Conselho Nacional de Desenvolvimento Científico e Tecnológico / A síndrome da imunodeficiência adquirida (AIDS), causada pelo vírus da imunodeficiência humana (HIV), é uma das epidemias mais impactantes do milênio e, desde o início, o número de mulheres jovens infectadas vem aumentando vertiginosamente, principalmente nos países em desenvolvimento onde muitas destas engravidam precocemente. Apesar da grande maioria dos casos de AIDS pediátrico no mundo resultar da transmissão vertical, aproximadamente dois terços dos neonatos expostos ao HIV durante a vida fetal não são contaminados. Neste sentido, seguindo as recomendações do consenso brasileiro (Ministério da Saúde), toda criança cuja transmissão vertical tenha sido descartada laboratorialmente não necessita de acompanhamento ambulatorial particularizado. Entretanto, resultados anteriores obtidos pelo nosso grupo demonstraram que, gestantes infectadas pelo HIV-1 que não controlam a carga viral plasmática (CVP), apresentam níveis elevados de citocinas inflamatórias e, no presente estudo, resultados revelam que neonatos não-infectados nascidos dessas gestantes apresentam anormalidades imunofuncionais no compartimento das células T do cordão umbilical quando expostos in vitro a ativadores policlonais, mas não aos antígenos do HIV-1. Ademais, quando comparada a neonatos não expostos, a ativação in vitro das células T de neonatos expostos ao HIV-1 com anti-CD3/anti-CD28 induziu a produção de níveis elevados de IL-17 e reduzidos de IL-10. Interessantemente, essa tendência das células T em secretar IL-17 parece estar relacionada à liberação de níveis elevados de IL-23 pelas células dendríticas derivadas de monócitos do sangue do cordão umbilical estimuladas com lipopolissacarídeo bacteriano. Uma ausência de sensibilização uterina aos antígenos do HIV-1 sugere que essas alterações possam traduzir um efeito adverso da produção elevada de citocinas inflamatórias maternas sobre o sistema imune do neonato, o que pode desequilibrar os eventos envolvidos na maturação e homeostasia imune fetal e neonatal, favorecendo o predomínio de fenótipos Th anômalos, tal como Th17. Essa hiper-responsividade das células Th17 pode vir a comprometer não apenas a capacidade da criança em responder de forma adequada a diferentes estímulos antigênicos ao longo de sua vida, como também pode torná-la mais suscetível a desordens imunomediadas / The acquired immunodeficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV), is one of the most impelling epidemic in the world, and the HIV-infection in young women has been increasing fast in the recent times, mainly in developing countries where most of them become pregnant precociously. Although the great majority of the pediatric AIDS cases all over the world results from vertical transmission, approximately, two thirds of the children exposed to HIV during fetal life are not contaminated. In this context, following brazilian consensus recommendations (Health Ministry), every child whom vertical transmission had been laboratorialy discarded does not need a specific ambulatorial follow up. However, our previous results demonstrated that HIV-1-infected pregnant women who did not control their plasma viral load presented elevated levels of inflammatory cytokines, and in the present study our results revealed that non-infected neonates, born from these pregnant women display immune functional abnormalities in umbilical cord T cells compartment when exposed in vitro to policlonal activators, but not to HIV-1 antigens. Furthermore, when compared to non-exposed neonates, T cell in vitro activation with anti-CD3/anti-CD28 from neonates exposed to HIV-1 induced production of high IL-17 levels and decreased of IL-10. Interestingly, this T cell bias in secreting IL-17 seem to be related to liberation of high IL-23 levels by dendritic cells derived from umbilical cord blood monocytes following stimulation with bacterial lipopolysacharide (LPS). The lack of uterine sensitization to HIV-1 antigens suggests that, these alterations, may translate an adverse effect of a high level maternal inflammatory cytokines production on neonates immune system, which may unbalance events related to neonatal and fetal immune maturation and homeostasis, favoring Th anomalous phenotypes predominance, such as Th17. This Th17 hyper-responsiveness may then compromise not only the childs capacity to respond in an adequate way to different antigenic stimuli through life, as well as becoming them more susceptible to immune-mediated disorders

Since 1990, many countries world-wide implemented salt iodisation programs in an effort to<p>tackle iodine deficiency. It was however only during the last few years that an effort was<p>undertaken in order to eliminate iodine deficiency as a public health problem in Belgium. In autumn 1998, a nation-wide study among children clearly showed mild iodine deficiency in<p>Belgium, but no action was taken before 2009. It was only in the framework of the first<p>National Nutrition and Health Plan 2005-2010 that iodine deficiency was formally recognized<p>as a public health problem. An agreement between the Ministry of Health and the bakery<p>sector in April 2009 aimed to encourage and increase the use of iodised salt in the<p>production of bread. A selective and progressive approach was used in order to keep control<p>and to avoid a too rapid increase of iodine intake or an excessive iodine intake among the<p>population. It was calculated that the net yearly savings after installation of such a program<p>amount to at least 14 million Euros a year.<p>A recent national survey among school-aged children in autumn 2010 showed a clear and<p>significant improvement in iodine status compared to more than 10 years ago, suggesting<p>iodine sufficiency among school-aged children. The median urinary iodine concentration was<p>however at the lower end of the optimal range and seasonal effects were not taken into<p>account. The improvement was at least partly linked to the increasing use of iodised salt in<p>the bakery industry. However, some further silent iodine prophylaxis might also have<p>occurred, due to changing dietary habits (milk and fish consumption). Pregnant women and<p>women of child-bearing age in Belgium were found to still suffer from mild iodine deficiency<p>according to the current recommendations. This is at least partly linked to their lower<p>consumption of milk and dairy drinks compared to children and due to the higher iodine<p>requirements during pregnancy. Although the use of iodine-containing supplements among<p>pregnant women was found to be quite high in Belgium compared to other European<p>countries, because of the low iodine status among women of child-bearing age, women<p>became pregnant with a suboptimal iodine status.<p>In view of these findings, a further increase in the use of iodised instead of non-iodised<p>household salt and iodised salt by the bakers is recommended. In addition, one should put<p>efforts in increasing awareness among the public and among health professionals with<p>regard to iodine-rich food sources and with regard to the use of iodine-containing<p>supplements starting before conception and continuing during lactation.<p>In order to further improve iodine status in Belgium and sustain an optimal iodine status<p>over time, a legal framework is necessary. Mandatory fortification of all household salt and<p>bread is recommended, while non-iodised alternatives could still be offered upon specific<p>request. A rigorous monitoring program is indispensable, including vulnerable groups such as<p>pregnant and lactating women and infants. In addition, sustainability is a key issue as iodine<p>deficiency re-emerged in several industrial countries due to lack of interest, regulations and<p>monitoring. Political willing, salt reduction measures, changes in dietary habits among the<p>population and changes in industrial practices all may affect iodine status in Belgium in the<p>future. Therefore the strategy of controlling iodine deficiency needs to be directed and<p>monitored by a Belgian Scientific Committee for the Control of iodine deficiency disorders. / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A síndrome da imunodeficiência adquirida (AIDS), causada pelo vírus da imunodeficiência humana (HIV), é uma das epidemias mais impactantes do milênio e, desde o início, o número de mulheres jovens infectadas vem aumentando vertiginosamente, principalmente nos países em desenvolvimento onde muitas destas engravidam precocemente. Apesar da grande maioria dos casos de AIDS pediátrico no mundo resultar da transmissão vertical, aproximadamente dois terços dos neonatos expostos ao HIV durante a vida fetal não são contaminados. Neste sentido, seguindo as recomendações do consenso brasileiro (Ministério da Saúde), toda criança cuja transmissão vertical tenha sido descartada laboratorialmente não necessita de acompanhamento ambulatorial particularizado. Entretanto, resultados anteriores obtidos pelo nosso grupo demonstraram que, gestantes infectadas pelo HIV-1 que não controlam a carga viral plasmática (CVP), apresentam níveis elevados de citocinas inflamatórias e, no presente estudo, resultados revelam que neonatos não-infectados nascidos dessas gestantes apresentam anormalidades imunofuncionais no compartimento das células T do cordão umbilical quando expostos in vitro a ativadores policlonais, mas não aos antígenos do HIV-1. Ademais, quando comparada a neonatos não expostos, a ativação in vitro das células T de neonatos expostos ao HIV-1 com anti-CD3/anti-CD28 induziu a produção de níveis elevados de IL-17 e reduzidos de IL-10. Interessantemente, essa tendência das células T em secretar IL-17 parece estar relacionada à liberação de níveis elevados de IL-23 pelas células dendríticas derivadas de monócitos do sangue do cordão umbilical estimuladas com lipopolissacarídeo bacteriano. Uma ausência de sensibilização uterina aos antígenos do HIV-1 sugere que essas alterações possam traduzir um efeito adverso da produção elevada de citocinas inflamatórias maternas sobre o sistema imune do neonato, o que pode desequilibrar os eventos envolvidos na maturação e homeostasia imune fetal e neonatal, favorecendo o predomínio de fenótipos Th anômalos, tal como Th17. Essa hiper-responsividade das células Th17 pode vir a comprometer não apenas a capacidade da criança em responder de forma adequada a diferentes estímulos antigênicos ao longo de sua vida, como também pode torná-la mais suscetível a desordens imunomediadas / The acquired immunodeficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV), is one of the most impelling epidemic in the world, and the HIV-infection in young women has been increasing fast in the recent times, mainly in developing countries where most of them become pregnant precociously. Although the great majority of the pediatric AIDS cases all over the world results from vertical transmission, approximately, two thirds of the children exposed to HIV during fetal life are not contaminated. In this context, following brazilian consensus recommendations (Health Ministry), every child whom vertical transmission had been laboratorialy discarded does not need a specific ambulatorial follow up. However, our previous results demonstrated that HIV-1-infected pregnant women who did not control their plasma viral load presented elevated levels of inflammatory cytokines, and in the present study our results revealed that non-infected neonates, born from these pregnant women display immune functional abnormalities in umbilical cord T cells compartment when exposed in vitro to policlonal activators, but not to HIV-1 antigens. Furthermore, when compared to non-exposed neonates, T cell in vitro activation with anti-CD3/anti-CD28 from neonates exposed to HIV-1 induced production of high IL-17 levels and decreased of IL-10. Interestingly, this T cell bias in secreting IL-17 seem to be related to liberation of high IL-23 levels by dendritic cells derived from umbilical cord blood monocytes following stimulation with bacterial lipopolysacharide (LPS). The lack of uterine sensitization to HIV-1 antigens suggests that, these alterations, may translate an adverse effect of a high level maternal inflammatory cytokines production on neonates immune system, which may unbalance events related to neonatal and fetal immune maturation and homeostasis, favoring Th anomalous phenotypes predominance, such as Th17. This Th17 hyper-responsiveness may then compromise not only the childs capacity to respond in an adequate way to different antigenic stimuli through life, as well as becoming them more susceptible to immune-mediated disorders

A prematuridade ao nascimento é um fator de risco para a visão, podendo causar retinopatia, uma condição em que há descolamento da retina. Retinopatia da prematuridade ocorre em uma parcela relativamente pequena dos recém nascidos prematuros e não sabemos se os demais, cujo desenvolvimento visual é aparentemente normal, seguem de fato o mesmo curso que o observado em bebes nascidos após uma gestação completa, ou se também sofrem algum prejuízo devido ao nascimento prematuro. Alternativamente, estes bebês poderiam ter um desenvolvimento visual acelerado pela sua exposição mais longa ao mundo visual. Para saber se a condição de prematuridade acelera, retarda, ou não altera o desenvolvimento da visão, o presente trabalho comparou o desenvolvimento das funções de acuidade visual e de sensibilidade ao contraste espacial de luminância em bebês nascidos prematuros e a termo. O estudo utilizou o método dos Potenciais Visuais Corticais Provocados de Varredura para examinar essas funções. Possíveis correlações entre os limiares visuais obtidos durante o primeiro ano de vida e idade gestacional, índices de Apgar, e valores de peso ao nascimento, foram examinadas. Os participantes foram 57 bebês de ambos os sexos encaminhados pelo Hospital Universitário da Universidade de São Paulo, dos quais 31 prematuros e 26 nascidos a termo. As avaliações foram realizadas principalmente em 3 fases do desenvolvimento visual: 4, 6 e 12 meses de vida. Os bebês prematuros tiveram suas idades corrigidas com relação à idade gestacional para a comparação com os grupos de termos. Um grupo de 14 sujeitos adultos também foi avaliado com os mesmos estímulos visuais. As avaliações das funções de acuidade visual e sensibilidade ao contraste foram realizadas através do método de potenciais visuais corticais provocados de varredura. Eletrodos posicionados no escalpo da região occipital dos pacientes captaram as respostas eletrofisiológicas provocadas por estímulos gerados em um monitor de alta resolução por um sistema computadorizado (sistema NuDiva). Estes estímulos consistiam de grades quadradas com valor de contraste fixo (80%) para avaliação da acuidade visual, e grades senoidais de 4 freqüências espaciais: 0,2 , 0,8 , 2,0 e 4,0 ciclos por grau para a avaliação da sensibilidade ao contraste. Prematuros e termos não apresentaram diferenças estatísticas significantes nas funções visuais avaliadas em nenhuma fase do desenvolvimento. O pico de sensibilidade ao contraste ocorreu entre .8 e 2.0 cpg de 4 meses de idade. No sexto mês o pico deslocou-se para 2.0 cpg, e entre os meses 9 e 12 passou para freqüências espaciais mais altas, por volta de 4.0 cpg coincidindo com o pico encontrado para os adultos. Nossos dados sugerem que nem a experiência visual, maior nos prematuros em relação aos termos, nem o tempo de gestação, maior nos termos em relação aos prematuros, afetam o desenvolvimento da visão espacial em humanos. / Prematurity at birth is a risk factor for vision, since it may lead to retinopathy - a condition in which there is retinal detachment. Retinopathy of prematurity occurs in a relatively small percentage of premature infants and it is not known if the remainder, whose visual development is apparently normal, follow the same course as in term babies after a complete gestational period, or if they also suffer some loss from having been born before complete development. Alternatively, these babies might have an accelerated visual development due to their longer exposure to the visual world, compared to term babies. To examine if prematurity accelerates, slows down, or does not affect visual development, the present study compared the development of visual acuity and contrast sensitivity in premature and term babies. The study used the methodology of the sweep visual evoked potentials to examine these functions. Possible correlations between visual thresholds obtained during the first year of life and gestational age, apgar index and birth weight, were examined. Participants were 57 infants of both genders, recruited by the University Hospital of São Paulo University, of which 31 were prematurely born and 26 were term infants. Evaluations were performed at three visual developmental epochs: 4, 6 e 12 months of age. The age of preterm infants was corrected by their gestational ages in order to allow comparison with the term infants. Another group with 14 adult subjects was tested with the same visual stimulus. Visual acuity and contrast sensitivity tests were performed with the sweep visual evoked potential method. Electrodes placed over the infant\'s scalp at the occipital role recorded electrophysiological responses evoked to visual stimuli generated by a high resolution monitor of a computerized system. The stimuli were square wave gratings with 80% of contrast to evaluate visual acuity, and sine wave gratings of 4 spatial frequencies: 0,2 , 0,8 , 2,0 e 4,0 cycles per degree to evaluate contrast sensitivity. Preterm and term infants did not show statistical differences in the evaluated visual functions in any developmental phase. The contrast sensitivity peak occurred between 0.8 and 2.0 cpd at 4 months of age. At the sixth month the peak moved to 2.0 cpd and it was displaced to a higher spatial frequency (4.0 cpd) at 12 months, where it coincides with the adult SCS peak. Our data suggest that neither visual experience, longer in the preterm, nor gestational age, longer in the term infants, seems to affect spatial vision functions in humans.

As proteínas de classe 3 são candidatas na preparação de uma vacina contra a doença meningocócica. O objetivo deste estudo é determinar a imunogenicidade da proteína de classe 3 purificada da cepa de Neisseria meningitidis do sorogrupo B juntamente com a capacidade adjuvante de whole cells de Bordetella pertussis. Foram imunizados camundongos BALB/c neonatos em um intervalo de 3 a 12 dias entre 1 e 4 doses da proteína de classe 3 mais adjuvante, pela via intranasal e no 21º dia pela via intramuscular com a proteína de classe 3 emulsificada com hidróxido de alumínio. Os resultados demonstraram que após 2 doses pela via intranasal e 1 dose pela via intramuscular houve rápido estímulo das células imunes nos camundongos adultos BALB/c e neonatos BALB/c e outbred. Todos os soros foram analisados por ELISA e immunoblot. O adjuvante B. pertussis administrado pelas vias intranasal ou intramuscular, aumentou a resposta imune comparada com os controles. Anticorpos bactericidas e de alta afinidade foram produzidos. / Proteins of class 3 sound candidates in the preparation of vaccine against meningococcal illness. The aim of this study was to determine the immunogenicity of class 3 proteins purified of Neisseria meningitidis of the serogroup B along with whole cells of Bordetella pertussis as adjuvant. BALB/c and outbred neonate mice between 3 and 12 days old were immunized with 1 to 4 doses of the purified class 3 proteins with or without adjuvant given by the intranasal route, and on the 21st day the animals received an intramuscular dose of the class 3 proteins with or without aluminum hydroxide. The results demonstrated that after 2 doses by the intranasal route and 1 dose intramuscular there was a rapid stimulation of the immune cells in BALB/c adult mice as well as BALB/c and outbred neonates mice. All sera were analyzed by ELISA and immunoblot. The adjuvant B. pertussis used in the present investigation and given via the intranasal or intramuscular route increased the immune response compared with the controls. High affinity and bactericidal antibodies were produced.

Die Besiedlung des kindlichen Darms beginnt unmittelbar mit der Geburt. Hier findet der erste Kontakt mit verschiedensten Bakterien statt. Deshalb war die zentrale Fragestellung unserer Untersuchung, wie sich die Bakterienarten bei den Geburtsmodi unterscheiden und wie sich die bakterielle Zusammensetzung im Stuhl von Neugeborenen im Laufe der Jahre verändert hat. Wir untersuchten die Stuhlproben von 42 Neugeborenen, wovon 22 vaginal und 20 per Sectio entbunden wurden, am ersten, zweiten und dritten Lebenstag auf Bakterienwachstum. Es wurden die aufgetretenen Bakteriengattungen mittels Kultur bestimmt und von den aufgetretenen Staphylokokken und Enterokokken die Arten und deren Resistenzen mittels des Phönix-Vollautomaten untersucht. Wir konnten zeigen, dass im Gegensatz zu früheren Untersuchungen heutzutage vermehrt Staphylokokken den Darm von Neugeborenen besiedeln. Außerdem fiel auf, dass per Sectio entbundene Kinder eine verminderte Heterogenität in ihrer Stuhlflora haben und erst später besiedelt werden als vaginal entbundene Kinder.

Consonnes et voyelles sont les deux catégories de sons qui composent la parole. Elles se distinguent à divers niveaux et notamment servent des fonctions linguistiques différentes. Cette asymétrie consonne/voyelle établie chez les adultes, a conduit Nespor, Peña et Mehler (2003) à suggérer un partage du travail dès la naissance, les consonnes facilitant l'acquisition des mots tandis que les voyelles aideraient à apprendre les règles de grammaire. La validité développementale de cette hypothèse est explorée par l'étude de ses origines chez les bébés français. Premièrement, nos études d'imagerie cérébrale optique montrent que consonnes et voyelles sont également traitées par les mécanismes précurseurs de l'apprentissage syntaxique à la naissance (Exp. 1 - 3). Deuxièmement, nos études sur la reconnaissance du prénom chez les enfants de 5 mois montrent une sensibilité à une modification vocalique (Alix/Elix) chez les bébés monolingues, mais pas à une modification consonantique en position initiale (Victor/Zictor) chez les bébés monolingues et bilingues, ou finale chez les monolingues (Luca/Luga; Exp. 4 - 9). Au stade des premiers mots, le traitement lexical privilégie donc les voyelles. Nos résultats contribuent à la compréhension des origines développementales de l'asymétrie fonctionnelle consonne/voyelle, et du rôle spécifique de la langue native dans son émergence. / Speech is composed of two categories of sound, i.e. consonants and vowels, which have different properties and serve different linguistic functions. This consonant/vowel asymmetry, which is established in adults, has led Nespor, Peña and Mehler (2003) to suggest a division of labor present from birth, whereby consonants would facilitate lexical acquisition while vowels would help to learn grammatical rules of language. We have explored the developmental validity of this hypothesis by studying its origins in French-learning infants. First, our optical brain imaging studies show that both consonants and vowels provide input for precursory mechanisms of syntax processing (Exp. 1 - 3). Secondly, our studies on own-name recognition at 5 months demonstrate sensitivity to a vowel mispronunciation in monolingual infants (Alix/Elix), but fail to show a reaction to a consonant mispronunciation in initial position (Victor/Zictor) for monolinguals and bilinguals, or in final position (Luca/Luga) for monolinguals (Exp. 4 - 9). Thus, vowels are a better input for lexical processing in first familiar words. Our results contribute to the understanding of the developmental origin of consonant/vowel functional asymmetry, hence the influence of the native input on its emergence.

A methodology for ageing foetal and neonatal cattle is developed, involving radiographic examination of infant mandibles for early developmental stages in molariform teeth; tooth-wear methodologies are imprecise at this stage before wear commences. Known-age modern bovine foetal and neonate material are collected as a control assemblage for method development (n=73); six Neolithic to Norse era assemblages from Orkney are examined using the modified technique together with standard tooth-wear analysis and other methodologies. Foetal and died-at-birth material is diagnosed at most sites using the new technique, together with a range of other peri-natal age-groups. Ageing at this early stage is highly relevant in the diagnosis of milking as a palaeoeconomy: the accepted view is that unwanted (male) calves were slaughtered to maximise milk for human consumption, hence a surfeit of neonate calf remains, as at the study sites. The diagnosis of foetal and died-at-birth material challenges this view, suggesting that attritional causes may have contributed to deaths at this stage. Although milking was probably carried out at most of the study sites, this may have been combined with slaughter of cattle for meat in a pragmatic exploitation strategy. Literary research shows possible attritional causes of abortion and early death in calves, in particular dietary insufficiency in pregnant cows, microbial infections, and also inadequate colostrum uptake. Additionally, research is used to consider the challenges to health that early milking might have posed, to the calf as mentioned, but also to the cow, where three main health issues are highlighted: infertility, mastitis and lameness. / The attached files include the Landscape pages and appendices V and VI. Not included are the jpeg Mandible files. A cover sheet was not available.

The capture of neonate ungulates has played an integral role in studies of habitat selection, phenology, survival, and other topics of ecological interest. However, neonates can be difficult for researchers to locate and capture. Neonate ungulates are born in habitats with reduced visibility, frequently spend time in a concealed, prone position, and may display cryptic coloration. In an attempt to improve researchers' likelihood of locating and capturing neonate ungulates, multiple capture methods have been developed. Much remains unknown about biases associated with capture methods and how to further improve capture methods once biases are understood. Our objectives were to determine if opportunistic captures of neonate mule deer (Odocoileus hemionus) bias estimates of litter size (Chapter 1) and to determine when searches for neonate elk (Cervus canadensis) should begin following parturition to maximize likelihood of capture while minimizing disturbance (Chapter 2). To complete our objectives, we analyzed data from 161 litters of mule deer and 55 attempted captures of neonate elk during 2019-2021 in Utah, USA. Estimates of litter size derived from opportunistic captures of mule deer were smaller than estimates derived from movement-based captures or captures completed with the aid of vaginal implant transmitters (VITs). The time elapsed between parturition and when searches were initiated for neonate mule deer did not influence estimates of litter size, but we could only analyze this relationship for VIT-aided captures within approximately 2 days of parturition. Until more data are available, we recommend that estimates of litter size for neonate mule deer be completed using movement-based or VIT-aided captures within approximately 2 days of parturition. When attempting to capture neonate elk, reducing the time elapsed between parturition and when searches were initiated resulted in a decreased search length, decreased distance traveled by the neonate, and increased likelihood of capture. We initiated searches as early as 3.6 hours post-parturition with no evidence of maternal abandonment and probability of capture was near or above 90% when searches were initiated within 10 hours of parturition. We recommend that searches for neonate elk be initiated 3.6-10 hours post-parturition. Future researchers can use utilize our results to perform captures of neonate ungulates that minimize bias, decrease disturbance, increase efficiency, and maximize the likelihood of capture success.

Le niveau d’hémoglobine (Hb) d’un nouveau-né diminue dans les premiers mois de vie. Cette anémie dite physiologique est plus sévère chez les nourrissons admis aux soins intensifs néonataux (SIN), et ceux-ci nécessitent souvent une transfusion sanguine. En néonatalogie, les indications de transfuser sont controversées et les pratiques transfusionnelles sont très variables. Pour mieux comprendre ces pratiques, nous avons mené l’étude prospective «Epidemiology and determinants of red blood cells transfusion in a neonatal intensive care unit: a cohort study». 13.4% des patients consécutifs admis aux SIN pendant l’étude ont reçu au moins une transfusion sanguine. Les prématurés nés à moins de 28 semaines d’âge gestationnel ont reçu la majorité des transfusions (62.2%) mais les nourrissons à terme admis aux SIN sont aussi fréquemment transfusés (4.9% des transfusions). Les principales justifications évoquées par les cliniciens prescrivant des transfusions sont un niveau bas d’Hb, la maladie de base et le désir d’améliorer l’oxygénation des organes. Notre étude a confirmé une grande variabilité du seuil d’Hb justifiant une transfusion, s’étendant de 62 à 137 g/L. Le syndrome de défaillance multiviscérale (SDMV), défini par l’observation simultanée d’au moins deux dysfonctions d’organes, est un facteur important de mortalité-morbidité chez les enfants traités en soins intensifs pédiatriques. L’association entre SDMV et transfusions est bien décrite dans cette population. Deux listes de critères diagnostiques du SDMV pédiatrique sont utilisées dans la littérature médicale : celles de Proulx et de Goldstein. Nous avons entrepris l’étude de cohorte prospective «Multiple organ dysfunction syndrome in critically ill children : clinical value of two lists of diagnostic criteria» dans le but de valider et de comparer leur valeur diagnostique respective. Nos résultats ont démontré que l’épidémiologie du SDMV varie selon la définition utilisée : l’incidence était de 21.4% vs. 37.3% selon les critères de Proulx et de Goldstein respectivement. Les deux listes de critères diagnostiques ont une bonne reproductibilité inter- et intra-observateur; celle de Proulx est cependant associée à une plus haute mortalité à 90 jours (17.8% vs. 11.5%, p = 0.038). Le SDMV a été décrit chez les nouveau-nés en SIN en utilisant le NEOMOD, un score adapté à cette population. Avec une meilleure caractérisation, le SDMV deviendrait un critère de jugement intéressant pour les essais cliniques randomisés en médecine transfusionnelle en néonatologie. / In the first few months of life, the level of hemoglobin (Hb) in the newborn normally decreases. This physiological anemia is more severe in neonates admitted to a neonatal intensive care unit (NICU), who frequently require a red blood cells (RBC) transfusion. In neonatal medicine, the indications for transfusion are controversial and practices are highly variable. To better understand those practices, we conducted the prospective study: «Epidemiology and determinants of red blood cells transfusion in a neonatal intensive care unit: a cohort study». Among the patients consecutively admitted to NICU during the study period, 13.4% received at least one RBC transfusion. Although premature babies born at less than 28 weeks gestation received the majority of transfusions (62.2%), term neonates admitted to NICU were also frequently transfused (4.9% of transfusions). The main justifications for giving a RBC transfusion were: low Hb level, underlying illness and to improve oxygen delivery. We also observed a wide range of Hb thresholds that triggered a decision to transfuse (from 62 to 137 g/L). The multiple organ dysfunction syndrome (MODS), which is defined as the simultaneous dysfunction of at least two organs or systems, is highly associated with mortality and morbidity in critically ill children. The association between MODS and transfusions is also well described in this population. Two sets of criteria of pediatric MODS are currently used in the medical literature: one by Proulx, and another by Goldstein. We did the prospective cohort study «Multiple organ dysfunction syndrome in critically ill children : clinical value of two lists of diagnostic criteria» to validate and compare the diagnostic value of those two definitions of MODS. We observed that the epidemiology of MODS varies according to which list of criteria is used: the incidence was 21.4% vs. 37.3% with Proulx and Goldstein criteria, respectively. Both sets of criteria have a good inter- and intra-rater reproducibility. The diagnostic of MODS according to Proulx criteria is associated with higher 90-days mortality (17.8% vs. 11.5%, p = 0.038). MODS is also described in neonates, using a score adapted to this population, the NEOMOD. Neonatal MODS represents an interesting outcome measure in clinical trials in neonatal transfusion medicine. However, prior to that, it needs to be better characterized.