann-Whitney Sudent when appropriate. We calculated sensitivity, specificity, and positive and negative predictive values of serological tests. Data were analyzed using SPSS 20.0 P values <0.05 were considered statistically Results: The diagnosis of congenital toxoplasmosis occurred in 15% of babies, of which 5 (40%) were asymptomatic at birth. The most common symptom was chorioretinitis. The sensitivity and specificity of IgA and IgM collected from newborns were 92/92% 99/96%, respectively. When associated with negative maternal IgA were observed positive or false negative results. Conclusion: The combined detection of IgM or IgA antibodies in the neonate associated with maternal IgA, combined with clinical data, can be useful in identifying newborns with congenital toxoplasmosis 2015-08-28T00:00:00Z https://repositorio.ufu.br/handle/123456789/49329 Title: Associação da insegurança alimentar com vitaminas e carotenóides plasmáticos em adultos participantes do National Health and Nutrition Examination Survey (NHANES) 2017-2018 Abstract: Introduction: In the United States, food insecurity (FI) predisposes vulnerable populations to the paradox of obesity coexisting with “hidden hunger.” Although the literature points to poor diet quality as a mediator of this relationship, the evidence is based primarily on dietary surveys. To overcome the limitations of self-reporting, the use of serum biomarkers is essential for quantifying the impact of this vulnerability on dietary quality. Objective: To evaluate the relationship between Food Insecurity and the serum biochemical profile of vitamins and carotenoids in U.S. adults and older adults, considering effect modification by sex, age group, and race/ethnicity. Material and methods: A cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, comprising 3,092 adults (≥20 years). Serum levels of vitamins A, C, D, and E, as well as carotenoids, were evaluated. Survey-weighted linear regression models were used to examine the association between FI and these biomarkers. Food Insecurity was assessed using the Household Food Security Survey Module. Confounding variables for the adjusted models were strictly selected using a Directed Acyclic Graph (DAG). Analyses were performed on the total sample and stratified by sex, age, and race/ethnicity. Results: In the total sample, after adjustments, Food Insecurity maintained a significant inverse association with levels of total carotenoids, cis-, and trans-beta-carotene. In stratified analyses, carotenoid depletion persisted among women and young adults. In contrast, men showed an association with reduced vitamin E and lycopene, and older adults with vitamins D and E. Regarding race/ethnicity, the association lost significance among minorities after socioeconomic adjustments, indicating that structural variables such as income and education absorb the isolated impact of Food Insecurity in these groups. Conclusion: Food Insecurity in the U.S. transcends caloric restriction and constitutes a severe state of hidden hunger. The depletion of carotenoids highlights the restricted access to fresh, unprocessed foods (fruits and vegetables). The use of serum biomarkers underscored how social vulnerability can be reflected in measurable nutritional differences. 2026-05-29T00:00:00Z https://repositorio.ufu.br/handle/123456789/48907 Title: Tendência temporal dos indicadores da alimentação infantil e sua associação com fatores sociodemográficos entre crianças de 6 a 23 meses de idade em países da América Latina e do Caribe nas décadas de 2000 e 2010 Abstract: Introduction: Infant and young child feeding indicators were primarily developed to monitor progress toward established targets and to assess the impact of public policies on infant and young child nutrition. Objectives: To analyze temporal trends in infant and young child feeding indicators during the 2000s and 2010s and to examine their association with sociodemographic factors among children aged 6–23 months living in Latin America and the Caribbean in the 2010s. Methods: This cross-sectional study used data from the Demographic and Health Surveys (DHS), Multiple Indicator Cluster Surveys (MICS), and the Brazilian National Survey on Child Nutrition (ENANI), conducted during the 2000s and 2010s among children aged 6–23 months living in Latin American and Caribbean countries. To describe the prevalence of infant and young child feeding practices across the two decades, indicators proposed by the World Health Organization (WHO, 2021) were used: continued breastfeeding (CBF); introduction of solid, semi-solid, or soft foods (ISSSF); minimum dietary diversity (MDD); minimum meal frequency (MMF); consumption of eggs and/or flesh foods (EFF); and zero consumption of fruits or vegetables (ZFV). The sociodemographic variables analyzed included child sex and age; maternal age and education; marital status; number of children; household wealth index; and area of residence. Temporal trends were assessed using prevalence estimates and 95% confidence intervals (95% CI) by country and survey year. Associations between sociodemographic factors and feeding indicators were examined using multilevel logistic regression models, with calculation of the intraclass correlation coefficient (ICC). Results were expressed as odds ratio (OR) and 95% CI. Results: Continued breastfeeding showed a declining trend in Haiti, Honduras, and the Dominican Republic, with reductions ranging from −9.2 to −35.2 percentage points. The prevalence of ISSSF exceeded 80% in the most recent surveys, with increases observed in Haiti and Peru. Both MDD and MMF increased in Peru (+6.5 percentage points) and the Dominican Republic (+29.5 percentage points). The EFF indicator increased in Honduras, Peru, and the Dominican Republic, reaching prevalences above 80%, while ZFV decreased in Peru and the Dominican Republic. Older children had lower odds of continued breastfeeding (OR=0.15; 95% CI=0.12–0.19) and higher odds of meeting ISSSF (OR=2.71; 95% CI=2.01–3.64), MDD (OR=1.66; 95% CI=1.23–2.24), MMF (OR=2.71; 95% CI=2.01–3.64), and EFF (OR=2.41; 95% CI=1.97–2.94), as well as lower odds of ZFV (OR=0.70; 95% CI=0.59–0.83). Older mothers had higher odds of meeting CBF (OR=2.29; 95% CI=1.60–3.27), ISSSF (OR=2.01; 95% CI=1.02–3.97), MDD (OR=3.19; 95% CI=1.40–6.90), and MMF (OR=5.10; 95% CI=2.89–8.98), and lower odds of ZFV (OR=0.49; 95% CI=0.36–0.48). Mothers with higher education had lower odds of continued breastfeeding (OR=0.53; 95% CI=0.37–0.76) and higher odds of meeting the EFF and ZFV indicators. A higher number of children and rural residence were associated with lower odds of meeting ISSSF, MMF, EFF, and ZFV. The proportion of variance in feeding indicators explained by the contextual level ranged from 19% for ZFV to 55% for MDD. Conclusion: Continued breastfeeding showed a declining trend between the 2000s and 2010s; however, an overall improvement was observed in other infant and young child feeding indicators. Children older than 12 months and those whose mothers were older and more educated had higher odds of meeting infant and young child feeding recommendations. In contrast, children living in rural areas and those whose mothers had a higher number of children were less likely to meet these indicators. 2026-02-27T00:00:00Z