Prevalence of helmintic infections in Brazilian Maxakali indigenous: a repeated cross-sectional design.

BACKGROUND: The prevalence of intestinal parasites is known to be high among Amerindian populations; further, there are serious problems in the healthcare of these populations in Brazil. The Maxakali, located in the northeastern region of Minas Gerais, Brazil, is an indigenous group that still preserves many of its cultural aspects. This study aimed to compare the positivity rate of schistosomiasis and soil-transmitted helminths in this ethnic group in epidemiological surveys conducted in 1972 and 2014. METHODS: Stool parasitological examinations were performed by the Kato-Katz technique during both periods in this population. In 2014, the parasitological diagnosis was also realized with the TF-Test® technique. RESULTS: In 1972, 270 inhabitants were examined. The positivity rates were 67.4% for Schistosoma mansoni, 72.9% for hookworms, 43.7% for Ascaris lumbricoides, and 23.7% for Trichuris trichiura. In 2014, 545 individuals were examined, and the positivity rates obtained were 45.7% for S. mansoni, 22.8% for hookworms, 0.6% for A. lumbricoides, and 2.8% for T. trichiura. CONCLUSIONS: The comparison of the parasitological surveys conducted in 1972 and 2014, indicates that the indigenous Maxakali remained neglected by the health and indigenous protection authorities during these four decades. The infection rate observed in 2014 for schistosomiasis and hookworm remains high, considering the current epidemiological view of these diseases in the Brazilian population.

Rotating shift work time is directly associated with excess body adiposity.

OBJECTIVE: To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts. METHODS: The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model. RESULTS: The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm). CONCLUSION: The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work.

The combined consumption of fresh/minimally processed food and ultra-processed food on food insecurity: COVID Inconfidentes, a population-based survey.

OBJECTIVE: To investigate whether the combined consumption of fresh/minimally processed and ultra-processed food is associated with food insecurity (FI) during the COVID-19 pandemic. DESIGN: Cross-sectional observational study was derived from a survey using a population-based search of a complex sample. FI was assessed using the validated Brazilian Food Insecurity Scale. Food consumption was assessed using a qualitative FFQ and the NOVA classification for fresh/minimally processed food and ultra-processed food. A scoring system was used to evaluate combined food consumption according to the extent and purpose of processing, considering the weekly consumption of the two groups (according to the NOVA classification). Higher punctuation reflects worse diet quality (higher consumption of ultra-processed foods and lower consumption of fresh/minimally processed foods). A theoretical causality model was constructed using a directed acyclic graph, and multivariate analysis was performed using Poisson regression to test the association between FI and food consumption. SETTING: Ouro Preto and Mariana, Brazil, between October and December 2020. PARTICIPANTS: An epidemiological household survey was conducted with 1753 individuals selected through a stratified and clustered sampling design in three stages. RESULTS: Those with food consumption scores in the fourth quartile had a 60 % higher prevalence ratio (PR) for FI (PR: 1·60 and 95 % CI: 1·06 - 2·40). Also, the increased consumption of fresh/minimally processed foods and low consumption of ultra-processed foods presented a 45 % lower prevalence ratio of FI (PR: 0·55 and 95 % CI: 0·40 - 0·80). CONCLUSION: These results indicate an inverse association between FI and diet quality.

Rotating shift workers with vitamin D deficiency have a higher risk of obstructive sleep apnea.

OBJECTIVES: The study aimed to evaluate the association between obstructive sleep apnea (OSA) and vitamin D deficiency (VDD) in shift workers. METHODS: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Risk of developing OSA was classified by Berlin questionnaire (BQ) and NoSAS score. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression analysis was performed to investigate whether or not VDD was associated with OSA risk assessment. RESULTS: Among 1423 male workers, mostly younger, aged 30 to 39 years (53%), worked shifts for more than 5 years (76%). The prevalence of high risk of OSA by BQ was 16%, and 33% by NoSAS score. Additionally, 29% had VDD. In multivariate analysis, controlled for confounding factors, workers with VDD had a 52% increased chance of OSA by BQ (OR 1.52; CI95% 1.06-2.18) and a 64% increased chance of OSA by NoSAS score (OR 1.64; CI95% 1.09-2.48). After subgroup analyses, similar results were not observed in workers aged 20-29 and 30-39 years. CONCLUSION: Rotating shift workers with vitamin D deficiency are more likely to have obstructive sleep apnea, assessed by the Berlin questionnaire and NoSAS score.

Sedentary behavior is associated with poor sleep quality during the COVID-19 pandemic, and physical activity mitigates its adverse effects.

BACKGROUND: We aimed to evaluate the association of sedentary behavior (SB) and moderate to vigorous leisure-time physical activity (MVPA) with sleep quality during the COVID-19 pandemic. METHODS: Cross-sectional, population-based study in adults, conducted from October to December 2020 in the Iron Quadrangle region, Brazil. The outcome was sleep quality, evaluated with the Pittsburgh Sleep Quality Index. SB was assessed by self-report of total sitting time, before and during the pandemic. Individuals with ≥ 9 h of total sitting time were classified as SB. In addition, the ratio of time spent in MVPA to time in SB was analyzed. A contrasted directed acyclic graph (DAG) model was constructed to adjust logistic regression models. RESULTS: A total of 1629 individuals were evaluated, the prevalence of SB before the pandemic was 11.3% (95%CI: 8.6-14.8), and during the pandemic 15.2% (95%CI: 12.1-18.9). In multivariate analysis, the chance of poor sleep quality was 77% higher in subjects with SB ≥ 9 h per day (OR: 1.77; 95% CI: 1.02-2.97). Furthermore, a one-hour increase in SB during the pandemic, increased the chance of poor sleep quality by 8% (OR: 1.08; 95%CI 1.01-1.15). In the analysis of the ratio of MVPA per SB in individuals with SB ≥ 9 h, practicing 1 min of MVPA per hour of SB reduces the chance of poor sleep quality by 19% (OR: 0.84; 95%CI: 0.73-0.98). CONCLUSION: SB during the pandemic was a factor associated with poor sleep quality, and the practice of MVPA can reduce the effects of SB.

Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers.

BACKGROUND: Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. METHODS: This cross-sectional study included male rotating shift workers, drivers of heavy off-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defined as an apnea-hypopnea index (AHI) of ≥ 5 events/h. The Shapiro-Wilk test verified the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann-Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph. RESULTS: Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI ≥ 5), and 46% had moderate to severe sleep apnea (AHI ≥ 15). For AHI ≥ 5, the NoSAS score had higher sensitivity and specificity than the BQ. For AHI ≥ 15 and AHI ≥ 30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. CONCLUSION: In rotating shift workers, drivers of heavy off-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.

COVID-Inconfidentes: how did COVID-19 and work from home influence the prevalence of leisure-time physical inactivity? An analysis of before and during the pandemic.

BACKGROUND: The COVID-19 pandemic has brought drastic changes to the lives of the global population. The restrictions imposed by government agencies impacted the daily lives of citizens, influencing several health behaviors, such as physical activity (PA). Thus, the present study aimed to assess the prevalence of physical inactivity (PI) and its associated factors before and during the COVID-19 pandemic. METHODS: A population-based household seroepidemiological survey was conducted in two Brazilian municipalities located in the state of Minas Gerais, in which 1750 volunteers were interviewed between October and December 2020. Face-to-face interviews were conducted using a structured questionnaire in an electronic format. The moments considered for the PI analysis were M0 (before the pandemic), M1 (from March to July 2020), and M2 (from October to December 2020). Descriptive statistics and univariate and multivariate logistic regression were used to examine the factors associated with PI before (M0) and during the pandemic (M1 and M2). RESULTS: The prevalence of PI was higher in the first months of the pandemic (M1) (67.3%; 95% confidence interval (CI): 62.4-71.9) than in the months from October to December 2020 (M2) (58.7%; 95% CI: 52.8-64.3); however, at both times (M1 and M2), PI was more prevalent than in the period before the pandemic started (M0) (39.7%; 95% CI: 35.6-43.8). Individuals who were overweight, obese, and had low educational levels were more likely to be physically inactive. At both M1 and M2, individuals who worked at a work from home were less likely to have PI. CONCLUSIONS: The results suggest that the COVID-19 pandemic negatively influenced PA, substantially increasing the prevalence of PI. The determinants associated with PI were education, body mass index, and work from home.

Evaluation of three recombinant proteins for the development of ELISA and immunochromatographic tests for visceral leishmaniasis serodiagnosis.

BACKGROUND: Visceral Leishmaniasis (VL) is an infectious disease that is a significant cause of death among infants aged under 1 year and the elderly in Brazil. Serodiagnosis is a mainstay of VL elimination programs; however, it has significant limitations due to low accuracy. OBJECTIVE: This study aimed to evaluate three recombinant Leishmania infantum proteins (rFc, rC9, and rA2) selected from previous proteomics and genomics analyses to develop enzyme-linked immunosorbent assay (ELISA) and immunochromatographic tests (ICT) for the serodiagnosis of human VL (HVL) and canine VL (CVL). METHODS: A total of 186 human (70 L. infantum-infected symptomatic, 20 other disease-infected, and 96 healthy) and 185 canine (82 L. infantum-infected symptomatic, 27 L. infantum-infected asymptomatic, and 76 healthy) sera samples were used for antibody detection. FINDINGS: Of the three proteins, rA2 (91.5% sensitivity and 87% specificity) and rC9 (95.7% sensitivity and 87.5% specificity) displayed the best performance in ELISA-HVL and ELISA-CVL, respectively. ICT-rA2 also displayed the best performance for HVL diagnosis (92.3% sensitivity and 88.0% specificity) and had high concordance with immunofluorescence antibody tests (IFAT), ELISA-rK39, IT-LEISH®, and ELISAEXT. ICT-rFc, ICT-rC9, and ICT-rA2 had sensitivities of 88.6%, 86.5%, and 87.0%, respectively, with specificity values of 84.0%, 92.0%, and 100%, respectively for CVL diagnosis. MAIN CONCLUSIONS: The three antigens selected by us are promising candidates for VL diagnosis regardless of the test format, although the antigen combinations and test parameters may warrant further optimisation.

Clustered Cardiovascular Risk Factors Are Associated with Inflammatory Markers in Adolescents.

BACKGROUND: Clusters of cardiovascular risk (CVR) factors are associated with an increased risk of developing cardiovascular diseases (CVDs). This cross-sectional study assessed the associations between classic CVR factor clusters and inflammatory markers in Brazilian adolescents. METHODS: Measurements included anthropometric, clinical and biochemical parameters and selected inflammatory markers in 487 adolescents (236 boys/251 girls; 12.06 ± 1.41 years). RESULTS: After stratifying the population by gender and adjusting for potential confounding variables, principal component analysis was performed and it produced 5 independent components in both genders: adiposity, glucose metabolism, blood pressure, high-density lipoprotein (HDL)/triacylglycerols (TG), and cholesterol/low-density lipoprotein. Glucose metabolism was inversely associated with interleukin-1ß (IL-1ß) in both genders (r = -0.026; r = -0.021); blood pressure was inversely associated with tumor necrosis factor alpha (TNF-α) in girls (r = -0.046); HDL/TG was positively associated with interleukin-6 in girls (r = 0.012), with IL-1ß (r = 0.010) TNF-α (r = 0.045) in boys, and inversely associated with adiponectin in both genders (r = -0.015; r = -0.013). CONCLUSION: The results suggest that lipid metabolism alterations, as potential early events in the development of CVDs, have a strong link to the inflammatory process, in contrast to other clusters of risk factors.

[Environmental conditions and prevalence of parasitic infection in Xukuru-Kariri indigenous people, Caldas, Brazil]. / Condições ambientais e prevalência de infecção parasitária em indígenas Xukuru-Kariri, Caldas, Brasil.

OBJECTIVE: To describe the environmental conditions and the parasitic infection status of Xukuru-Kariri individuals living in the municipality of Caldas, state of Minas Gerais, Brazil. METHODS: A cross-sectional study was carried out in March 2009. Sociodemographic and environmental data were collected through interviews. Water and fecal samples were collected for determination of environmental contamination and parasitic infection status. RESULTS: The Xukuru-Kariri population living in Caldas included 86 people divided into 22 families. Of 22 heads of household, 81.8% had low schooling (not higher than elementary education). Of 26 water samples collected for microbiological analysis, 77.0% were positive for total coliforms and 4.0% for Escherichia coli. Residents of 27.3% of households defecated in the open. Trash was scattered in the yard of 54.5% of households. Fecal samples were collected from 60 individuals, with parasitic infection in 66.6%. The following prevalence rates were recorded: Entamoeba histolytica/dispar, 6.7%; Entamoeba coli, 60.0%; Endolimax nana, 1.8%; and Giardia duodenalis, 6.6%. CONCLUSIONS: The people included in this study faced environmental characteristics that contributed to their health vulnerability. Health actions as well as the implementation of public policies to provide sanitation, with quality water and adequate collection and treatment of human and household waste, are essential to prevent environmental degradation and improve the quality of life of these individuals.

Retinol-binding protein 4 and insulin resistance are related to body fat in primary and secondary schoolchildren: the Ouro Preto study.

PURPOSE: Evidence suggests that plasma retinol-binding protein 4 (RBP4) and insulin resistance are related to body fat (BF). We aimed to assess the relationship between RBP4 and insulin resistance with obesity in a mixed (skin color) cohort of the Brazilian population. METHODS: A nested case-control study was conducted in 227 schoolchildren aged 7-14 years. Schoolchildren with a high BF percentage (% BF, ≥ 30 for girls and ≥ 25 for boys) were identified as the obese group (n = 137), and those with lower values were identified as the non-obese group (n = 90). Percentage of body fat (% BF) was determined by tetrapolar bioimpedance (Quantum II, RJL System), RBP4 by enzyme-linked immunosorbent assay (Immunology Consultants Laboratory), plasma fasting insulin by chemiluminescent immunoassay (Access(®) Immunoassay System) and insulin resistance by the homeostasis model insulin resistance (IR(HOMA)) index. Serum lipid profile and arterial blood pressure were evaluated. RESULTS: The significant independent risk factors associated with obesity were as follows: male sex, increased serum LDL-C, RBP4 and IR(HOMA). Among children with higher RBP4, the association with obesity increased significantly (from 3.1 to 8.5) in the presence of insulin resistance, when compared to higher RBP4 and non-insulin resistance. CONCLUSION: IR(HOMA) and RBP4 showed significant associations with obesity and traditional CVD risk factors. They might therefore be used as a marker for CVD risk and have clinical implications in the development of comorbidities associated with obesity.

The Interaction between Education and Sex with Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Analysis of Two Brazilian Cities.

This cross-sectional study, carried out between October and December 2020 in two Brazilian cities, aimed to evaluate the joint association of education and sex with habitual and episodic excessive alcohol consumption during the COVID-19 pandemic. Habitual alcohol consumption was defined as drinking any quantity of alcohol at least once per week. Excessive episodic alcohol consumption was defined as the consumption of five or more drinks by men or four or more drinks by women at least once in the last 30 days. Adjusted multivariate logistic regression models were used to analyze associations of education and sex with alcohol consumption. Education was not associated with habitual alcohol consumption and excessive episodic alcohol consumption. However, when evaluating the joint effect between education and sex, it can be seen that men with low education were more likely to habitually consume (OR: 5.85; CI95:2.74-14.84) and abuse alcohol (OR: 4.45; IC95:1.54-12.82) and women with high education were more likely to have habitual (OR: 2.16; IC95:1.18-3.95) and abusive alcohol consumption (OR: 2.00; IC95:1.16-3.43). These findings highlight the modifying effect of sex on the relationship between education and alcohol consumption, such that education influenced alcohol consumption differently between sexes during the pandemic.

Vitamin D deficiency and VDR gene polymorphism FokI (rs2228570) are associated with diabetes mellitus in adults: COVID-inconfidentes study.

BACKGROUND: Diabetes mellitus is a chronic and multifactorial condition, including environmental risk factors such as lifestyle habits and genetic conditions. OBJECTIVE: We aimed to evaluate the association of VDR gene polymorphism (rs2228570) FokI and vitamin D levels with diabetes in adults. METHODS: Cross-sectional population-based study in adults, conducted from October to December 2020 in two Brazilian cities. The outcome variable was diabetes, defined as glycated hemoglobin ≥ 6.5% or self-report medical diagnosis or use of oral hypoglycemic drugs. Vitamin D (25-hydroxyvitamin D) was measured by indirect electrochemiluminescence, and classified as deficiency when 25(OH)D < 20 ng/mL. All participants were genotyped for VDR FokI polymorphism by qPCR and classified as homozygous mutant (ff or GG), heterozygous (Ff or AG), or homozygous wild (FF or AA). A combined analysis between the FokI polymorphism and vitamin D levels with diabetes was also examined. A directed acyclic graph (DAG) was used to select minimal and sufficient adjustment for confounding variables by the backdoor criterion. RESULTS: The prevalence of DM was 9.4% and vitamin D deficiency (VDD) was 19.9%. The genotype distribution of FokI polymorphism was 9.9% FF, 44.8% Ff, and 45.3% ff. It was possible to verify a positive association between vitamin D deficiency and DM (OR = 2.19; 95% CI: 1.06-4.50). Individuals with the altered allele (ff) had a 1.78 higher prevalence of DM (OR: 1.78; 95% CI; 1.10-2.87). Combined analyses, individuals with vitamin D deficiency and one or two copies of the altered FokI allele had a higher prevalence of DM (Ff + ff: OR: 1.67; 95% CI; 1.07-2.61; ff: OR: 3.60; 95% CI; 1.40-9.25). CONCLUSION: Our data suggest that vitamin D deficiency and FokI polymorphism are associated with DM.

The role of interaction between vitamin D and VDR FokI gene polymorphism (rs2228570) in sleep quality of adults.

To evaluate association of vitamin D with sleep quality in adults and the influence of VDR-gene polymorphism FokI (rs2228570;A > G). Cross-sectional population-based study in adults, conducted in Brazil. The outcome was sleep-quality, evaluated by the Pittsburgh Sleep Quality Index. Vitamin D was determined by indirect electrochemiluminescence and classified as deficiency (VDD), 25(OH)D < 20 ng/mL in a healthy population or 25(OH)D < 30 ng/mL for groups at risk for VDD. FokI polymorphism in the VDR-gene was genotyped by qPCR and classified as homozygous wild (FF or AA), heterozygous (Ff or AG), or homozygous mutant (ff or GG). Multivariate logistic analysis was used to estimate the association between vitamin D and FokI polymorphism with sleep-quality. In a total of 1674 individuals evaluated, 53.6% had poor-sleep-quality, 31.5% had VDD, and the genotype frequency of the FokI polymorphism was 9.9% FF, 44.6% Ff, and 45.5% ff. In multivariate analysis, individuals with VDD had 1.51 times the chance of poor-sleep-quality, and individuals with the ff genotype had 1.49 times the chance of poor-sleep-quality (OR:1.49;95%CI:1.05-2.12) when compared to individuals with the FF or Ff genotype. In the combined analysis, individuals with VDD and ff genotype had more chance of poor-sleep-quality than individuals with sufficient vitamin D and genotype Ff or FF (OR:2.19;95%CI:1.27-3.76). Our data suggest that VDD and VDR FokI gene polymorphism are associated with poor-sleep-quality, and combining the two factors increases the chance of poor-sleep-quality compared to separate groups.

Frequency of breakfast consumption and its associations with food consumption by degree of industrial processing and with indicators of overweight in Brazilian adolescents (EVA-JF Study).

OBJECTIVE: The aim of this study was to investigate the frequency of breakfast consumption and estimate its associations with the consumption of food at different degrees of industrial processing and with overweight indicators in Brazilian adolescents. METHODS: This cross-sectional study involved a probabilistic sample of 14- to 19-y-old adolescents enrolled in 29 public schools in the municipality of Juiz de Fora, MG, Southeast Brazil (n = 805). The frequency of breakfast consumption was evaluated via a questionnaire (classified into "do not consume", "sometimes consume", and "regularly consume"). The evaluation of food consumption involved two 24-h dietary recalls, the items of which were analyzed according to the NOVA classification system. Overweight indicators (waist circumference, body mass index for age (BMI-for-age), and body fat percentage) were evaluated according to a standard protocol. Linear regression models were performed, first without and then with adjustments for sociodemographic characteristics. RESULTS: We found that 20% of adolescents skipped breakfast, and ∼46% of the caloric intake came from ultra-processed foods. Breakfast omission was associated with a mean increase of 3.02% (95% confidence interval [CI], 0.52-5.53) in energy intake from ultra-processed foods, in addition to a mean increase of 0.28 z-score (95% CI, 0.05- 0.52) of BMI-for-age and of 1.64% (95% CI, 0.21-3.08) in body fat. CONCLUSIONS: We verified that the omission of breakfast was associated with higher consumption of ultra-processed foods, as well as a higher BMI-for-age and higher percentage of body fat, reinforcing the importance of actions to encourage the consumption of this meal and the adoption of healthy eating practices in adolescents.

Temporal patterns of food consumption and their association with cardiovascular risk in rotating shift workers.

OBJECTIVE: We aimed to evaluate the association of temporal patterns of food consumption with cardiovascular disease (CVD) risk. METHODS: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Data on food consumption was collected using a 24 h recall, applied by trained interviewers. The variables for temporal patterns of food consumption were: eating window, eating at night, number of meals and omission of breakfast. CVD-risk was measured by calculating the Framingham coronary heart disease risk score (FCRS), and classified as low risk or intermediate to high risk. Descriptive, univariate and multivariate logistic regression analyses examined the association between variables related to temporal patterns of food consumption and CVD-risk. RESULTS: The study assessed 208 workers, the majority with 20-34 years (45.1%), non-white (77.2%), and 5 years or more in shift work (76.0%). Most participants had a feeding window exceeding 12 h (63.9%), consumed meals until 10 p.m. (68.1%), had five or more meals per day (54.8%), and did not skip breakfast (86.5%). Regarding CVD-risk, 43.8% of the participants were classified with intermediate to high risk for CVD. In the multivariate model, a feeding window (OR: 2.32; 95%CI: 1.01-5.35), eating after 10 p.m. (OR: 3.31; 95%CI: 1.01-11.0), and skipping breakfast (OR: 2.58; 95%CI: 1.07-6.19) increased the likelihood of intermediate to high CVD-risk. Conversely, having five or more meals per day decreased the odds (OR: 0.27; 95%CI: 0.08-0.92). CONCLUSION: Eating window longer than 12 h, eating after 10 p.m., less than four meals a day and omission of breakfast, are associated with cardiovascular risk in shift workers.

Lung function and quality of life one year after severe COVID-19 in Brazil.

OBJECTIVE: To evaluate symptoms, lung function, and quality of life of a cohort of patients hospitalized for severe COVID-19 12 months after hospital admission. METHODS: This was a cross-sectional study. We included severe COVID-19 survivors hospitalized in one of three tertiary referral hospitals for COVID-19 in the city of Belo Horizonte, Brazil. Participants were submitted to lung function and six-minute walk tests and completed the EQ-5D-3L questionnaire. RESULTS: The whole sample comprised 189 COVID-19 survivors (mean age = 59.6 ± 13.4 years) who had been admitted to a ward only (n = 96; 50.8%) or to an ICU (n = 93; 49.2%). At 12 months of follow-up, 43% of patients presented with dyspnea, 27% of whom had a restrictive ventilatory disorder and 18% of whom presented with impaired DLCO. There were no significant differences in FVC, FEV1, and TLC between the survivors with or without dyspnea. However, those who still had dyspnea had significantly more impaired DLCO (14.9% vs. 22.4%; p < 0.020) and poorer quality of life. CONCLUSIONS: After one year, survivors of severe COVID-19 in a middle-income country still present with high symptom burden, restrictive ventilatory changes, and loss of quality of life. Ongoing follow-up is needed to characterize long COVID-19 and identify strategies to mitigate its consequences.

A serological, parasitological and clinical evaluation of untreated Chagas disease patients and those treated with benznidazole before and thirteen years after intervention.

The etiological treatment of Chagas disease is recommended for all patients with acute or recent chronic infection, but controversies remain regarding the benefit of chemotherapy and interpretations of the parasitological cure after etiological treatment. This study compares the laboratory and clinical evaluations of Chagas disease patients who were diagnosed 13 years earlier. Fifty-eight Chagas disease patients (29 treated with benznidazole and 29 untreated) were matched at the time of treatment based on several variables. Conventional serology revealed the absence of seroconversion in all patients. However, lower serological titres were verified in the treated group, primarily among patients who had the indeterminate form of the disease. Haemoculture performed 13 years after the intervention was positive for 6.9% and 27.6% of the treated and untreated patients, respectively. Polymerase chain reaction tests were positive for 44.8% and 13.8% of the treated and untreated patients, respectively. Patients who presented with the indeterminate form of the disease at the beginning of the study exhibited less clinical progression (17.4%) compared with the untreated group (56.5%). Therefore, this global analysis revealed that etiological treatment with benznidazole may benefit patients with respect to the clinical progression of Chagas disease and the prognosis, particularly when administered to patients with the indeterminate form of the disease.

Poor Sleep Quality and Working From Home Influence the Prevalence of Leisure Time Physical Inactivity During the COVID-19 Pandemic: COVID-Inconfidentes Study.

OBJECTIVE: The aim of the study is to explore possible associations according to quality of sleep and work from home (WFH) with physical inactivity (PI) during the COVID-19 pandemic. METHODS: This is a cross-sectional study in two Brazilian cities (>18 years), by probability sampling. Leisure-time physical activity was self-reported and classified according to guidelines. Sleep was by applying the Pittsburgh Sleep Quality Index. Work from home was classified as: total WFH or no WFH. RESULTS: A total of 1750 adults were analyzed, 69.1% were physically inactive, 51.9% had poor sleep quality, and 79.8% were not in WFH. PI was associated with poor sleep quality and non-WFH. Compared with those who reported WFH and good sleep quality, those who reported non-WFH and poor sleep quality had 4 times the prevalence of PI. CONCLUSIONS: Poor sleep quality, and not WFH, is associated with leisure PI. These factors combined increase the probability of PI.

Association of Hypovitaminosis D with Sleep Parameters in Rotating Shift Worker Drivers.

Objective To evaluate the association between sleep parameters and hypovitaminosis D in rotating shift drivers. Material and Methods We conducted a cross-sectional study on 82 male rotating shift workers (24-57 years old) with at least one cardiovascular risk factor (such as hyperglycemia, dyslipidemia, abdominal obesity, physical inactivity, hypertension, and smoking). Polysomnography was used to evaluate sleep parameters. Logistic regression was used to model the association between hypovitaminosis D and sleep parameters after adjustment for relevant covariates. Results Hypovitaminosis D (< 20 ng/mL) was seen in 30.5% of the workers. Shift workers with hypovitaminosis D had lower sleep efficiency (odds ratio [OR]: 3.68; 95% confidence interval [CI]: 1.95-5.53), lower arterial oxygen saturation (OR: 5.35; 95% CI: 3.37-6.12), and increased microarousal index (OR: 3.85; 95% CI: 1.26-5.63) after adjusting. Conclusion We suggest that hypovitaminosis D is associated with greater sleep disturbances in rotating shift workers.