Body fat, cardiovascular risk factors and polymorphism in the FTO gene: randomized clinical trial and different physical exercise for adolescents

Abstract Objective: To investigate the effects of different physical exercise programs and polymorphisms of the FTO (fat mass and obesity-associated gene) on body composition and cardiovascular risk factors in adolescents with overweight and obesity. Methods: A randomized, parallel, double-blind clinical trial consisting of the adolescent overweight from the state public network, in a simple representative random sample, who participated in an aerobic exercise or weight training intervention for 10 weeks. Anthropometry, body composition, biochemical markers, sexual maturation, and rs9939609 polymorphism in the FTO gene were assessed. 347 adolescents had their characterization of nutritional status. 72 individuals with overweight and obesity were invited to participate. 39 remained for the start of the program and were randomly allocated to both types of intervention. In the end, 26 subjects participated in the intervention programs, with 12 and 14 in the aerobic and weight training programs, respectively. Results: Heterozygous and homozygous bearers of risk allele A participating in the aerobic program showed improvements in glycemia (p = 0.002) and total cholesterol (p = 0.023) and a reduction in body fat mass (p = 0.041). The weight training program reduced glycemia in patients with the risk allele A (p = 0.027). Cameron's stage four sexual maturation participants were 2.1 times more likely to improve their body fat (CI = 1.31-3.39). Conclusion: Aerobic exercises produced exclusively a significant decrease in fat mass and total cholesterol in patients with risk allele A. Distinct physical exercise programs may cause diverse changes in risk variables related to the health of adolescents.

Body fat, cardiovascular risk factors and polymorphism in the FTO gene: randomized clinical trial and different physical exercise for adolescents.

OBJECTIVE: To investigate the effects of different physical exercise programs and polymorphisms of the FTO (fat mass and obesity-associated gene) on body composition and cardiovascular risk factors in adolescents with overweight and obesity. METHODS: A randomized, parallel, double-blind clinical trial consisting of the adolescent overweight from the state public network, in a simple representative random sample, who participated in an aerobic exercise or weight training intervention for 10 weeks. Anthropometry, body composition, biochemical markers, sexual maturation, and rs9939609 polymorphism in the FTO gene were assessed. 347 adolescents had their characterization of nutritional status. 72 individuals with overweight and obesity were invited to participate. 39 remained for the start of the program and were randomly allocated to both types of intervention. In the end, 26 subjects participated in the intervention programs, with 12 and 14 in the aerobic and weight training programs, respectively. RESULTS: Heterozygous and homozygous bearers of risk allele A participating in the aerobic program showed improvements in glycemia (p = 0.002) and total cholesterol (p = 0.023) and a reduction in body fat mass (p = 0.041). The weight training program reduced glycemia in patients with the risk allele A (p = 0.027). Cameron's stage four sexual maturation participants were 2.1 times more likely to improve their body fat (CI = 1.31-3.39). CONCLUSION: Aerobic exercises produced exclusively a significant decrease in fat mass and total cholesterol in patients with risk allele A. Distinct physical exercise programs may cause diverse changes in risk variables related to the health of adolescents.

Optimization and Clinical Validation of Colorimetric Reverse Transcription Loop-Mediated Isothermal Amplification, a Fast, Highly Sensitive and Specific COVID-19 Molecular Diagnostic Tool That Is Robust to Detect SARS-CoV-2 Variants of Concern.

The coronavirus disease 2019 (COVID-19) pandemic unfolded due to the widespread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission reinforced the urgent need for affordable molecular diagnostic alternative methods for massive testing screening. We present the clinical validation of a pH-dependent colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP) for SARS-CoV-2 detection. The method revealed a limit of detection of 19.3 ± 2.7 viral genomic copies/µL when using RNA extracted samples obtained from nasopharyngeal swabs collected in guanidine-containing viral transport medium. Typical RT-LAMP reactions were performed at 65°C for 30 min. When compared to reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR), up to cycle-threshold (Ct) value 32, RT-LAMP presented 98% [95% confidence interval (CI) = 95.3-99.5%] sensitivity and 100% (95% CI = 94.5-100%) specificity for SARS-CoV-2 RNA detection targeting E and N genes. No cross-reactivity was detected when testing other non-SARS-CoV virus, confirming high specificity. The test is compatible with primary RNA extraction-free samples. We also demonstrated that colorimetric RT-LAMP can detect SARS-CoV-2 variants of concern and variants of interest, such as variants occurring in Brazil named gamma (P.1), zeta (P.2), delta (B.1.617.2), B.1.1.374, and B.1.1.371. The method meets point-of-care requirements and can be deployed in the field for high-throughput COVID-19 testing campaigns, especially in countries where COVID-19 testing efforts are far from ideal to tackle the pandemics. Although RT-qPCR is considered the gold standard for SARS-CoV-2 RNA detection, it requires expensive equipment, infrastructure, and highly trained personnel. In contrast, RT-LAMP emerges as an affordable, inexpensive, and simple alternative for SARS-CoV-2 molecular detection that can be applied to massive COVID-19 testing campaigns and save lives.

Impact of adenotonsilectomy on nasal airflow and pulmonary blood pressure in mouth breathing children.

INTRODUCTION: Adenotonsillar hyperplasia (ATH) causing upper airway obstruction (UAO) may increase pulmonary artery systolic pressure (PASP). Early diagnosis and mouth breathing (MB) management may help in cases of high PASP. Total inspiratory nasal airflow (TINAF) obtained by active anterior rhinomanometry (AARM) is a means to quantify nasal patency. This study aimed to correlate TINAF with high PASP. METHODS: This is a prospective study involving 30 children between two and twelve years of age, with indication for adenotonsillectomy due to ATH, evaluated before and six months after surgery; and 29 nasal breathing (NB) children in the same age group. We obtained the PASP, calculated for tricuspid regurgitation, by means of a transthoracic echocardiography. We assessed nasal patency using the AARM to estimate the TINAF. RESULTS: The mean PASP among mouth breathing children was 25.99 mmHg, with a Standard Deviation of (±) 3.27, p = 0.01 in the preoperative period; and 21.79 mmHg (±2.48; p = 0.01) in the postoperative period. Among nasal breathers, this mean value was 21.64 mmHg (±3.87, p = 0.01). The mean pre-operative TINAF was 266.76 cm3/s (±112.21, p = 0.01); and 498.93 cm3/s (±137.80, p = 0.01) after surgery. Among nasal breathers it was 609.37 cm3/s (±109.16; p = 0.01). The mean nasal patency in the preoperative period was 42.85% (±17.83; p = 0.01); and 79.33% (±21.35; p = 0.01) in the post-op. Among nasal breathers it was 112.94% (±15.88, p = 0.01). There was a significant Spearman correlation value between TINAF and PASP (r = -0.459; p = 0.01) when we analyzed all the groups. CONCLUSION: PASP and TINAF values improved postoperatively and had an inverse correlation. This study suggests that by improving TINAF there was a decrease in PASP.

The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005 / Impacto de los cambios en los indicadores de salud sobre las tasas de mortalidad infantil en Brasil, 2000 y 2005

OBJECTIVES: To investigate the associations between changes in indicators of health-related resources and coverage, and variations in infant mortality rates (IMR) in Brazil's 27 states in 2000 and 2005. METHODS: Data were obtained from the Ministry of Health's online database, DATASUS. Stepwise multiple regressions were performed to model changes in IMR and its components (early, late, and post-neonatal mortality), using changes in the selected health indicators as predictors. RESULTS: Regression analysis showed that improving access to prenatal care (B = -0.89 per 1 000; P < 0.001), increasing public expenditure on health as a proportion of gross domestic product (GDP) (B = -0.72 per 1 000; P = 0.031), and increasing access to the water supply (B = -0.22 per 1 000; P = 0.033) were associated with significant reductions in IMR. Declining early neonatal mortality rates were associated with prenatal care (B = -0.14 per 1 000; P = 0.026) and access to sanitation services (B = -0.05 per 1 000; P = 0.026). Reductions in late neonatal mortality rates were associated with prenatal care (B = -0.12 per 1 000; P = 0.003) and inversely correlated to the rate of cesarean deliveries (B = 0.13 per 1 000; P = 0.005). Post-neonatal mortality rate reductions were associated with prenatal care (B = -0.64 per 1 000; P < 0.001), increasing public expenditure on health as a proportion of GDP (B = -0.76 per 1 000; P = 0.005), and access to the water supply (B = -0.17 per 1 000; P = 0.037). CONCLUSIONS: Improving access to prenatal care, increasing public expenditure on health, and access to sanitation and water supply were all independently correlated to declining IMR; however, higher rates of cesarean deliveries were associated with higher late neonatal mortality rates. Continuous collection and analysis of relevant health indicators is recommended for developing evidence-based health policies and accurate predictions of how specific public health interventions...

OBJETIVOS: Investigar las asociaciones entre los cambios en los indicadores de recursos y cobertura relacionados con la salud y las variaciones en las tasas de mortalidad infantil (TMI) en los 27 estados de Brasil entre los años 2000 y 2005. MÉTODOS: Los datos se obtuvieron de la base de datos en línea del Ministerio de Salud, DATASUS. Mediante regresión múltiple paso a paso se modelaron los cambios en la TMI y sus componentes (mortalidades temprana, tardía y posneonatal), utilizando como predictores los cambios en indicadores seleccionados de salud. RESULTADOS: Según el análisis de regresión, el mejoramiento del acceso a la atención prenatal (B = -0,89 por 1 000; P < 0,001) y al suministro de agua (B = -0,22 por 1 000; P = 0,033), y el aumento del gasto público en salud como proporción del producto interno bruto (PIB) (B = -0,72 por 1 000; P = 0,031) se asociaron con reducciones significativas de las TMI. Las reducciones de las tasas de mortalidad neonatal temprana se asociaron con la atención prenatal (B = -0,14 por 1 000; P = 0,026) y el acceso a servicios de saneamiento (B = -0,05 por 1 000; P = 0,026). Las reducciones en las tasas de mortalidad neonatal tardía se asociaron con la atención prenatal (B = -0,12 por 1 000; P = 0,003) e, inversamente, con la tasa de partos por cesárea (B = 0,13 por 1 000; P = 0,005). Las reducciones en las tasas de mortalidad posneonatal se asociaron con la atención prenatal (B = -0,64 por 1 000; P < 0,001), el aumento en el gasto público en salud como proporción del PIB (B = -0,76 por 1 000; P = 0,005) y el acceso a fuentes de agua (B = -0,17 por 1 000; P = 0,037). CONCLUSIONES: El mejoramiento del acceso al cuidado prenatal, el incremento del gasto público en salud y el acceso al saneamiento y a fuentes de agua se correlacionaron independientemente con la reducción en las TMI; mayores tasas de partos por cesárea se asociaron con mayores tasas de mortalidad neonatal tardía. Se recomienda mantener la...

The impact of changing health indicators on infant mortality rates in Brazil, 2000 and 2005.

OBJECTIVES: To investigate the associations between changes in indicators of health-related resources and coverage, and variations in infant mortality rates (IMR) in Brazil's 27 states in 2000 and 2005. METHODS: Data were obtained from the Ministry of Health's online database, DATASUS. Stepwise multiple regressions were performed to model changes in IMR and its components (early, late, and post-neonatal mortality), using changes in the selected health indicators as predictors. RESULTS: Regression analysis showed that improving access to prenatal care (B = -0.89 per 1 000; P < 0.001), increasing public expenditure on health as a proportion of gross domestic product (GDP) (B = -0.72 per 1 000; P = 0.031), and increasing access to the water supply (B = -0.22 per 1 000; P = 0.033) were associated with significant reductions in IMR. Declining early neonatal mortality rates were associated with prenatal care (B = -0.14 per 1 000; P = 0.026) and access to sanitation services (B = -0.05 per 1 000; P = 0.026). Reductions in late neonatal mortality rates were associated with prenatal care (B = -0.12 per 1 000; P = 0.003) and inversely correlated to the rate of cesarean deliveries (B = 0.13 per 1 000; P = 0.005). Post-neonatal mortality rate reductions were associated with prenatal care (B = -0.64 per 1 000; P < 0.001), increasing public expenditure on health as a proportion of GDP (B = -0.76 per 1 000; P = 0.005), and access to the water supply (B = -0.17 per 1 000; P = 0.037). CONCLUSIONS: Improving access to prenatal care, increasing public expenditure on health, and access to sanitation and water supply were all independently correlated to declining IMR; however, higher rates of cesarean deliveries were associated with higher late neonatal mortality rates. Continuous collection and analysis of relevant health indicators is recommended for developing evidence-based health policies and accurate predictions of how specific public health interventions might impact IMR.