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Background The behavior of anthropometrics and the relationship with genetic factors through a long-term perspective should be better explored. This study aims to verify the odds of maintaining the nutritional status classification after three years, according to the rs9939609 polymorphism (FTO gene). Methods It was a retrospective longitudinal study with 355 schoolchildren (7–17 years). Body mass index, body-fat percentage (BF%), and waist circumference (WC) were measured at baseline and follow-up. The FTO gene was evaluated from blood collection and genotyping performed by real-time polymerase chain reaction. Odds ratios and 95% confidence intervals were calculated. Results For those homozygous with the A allele, the odds of being at less favorable classification at follow-up were 2.29 (1.24; 4.22) and 4.05 (2.08; 7.86) times higher than expected for BF% and WC, respectively, whereas the odds of being in the more favorable classification at follow-up were 0.34 (0.12; 0.93) and 0.11 (0.01; 0.78) for BF% and WC, respectively. The odds of being at less favorable classification were higher for AA carriers with less favorable classification at baseline for BF% and WC compared to AT and TT carriers. Conclusions Schoolchildren with a genetic predisposition to obesity and unfavorable anthropometric profile at baseline had more chances of maintaining their nutritional status after three years of follow-up.

Resumo A Educação Permanente em Saúde legitimou a educação na saúde com base na aprendizagem significativa, em vivências no cotidiano de trabalho e na solução de problemas de forma coletiva, além de estar pautada no Quadrilátero Ensino-Gestão-Atenção-Controle Social. A pandemia da Covid-19 exigiu novas formas de fazer saúde e educação, principalmente no sistema prisional, onde a superlotação é um impeditivo ao isolamento social. Este estudo teve como objetivo identificar, por meio de rodas de conversa virtuais, os desafios encontrados no cotidiano de trabalho e discutir propostas de intervenção com os atores do sistema prisional no período pandêmico, na perspectiva da Educação Permanente em Saúde. Foi utilizada abordagem qualitativa de investigação com caráter descritivo, interpretativo e compreensivo de análise do fenômeno social, por meio da análise de conteúdo temático de Minayo. Da análise temática de conteúdo emergiram quatro categorias: desafios da assistência em saúde no sistema prisional no contexto da pandemia da Covid-19; desafios para a gestão da saúde nos estabelecimentos prisionais; interlocução entre instituições de ensino e sistema prisional; e o controle social e a representação familiar. As rodas de conversa virtuais propiciaram discussões aprofundadas e construções coletivas, propondo encaminhamentos pautados no Quadrilátero da Educação Permanente em Saúde.

The aim of the present study was to verify whether the amount of sleep duration, screen time, and physical activity moderate the relationship between FTO rs9939609 polymorphism and waist circumference (WC) in children and adolescents. This is a cross-sectional study conducted with 1338 children and adolescents, aged between 6 and 17 years. Lifestyle habits were assessed through self-reported questionnaire. WC was measured on the narrowest part of the trunk between the last rib and the iliac crest. FTO rs9939609 polymorphism was genotyped by real time polymerase chain reaction. The PROCESS macro for the SPSS was used for moderation analyses, through multiple linear regression models. Results indicated significant interactions were found between sleep duration and screen time X FTO rs9939609, showing that these lifestyle behaviours are moderators in the relationship between a genetic predisposition for obesity and higher WC. For physical activity, there was no significant interaction. Therefore, sleeping more than 564 min a day (i.e. 9.4 h) and spending no more than 233 min in front of screen may counteract the genetic predisposition to obesity in children and adolescents.

No ambiente prisional, as doenças infectocontagiosas se tornam alarmantes, uma vez que nesses ambientes a superlotação, falta de ventilação e de iluminação é comumente encontrada. Entre as doenças infectocontagiosas, destaca-se a tuberculose (TB), que se configura como uma doença que mais mata mundialmente. Sendo assim, a População Privada de Liberdade (PPL) torna-se suscetível pelo ambiente precário e dessa forma, ocorrendo a alta disseminação da doença. Objetivou-se descrever as características sociodemográficas e clínicas da PPL, assim como avaliar os indicadores de saúde encontrados. Este é um estudo transversal retrospectivo, com dados obtidos do Sistema de Agravos e Notificação (SINAN) e do Levantamento Nacional de Informações Penitenciárias (INFOPEN). Foram analisadas as variáveis: sexo, idade, escolaridade, HIV, raça/cor, forma da doença, tipo de entrada, baciloscopia, cultura e desfecho do tratamento. Das 4279 notificações no período de 2014 a 2018, predominou o sexo masculino (94,8%), de maioria branca (60,0%). Uma alta proporção de coinfecção TB/HIV foi encontrada (18,2%). Os principais desfechos foram cura (46,6%), transferência (16,5%) e abandono (12,7%). A incidência em todo período foi de 1.611,46 casos/100 mil presos, prevalência de 2.526,7 casos/100 mil presos e mortalidade de 35,43 óbitos/100 mil presos. A PPL demonstrou piores indicadores quando comparado com a população geral. A intensificação do diagnóstico prévio, bem como qualificação na assistência será necessária para alcançar as metas definidas pela Organização Mundial de Saúde.

Population-based data on COVID-19 are urgently needed. We report on three rounds of probability sample household surveys in the state of Rio Grande do Sul (Brazil), carried out in nine large municipalities using the Wondfo lateral flow point-of-care test for immunoglobulin M and G antibodies against SARS-CoV-2 (https://en.wondfo.com.cn/product/wondfo-sars-cov-2-antibody-test-lateral-flow-method-2/). Before survey use, the assay underwent four validation studies with pooled estimates of sensitivity (84.8%; 95% confidence interval (CI) = 81.4-87.8%) and specificity (99.0%; 95% CI = 97.8-99.7%). We calculated that the seroprevalence was 0.048% (2/4,151; 95% CI = 0.006-0.174) on 11-13 April (round 1), 0.135% (6/4,460; 95% CI = 0.049-0.293%) on 25-27 April (round 2) and 0.222% (10/4,500; 95% CI = 0.107-0.408) on 9-11 May (round 3), with a significant upward trend over the course of the surveys. Of 37 family members of positive individuals, 17 (35%) were also positive. The epidemic is at an early stage in the state, and there is high compliance with social distancing, unlike in other parts of Brazil. Periodic survey rounds will continue to monitor trends until at least the end of September, and our population-based data will inform decisions on preventive policies and health system preparedness at the state level.

The human locus FNDC5 rs16835198 contributes positively to anthropometric phenotypes in children and adolescents. However, the role of specific components of physical fitness in this relationship is not known. The present study aimed to verify the moderator role of cardiorespiratory fitness (CRF) and muscular strength in the relationship between rs16835198 polymorphism FNDC5 and adiposity in children and adolescents. This cross-sectional study was carried out by genotyping the rs16835198 FNDC5 polymorphism in 1701 children and adolescents (mean age 11.73 ± 2.75 years). Obesity was assessed using waist circumference and body mass index (BMI) z-scores. To evaluate CRF and muscular strength, the 6 min run/walk test and lower limb strength (LLS) were used. Linear regression models were applied, and all analyses were adjusted for age, sex, skin color, living area, and school type. A significant interaction term for CRF (p = 0.038) and LLS (p = 0.040) × rs16835198 FNDC5 with WC was identified. Regarding BMI, a significant interaction term for CRF (p = 0.007) and LLS (p = 0.044) × rs16835198 FNDC5 was observed. Moreover, medium and high CRF and LLS levels protected against higher WC and BMI. In conclusion, adiposity levels of children and adolescents with a genetic predisposition to obesity might be modified by improving CRF and muscular strength.

Few studies show the potential changing effect of fat-mass and obesity-associated (FTO) rs9939609 gene on cardiometabolic risk after a lifestyle intervention. This study aims to evaluate whether overweight and obese adolescents, carriers of the risk genotypes for obesity of the FTO rs9939609 gene polymorphism, have different anthropometric and biochemical responses to an interdisciplinary intervention program. The quasi-experimental study involved 34 adolescents aged 10 to 15 years. Schoolchildren with AA/AT genotype decreased glucose, total cholesterol, low-density lipoprotein cholesterol, and increased high-density lipoprotein cholesterol. However, there were no differences between the genotypes, suggesting that the “A” allele did not modify the subject's response to the intervention program.

O leite materno é considerado pela comunidade científica um alimento completo, pois atende integralmente às necessidades nutricionais, metabólicas e imunológicas do lactente até os seis meses de vida. No entanto, os efeitos positivos sobre a saúde do lactente não se restringem ao período neonatal, à medida que os conhecimentos epigenéticos vinculam intrinsecamente os futuros padrões antropométricos e bioquímicos com o tempo de aleitamento materno exclusivo. Somado a isso, a obesidade é uma doença crônica multifatorial e poligênica que assola a saúde mundialmente. Essa conjuntura é preocupante pelo seu caráter epidêmico e por vincular-se intrinsecamente a graves disfunções metabólicas como dislipidemia, diabetes e hipertensão arterial sistêmica. Sabe-se que a carga genética é contribuinte para a suscetibilidade de desenvolvimento da obesidade, então, os Polimorfismos de Nucleotídeo Único (SNP) no gene FTO (Fat mass obesity-associated) revelam-se concatenados a alterações nos parâmetros antropométricos e bioquímicos. Contudo, o estudo, de caráter transversal, intentou avaliar se a amamentação e seus benefícios influenciariam o efeito do genótipo de risco do gene FTO e suas repercussões nos parâmetros antropométricos e bioquímicos de escolares. Assim, observou-se que a amamentação exclusiva por tempo ≤3 meses influencia significativamente o efeito da genotipagem da variante rs9939609 no gene e se diferencia entre os sexos na manifestação dos parâmetros antropométricos.

Índices globais de obesidade aumentaram exponencialmente nas últimas décadas. Sendo assim, a obesidade se tornou um motivo de preocupação na saúde pública. Além de fatores ambientais, a genética tem contribuído para essa condição. SNPs como rs182052 presente no gene ADIPOQ, rs6548238 no TMEM18 e rs16835198 no FNDC5 e as proteínas séricas adiponectina e irisina têm sido associados com aumento de parâmetros de adiposidade. A partir disso, o objetivo do estudo foi relacionar a presença desses polimorfismos e níveis séricos plasmáticos dessas proteínas com parâmetros antropométricos e bioquímicos. Estudo de caráter transversal, contou com participação de 500 escolares, com idades entre sete e 17 anos. A genotipagem dos SNPs foi realizada pelo qPCR. O tratamento dos dados deu-se por estatística descritiva, UNIANOVA ajustado por sexo e idade e Kruskal-Wallis. Escolares com excesso de peso portadores do genótipo CC para o polimorfismo rs6548238 no TMEM18 estiveram relacionados a maiores médias para colesterol total (p=0,021). Portadores dos genótipos AG+AA para o polimorfismo rs182052 no ADIPOQ foram associados com maiores médias para circunferência da cintura (p=0,042) e triglicerídeos (p=0,021). Indivíduos eutróficos com os genótipos GT e GG para o SNP rs16835198 no FNDC5 foram associados com maiores valores de IMC (p=0,033) e circunferência da Cintura (p=0,044). Níveis séricos de adiponectina e irisina não demonstraram associação com nenhuma variável estudada.

Objective We investigated the association of IRX3 SNP rs3751723 with anthropometric characteristics related to adiposity and potential relationships with FTO SNP rs9939609 in a population of Brazilian children and adolescents. Methods A total of 871 children and adolescents between 7 and 17 years of age were recruited. Adiposity measurements and biochemical parameters were assessed. The variants were genotyped by real-time PCR. Analysis of multiple linear regression, multiple logistic regression, and generalised multifactor dimensionality reduction (GMDR) adjusted for sex, age and ethnicity were applied to test the polymorphisms association with obesity-related phenotypes and the interaction between them. Results The analyses showed that IRX3 was associated with obesity and fat percentage (BF%). An association of FTO rs9939609 with body mass index (BMI) Z-Score and with waist circumference (WC) was detected. The odds ratios (OR) showed that IRX3 rs3751723 was associated with risk of obesity in additive model (p = 0.017), recessive model (p = 0.016) and with high BF% in all models. FTO rs9939609 was associated with risk of obesity in additive model (p = 0.031), recessive (p = 0.033) and with altered WC in all models. GMDR-based predictive models for the risk of obesity, altered WC and high BF% adjusted by age, ethnicity and sex suggested no interaction of the two loci. Conclusions The genetic variants rs3751723 and rs9939609 have an influence on the characteristics of adiposity; however, the effects of IRX3 and FTO investigated polymorphisms are independent in relation to adiposity parameters.

The fat mass and obesity-associated gene (FTO) has been extensively reported in the literature related to nutritional status, but there has been limited description of the genetic contribution to obesity risk during childhood and adolescence, especially in Latin Americans. This study aims to associate the rs9939609 polymorphism, of the FTO gene, with changes in nutritional status in Brazilian schoolchildren followed for 3 years. A longitudinal study was conducted with 355 schoolchildren, aged 7–15 years in 2011/2012 and subsequently re-evaluated in 2014/2015. Nutritional (obesity) status was classified by identifying those exceeding recommended thresholds for waist circumference (WC), waist-to-height ratio (WHtR), body mass index (BMI), and body fat percentage (BF%). The rs9939609 polymorphism was genotyped by a real-time polymerase chain reaction. Relative risk (RR with 95% confidence interval) of obesity status by FTO gene polymorphism was calculated by Poisson regression. The risk group was determined for genotypes with the allele A polymorphism, and regression models were adjusted for age, sex, height, ethnicity, and geographical location. Considering the longitudinal changes in status over the 3-year follow-up, the RR of developing a WC exceeding the threshold recommended (WC >75th age and sex-standardized percentile), or remaining with this condition, was higher in children with AT/AA genotype. For WC, the RR was 1.66 (1.07; 2.58) in crude analysis and 1.17 (1.01; 1.35) following adjustment for age (years), gender, ethnicity, and geographical location. The comparative risk of abdominal obesity, assessed by WHtR (not recommended threshold ≥0.50), was 53% and 8%, respectively, higher in AT/AA compared to TT genotype. Conclusion: This is one of the first longitudinal investigations to show a significant association between the A allele of the rs9939609 polymorphism and individuals with higher than recommended WC and WHtR measures in Brazilian children and adolescents.

Objective The goal of this study was to analyze whether the relationship between the rs9939609 polymorphism of the fat mass and obesity-associated gene (FTO) with nutritional status is moderated by the ponderal index (PI) at birth in children and adolescents. Methods A cross-sectional study evaluated 382 schoolchildren aged 6-17 years. Anthropometric variables such as waist circumference (WC), body mass index (BMI) and body fat percentage (BF%) were used to assess nutritional status. Weight and height at birth were used for the PI calculation, which was divided into tertiles (lower, middle and upper). To compare the continuous variables between genotypes of the rs9939609 polymorphism, a recessive model (TT/AT vs. AA) and covariance analysis (ANCOVA) were used. Results The AA genotype of the rs9939609 polymorphism was associated with higher WC in schoolchildren born with lower PI (β = 4.40; p = .048). However, for BF%, the genotype association was found in the upper PI tertile (β = 7.35; p = .040). Conclusion The relationship between WC and BF% with rs9939609 polymorphism (FTO) seems to be moderated by PI at birth. This is an important insight, since the data for intrauterine growth, genetic factors and the presence of obesity in children and adolescents are still contradictory.

A fim de reconhecer as temáticas mais publicadas, entre 2011 a 2021, pela Revista de Epidemiologia e Controle de Infecção (RECI) realizou-se um estudo descritivo retrospectivo a partir de um levantamento e posterior análise de diversos assuntos com manuscritos já veiculados no periódico, com ênfase para o campo de doenças. Os resultados evidenciam que a maioria das publicações possuíam como temática a tuberculose (15%), seguida das doenças crônicas não transmissíveis (13%) e zoonoses (10%). Observa-se que tais dados são necessários para identificar quais temáticas predominam, direcionando o enfoque do periódico, além de aperfeiçoá-lo e de definir estratégias, tais como chamadas para publicações especiais.

Obesity is an important risk factor associated with non-communicable cardiometabolic diseases. Previous studies have indicated that children and adolescents with a predisposed genetic risk for obesity could benefit from an active lifestyle, but there are no studies investigating whether physical fitness moderates the association of genetics and obesity. The aim of this study was to verify the moderating role of physical fitness in the relationship between genetic risk score (GRS) and body mass index (BMI) in children and adolescents. This cross-sectional study was carried out with 1471 children and adolescents, aged between 6 and 17 years from Santa Cruz do Sul, Brazil. Weight and height were assessed to determine BMI. Physical fitness components (cardiorespiratory fitness [CRF], lower limb strength [LLS], upper limb strength, and abdominal strength) were evaluated. The GRS was based on previously associated obesity single-nucleotide polymorphism rs9939609 (FTO), rs6548238 (TMEM18), and rs16835198 (FNDC5). Moderation analyses were tested using linear regression models, and the interactions were represented by physical fitness components X GRS (categorical variable). All analyses were adjusted for skin color/ethnicity, sex, and sexual maturation. Significant interactions for CRF (P = 0.041), LLS (P = 0.041), and abdominal strength (P = 0.046) X 5 and 6 risk alleles with BMI were found only in adolescents. In addition, there was evidence that fitness components attenuated the high genetic predisposition to high BMI. Physical fitness components are moderators in the relationship between GRS and BMI in adolescents. These findings highlight the need for interventions targeting to improve this aspect, which is an important health indicator in all ages.

Objectives Evaluate the influence of the genetic variant rs9939609 of the FTO gene on anthropometric characteristics and whether parental obesity is related to children and adolescents being overweight. Methods A total of 2,364 children and adolescents between 6 and 17 years old were genotyped and the lipid profile, plasma glucose level, and anthropometric characteristics were measured to assess adiposity. Results The AA genotype (risk) was associated with higher body mass index (BMI Z-score; p = 0.006), waist circumference (WC; p = 0.001), and triglycerides (p = 0.033). The association of the participants’ adiposity characteristics with the parents’ BMI and FTO genotypes showed an association of the BMI Z-score when either the mother or father was overweight or obese (p = 0.028 and p = 0.029). In the overweight or obese father/eutrophic mother, we also observe an association of FTO rs9939609 with WC (p = 0.039). The effect of these variables on the risk of obesity was also tested: overweight or obese mother (OR = 1.82, p = 0.041), overweight and obese parents (OR = 3.09, p < 0.0001), and FTO rs9939609 AA genotype (OR = 2.08, p = 0.0004) were associated. With regard to altered WC and high body fat percentage (BF%), either overweight or obese parents (OR = 2.39, p < 0.0001; OR = 1.92, p < 0.002) showed an association. The FTO rs9939609 AA genotype (OR = 1.99, p = 0.0002) was associated with altered WC. Conclusions The results show that parental weight also contributes to obesity and may interact with the FTO genetic make-up.

A obesidade é uma doença multifatorial e poligênica, relacionada ao desenvolvimento de complicações metabólicas e cardiorrespiratórias. Sugere-se que fatores genéticos contribuam de 40 a 70% na susceptibilidade de desenvolvimento da obesidade e, nesse contexto, Polimorfismos de Nucleotídeo Único (SNPs) nos genes FTO (Fat mass obesity-associated), TMEM18 (proteína transmembranar 18) e ADIPOQ (Adiponectina) se mostraram relacionados à alterações nos parâmetros antropométricos e bioquímicos. A partir disso, objetivou-se analisar a relação entre os SNPs nos genes FTO (rs9939609), TMEM18 (rs6548238) e ADIPOQ (rs182052) com o excesso de peso e as características antropométricas e bioquímicas em escolares de Santa Cruz do Sul/RS. Esse estudo, de caráter transversal, contou com participação de 600 escolares, com idades entre sete e 17 anos. A genotipagem dos SNPs foi realizada através de qPCR. O tratamento dos dados deu-se por estatística descritiva, ANOVA e Kruskal-Wallis. Observou-se neste estudo, que a prevalência de excesso de peso é de 38,3%, que portadores do genótipo AT do rs9939609 (FTO) apresentaram maiores valores de índice de massa corporal (p=0,042), percentual de gordura (%G) (p=0,045) e triglicerídeos (p

Recently, the highest wave of SARS-CoV-2 epidemic occurred since the beginning of the pandemic in Brazil was registered in Rio Grande do Sul (RS) State, Southern Brazil, considering the number of cases, deaths and hospitalization per day caused by COVID-19. In this study we described which lineages were circulating in the first quarter of 2021 in Southern Brazil to better understand the viral factors involved in the health crisis caused by SARS-CoV-2 in the region, searching also for possible additional SARS-CoV-2 sequence mutations. A total of 70 positive SARS-CoV-2 samples collected between January 28th, 2021 until April 23rd, 2021, were selected to sequencing. Whole genome sequencing of 70 SARS-CoV-2 samples showed a predominance of Gamma lineage (67%, 47/70), followed by P.2 lineage (27%, 19/70) and B.1.1.28 (6%, 4/70). Two Gamma lineage consensus sequences presented a new S:D614A mutation. Newly mutations could be emerging due the quick SARS-CoV-2 spreading. Thus, the greater understanding about immune protection and variants vigilance is essential to the better management of the health SARS-CoV-2 crisis.

To estimate the SARS-CoV-2 seroprevalence in a non-metropolitan area (Vale do Rio Pardo) in the state of Rio Grande do Sul, Brazil, and determine the association between seroprevalence and adherence to social distancing measures.For the present population-based, cross-sectional study, data were collected in four stages from August to October 2020. SARS-CoV-2 seroprevalence was assessed using an IgG/IgM rapid test. Demographic, socioeconomic, clinical, and behavioral data were also collected, with administration of a three-question survey to determine adherence to social distancing measures with a focus on the level of social distancing practiced by participants, their routine activities, and circulation of people in the home. The association between sociodemographic data and social distancing was assessed using the chi-square test for linear trends in proportions, and the association between social distancing and seroprevalence was assessed using Poisson regression (95% confidence interval [95%CI];Of 4 252 tested and interviewed participants, 11.8% (95%CI: 10.8; 12.8) did not adhere to social distancing measures. The prevalence of a positive rapid test was 4.7% in participants who did not practice social distancing and 1.9% in participants who adhered to social distancing measures (The results indicate a reduction in seroprevalence with the adherence to social distancing measures.Investigar la seroprevalencia del SARS-CoV-2 en la zona del Vale do Rio Pardo (Rio Grande do Sul, Brasil), y analizar la relación entre la seroprevalencia y el cumplimiento de las medidas de distanciamiento social por parte de la población.Este estudio transversal basado en la población comprendió cuatro etapas de recopilación domiciliaria de datos entre agosto y octubre del 2020. La seroprevalencia se evaluó con la prueba rápida de anticuerpos IgM e IgG. Además, se recopilaron datos demográficos, socioeconómicos, clínicos y comportamentales por medio de un cuestionario de tres preguntas sobre el cumplimiento de las medidas de distanciamiento social, centrado en el grado de distanciamiento social que la persona entrevistada lograba tener, la rutina de las actividades de la persona entrevistada y la circulación de personas en el hogar. La relación entre los datos sociodemográficos y la práctica de distanciamiento social se evaluó con la prueba del ji cuadrado para determinar la tendencia lineal y la heterogeneidad de las proporciones, y la relación entre el distanciamiento social y la seroprevalencia se evaluó con el modelo de regresión de Poisson (intervalo de confianza de 95% [IC95%];De las 4 252 personas que se entrevistaron y a las que se les realizó la prueba, 11,8% (IC95%: 10,8; 12,8) no cumplían el distanciamiento social. La prevalencia de la realización de la prueba rápida con reactivo fue de 4,7% entre quienes no cumplían el distanciamiento social y de 1,9% entre quienes cumplían con esa medida (Los resultados indican una reducción de la seroprevalencia a causa de las medidas de distanciamiento social.

Objective: To evaluate the possible association between hyperuricemia and cardiorespiratory fitness levels/nutritional profile, grouped into a single variable, in schoolchildren. Method: Cross-sectional study of 2335 students from Elementary schools, aged 7–17 years of both genders, stratified by conglomerates of a municipality in Southern Brazil. Body mass index (BMI) was calculated and cardiorespiratory fitness (CRF) was assessed by the 6-minute run/walk test. The BMI and CRF were grouped into a single variable, considering: (1) low and normal weight/fit; (2) low and normal weight/unfit; (3) overweight-obesity/fit; (4) overweight-obesity/unfit. The Poisson regression (prevalence ratio, PR) was used for the association between hyperuricemia and BMI/CRF ratio with 95% confidence intervals and differences were considered significant when p

The prevalence of childhood obesity has increased worldwide. Although it is considered a polygenic inheritance disease, little is known about its susceptibility when the additive effect is considered. The aim of this study is to investigate whether the genetic risk score (GRS) based on previously associated obesity polymorphisms (SNP) rs9939609 (fat mass and obesity-associated (FTO)), rs6548238 (transmembrane protein 18 (TMEM18)) and rs16835198 (fibronectin type III domain containing 5 (FNDC5)) could serve as a predictor for anthropometric characteristics in a sample of Brazilian children and adolescents. This is a cross-sectional study with 1471 children and adolescents aged 6–17 years. BMI, waist circumference (WC) and percentage of body fat and metabolic parameters were verified. In all, three SNP were genotyped by TaqMan™ allelic discrimination. The metabolic and anthropometric parameters were compared between the genotypes, and the unweighted and weighted GRS (GRS and wGRS, respectively) were created to test the additive effect of these genetic polymorphisms on anthropometric parameters. The prevalence of overweight plus obesity was 41 %. Significant associations were identified forFTOrs9939609,TMEM18rs6548238 andFNDC5rs16835198 and for GRS and wGRS with anthropometric phenotypes. The higher score of wGRS was associated with obesity (OR: 2·65, 95 % CI 1·40, 5·04,P=0·003) and with greater WC (OR: 2·91, 95 % CI 1·57, 5·40,P=0·001). Our results suggest that these genetic variants contribute to obesity susceptibility in children and adolescents and reinforce the idea that the additive effect may be useful to elucidate the genetic component of obesity.

Objective: To identify tuberculosis-related health care and surveillance actions in Prison Health Units. Method: Cross-sectional study, of quantitative, exploratory and descriptive character. We visited 13 Teams of Prison Health, and nurses and technicians were interviewed regarding epidemiological surveillance instruments, physical structure and materials. Results: Search for respiratory symptoms in admission was reported by 6 (46.2%) of the teams, and the smear microscopy was the most requested test. The Logbook of Respiratory Symptoms and the Logbook for Monitoring Tuberculosis Cases were used in 7 (53.8%) institutions. Two of them (15.4%) had a location for sputum collection and 1 (7.7%) had a radiographer. The Directly Observed Therapy was reported in 7 (53.8%) units. Conclusion: Health care actions related to the search for respiratory symptoms and Directly Observed Therapy should be expanded, as well as surveillance actions and recording in official documents of the National Tuberculosis Control Program. RESUMEN Objetivo: Identificar acciones asistenciales y de control de la tuberculosis en Unidades de Salud en Prisiones. Método: Estudio transversal, de tipo cuantitativo, exploratorio y descriptivo. Se visitaron a 13 equipos de Salud en Prisiones, de los cuales participaron enfermeros y técnicos de enfermería de una entrevista sobre los instrumentos de control epidemiológico, la estructura física local y los materiales. Resultados: La búsqueda de sintomáticos respiratorios durante la admisión fue relatada por 6 (un 46,2%) equipos, siendo la baciloscopía el examen más solicitado. El Libro de Registro de Sintomáticos Respiratorios y el Libro de Registro de Seguimiento de los casos de Tuberculosis son utilizados en 7 (un 53,8%) instituciones. Dos (un 15,4%) de ellas contaban con un local para recolección de esputo y 1 (un 7,7%) tiene radiógrafo. El Tratamiento Directamente Observado se mencionó en 7 (un 53,8%) unidades. Conclusión: Las acciones asistenciales relacionadas con la búsqueda de sintomáticos respiratorios y el Tratamiento Directamente Observado deberían ser ampliadas, así como las acciones de control y registro en los documentos oficiales del Programa Nacional de Control de la Tuberculosis. RESUMO Objetivo: Identificar ações assistenciais e de vigilância relacionadas à tuberculose em Unidades de Saúde Prisional. Método: Estudo transversal, de caráter quantitativo, exploratório e descritivo. Foram visitadas 13 Equipes de Saúde Prisional e entrevistados enfermeiros e técnicos de enfermagem com relação à instrumentos de vigilância epidemiológica, estrutura física e materiais. Resultados: A busca de sintomáticos respiratórios na admissão foi relatada por 6(46,2%) equipes, sendo a baciloscopia o exame mais solicitado. O Livro de Registro de Sintomáticos Respiratórios e o Livro de Registro de Acompanhamento dos Caso de Tuberculose eram utilizados em 7(53,8%) instituições. Duas (15,4%) apresentavam local para coleta de escarro e 1(7,7%) possuía radiógrafo. O Tratamento Diretamente Observado foi referido em 7(53,8%) unidades. Conclusão: As ações assistenciais relacionadas à busca de sintomáticos respiratório e Tratamento Diretamente Observado deveriam ser ampliadas, bem como as ações de vigilância e registro nos documentos oficiais do Programa Nacional de Controle da Tuberculose.

Objectives The aim of the present study was to evaluate the relationship between the rs9939609 fat mass and obesity-associated (FTO) polymorphism and cardiorespiratory fitness (CRF) with overweight/obesity outcomes in youth. Methods This study included 420 youths, comprising 211 boys and 209 girls aged 7–17. Overweight/obesity were evaluated by body mass index (BMI), waist circumference (WC), and the percentage of fat (PF) according to two skinfold thickness measurements. Genotyping of the rs9939609 polymorphism was conducted using real-time Polymerase Chain Reaction (PCR) utilizing TaqMan® probes, and CRF was evaluated through a 9-minute run/walk test, categorized as fit or unfit. Logistic regression was utilized to evaluate a possible association between the polymorphism and CRF, with three obesity indicators evaluated. Results Individuals with the genotype risk (AA) of FTO polymorphism rs9939609 showed higher prevalence of overweight/obesity, as evaluated by BMI (OR: 3.21; CI: 1.71–6.05), WC (OR: 2.59; CI: 1.35–4.97), and PF (OR: 2.59; CI: 1.36–4.92). Additionally, students with the AA genotype in the unfit model had a significant odds ratio for obesity (OR: 4.40; CI: 1.83–10.61 for BMI; OR: 3.54; CI: 1.58–7.96 for WC), whereas we did not observe associations between the AA genotype with BMI and WC using the fit model. Conversely, PF was associated with the AA genotype only in the fit model (OR: 3.24; CI: 1.26–8.34). Conclusions This study demonstrated that the rs9939609 (FTO) polymorphism showed a relationship with obesity in the population studied and an interaction with CRF. Students with low levels of CRF and the AA genotype have a higher risk of being overweight/obese. This association was not found in students with higher levels of CRF. Am. J. Hum. Biol., 2015. © 2015 Wiley Periodicals, Inc.

The scope of this study was to verify the association between different overweight and obesity parameters and the metabolic risk profile among school-age students. The randomized cross-sectional study included 1254 children and adolescents, aged 7 to 17, from a city in southern Brazil. Body mass index (BMI), waist circumference (WC) and percentage of fat (PF), measured at the triceps and based on subscapular skinfold thickness, were used as the parameters to evaluate overweight/obesity status. Systolic blood pressure (SBP), total cholesterol, high-density lipoprotein cholesterol (HDL), low-density protein cholesterol (LDL) and triglycerides were also measured. The metabolic risk profile was calculated based on the sum of the z score of the metabolic variables adjusted by age. A three-model Poisson analysis was used to verify the association between BMI, WC and PF with metabolic risk profile. BMI showed the highest probability for developing metabolic risk compared with WC (overweight - PR: 1.63 and obesity – PR: 3.87) and PF (overweight – PR: 1.62 and obesity – PR: 2.92). In conclusion, BMI seems to be a better parameter of overweight/obesity than WC and PF in the assessment of metabolic risk among youths. ResumoO objetivo deste estudo foi verificar associação entre diferentes parâmetros de sobrepeso e obesidade com o perfil de risco metabólico em escolares. O estudo transversal randomizado incluiu 1.254 crianças e adolescentes, com idades entre 7 e 17 anos, de uma cidade do sul do Brasil. O índice de massa corporal (IMC), a circunferência da cintura (CC) e o percentual de gordura (PG), avaliado através das medidas das dobras cutâneas tricipital e subescapular, foram usados como parâmetros para avaliar sobrepeso/obesidade. Pressão arterial sistólica (PAS), colesterol total, lipoproteína de alta densidade (HDL), lipoproteína de baixa densidade (LDL) e triglicerídeos também foram mensurados. O perfil de risco metabólico foi calculado com base no somatório do escore z das variáveis metabólicas ajustadas por idade. Três modelos de regressão de Poisson foram utlizados para verificar a associação entre IMC, CC e PG com o perfil de risco metabólico. Os dados demostram que o IMC foi o parâmetro que apresentou a maior associação com o desenvolvimento de risco metabólico, em comparação com CC (sobrepeso - RP: 1,63 e obesidade - RP: 3,87) e PG (sobrepeso - RP: 1,62 e obesidade - RP: 2,92). Conclui-se que o IMC parece ser um melhor parâmetro de sobrepeso/obesidade do que CC e PG, na avaliação do risco metabólico em escolares.

Activation of adipose tissue inflammation is associated with obesity caused by lipid accumulation in adipocytes. Through this activation, proinflammatory cytokines, such as Interleukin-6 (IL-6) and C-reactive protein (CRP) seem to influence metabolic disorders. The present study evaluated whether polymorphisms in the CRP (rs1205) and IL-6 (rs1800795, rs2069845) genes are associated with the development of metabolic disorders in children and adolescents. A cross-sectional study was performed, consisting of 470 students from the municipality of Santa Cruz do Sul, Brazil, aged 7-17 years. Body mass index (BMI) was classified according to overweight and obesity. Genotyping was performed by real-time Polymerase Chain Reaction(PCR). Anthropometric characteristics, biochemical markers, immunological markers and blood pressure were assessed. Descriptive statistics, chi-square and logistic regression were used for the analyses. No association was detected between the rs1800795 polymorphism and the assessed variables. Individuals with the risk genotype in the rs1205 gene were associated with the risk of developing hypercholesterolemia (OR 2.79; CI 1.40, 5.57; p = 0.003). Carriers of the risk genotype in the rs2069845 gene are associated with the risk of developing obesity (OR 3.07; CI 1.08, 8.72; p = 0.03). The polymorphism rs2069845 was associated with obesity and rs1205 was associated with the risk of developing hypercholesterolemia in Brazilian schoolchildren. A ativação da inflamação do tecido adiposo está relacionada com a obesidade, causada pelo acúmulo de lipídios nos adipócitos. Através dessa ativação, citocinas pró-inflamatórias como Interleucina-6 (IL-6) e Proteína C-Reativa (CRP) parecem influenciar as desordens metabólicas. O presente estudo avaliou se polimorfis mos nos genes da CRP (rs1205) e da IL-6(rs1800795 rs2069845) estão relacionados com o desenvolvimento de alterações metabólicas em crianças e adolescentes. Estudo transversal, foi feito com 470 escolares do município de Santa Cruz do Sul, Brasil, com idades entre 7 a 17 anos. O índice de massa corporal (IMC) foi classificado de acordo com sobrepeso e obesidade. A genotipagem foi realizada através da Reação em Cadeia de Polimerase (PCR) em tempo real. Características antropométricas, indicadores bioquímicos, marcadores imunológicos e a pressão arterial foram avaliados. Estatísticas descritivas, qui-quadrado e regressão logística foram utilizadas para as análises. Nenhuma associação foi detectada entre o polimorfismo rs1800795 e as variáveis avaliadas. Indivíduos com o genótipo de risco no gene rs1205 foram associados ao risco de desenvolver hipercolesterolemia (OR = 2,79; IC: 1,40, 5,57; p = 0,003). Portadores do genótipo de risco no gene rs2069845 estão associados com o risco de desenvolver obesidade (OR = 3,07; IC: 1,08, 8,72; p = 0,03). O polimorfismo rs2069845 foi relacionado com obesidade e o rs1205 associado ao risco de desen volver hipercolesterolemia em escolares brasileiros.

In order to analyze the outcomes, clinical features, and resistance of Staphylococcus spp infections, a prospective cohort study was conducted at a 234-bed, tertiary care teaching hospital. Multidrug-resistant (MDR) infections were associated with increased mortality and length of hospital stay (LOS), whereas methicillin resistance (MRS) was correlated with prolonged LOS after infection. These data highlight the importance of infection control and antibiotic stewardship to prevent the emergence and spread of MRS and MDR health care–associated infections.

Justificativa e objetivos: Aptidão física e desempenho motor são importantes preditores de risco cardiovascular em crianças e adolescentes. O presente estudo transversal objetiva verificar se existe associação entre o deslocamento para a escola e aptidão física relacionada ao desempenho motor em escolares. Métodos: A amostra é composta por 751 crianças e adolescentes, sendo 349 do sexo feminino, com idades entre 7 e 17 anos, residentes do município de Santa Cruz do Sul-RS. Para a avaliação do deslocamento para a escola, foi utilizado um questionário. A avaliação da aptidão física relacionada ao desempenho motor foi realizada por meio dos testes de agilidade, velocidade, força de membros superiores e inferiores. Resultados: A maior parte dos meninos (81,4%) e das meninas (84,1%) se deslocam de forma sedentária para a escola, sendo que as meninas que se deslocam de forma ativa para a escola apresentam melhores níveis de força de membros superiores (p=0,023) e de velocidade (p=0,003). Entre os meninos, não foi observada diferença significativa para os indicadores de aptidão física relacionada ao desempenho motor, de acordo com o tipo de deslocamento para a escola. Conclusão: Constatou-se que meninas que se deslocam de forma ativa para a escola apresentam melhores resultados nos testes de aptidão física relacionada ao desempenho motor.

OBJECTIVE There is no consensus on the best diagnostic criteria for metabolic syndrome (MetS) in the child and adolescent population. Thus, the present study aimed to establish cutoff points for a continuous metabolic risk score (cMetS) in adolescents from southern Brazil. METHODS This was a cross-sectional study conducted between 2014 and 2015. The sample consisted of 1739 schoolchildren (985 girls), aged 10-17 years. cMetS was calculated by sum of the Z-score of the following parameters: waist circumference, systolic blood pressure, glucose, high-density lipoprotein cholesterol, triglycerides, and cardiorespiratory fitness. Three diagnostic criteria of MetS were used to create cut points for cMetS. RESULTS The best cutoff point for cMetS was set at 3.40 for boys (sensitivity: 100.0%, specificity: 92.9%, AUC: 0.978) and 3.61 for girls (sensitivity: 100, 0%, specificity: 93.1%, AUC: 0.991). For these cutoff points, metabolic risk was found in 8.9% of adolescents (9.4% for boys and 8.5% for girls). A linear relationship was found between the mean values of cMetS and the number of components of MetS (mean cMetS -1.09 for no component present and 6.66 for 3 or more components). CONCLUSIONS The use of cMetS is valid for adolescents and can detect a greater proportion of students with metabolic risk, compared to the current criteria for diagnosis of MetS.

Background: We aimed to assess the level of DNA damage and susceptibility to exogenous mutagens in peripheral blood cells of Chronic Obstructive Pulmonary Disease (COPD) patients and healthy individuals by comet assay. Oxidative stress was also evaluated by means of thiobarbituric acid reactive species (TBARS) in blood plasma. Methods: Case-control study enrolling 51 COPD patients and 51 controls. Peripheral blood was used to perform the alkaline (pH>13) and neutral (pH=8.5) comet assay. For the assessment of susceptibility to exogenous DNA damage, the cells were treated with methylmethane sulfonate (MMS) for 1-hour or 3-hour at 37° C. The percentage of residual DNA damage after 3-h MMS treatment was calculated using the value of 1-h MMS treatment for each subject as 100%. Lipid peroxidation was evaluated by measuring TBARS in blood plasma. Results: DNA damage in patients was significantly higher than in controls as measured by the neutral and alkaline comet assay. Residual DNA damage detected after MMS treatment increased in patients, in contrast to controls, indicating higher susceptibility to alkylation damage and/or repair inhibition. High susceptibility to exogenous DNA damage in COPD patients correlates with high amount of TBARS and low forced vital capacity and expiratory volume. Conclusion: The positive correlation between increased susceptibility to exogenous DNA damage and TBARS levels in COPD patients suggests the possible involvement of oxidative stress in damage induction and/or repair inhibition.

Acredita-se que fatores genéticos podem modificar o risco individual tornando os indivíduos mais susceptíveis a certas patologias. Polimorfismos de nucleotídeo único (SNP) em genes de mediadores inflamatórios estão fortemente relacionados a esta propensão. Objetivou-se relacionar a presença de SNP em gene que codifica uma citocina pró-inflamatória com susceptibilidade às doenças pulmonares. Foi realizado um estudo do tipo caso-controle em indivíduos com doença pulmonar obstrutiva crônica (DPOC), câncer de pulmão (CP) e tuberculose (TB). Foram realizadas coletas de dados epidemiológicos e ainda de material biológico para genotipagem do polimorfismo rs1800795 do gene IL6 através da técnica de reação em cadeia da polimerase (PCR) em tempo real. Para as análises estatísticas foram avaliadas a frequência (%), média e desvio-padrão e o teste x2 para as variáveis categóricas. Observou-se o predomínio do sexo masculino, bem como a maioria dos indivíduos se autodeclarou caucasiano. Quanto à frequência alélica para o polimorfismo rs1800795 do gene IL6, a presença foi maior no alelo considerado de risco em todos os grupos de casos, mas ao comparar estes achados a um grupo controle, não foi observada diferença estatística significativa, fato que demonstra que não há relação entre as frequências genotípicas e alélicas e presença do polimorfismo em IL6 com a susceptibilidade a doenças pulmonares nesta população.

Justificativa e Objetivo: Polimorfismos no gene relacionado à massa gorda e obesidade - FTO (fat mass and obesity associated) têm sido associados com obesidade pelos seus efeitos na homeostase de energia do indivíduo. Assim, busca-se verificar se escolares portadores do alelo de risco para obesidade (A), do polimorfismo rs9939609, do gene FTO, respondem diferentemente a um programa de intervenção com exercício físico e orientação nutricional, em comparação aos escolares que não possuem este alelo, com relação ao Índice de Massa Corporal (IMC). Métodos: estudo quase experimental, realizado com 46 escolares, distribuídos, igualmente, em grupos experimental e controle, da zona rural do município de Santa Cruz do Sul-RS. A variante A/T, do polimorfismo rs9939609 do gene FTO, foi genotipada utilizando-se o sistemaTaqManTM, em equipamento automatizado StepOne Plus. O programa interdisciplinar teve duração de 4 meses, sendo realizado 3 vezes por semana, no turno contrário ao das aulas. A duração de cada foi de 1 hora e 30 minutos. Resultados: no grupo experimental, um escolar com genótipo TT que apresentava sobrepeso, passou a ter IMC normal após o programa. Para os genótipos AT + AA, os escolares mantiveram a classificação (obesidade), sendo que um escolar que apresentava sobrepeso, passou a apresentar obesidade, após o término da intervenção. A análise dos valores de IMC, antes e após a intervenção, revelou que não houve diferença significativa, tanto no grupo experimental (p=0,088), quanto no controle (p=0,964). Conclusão: independente do genótipo, os escolares responderam de forma semelhante ao programa interdisciplinar com exercícios físicos e orientação nutricional.

A obesidade é um grave pro¬blema de saúde pública e está relacionada a um baixo grau de inflamação crô¬nica. A Proteína C Reativa (PCR) é caracterizada como proteína de fase aguda, mas em resposta à inflamação e em estados crônicos, pode assumir um papel pró-inflamatório, como no caso da obesidade. Para tanto, teve-se por objetivo avaliar a possível relação dos níveis de PCR circulante e do SNP rs1205 do gene CRP com obesidade, características antropométricas e marcadores bioquímicos em escolares de Santa Cruz do Sul – RS. Este estudo caracteriza-se por ser transversal retrospectivo, sendo realizado com 380 escolares de 07 a 17 anos de idade. A genotipagem do polimorfismo de nucleotídeo único (SNP) rs1205C/T foi realizada através de PCR em tempo real. Foram coletados dados antropométricos e realizados testes bioquímicos. O tratamento estatístico foi realizado por estatística descritiva, Kruskal-Wallis, Mann-Whitney e regressão logística multivariada. Com este estudo, foi observada prevalência de 25,3% de sobrepeso e obesidade nos escolares estudados, e que portadores do alelo de risco (T) apresentaram maior chance de desenvolver hipercolesterolemia (OR =2,67; 95% IC: 1,265 - 5,657). O SNP rs1205 do gene CRP foi associado à hipercolesterolemia, podendo assim, aumentar o risco de problemas cardiovasculares na fase adulta.

Nutritional, lipid and feeding habits of school children in two municipalities in South Brazil are compared. Transversal study analyzed indicators of obesity, lipid profile and feeding habits of school children, aged between 7 and 17 years, in Santa Cruz do Sul RS Brazil, and Chapeco SC Brazil. Difference (p

The aim of the present study was to evaluate the relationship between the rs9939609 fat mass and obesity-associated (FTO) polymorphism and cardiorespiratory fitness (CRF) with overweight/obesity outcomes in youth.This study included 420 youths, comprising 211 boys and 209 girls aged 7-17. Overweight/obesity were evaluated by body mass index (BMI), waist circumference (WC), and the percentage of fat (PF) according to two skinfold thickness measurements. Genotyping of the rs9939609 polymorphism was conducted using real-time Polymerase Chain Reaction (PCR) utilizing TaqMan(®) probes, and CRF was evaluated through a 9-minute run/walk test, categorized as fit or unfit. Logistic regression was utilized to evaluate a possible association between the polymorphism and CRF, with three obesity indicators evaluated.Individuals with the genotype risk (AA) of FTO polymorphism rs9939609 showed higher prevalence of overweight/obesity, as evaluated by BMI (OR: 3.21; CI: 1.71-6.05), WC (OR: 2.59; CI: 1.35-4.97), and PF (OR: 2.59; CI: 1.36-4.92). Additionally, students with the AA genotype in the unfit model had a significant odds ratio for obesity (OR: 4.40; CI: 1.83-10.61 for BMI; OR: 3.54; CI: 1.58-7.96 for WC), whereas we did not observe associations between the AA genotype with BMI and WC using the fit model. Conversely, PF was associated with the AA genotype only in the fit model (OR: 3.24; CI: 1.26-8.34).This study demonstrated that the rs9939609 (FTO) polymorphism showed a relationship with obesity in the population studied and an interaction with CRF. Students with low levels of CRF and the AA genotype have a higher risk of being overweight/obese. This association was not found in students with higher levels of CRF. Am. J. Hum. Biol. 28:381-386, 2016. © 2015 Wiley Periodicals, Inc.

The reported incidence of tuberculosis (TB) in three different regions of Rio Grande do Sul State in Brazil varies considerably. We used IS6110-RFLP and spoligotyping methods to genotype Mycobacterium tuberculosis isolates obtained from 268 patients between 1998 and 2000 in order to assess the levels of recent transmission of TB in the three regions. The degree of clustering of the strain types did not differ among the three regions; neither did other characteristics such as demographic features, underlying medical conditions, or the proportion of resistant TB. As reported previously, male patients were at greater risk of developing TB and our data suggest that part of this may be related to the higher rates of recent transmission among them (P0.05). In addition, we found that retired patients were almost 3 times more likely to be infected with cluster-pattern strains than patients reporting any other occupation (P0.05), and more than 3 times more likely than non-retired patients in the same age group (P0.05) to be infected with cluster-pattern strains. We conclude that recent transmission is not a major factor contributing to the differences in TB incidence in the three regions of Rio Grande do Sul. The reason for the suggested high proportion of recent transmission TB cases among the retired people needs further studies.

The presence of mutations in specific regions of the katG , inhA , and ahpC genes was analyzed with 69 Mycobacterium tuberculosis isoniazid-resistant isolates from three Brazilian states. Point mutations in codon 315 of the katG gene were observed in 87.1, 60.9, and 60% of the isolates from Rio Grande do Sul, Rio de Janeiro, and São Paulo, respectively. Mutations in the inhA gene were identified only in one isolate from RJ State, and the ahpC promoter region revealed mutations in distinct positions in 12.9, 21.7, and 6.7% of the isolates from RS, RJ and SP, respectively.

The main objective of this study was to evaluate INNO-LiPA Rif.TB and to determine the frequency of mutations in rpoB in rifampicin-resistant Mycobacterium tuberculosis isolates of Brazilian tuberculosis patients. We used the reverse hybridization assay on 113 resistant and 15 sensitive clinical isolates of M. tuberculosis and on reference strains belonging to 37 different species. All MTB complex strains and none of the other strains reacted with the MTB complex-specific probe, meaning that the assay is 100% specific and 100% sensitive for detection of strains of the MTB complex. In 80 resistant strains, mutations causing S531L (n=55), H526Y (n=9), H526D (n=12) or D516V (n=9) were detected while in 30 strains, mutations were present but their exact nature was not determined by the assay (DeltaS patterns). All sensitive strains had the sensitive genotype while among resistant isolates, a sensitive genotype was obtained in three due to the absence of mutations in the hot spot region, demonstrating an assay accuracy of 97.6% for detection of drug susceptibility. In 10 resistant cultures, two or more mutations were detected and in five, mixed sensitive and resistant genotypes were observed. The sensitivity of the assay for detection of resistant organisms in a mixture with sensitive ones were 2% and 70%, respectively, considering the appearance and disappearance of the R2 and S2 bands. The sensitivity to detect heteroresistance is similar to that of the proportion method when a specific probe for the mutation is present but the performance of the assay in the patient population will depend on the frequency of mutation distribution.

A vancomicina é um antibiótico glicopeptídeo efetivo em infecções graves por bactérias gram-positivas. Necessita atingir um nível sérico adequado para alcançar efetividade terapêutica e requer monitorização constante durante seu uso uma vez que pode causar toxicidade. O objetivo deste trabalho foi verificar qual o nível sérico de vancomicina nos pacientes internados em um hospital de ensino da região central do Rio Grande do Sul. Este estudo foi realizado com 69 pacientes, sendo 22 recém-nascidos, no período de julho de 2012 a dezembro 2013. As dosagens séricas de vancomicina foram realizadas após 72 horas do início do tratamento com o antimicrobiano, 30 minutos antes de sua administração através de imunoensaio de micropartículas por quimioluminescência. Foram realizadas e analisadas 117 dosagens séricas de vancomicina, sendo que apenas 19,4% das dosagens permaneceram na faixa ideal (10-20 µg/mL), enquanto que 38,1% permaneceram abaixo e 42,5% acima da faixa adequada. Com base nestes resultados, concluímos que é importante mensurar os níveis séricos deste antimicrobiano, a fim de evitar a toxicidade e alcançar níveis adequados para o sucesso terapêutico.

Mutations in a 69-bp region of the rpoB gene associated with rifampin resistance (Rif r ) in 100 isolates (82 Rif r ) from three states of Brazil were studied. Twenty-one different kinds of mutations were identified in the Rif r isolates, and six new alleles are described.

Surgical site infections (SSIs) are a major health care-related problem in Brazil. SSIs are considered the third most prevalent sort of infection in our country. A national study carried out by the Ministry of Health of Brazil in 1999 found SSI in 11% of all surgical procedures analyzed. The recent review article by Chlebicki et al, whose metaanalysis suggested no benefit of using chlorhexidine to prevent SSI, sparked a debate in our service regarding our practice of chlorhexidine use. Chlorhexidine is a broad-spectrum topical antiseptic agent capable of decreasing colonization by bacteria from the skin with effectiveness againstmultidrug-resistant organisms (eg, methicillinresistant Staphylococcus aureus, vancomycin-resistant Enterococcus). This antiseptic agent has the potential to prevent other types of health-related infections besides SSIs. A recent randomized clinical trial published by Climo et al studied the effect of daily bathing/showering with chlorhexidine in preventing nosocomial bloodstream infections in patients admitted to intensive care units. This multicenter study assessed 7,727 patients and observed a significant decrease in bloodstream infection rates in patients at risk for infection. Considering that the effect of chlorhexidine is a topical one, we believe that the inclusion of contaminated surgeries in the meta-analysis was inappropriate, although a subgroup analysis excluding these surgeries did not change the results. Furthermore, preoperative prophylaxis differed among the studies, possibly contributing to the differences in outcome. Analyzing the types of surgeries covered in the studies reveals a remarkable diversity of surgical sites, which could affect infection risk based on timing and complexity of surgical procedures and disease severity. Interestingly, the meta-analysis and randomized clinical trial had a similar number of patients. Despite the different methodologies and outcomes of previous studies, we conclude that the protective effect of chlorhexidine is real. Considering the lack of well-designed studies to allow a metaanalysis with little bias, we remain in favor of continuing preoperative chlorhexidine baths/showers for the prevention of SSIs, especially in orthopedic and cardiac implant surgeries.

Introduction: The present study aimed to assess the antibiotic resistance profiles and detect the presence of the sul2 gene in sulfamethoxazole-susceptible and resistant isolates of Escherichia coli obtained from outpatients and inpatients with urinary tract infections. Methodology: The resistance profiles of 739 strains were assessed and the presence of the sul2 gene in 100 isolates was tested. Results: The antibiotics with the highest resistance rates were ampicillin (57.4%) and trimethoprim-sulfamethoxazole (44.7%). The presence of the gene sul2 was detected in 66.7% of outpatient samples and 67.9% of inpatient samples. Conclusions: Our results demonstrate that E. coli isolates exhibit high resistance to various classes of antibiotics, highlighting the need for developing strategies to help in prescribing antibiotics.

Sixty isolates of Mycobacterium tuberculosis identified as multidrug-resistant (MDR) at a reference laboratory in Rio Grande do Sul State during the years 1999 and 2000 were analyzed using the IS6110-restriction fragment length polymorphism (RFLP) technique. We also genotyped 202 susceptible strains to compare the genotyping results, as well as the clinical and demographic data. Spacer oligotyping (spoligotyping) analysis was performed for isolates presenting low IS6110 copy number. Patients with identical DNA pattern strains were considered clustered. From 262 isolates, 94 (36%) belonged to 20 distinct RFLP clusters, and after spoligotyping analysis, 89 of the isolates (34%) remained in cluster. MDR isolates did not differ statistically in clustering proportion from susceptible strains. A significant association between the occurrence of MDR and previous tuberculosis (TB) treatment was observed (p0.001), as well as failure on TB treatment (p0.001). Human immunodeficiency virus (HIV)-positive patients were associated with susceptible tuberculosis (p = 0.024). We also identified that unmarried patients were more likely to develop TB due to recent transmission than married patients (p0.005). The introduction of directly observed therapy short-course (DOTS) strategy will be important in decreasing default and failure rates and avoiding the development of new MDR strains.

Progress to understanding the basis of resistance to antituberculous drugs has allowed molecular tests for detection of drug-resistant tuberculosis to be developed. Drug-resistant tuberculosis poses a threat to tuberculosis control programs. It is necessary thus to know drug susceptibilities of individual patient's strain to provide the appropriate drug combinations. Molecular studies on the mechanism of action of antituberculous drugs have elucidated the genetic basis of drug resistance in M. tuberculosis. The mechanisms of drug resistance in tuberculosis are a result of chromosomal mutations in different genes of the bacteria. Upon drug exposure there is a selective pressure for such resistant mutants. Multidrug-resistant tuberculosis is a health problem of increasing significance for the whole global community. This paper reviews the molecular mechanisms associated with drug-resistance as well the new perspectives for detecting resistant isolates.

Objetivo: Estimar a prevalência de sintomáticos respiratórios e tuberculose ativa em uma população privada de liberdade no Rio Grande do Sul, Brasil. Métodos: Estudo epidemiológico descritivo no Presídio Regional de Santa Cruz do Sul, a partir de triagem realizada para identificação de sintomáticos respiratórios (SR) utilizando instrumento recomendado pela OMS. Após a identificação dos sintomáticos respiratórios, foi realizada entrevista e coleta de amostras biológicas para realização de sorologia para HIV, baciloscopia, cultura e teste de susceptibilidade do Mycobacterium tuberculosis frente aos antibióticos para. Resultados: Um total de 70 indivíduos (20,6%) foram considerados sintomáticos respiratórios. Entre os sintomáticos respiratórios, a prevalência de tuberculose e HIV na população estudada foi de 1,9% e 4,48%, respectivamente. Conclusão: Medidas de prevenção devem ser adotadas como forma de conter a transmissão da tuberculose no presídio e de prevenir o contágio na comunidade carcerária, bem como de familiares. A cooperação entre o sistema prisional e departamentos locais de saúde é necessária para melhorar a realização de diagnósticos e acompanhamento de pacientes.

Background and Objectives: The control of leprosy is a public health priority, however, the low prevalence in Rio Grande do Sul favoring underdiagnosis. The objective was to evaluate patients with leprosy during 1995 to 2005 in the city of Santa Cruz do Sul, RS. Results: We performed a retrospective analysis of 38 medical records and assessed the situation of 67 contacts. The mean age was 50.5 years, without gender dominance. The majority (87.2%) were Caucasian farmers with low education (74%). Multibacillary cases predominated (71.1%), clinical form virchowiana (52%) and functional incapacity was found in 36.8%. Only one contact with leprosy was identified. Conclusion: The control of a low prevalence area should prioritize early detection, facilitating the prevention of disabilities. Keywords: Communicable disease control, Hansen’s disease, Leprosy, Mycobacterium leprae.