Prioritizing persons deprived of liberty in global guidelines for tuberculosis preventive treatment.

In this Policy Forum piece, Aditya Narayan and colleagues discuss the challenges and opportunities for tuberculosis preventive treatment in carceral settings.

Deoxyribonucleic acid damage and repair response in the chemotherapy of lung cancer: cross-sectional study.

This study evaluated 24 patients with lung cancer (CA) and 23 individuals with no smoking history or cancer in the family and without respiratory disease in childhood (CO). Peripheral blood lymphocytes was used to perform alkaline comet assay and to assess DNA damage as well as to evaluate methyl methane sulfonate (MMS) DNA repair after one hour and three hours at 37 ºC. The percentage of residual damage (RD) after three hours of MMS treatment, for each patient was assessed. The majority of patients were in the CA group, male patients, former smokers, with a history of smoking for 15 years and without associated comorbidities. Alkaline and residual damages were higher in the CA group when compared to controls (alkaline damage P = 0.015 and RD P = 0.05). After one hour of MMS treatment the DNA damage of the CA increased indicating failure to repair it, compared to the controls, and after three hours DNA repair was observed in both groups. Patients with lung cancer are mostly men, former smokers and with more than 15 years of tobacco consumption, undergoing chemotherapy, have high rates of DNA damage and deficiency in their ability to repair against induced damage when compared to controls.

Association of IL-6 and CRP gene polymorphisms with obesity and metabolic disorders in children and adolescents.

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.

Polymorphisms in CYP2E1, GSTM1 and GSTT1 and anti-tuberculosis drug-induced hepatotoxicity.

Anti-tuberculosis drug-induced hepatitis (ATD- induced hepatitis) has been linked to polymorphisms in genes encoding drug metabolizing enzymes. N-acetyltransferase 2 (NAT2), cytochrome P450 2E1 (CYP2E1) and glutathione S-transferase (loci GSTM1 and GSTT1) are involved in the metabolism of isoniazid, the most toxic drug for the treatment of tuberculosis (TB). This study was designed to determine the frequency and to evaluate whether polymorphisms at CYP2E1, GSTM1 and GSTT1 genes are associated with drug response, as well as to identify clinical risk factors for ATD-induced hepatitis. A total of 245 Brazilian patients undergoing treatment for TB were genotyped using polymerase chain reaction and restriction fragment length polymorphism and sequencing methods. The frequencies of the CYP2E1 polymorphic alleles RsaI, PstI and DraI are 8%, 8.5% and 12%, respectively. GSTM1 and GSTT1 genes are deleted in 42.9% and 12.4% of the population, respectively. Fifteen patients (6.1%) developed hepatotoxicity. Clinical (HIV, female sex and extrapulmonary TB) and genetic characteristics (CYP2E1 without any mutations, having NAT2 slow acetylator profile) are at higher risk of developing ATD-induced hepatitis in this population. Genotyping for GSTM1 and GSTT1 showed no influence on drug response.

Effects of Crossfit® and street running practice on anthropometric, lipids parameters, cardiorespiratory fitness and sleep quality.

BACKGROUND: Street running (SR) and CrossFit® (CF) have different characteristics ranging from aerobic training to high intensity. This study aimed to describe the subject's physical training, anthropometric and lipid parameters, cardiorespiratory fitness and sleep quality and duration. METHODS: Cross-sectional, study, that collected personal data, Pittsburgh Sleep Quality Index (PSQI), anthropometric assessment, cardiorespiratory fitness, and lipid profile. The subjects were separated in CF group (CFG) and SR group (SRG). RESULTS: The SRG training frequency was lower (P=0.006), had better maximum oxygen consumption (V̇O2max) levels (P<0.001). 59.3% of the SRG had excellent V̇O2max. Cardiorespiratory fitness (49.97 mL/kg/min; P=0.001) and Body Mass Index (BMI) were positively related in SR (P=0.031). An inverse correlation was found between V̇O2max and body fat percentage (BF%) (SRG: P=0.001; CFG: P=0.013). Sleep duration is strongly and inversely associated with PSQI. There was a correlation between total cholesterol (TC) and high-density lipoprotein cholesterol (P=0.020), TC and triglycerides (TGs) (P=0.029) and levels of TGs and BMI (P=0.008) in SRG. In the CFG group, there was a correlation of TC between TGs levels (P=0.025), light-density lipoprotein cholesterol (P<0.001) and BMI (P=0.050). CONCLUSIONS: The SR have a higher V̇O2max although they train less than the CF practitioners regardless of factors such as BF%, gender and age.

Social distancing patterns in nine municipalities of Rio Grande do Sul, Brazil: the Epicovid19/RS study.

OBJECTIVE To describe social distancing practices in nine municipalities of the state of Rio Grande do Sul, Brazil, stratified by gender, age, and educational attainment. METHODS Two sequential cross-sectional studies were conducted in the municipalities of Canoas, Caxias do Sul, Ijuí, Passo Fundo, Pelotas, Porto Alegre, Santa Cruz do Sul, Santa Maria, and Uruguaiana to estimate the population prevalence of COVID-19. The study was designed to be representative of the urban population of these municipalities. A questionnaire including three questions about social distancing was also administered to the participants. Here, we present descriptive analyses of social distancing practices by subgroups and use chi-square tests for comparisons. RESULTS In terms of degree of social distancing, 25.8% of the interviewees reported being essentially isolated and 41.1% reported being quite isolated. 20.1% of respondents reported staying at home all the time, while 44.5% left only for essential activities. More than half of households reported receiving no visits from non-residents. Adults aged 20 to 59 reported the least social distancing, while more than 80% of participants aged 60 years or older reported being essentially isolated or quite isolated. Women reported more stringent distancing than men. Groups with higher educational attainment reported going out for daily activities more frequently. CONCLUSIONS The extremes of age are more protected by social distancing, but some groups remain highly exposed. This can be an important limiting factor in controlling progression of the COVID-19 pandemic.

High frequency of aac(6')-Ib-cr gene associated with double mutations in gyrA and parC in Escherichia coli isolates from patients with urinary tract infections.

OBJECTIVES: The aims of this study were (i) to determine the frequency of plasmid-mediated resistance to fluoroquinolones (FQs) in Escherichia coli isolated from patients with urinary tract infections (UTIs) of nosocomial and community origin and (ii) to determine the relationships between the presence of extended-spectrum ß-lactamases (ESBLs), mutations in the gyrA and parC genes, and resistance to FQs. METHODS: A total of 71 E. coli isolates, including 38 ESBL-producers and 33 non-ESBL-producers, were analysed. The aac(6')-Ib gene was amplified using PCR and was subsequently digested with the BtsCI restriction enzyme to identify aac(6')-Ib-cr, a variant associated with FQ resistance. Detection of qnr genes was performed by multiplex PCR. In isolates that tested positive for these genes, the gyrA and parC genes were sequenced and the modulation factor of an efflux pump inhibitor was determined on the minimum inhibitory concentration (MIC) of norfloxacin. RESULTS: The frequencies of qnrS, qnrB and qnrA were 4.2%, 2.8% and 0%, respectively. The frequency of aac(6')-Ib-cr was 40.8% and this variant was associated with double mutations in gyrA and parC as well as resistance to FQs and ESBL production. Modulation of efflux pump activity was more frequent in resistant isolates that had a wild-type parC gene. CONCLUSION: An interplay of resistance mechanisms increased the level of resistance to FQs, and the high frequency of putative plasmid-mediated quinolone resistance genes associated with ESBL-producing isolates reduced therapeutic options to treat UTIs in the affected population.

Social distancing patterns in nine municipalities of Rio Grande do Sul, Brazil: the Epicovid19/RS study / Padrões de distanciamento social em nove cidades gaúchas: estudo Epicovid19/RS

ABSTRACT OBJECTIVE To describe social distancing practices in nine municipalities of the state of Rio Grande do Sul, Brazil, stratified by gender, age, and educational attainment. METHODS Two sequential cross-sectional studies were conducted in the municipalities of Canoas, Caxias do Sul, Ijuí, Passo Fundo, Pelotas, Porto Alegre, Santa Cruz do Sul, Santa Maria, and Uruguaiana to estimate the population prevalence of COVID-19. The study was designed to be representative of the urban population of these municipalities. A questionnaire including three questions about social distancing was also administered to the participants. Here, we present descriptive analyses of social distancing practices by subgroups and use chi-square tests for comparisons. RESULTS In terms of degree of social distancing, 25.8% of the interviewees reported being essentially isolated and 41.1% reported being quite isolated. 20.1% of respondents reported staying at home all the time, while 44.5% left only for essential activities. More than half of households reported receiving no visits from non-residents. Adults aged 20 to 59 reported the least social distancing, while more than 80% of participants aged 60 years or older reported being essentially isolated or quite isolated. Women reported more stringent distancing than men. Groups with higher educational attainment reported going out for daily activities more frequently. CONCLUSIONS The extremes of age are more protected by social distancing, but some groups remain highly exposed. This can be an important limiting factor in controlling progression of the COVID-19 pandemic.

RESUMO OBJETIVO Descrever práticas de distanciamento social em nove municípios do Rio Grande do Sul por sexo, idade, escolaridade e cidade. MÉTODOS Foram realizados dois estudos transversais sequenciais representativos da população urbana nos municípios de Canoas, Caxias do Sul, Ijuí, Passo Fundo, Pelotas, Porto Alegre, Santa Cruz do Sul, Santa Maria e Uruguaiana com o intuito de estimar a prevalência populacional de Covid-19. Foi aplicado questionário contendo três perguntas sobre distanciamento social, cujas práticas foram submetidas a análises descritivas por subgrupos. Os dados foram comparados por testes qui-quadrado. RESULTADOS Em termos de grau de distanciamento social, 25,8% dos entrevistados relataram estar praticamente isolados e 41,1% indicam praticar bastante distanciamento. Relataram ficar em casa o tempo todo 20,1% dos entrevistados, e 44,5% informam que saem apenas para atividades essenciais. Mais da metade dos domicílios não recebe visitas de não moradores. O grupo que relatou menos distanciamento social foi o de adultos entre 20 e 59 anos, enquanto mais de 80% dos entrevistados com 60 anos ou mais relataram estar praticamente isolados ou fazendo bastante distanciamento. As mulheres relataram fazer mais distanciamento que os homens, e os grupos de maior escolaridade foram os que relataram sair diariamente para atividades regulares com mais frequência. CONCLUSÕES Os grupos mais jovens e mais idosos estão mais protegidos pelo distanciamento social, mas há grupos bastante expostos, o que pode ser um limitador importante no controle da progressão da epidemia de Covid-19.

Avaliação do nível sérico de antígeno prostático específico (PSA) em pacientes do Rio Grande do Sul, Brasil / Evaluation of prostatic-specific antigen (PSA) serum level of in patients of Rio Grande

O Antígeno Prostático Específico (PSA) é a principal alternativa para detecção do câncer de próstata, quando presentadas quantidades anormais de PSA, no soro. O objetivo do presente estudo foi avaliar alterações dos níveis de PSA, assim como as características epidemiológicas de um grupo de pacientes do interior do Rio Grande do Sul. Foram analisados os resultados dos exames de PSA de 50 pacientes atendidos em um laboratórioprivado do RS, no período de fevereiro a junho de 2010. Os dados epidemiológicos foram coletados no momento da realização do exame. Estatísticas descritivas foram realizadas,utilizando o programa SPSS versão 18.0. Um total de 19 (38%) pacientes, com média de idade de 66 anos, apresentou níveis de PSA alterados. Com relação à profissão, 50% eram agricultores e, destes, 56% apresentavam níveis alterados de PSA. Observou-se, também, que a metade dos indivíduos que tinham histórico familiar de câncer de próstata apresentou níveis de PSA alterados. Através deste estudo, foi possível observar que o nível médio de PSA aumenta de acordo com a idade, evidenciando a característica de uma doença de terceira idade, bem como se mostrou elevado entre os agricultores.Estes resultados demonstram que programas de controle e prevenção do câncer de próstata deveriam levar em consideração características relacionadas à idade e àatividade profissional, associadas aos níveis de PSA.

The Prostate Specific Antigen (PSA) is the main alternative for thedetection of prostate cancer, when PSA levels are in abnormalamounts in the serum. The aim of this study was to evaluate changesin PSA levels as well the epidemiological characteristics of a groupof healthy patients in the interior of Rio Grande do Sul (RS), Brazil.We analyzed the results of PSA tests in 50 patients treated at aprivate laboratory in the RS from February to June 2010. Theepidemiological data were collected at the time of examination.Descriptive statistics were performed using the software SPSS version18.0. A total of 19 (38%) patients with a mean age of 66 years hadPSA levels changed. Regarding occupation, 50% were farmers, andof these 56% presented altered levels of PSA. Also, it was observedthat half of the individuals who have a family history of prostatecancer have PSA levels changed. It was observed, through thisstudy, that the average level of PSA increases with age showing thecharacteristic of a disease of old age and appears high amongfarmers. These results shown that programs for control andprevention of prostate cancer should take in considerationcharacteristics related to age and occupation associated with PSAlevels.