TRICHINELLA AND AT LEAST THREE SPECIES OF SARCOCYSTIS PARASITIZE THE MUSCLES OF BOBCATS (LYNX RUFUS) FROM MISSISSIPPI.

Muscles of 25 bobcats (Lynx rufus) from remote areas of Mississippi in 2017 were tested for parasites. Testing for Sarcocystis infections included microscopic examination of fresh unstained muscle squashes, pepsin digestion of hearts and tongues, and histological sections of paraffin-embedded tissues. Sarcocystis spp. infections were detected in the muscles of 21 (84%) by a combination of methods. Sarcocysts were detected in the unstained tongue squashes of 2 bobcats. Sarcocystis sp. bradyzoites were detected in the pepsin digests of 3 of 19 hearts, and 12 of 19 tongues. In paraffin-embedded histological sections, sarcocysts were detected in 7 of 25 hearts, 17 of 25 tongues, and 5 of 23 limb muscles. Based on the character of the cyst wall, at least 3 morphologic types of sarcocysts were detected: those with small spikes on the cyst wall, corresponding to Sarcocystis felis, those with long villar protrusions, corresponding to Sarcocystis neurona, and those lacking visible cyst wall protrusions, representing an unidentified type of sarcocyst. Myositis associated with sarcocysts was seen in the tongues of 3, and in the limb muscles of 1 bobcat. Multilocus genotyping of the DNA extracted from paraffin-embedded sections from 2 bobcats, employing 18S, 28S, COI, ITS-1, and 5.8S and rpoB genes, diagnosed Sarcocystis caninum, S. felis, Sarcocystis lutrae, and S. neurona. An encapsulated species of Trichinella was identified in the tongue of 1; it represents the first documented occurrences in bobcats from Mississippi. Taken together, these observations suggest intensive exposure of these wild carnivores to Trichinella tissue cysts, implies predation or scavenging on these tissues promotes parasite transmission, and raises caution concerning zoonotic risk when such meat is rendered for human consumption.

HER2 aptamer-conjugated iron oxide nanoparticles with PDMAEMA-b-PMPC coating for breast cancer cell identification.

Aim: To synthesize HER2 aptamer-conjugated iron oxide nanoparticles with a coating of poly(2-(dimethylamino) ethyl methacrylate)-poly(2-methacryloyloxyethylphosphorylcholine) block copolymer (IONPPPs). Methods: Characterization covered molecular structure, chemical composition, thermal stability, magnetic characteristics, aptamer interaction, crystalline nature and microscopic features. Subsequent investigations focused on IONPPPs for in vitro cancer cell identification. Results: Results demonstrated high biocompatibility of the diblock copolymer with no significant toxicity up to 150 µg/ml. The facile coating process yielded the IONPP complex, featuring a 13.27 nm metal core and a 3.10 nm polymer coating. Functionalized with a HER2-targeting DNA aptamer, IONPPP enhanced recognition in HER2-amplified SKBR3 cells via magnetization separation. Conclusion: These findings underscore IONPPP's potential in cancer research and clinical applications, showcasing diagnostic efficacy and HER2 protein targeting in a proof-of-concept approach.

Gravidez em meninas menores de 14 anos: análise espacial no Brasil, 2011 a 2021 / Pregnancy in girls under 14 years old: Spatial analysis in Brazil, 2011-2021

Resumo O objetivo foi analisar a distribuição espacial da gravidez em menores de 14 anos e seis meses segundo regiões e municípios brasileiros e características sociodemográficas e de saúde das parturientes e nascidos vivos. Estudo ecológico, analisando o Sistema de Informação sobre Nascidos Vivos (SINASC), 2011-2021, em três grupos etários (<14 anos e 6 meses, 15-19 e 20 anos e mais), segundo variáveis demográficas e do parto. Foram aplicados os Índices Global e Local de Moran. No período foram 127.022 nascidos vivos de meninas 10-14 anos, na maioria negras, 21,1% em união estável ou casadas, com menor proporção de 7 consultas de pré-natal e captação no primeiro trimestre, maior proporção de baixo peso ao nascer e baixo índice de Apgar, residentes nas regiões Norte e Nordeste. A taxa média de nascidos vivos de 10-14 anos mostrou autocorrelação significativa com o espaço, especialmente em municípios do Centro-Oeste e Norte. A gravidez de 10 a 14 revela uma sequência de vulnerabilidades sofridas por essas meninas, pela gravidez em idade precoce, maior frequência entre negras, com implicações na morbimortalidade para ela e seus filhos; e pela violência presumida nesses casos, incluindo o acesso negado ao aborto legal.

Abstract The objective was to analyze the spatial distribution of pregnancy in children under 14 years and six months by Brazilian region and municipality and sociodemographic and health characteristics of pregnant women and live births. Ecological study analyzing the Live Birth Information System (SINASC) from 2011 to 2021 in three age groups (< 14 years and six months, 15-19 years, and 20 years and above) by demographic and birth variables. We applied the Global and Local Moran. A total of 127,022 live births to girls aged 10-14 years were identified during the period, most of whom were Black, 21.1% in common-law or married relationships, with a lower proportion of seven prenatal care appointments and enrollment in the first trimester, a higher proportion of low birth weight and low Apgar score, residing in the North and Northeast. The mean live birth rate for 10-to-14-year-old girls was significantly autocorrelated with space, especially in municipalities of the Midwest and North. Pregnancy from 10 to 14 years of age reveals several vulnerabilities suffered by these girls due to pregnancy at an early age, which is more common among Black women, with implications for morbimortality for them and their children and the presumed violence in these cases, including denied access to legal abortion.

Impairments, health conditions and health risk behaviors: occurrence and associations, in the National Health Survey, Brazil, 2019.

OBJECTIVE: To analyze association of visual, hearing, mental/intellectual, physical and multiple impairments with health conditions and health risk behaviors in Brazil. METHODS: This was a cross-sectional study, using data from the 2019 National Health Survey; associations between impairments and presence of cardiovascular disease (CVD), hypertension, diabetes mellitus (DM), high cholesterol, alcohol abuse and smoking were estimated using logistic regression, thus obtaining the odds ratios (OR). RESULTS: Impairment was reported by 7.6% of the 90,846 participants. Having a impairment was associated with greater odds of reporting chronic conditions, especially CVD (OR = 2.11; 95%CI 1.76;2.54) and DM (OR = 1.78; 95%CI 1.56;2.02 ); visual impairment was associated with greater odds of smoking (OR = 1.52; 95%CI 1.28;1.81); mental/intellectual impairment was inversely related to smoking (OR = 0.45; 95%CI 0.30;0.67) and alcohol abuse (OR = 0.13; 95%CI 0.06;0.26). CONCLUSION: Having any of the impairments studied may be associated with greater odds of having chronic health conditions. MAIN RESULTS: Positive association was identified between having one or more impairments, and health conditions and health risk behaviors. The higher the prevalence of mental/intellectual, physical and multiple impairments, the lower alcohol abuse and smoking. IMPLICATIONS FOR SERVICES: As this population is vulnerable to chronic health conditions, health services need strategies to reduce barriers to access, as well as health promotion actions, such as health education, adapted for people with impairments. PERSPECTIVES: Topics for future studies, examining the inverse relationship between impairments and alcohol abuse and smoking, in addition to acting on the causal chain, so as to prevent health conditions and health risk behaviors.

SARCOCYSTIS AND OTHER PARASITES IN FECES OF BOBCATS (LYNX RUFUS) FROM MISSISSIPPI.

Rectal contents of 56 adult bobcats (Lynx rufus) in 2014 and 2017 from remote areas of Mississippi were examined microscopically for parasite stages after the sugar flotation method. Among the helminths, eggs/larvae found were: Paragonimus sp. in 12, Toxocara cati-like in 16, trichurid-capillarid-like in 3, hookworms in 27, and lungworms in 28. Among the protozoa, oocysts/cysts found were: Cystoisospora felis-like in 2, Cystoisospora rivolta-like in 4, Cryptosporidium sp. in 1, and Giardia sp. in 1. Additionally, numerous Sarcocystis sporocysts were detected in the feces of 12 bobcats; sporocysts were described morphologically. The status of C. felis derived from the bobcat and other wild felids is reviewed and compared with C. felis from the domestic cat. It is the first record of C. rivolta from the bobcat. The presence of eggs of Paragonimus sp. and T. cati in feces of 21.4% and 28.5%, respectively, suggests a role for the bobcat in the dissemination of these zoonotic helminths in the environment in the wild. Taxonomy of coccidia of wild Felidae is discussed and Isospora lyncisLevine and Ivens, 1981 from the Lynx is now regarded as a species inquirenda.

Principais causas de mortalidade por doenças respiratórias em crianças de 0 a 4 anos de 2015 a 2020 / Main causes of mortality to respiratory diseases in children aged 0 to 4 years from 2015 to 2020 / Principales causas de mortalidad por enfermedades respiratorias en niños de 0 a 4 años del 2015 al 2020

Introdução:A maioria das doenças respiratórias se enquadram no grupo de causas evitáveis e, dessa forma, taxas elevadas de mortalidade em crianças são reflexo das condições de desenvolvimento socioeconômico, além de mensurar o acesso e qualidade dos serviços de saúde.Objetivo:Avaliar a mortalidade por doenças respiratórias em crianças menores de 0 a 4 anos de idade no Brasil, no período de 2015 a 2020.Metodologia:Trata-se deum estudo ecológico de série temporal, retrospectivo, de abordagem quantitativa, com ênfase nas cinco doenças respiratórias mais evidentes em crianças de até 4 anos no Brasil, entre os anos de 2015 a 2020. Realizou-se coleta de dados pelo DATASUS, sendo utilizado o software Microsoft Excel©para subsidiar as etapas de processamento e análise. Resultados:A análise mostra a pneumonia como a principal causa de morte no país e, a partir da análise regional, a Região Norte possui taxas que excedem as demais regiões dentro do período observado. A mesma tendência é observada na análise das demais infecções respiratórias, porém é importante ressaltar o declínio da mortalidade em todas as variáveis e regiões observadas em 2020.Conclusões:Conclui-se que as maiorestaxas de mortalidade entre crianças no Brasil ratificam a premissa de que as afecções respiratórias são diretamente proporcionais à vulnerabilidade socioeconômica, enquanto a cobertura vacinal e a disponibilidade de leitos contribuem na redução dos indicadores. Não obstante, em 2020 evidenciou-se queda abrupta decorrente das medidas preventivas do coronavírus e, a partir da menor procura por atendimento, maior probabilidade de subnotificação dos casos (AU).

Introduction:The majority of respiratory diseases fall into the group of preventable causes and, therefore, high mortality rates in children are a reflection of socioeconomic development conditions, beyond measurethe access and the quality of health services. Objective:Evaluate the mortality by respiratory diseases in children younger than 4 years of age in Brazil, in the period from 2015 to 2020. Methodology:It is about ecologic study from time series, retrospective, of quantitative approach, with emphasis on the five respiratory diseases more evident in children of up to 4 years in Brazil, between the years from 2015 to 2020. Data was collected by DATASUS, being used byMicrosoft Excel to subsidize the processing steps and analysis. Results:The analysis shows pneumonia as the main cause of death in the country, and, from the regional analysis, the North region can have rates that exceed other regions under the period observed. The same trend is observed in the analysis from the other respiratory infections, although it is important to emphasize the decline of mortality in all variables and regions observed in 2020. Conclusions:It is concluded that the higher rates of mortality between children in Brazil ratifies the premise that respiratory affections are directly proportional to socioeconomic vulnerability, while the vaccination coverage and the availability of beds contribute to the reduction of indicators. However, in 2020, there was an evident steep drop dueto coronavirus preventive measures and, from smaller demand to attendance, higher probability of underreporting of cases (AU).

Introducción: La mayoría de las enfermedades respiratorias se enmarcan en elgrupo de las causas prevenibles y, por tanto, las altas tasas de mortalidad infantil son un reflejo de las condiciones de desarrollo socioeconómico, además de medir el acceso y la calidad de los servicios de salud.Objetivo: Evaluar la mortalidad por enfermedades respiratorias en niños de 0 a 4 años en Brasil, de 2015 a 2020. Metodología: Se trata de un estudio ecológico, retrospectivo, de serie temporal, con abordaje cuantitativo, con énfasis en las cinco enfermedades respiratorias más evidentes en niños de hasta 4 años en Brasil, entre los años 2015 a 2020. Los datos fueron recolectados mediante DATASUS, utilizando Microsoft Software Excel© para apoyar los pasos de procesamiento y análisis. Resultados: El análisis muestra a la neumonía como la principal causa de muerte en el país y, con base en el análisis regional, la Región Norte presenta tasas que superan a las demás regiones dentro del período observado. La misma tendencia se observa en el análisis de otras infecciones respiratorias, pero es importantedestacar la disminución de la mortalidad en todas las variables y regiones observadas en 2020.Conclusiones: Se concluye que las mayores tasas de mortalidad infantil en Brasil confirman la premisa de que las condiciones respiratorias son directamente proporcionales a la vulnerabilidad socioeconómica, mientras que las coberturas de vacunación y la disponibilidad de camas contribuyen para la reducción de los indicadores. Sin embargo, en 2020 hubo una caída abrupta por las medidas preventivas por el coronavirus y, a partir de la menor demanda de atención, una mayor probabilidad de subregistro de casos (AU).

Untangle the relationship of muscle mass and bone mineral content on handgrip strength: Results of ELSA-Brasil / Desvendando a relação entre massa muscular e conteúdo mineral ósseo na força de preensão palmar: Resultados do ELSA-Brasil

Abstract The study aims to investigate the independent association of muscle mass (MM) and bone mineral content (BMC) in the performance of the handgrip strength (HGS) test and whether there is effect modification by sex and age. In 12,491 participants from the ELSA-Brasil we estimated the associations between MM, BMC and HGS using linear regression models. All the analyses were performed for total population, also stratified for sex and age. For total population an interaction term was included between each explanatory variable of interest with sex and age to verify the presence of effect modification. We observed that the higher quintiles of MM and BMC were associated to an increasing in the mean of HGS compared to the first quintile, with greater magnitudes in men compared to women, also adults compared to elderly. When we estimated the independent effect of each exposure of interest, MM showed stronger effect in HGS in women, men and adults then BMC. In conclusion, we observed that higher amounts of MM and BMC are associated with higher HGS, regardless of sociodemographic characteristics, health conditions and lifestyle, with this effect being greater in men and adults.

Resumo O estudo tem como objetivo investigar a associação independente da massa muscular (MM) e conteúdo mineral ósseo (CMO) na realização do teste de força de preensão manual (FPM) e se há modificação do efeito por sexo e idade. Em 12.491 participantes do ELSA-Brasil estimamos as associações entre MM, CMO e FPM usando modelos de regressão linear. Todas as análises foram realizadas para a população total, também estratificada por sexo e idade. Para a população total foi incluído um termo de interação entre cada variável explicativa de interesse com sexo e idade para verificar a presença de modificação de efeito. Observamos que os maiores quintis de MM e BMC estiveram associados a um aumento na média da FPM em relação ao primeiro quintil, com maiores magnitudes em homens em relação a mulheres, também em adultos em relação a idosos. Quando estimamos o efeito independente de cada exposição de interesse, MM mostrou efeito mais forte na FPM em mulheres, homens e adultos do que BMC. Em conclusão, observamos que maiores quantidades de MM e BMC estão associadas a maior FPM, independentemente das características sociodemográficas, condições de saúde e estilo de vida, sendo esse efeito maior em homens e adultos.

Family instability in childhood affects language and memory in adulthood: results from the Pró-Saúde Study, Brazil / Instabilidade familiar na infância afeta a linguagem e memória na vida adulta: resultados do Estudo Pró-Saúde

Abstract The study aims to investigate associations between adverse childhood psychosocial exposures and declarative memory, language, and executive function in adults with secondary schooling or more and without dementia. In 361 participants from the Pró-Saúde Study, we estimated associations between maternal educational attainment, principal source of the family´s income, food insecurity, and childhood family structure and performance in learning, word recall, and semantic and phonemic verbal fluency tests using multiple linear regression models. Individuals whose mother was the family breadwinner (mean difference: -1.97, 95%CI: -3.27; -0.72) and head-of-household (mean difference: -1.62, 95%CI: -2.89; -0.35) or who lived with a non-parental caregiver or in institutions in childhood (mean difference: -2.19, 95%CI: -4.29; -0.09) showed a reduction in the mean number of words in language and memory in adulthood. The results provide further evidence of the effect of adverse exposures in childhood. Without effective interventions, such exposures are likely to have far-reaching impacts on cognition.

Resumo Nosso objetivo é investigar as associações de exposições psicossociais adversas na infância com memória declarativa, linguagem e função executiva em adultos livres de demência com ensino médio completo ou mais. Em 361 participantes do Estudo Pró-Saúde estimamos as associações entre escolaridade materna, principal apoio financeiro familiar, insegurança alimentar e estrutura familiar na infância com o desempenho no teste de aprendizagem e evocação de palavras, e fluência verbal semântica e fonêmica usando modelos de regressão linear múltipla. Ter a mãe como principal suporte financeiro familiar (diferença média: -1,97, IC95%: -3,27; -0,72) e ter morado apenas com ela (diferença média: -1,62, IC95%: -2,89; -0,35) ou outra pessoa/ser institucionalizado (diferença média: -2,19, IC95%: -4,29; -0,09) na infância permaneceu associada à uma redução na média de palavras nos testes de linguagem e memória na vida adulta. Nossos achados adicionam mais evidências sobre o efeito de exposições na infância que, sem intervenções apropriadas, provavelmente terão legados de longo alcance na cognição.

Long-term reproductive effects in male rats prenatally exposed to sodium arsenite.

Arsenic is an environmental toxicant known to be a carcinogen and endocrine disruptor. Maternal exposure to arsenic has been associated with fetus malformation and reproductive disorders in male offspring. However, it is unclear the extent to which those effects remain during postnatal development and adulthood. Therefore, this study aimed to investigate the long-term effects of prenatal arsenic exposure on reproductive parameters of male offspring at peripubertal and adult periods. Pregnant female Wistar rats were exposed to 0 or 10 mg/L sodium arsenite in drinking water from gestational day 1 (GD 1) until GD 21 and male pups were analyzed at postnatal day 44 (PND 44) and PND 70. We observed that some reproductive parameters were affected differently by arsenic exposure at each age evaluated. The body and reproductive organs weights, as well as testicular and epididymal morphology were strongly affected in peripubertal animals and recovered at adult period. On the other hand, the antioxidant genes expression (SOD1, SOD2, CAT and GSTK1) and the endogenous antioxidant system were affected in the testes and epididymides from both peripubertal and adult rats. Finally, an impairment in daily sperm production and in sperm parameters was observed in adult animals. Taken together, our findings show that prenatal arsenic exposure affected reproductive parameters of peripubertal and adult male rats mainly due to oxidative stress. Collectively, those alterations may be affecting fertility potential of adult animals.

Hipertensão em mulheres presas no Brasil: muito além do biológico / Hypertension in female prisoners in Brazil: far beyond the biological aspects

Resumo Objetivou-se estimar a prevalência de hipertensão arterial (HA) e os fatores de risco associados em mulheres presas. Utilizou-se dados do Inquérito Nacional de Saúde na População Penitenciária Feminina e em Servidoras Prisionais, investigando-se características sociodemográficas, fatores das prisões, comportamentos e condições de saúde. As informações foram coletadas por meio de questionário autoaplicado, sendo a magnitude da associação estimada por odds ratio e intervalo de confiança de 95%. Das 1.327 participantes, 24,4% eram hipertensas, a maioria tinha 31 anos ou mais (54,6%), 51,5% autorreferiram etnia/cor parda. Após mutual ajustamento pelos fatores de risco associados na análise bivariada, observou-se relação direta e com gradiente entre idade e HA, em que idade igual/maior a 41 anos foi associada independentemente com uma chance sete vezes maior de ter HA, se comparado a quem tem menos de 25 anos. Aquelas que autorreferiram etnia/cor negra apresentaram colesterol alto e estavam obesas, também foram associadas de forma independente com maior prevalência de HA. O maior número de pessoas com que a presa divide cela esteve associado à maior prevalência de há, sem uma relação dose-resposta. Conclui-se que idade, etnia/cor, obesidade, inatividade física e estresse são fatores de risco para HA em mulheres presas.

Abstract The scope was to estimate the prevalence of arterial hypertension (AHT) and associated risk factors among female prisoners. Data from the National Health Survey of the Female Prison Population and Prison Guards were used, investigating sociodemographic variables, prison characteristics, health behaviors and conditions. Information was collected through a self-administered questionnaire, and the magnitude of the association was estimated by the odds ratio and 95% confidence interval. Of the 1,327 prisoner participants, 24.4% were hypertensive, the majority were 31 years of age or older (54.6%), and 51.5% self-reported mixed race. After adjustment for associated risk factors in the bivariate analysis, a direct relationship between age and AHT was observed, in which age equal to/over 41 years was independently associated with a 7-fold greater chance of having AHT, compared to those under 25 years of age. Those who self-reported mixed race, had high cholesterol, were obese and were also independently associated with a higher prevalence of AHT. The greater the number of people with whom the inmate shares a cell was associated with a higher prevalence of AHT, but without a dose-response relationship. The conclusion drawn is that age, race, obesity, physical inactivity and stress are risk factors for AHT in female prisoners.

Presence of a companion in the delivery room and breastfeeding in the first hour of life: is there an association? / Presença de acompanhante na sala de parto e aleitamento materno na primeira hora de vida: há associação?

Abstract Objectives: to identify variables associated with the presence of a companion in the delivery room and its association with breastfeeding (BF) in the first hour of life. Methods: cross-sectional analysis of data from a cohort study (n=344). To investigate the factors associated with the presence of a companion during childbirth and breastfeeding in the first hour; we performed Poisson regression analyses, considering p<0.05 as the level of statistical significance. Results: 93.9% of the pregnant women had a companion in the delivery room, and no association was found between socioeconomic, obstetric and neonatal characteristics of the mother-child binomial and the presence of a companion. In a univariate analysis, the absence of a companion reduced the frequency of breastfeeding in the first hour (PR=0.64; CI95%=0.42-0.96), a result that was not confirmed in the adjusted analyses (PR=0.79; CI95%=0.54-1.15). Secondly, it was identified that the five minutes Apgar score was associated with first hour breastfeeding (PR=1.27; CI95%=1.14-1.40) regardless of the other factors. Conclusions: most women in the cohort had a companion in the delivery room, with no differences according to socioeconomic, obstetric and neonatal variables. The frequency of first hour breastfeeding was high; however, it was lower in the absence of a companion but this association was not independent of other factors.

Resumo Objetivos: identificar variáveis associadas à presença de acompanhante na sala de parto e sua associação com o aleitamento materno (AM) na primeira hora de vida. Métodos: análise transversal de dados provenientes de um estudo de coorte (n=344). Para investigação dos fatores associados entre a presença de companhia durante o parto e o AM na primeira hora foram realizadas análises de regressão de Poisson, considerando p<0,05 como nível de significância estatística. Resultados: 93,9% das parturientes tiveram acompanhante na sala de parto, não sendo encontrada associação entre características socioeconômicas, obstétricas e neonatais do binômio mãe-filho e esta presença. Em análise univariada, a ausência de acompanhante reduziu a frequência de AM na primeira hora (RP=0,64; IC95%=0,42-0,96), resultado que não se confirmou nas análises ajustadas (RP=0,79; IC95%=0,54-1,15). Secundariamente, identificou-se que o Apgar no quinto minuto associou-se com AM na primeira hora (RP=1,27; IC95%=1,14-1,40) independentemente dos demais fatores. Conclusões: a maioria das mulheres da coorte contou com acompanhante na sala de parto, sem diferenças segundo variáveis socioeconômicas, obstétricas e neonatais. A frequência de AM na primeira hora também foi alta e menor na ausência de acompanhante, contudo, essa associação não se mostrou independente de outros fatores.

Deficiências, condições de saúde e comportamentos de risco à saúde: ocorrência e associações, na Pesquisa Nacional de Saúde, Brasil, 2019 / Impairments, health conditions and health risk behaviors: occurrence and associations, in the National Health Survey, Brazil, 2019 / Discapacidades, condiciones de salud y conductas de riesgo para la salud: ocurrencia y asociaciones, en la Encuesta Nacional de Salud, Brasil, 2019

Objective To analyze association of visual, hearing, mental/intellectual, physical and multiple impairments with health conditions and health risk behaviors in Brazil. Methods This was a cross-sectional study, using data from the 2019 National Health Survey; associations between impairments and presence of cardiovascular disease (CVD), hypertension, diabetes mellitus (DM), high cholesterol, alcohol abuse and smoking were estimated using logistic regression, thus obtaining the odds ratios (OR). Results Impairment was reported by 7.6% of the 90,846 participants. Having a impairment was associated with greater odds of reporting chronic conditions, especially CVD (OR = 2.11; 95%CI 1.76;2.54) and DM (OR = 1.78; 95%CI 1.56;2.02 ); visual impairment was associated with greater odds of smoking (OR = 1.52; 95%CI 1.28;1.81); mental/intellectual impairment was inversely related to smoking (OR = 0.45; 95%CI 0.30;0.67) and alcohol abuse (OR = 0.13; 95%CI 0.06;0.26). Conclusion Having any of the impairments studied may be associated with greater odds of having chronic health conditions.

Objetivo Analizar la asociación entre discapacidad visual, auditiva, mental/intelectual, física y discapacidad múltiple con condiciones y conductas de riesgo para la salud en Brasil. Métodos Estudio transversal utilizando datos de la Encuesta Nacional de Salud de 2019; se estimaron, mediante regresión logística, las asociaciones entre discapacidad con la presencia de enfermedades cardiovasculares (ECV), hipertensión, diabetes, colesterol alto, consumo de alcohol y tabaquismo, obtención del odds ratio (OR). Resultados De los 90.846 participantes, el 7,6% refirió discapacidad. Tener una discapacidad se asoció con una mayor probabilidad de reportar enfermedades crónicas, especialmente ECV (OR = 2,11; IC95% 1,76;2,54) y diabetes (OR = 1,78; IC95% 1,56;2,02); la discapacidad visual se asoció con una mayor probabilidad de fumar (OR = 1,52; IC95% 1,28;1,81); la discapacidad mental/intelectual mostró una relación inversa con el tabaquismo (OR = 0,45; IC95% 0,30;0,67) y el consumo de alcohol (OR = 0,13; IC95% 0,06;0,26). Conclusión Se observó que tener alguna de las discapacidades estudiadas puede estar asociado con mayores posibilidades de tener condiciones crónicas de salud.

Objetivo Analisar a associação de deficiências visual, auditiva, mental/intelectual, física e deficiência múltipla com as condições e comportamentos de risco à saúde no Brasil. Métodos Estudo transversal, utilizando-se dados da Pesquisa Nacional de Saúde de 2019; associações entre deficiências e presença de doença cardiovascular (DCV), hipertensão arterial, diabetes mellitus (DM), colesterol alto, consumo abusivo de álcool e tabagismo foram estimados por regressão logística, obtendo-se a razão de chances (RC). Resultados Dos 90.846 participantes, 7,6% reportaram deficiência. Ter deficiência associou-se a maiores chances de relatar condições crônicas, especialmente DCV (RC = 2,11; IC95% 1,76;2,54) e DM (RC = 1,78; IC95% 1,56;2,02); deficiência visual associou-se a maior chance de tabagismo (RC = 1,52; IC95% 1,28;1,81); deficiência mental/intelectual apresentou relação inversa com tabagismo (RC = 0,45; IC95% 0,30;0,67) e consumo abusivo de álcool (RC = 0,13; IC95% 0,06;0,26). Conclusão Apresentar alguma das deficiências estudadas pode-se associar a maiores chances de ter condições crônicas de saúde.

IMPACTO-MR: um estudo brasileiro de plataforma nacional para avaliar infecções e multirresistência em unidades de terapia intensiva / IMPACTO-MR: a Brazilian nationwide platform study to assess infections and multidrug resistance in intensive care units

RESUMO Objetivo: Descrever o IMPACTO-MR, um estudo brasileiro de plataforma nacional em unidades de terapia intensiva focado no impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Métodos: Descrevemos a plataforma IMPACTO-MR, seu desenvolvimento, critérios para seleção das unidades de terapia intensiva, caracterização da coleta de dados, objetivos e projetos de pesquisa futuros a serem realizados na plataforma. Resultados: Os dados principais foram coletados por meio do Epimed Monitor System® e consistiram em dados demográficos, dados de comorbidades, estado funcional, escores clínicos, diagnóstico de internação e diagnósticos secundários, dados laboratoriais, clínicos e microbiológicos e suporte de órgãos durante a internação na unidade de terapia intensiva, entre outros. De outubro de 2019 a dezembro de 2020, 33.983 pacientes de 51 unidades de terapia intensiva foram incluídos no banco de dados principal. Conclusão: A plataforma IMPACTO-MR é um banco de dados clínico brasileiro de unidades de terapia intensiva focado na pesquisa do impacto das infecções por bactérias multirresistentes relacionadas à assistência à saúde. Essa plataforma fornece dados para o desenvolvimento e pesquisa de unidades de terapia intensiva individuais e ensaios clínicos observacionais e prospectivos multicêntricos.

ABSTRACT Objective: To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit platform study focused on the impact of health care-associated infections due to multidrug-resistant bacteria. Methods: We described the IMPACTO-MR platform, its development, criteria for intensive care unit selection, characterization of core data collection, objectives, and future research projects to be held within the platform. Results: The core data were collected using the Epimed Monitor System® and consisted of demographic data, comorbidity data, functional status, clinical scores, admission diagnosis and secondary diagnoses, laboratory, clinical, and microbiological data, and organ support during intensive care unit stay, among others. From October 2019 to December 2020, 33,983 patients from 51 intensive care units were included in the core database. Conclusion: The IMPACTO-MR platform is a nationwide Brazilian intensive care unit clinical database focused on researching the impact of health care-associated infections due to multidrug-resistant bacteria. This platform provides data for individual intensive care unit development and research and multicenter observational and prospective trials.

Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: Do ELSA-Brasil / Epicardial Fat Volume Is Associated with Endothelial Dysfunction, but not with Coronary Calcification: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Resumo Fundamento O aumento no volume de gordura epicárdica (VGE) está relacionado com doença arterial coronariana (DAC), independentemente de gordura visceral ou subcutânea. O mecanismo dessa associação não é claro. O escore de cálcio coronariano (CC) e a disfunção endotelial estão relacionados com eventos coronarianos, mas não está bem esclarecido se o VGE está relacionado com esses marcadores. Objetivos Avaliar a associação entre VGE medido por método automatizado, fatores de risco cardiovasculares, escore de CC, e função endotelial. Métodos: Em 470 participantes do Estudo Longitudinal de Saúde do Adulto LSA-Brasil com medidas de VGE, escore de CC e função endotelial, realizamos modelos multivariados para avaliar a relação entre fatore de risco cardiovascular e VGE (variável resposta), e entre VGE (variável explicativa), e função endotelial ou escore de CC. Valor de p<0,05 bilateral foi considerado estatisticamente significativo. Resultados A idade média foi 55 ± 8 anos, e 52,3% dos pacientes eram homens. O VGE médio foi 111mL (86-144), e a prevalência de escore de CC igual a zero foi 55%. Nas análises multivariadas, um VGE mais alto relacionou-se com sexo feminino, idade mais avançada, circunferência da cintura, e triglicerídeos (p<0,001 para todos). Um VGE mais alto foi associado com pior função endotelial: em comparação ao primeiro quartil, os valores de odds ratio para a amplitude de pulso basal foram (q2=1,22; IC95% 1,07-1,40; q3=1,50, IC95% 1,30-1,74; q4=1,50, IC95% 1,28-1,79) e para a razão de tonometria arterial periférica foram (q2=0,87; IC95% 0,81-0,95; q3=0,86, IC95% 0,79-0,94; q4=0,80, IC95% 0,73-0,89), mas não com escore de CC maior que zero. Conclusão Um VGE mais alto associou-se com comprometimento da função endotelial, mas não com escore de CC. Os resultados sugerem que o VGE esteja relacionado ao desenvolvimento de DAC por uma via diferente da via do CC, possivelmente pela piora da disfunção endotelial e doença microvascular.

Abstract Background The increase in epicardial fat volume (EFV) is related to coronary artery disease (CAD), independent of visceral or subcutaneous fat. The mechanism underlying this association is unclear. Coronary artery calcium (CAC) score and endothelial dysfunction are related to coronary events, but whether EFV is related to these markers needs further clarification. Objectives To evaluate the association between automatically measured EFV, cardiovascular risk factors, CAC, and endothelial function. Methods In 470 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with measures of EFV, CAC score and endothelial function, we performed multivariable models to evaluate the relation between cardiovascular risk factors and EFV (response variable), and between EFV (explanatory variable) and endothelial function variables or CAC score. Two-sided p <0.05 was considered statistically significant. Results Mean age was 55 ± 8 years, 52.3% of patients were men. Mean EFV was 111mL (IQ 86-144), and the prevalence of CAC score=0 was 55%. In the multivariable analyses, increased EFV was related to female sex, older age, waist circumference, and triglycerides (p<0.001 for all). Higher EFV was associated with worse endothelial function: as compared with the first quartile, the odds ratio for basal pulse amplitude were (q2=1.22, 95%CI 1.07-1.40; q3=1.50, 95%CI 1.30-1.74; q4=1.50, 95%CI 1.28-1.79) and for peripheral arterial tonometry ratio were (q2=0.87, 95%CI 0.81-0.95; q3=0.86, 95%CI 0.79-0.94; q4=0.80, 95%CI 0.73-0.89), but not with CAC score>0. Conclusion Higher EFV was associated with impaired endothelial function, but not with CAC. The results suggest that EFV is related to the development of CAD through a pathway different from the CAC pathway, possibly through aggravation of endothelial dysfunction and microvascular disease.

Epicardial Fat Volume Is Associated with Endothelial Dysfunction, but not with Coronary Calcification: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). / Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: Do ELSA-Brasil.

BACKGROUND: The increase in epicardial fat volume (EFV) is related to coronary artery disease (CAD), independent of visceral or subcutaneous fat. The mechanism underlying this association is unclear. Coronary artery calcium (CAC) score and endothelial dysfunction are related to coronary events, but whether EFV is related to these markers needs further clarification. OBJECTIVES: To evaluate the association between automatically measured EFV, cardiovascular risk factors, CAC, and endothelial function. METHODS: In 470 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with measures of EFV, CAC score and endothelial function, we performed multivariable models to evaluate the relation between cardiovascular risk factors and EFV (response variable), and between EFV (explanatory variable) and endothelial function variables or CAC score. Two-sided p <0.05 was considered statistically significant. RESULTS: Mean age was 55 ± 8 years, 52.3% of patients were men. Mean EFV was 111mL (IQ 86-144), and the prevalence of CAC score=0 was 55%. In the multivariable analyses, increased EFV was related to female sex, older age, waist circumference, and triglycerides (p<0.001 for all). Higher EFV was associated with worse endothelial function: as compared with the first quartile, the odds ratio for basal pulse amplitude were (q2=1.22, 95%CI 1.07-1.40; q3=1.50, 95%CI 1.30-1.74; q4=1.50, 95%CI 1.28-1.79) and for peripheral arterial tonometry ratio were (q2=0.87, 95%CI 0.81-0.95; q3=0.86, 95%CI 0.79-0.94; q4=0.80, 95%CI 0.73-0.89), but not with CAC score>0. CONCLUSION: Higher EFV was associated with impaired endothelial function, but not with CAC. The results suggest that EFV is related to the development of CAD through a pathway different from the CAC pathway, possibly through aggravation of endothelial dysfunction and microvascular disease.

FUNDAMENTO: O aumento no volume de gordura epicárdica (VGE) está relacionado com doença arterial coronariana (DAC), independentemente de gordura visceral ou subcutânea. O mecanismo dessa associação não é claro. O escore de cálcio coronariano (CC) e a disfunção endotelial estão relacionados com eventos coronarianos, mas não está bem esclarecido se o VGE está relacionado com esses marcadores. OBJETIVOS: Avaliar a associação entre VGE medido por método automatizado, fatores de risco cardiovasculares, escore de CC, e função endotelial. Métodos: Em 470 participantes do Estudo Longitudinal de Saúde do Adulto LSA-Brasil com medidas de VGE, escore de CC e função endotelial, realizamos modelos multivariados para avaliar a relação entre fatore de risco cardiovascular e VGE (variável resposta), e entre VGE (variável explicativa), e função endotelial ou escore de CC. Valor de p<0,05 bilateral foi considerado estatisticamente significativo. RESULTADOS: A idade média foi 55 ± 8 anos, e 52,3% dos pacientes eram homens. O VGE médio foi 111mL (86-144), e a prevalência de escore de CC igual a zero foi 55%. Nas análises multivariadas, um VGE mais alto relacionou-se com sexo feminino, idade mais avançada, circunferência da cintura, e triglicerídeos (p<0,001 para todos). Um VGE mais alto foi associado com pior função endotelial: em comparação ao primeiro quartil, os valores de odds ratio para a amplitude de pulso basal foram (q2=1,22; IC95% 1,07-1,40; q3=1,50, IC95% 1,30-1,74; q4=1,50, IC95% 1,28-1,79) e para a razão de tonometria arterial periférica foram (q2=0,87; IC95% 0,81-0,95; q3=0,86, IC95% 0,79-0,94; q4=0,80, IC95% 0,73-0,89), mas não com escore de CC maior que zero. CONCLUSÃO: Um VGE mais alto associou-se com comprometimento da função endotelial, mas não com escore de CC. Os resultados sugerem que o VGE esteja relacionado ao desenvolvimento de DAC por uma via diferente da via do CC, possivelmente pela piora da disfunção endotelial e doença microvascular.

Evaluation of acute toxicity, 28-day repeated dose toxicity, and genotoxicity of Moringa oleifera leaves infusion and powder.

ETHNOPHARMACOLOGICAL RELEVANCE: Moringa oleifera Lam. leaves infusion and powder are widely used by population due the nutritional and medicinal potentials, however data regarding safety of use are still inconclusive, leading to prohibition of this plant in some countries. AIM OF THE STUDY: The present work investigated the nutritional and phytochemical composition, acute and 28-day repeated dose toxicity, and genotoxicity of M. oleifera leaves infusion and powder. MATERIALS AND METHODS: For nutritional characterization of leaf powder, it was determined: humidity; mineral residue (ash); total lipid, protein, carbohydrate, and crude fiber contents; and total caloric value. Phytochemical composition was determined by high performance liquid chromatography (HPLC). The acute toxicity assay used Swiss female albino mice and oral administration in a single dose at 2000 and 5000 mg/kg of infusion or powder. The 28-day repeated dose toxicity assay employed female and male mice, with oral administration of infusion or powder at the doses 250, 500 and 1000 mg/kg. The animals were evaluated for body weight, water and feed consumption, biochemical and hematological parameters, and histology of the liver, spleen, and kidneys. In vivo genotoxicity and mutagenicity (2000 mg/kg) were evaluated by the comet assay and the micronucleus test, respectively. RESULTS: Nutritional characterization confirmed that M. oleifera leaves are rich in proteins, carbohydrates, lipids, minerals, and fiber. HPLC indicated the presence of flavonoids and cinnamic derivatives as major polyphenols. Acute toxicity did not reveal alterations in weight gain and water and feed consumptions and no change in biochemical, hematological, and histological parameters. Behavior alterations was observed in the first 2 h after administration at 5000 mg/kg in both treatments. Infusion did not present toxicity when administered for 28 days. Conversely, the powder at 500 and 1000 mg/kg promoted liver and kidney damages observed through biochemical parameters and histopathology. Genotoxicity and mutagenicity were not detected at 2000 mg/kg. CONCLUSIONS: The present study reveals that M. oleifera leaves are an important source of polyphenols and nutrients. Indiscriminate use of both infusion and crude leaf powder above 2000 mg/kg and powder at 500 and 1000 mg/kg are not recommended. Chronic toxicological studies and establishment of preparation protocols are suggested aiming to guarantee the safety in the use of M. oleifera leaves as nutraceutical by population.

Relação de fatores pessoais e ambientais com a prevalência de deficiências físicas adquiridas no Brasil - estudo de base populacional / Relationship between personal and environmental factors and prevalence of acquired physical impairment in Brazil - a population-based study

Resumo Objetivou estimar a relação de fatores pessoais e ambientais com a prevalência de deficiência física adquirida em adultos e idosos brasileiros. Realizado um estudo transversal com dados da Pesquisa Nacional de Saúde (PNS) 2013. A variável resposta foi: autorrelato deficiência física adquirida. As variáveis explicativas de interesse foram: sexo, raça/cor, escolaridade, classe social, trabalho remunerado, plano de saúde, água canalizada e rede de esgoto. As magnitudes das associações e seus respectivos intervalos de confiança (95%) foram estimadas utilizando a Regressão de Poisson. O autorrelato de deficiência física foi encontrado em 1,25% dos 55.369 participantes. Após completo ajustamento, o sexo masculino, raça/cor não branca, menores níveis de escolaridade, viver sozinho, não ter trabalho remunerado, plano de saúde, água canalizada e rede de esgoto foram associados a maiores prevalências de deficiência física adquirida. Esses achados evidenciam que a população mais vulnerável apresenta maior prevalência de deficiência física e os fatores pessoais e ambientais são importantes de serem avaliados em nível populacional.

Abstract The aim of this study was to estimate the relationship between personal and environmental factors and the prevalence of acquired physical impairment in adults and older persons in Brazil. We conducted a cross-sectional study using data from the 2013 National Health Survey. The response variable was self-reported acquired physical impairment. The explanatory variables were sex, race/skin color, education level, social class, paid employment, private health insurance, running water, and connection to a sewer network. The strength of association between the explanatory variables and response variable and respective 95% confidence intervals were estimated using Poisson Regression. Physical impairment was reported by 1.25% of the study population (n=55,369). After complete adjustment, being male and non-white, having a lower level of education, living alone, not being in paid employment, not having private health insurance, not having running water, and not living in a house connected to a sewer network were associated with higher prevalence of acquired physical impairment. The findings show that prevalence of physical impairment was higher among vulnerable groups and that personal and environmental factors are important elements that need to be assessed at the population level.

Sponsorship by food and beverage companies in soccer: an analysis of the 2019 Copa América / Patrocínio por empresas de alimentos e bebidas no futebol: análise da Copa América 2019

ABSTRACT OBJECTIVE To identify the sponsorship by food and beverage companies of the teams participating in the 2019 Copa América Soccer Cup and associate this sponsorship with characteristics of the teams and their respective countries. METHODS The sponsors of the 10 teams participating in the 46th edition of the Copa América were identified. These entities were classified into (i) food companies, (ii) alcoholic beverage companies, and (iii) other segments. The food companies were classified according to their products, according to the NOVA classification. In addition, data on the number of titles previously won by the teams in the Copa America and the World Cup were obtained, as well as data on the countries' Human Development Index, annual per capita sales of ultra-processed foods, and annual per capita consumption of alcoholic beverages. RESULTS A total of 89 sponsorships were identified for the 10 teams studied, some of these supporting two or more teams. Eighteen percent of the sponsors were food companies, with 12.4% being ultra-processed foods. The alcoholic beverage category represented 7.9% of the sponsors. Ultra-processed beverage and alcoholic beverage companies sponsored seven of the 10 teams studied. We noted higher participation of ultra-processed foods company sponsors in teams from countries with higher Human Development Index, sales of ultra-processed foods, and number of Copa América and World Cup titles. The sponsorship by alcoholic beverage companies was higher for teams from countries with lower Human Development Index, alcohol consumption, and number of Copa América and World Cup titles. CONCLUSION A significant presence of ultra-processed food and alcoholic beverage companies as sponsors of South American soccer teams was noted, along with the fact that sport performance characteristics of the teams and socioeconomic and market issues of the countries are associated with the occurrence of sponsorship.

RESUMO OBJETIVO Identificar o patrocínio por empresas do setor de alimentos e bebidas das seleções participantes da Copa América de Futebol 2019 e associar esse patrocínio a características das seleções e de seus respectivos países. MÉTODOS Foram identificados os patrocinadores das 10 seleções participantes da 46ª edição da Copa América de Futebol. Essas entidades foram classificadas em empresas i) de alimentos, ii) de bebidas alcoólicas e iii) de outros segmentos. As empresas de alimentos foram classificadas de acordo com seus produtos, segundo a classificação NOVA. Além disso, dados sobre o número de títulos anteriormente conquistados pelas seleções na Copa América e na Copa do Mundo foram obtidos, assim como dados do índice de desenvolvimento humano, de venda anual per capita de alimentos ultraprocessados e de consumo anual per capita de bebidas alcoólicas dos países. RESULTADOS Um total de 89 patrocínios foram identificados para as 10 seleções estudadas, alguns desses apoiando duas ou mais equipes. Dezoito por cento dos patrocinadores eram empresas de alimentos, sendo 12,4% de alimentos ultraprocessados. A categoria de bebidas alcoólicas representou 7,9% dos patrocinadores. As empresas de bebidas ultraprocessadas e as de bebidas alcoólicas patrocinaram sete das 10 seleções estudadas. Notou-se maior participação de patrocinadores de empresas de alimentos ultraprocessados em seleções de países com maior índice de desenvolvimento humano, venda de alimentos ultraprocessados e número de títulos de Copa América e Copa do Mundo. Já o patrocínio por empresas de bebidas alcoólicas foi maior em seleções de países com menor índice de desenvolvimento humano, consumo de álcool e número de títulos em Copa América e Copa do Mundo. CONCLUSÃO Evidenciou-se uma presença significativa de empresas de alimentos ultraprocessados e de bebidas alcoólicas como patrocinadores das seleções sul-americanas de futebol e que as características de desempenho esportivo das seleções e questões socioeconômicas e de mercado dos países se associam à ocorrência do patrocínio.

Birth weight is related with bone mineral content in adulthood: results of ELSA-Brasil

ABSTRACT OBJECTIVE To investigate the association between birth weight and bone mineral content (BMC), and whether this relationship differs between men and women. METHODS A total of 10,159 participants from the ELSA-Brasil cohort were eligible for this analysis. The outcome was the z-score of the ratio BMC (kg)/height (m). The exposure was the low birth weight (< 2.5kg). The magnitude of the associations was estimated by mean differences and their respective 95% confidence intervals (95%CI) using linear regression. All analyses were presented for the total population and stratified by sex. RESULTS Most were women (54.98%), and the mean age was 52.72 years (SD ± 6.6). In the crude model, we observed that low birth weight was associated with a lower mean BMC/height z-score, compared to adequate birth weight (mean difference: −0.30; 95%CI: −0.39 to −0.21), and this effect was stronger in men (mean difference: −0.43; 95%CI: −0.56 to −0.30) than in women (mean difference: −0.31; 95%CI: −0.44 to −0.19). After adjusting for age, sex per total population, race/skin color, maternal education, individual education, and current weight, there was a considerable reduction in the magnitude of the association (total population: −0.10; 95%CI: −0.14 to −0.06; men: −0.13; 95%CI: −0.21 to −0.06; women: −0.13; 95%CI: −0.21 to −0.05). CONCLUSION Low birth weight is related to BMC/height z-score in both sexes with no indication of differences by sex. The magnitude of the associations was attenuated after adjustment for the current weight.

Body fat distribution and its risk for cardiovascular events in 10 years: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) / A distribuição de gordura corporal está relacionada ao risco de eventos cardiovasculares em 10 anos: Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) / La distribución de la grasa corporal está relacionada con el riesgo de eventos cardiovasculares en 10 años: Estudio Longitudinal de Salud en Adultos (ELSA-Brasil)

Body fat distribution seems to have different effects in cardiovascular diseases (CVD). We aimed to estimate the associations between lower limbs and trunk fat ratio and the 10-year CVD risk, and isolated risk factors in men and women. A total of 10,917 participants from ELSA-Brasil were eligible for this cross-sectional study. Associations between lower limb/trunk fat ratio with the percentage of 10-year CVD risk - according to the Framingham Risk Score - and its risk factors (systolic blood pressure, total cholesterol and HDL-cholesterol, diabetes, and use of antihypertensive medication) were performed using generalized linear models, linear and logistic regressions. All analyses were stratified by gender and adjustments were made by age, self-reported skin color, educational attainment, alcohol consumption, leisure physical activity, hypolipidemic drug use and, for women, menopausal status. In this study, 55.91% were women, with a mean age of 52.68 (SD = 6.57) years. A higher lower limb/trunk fat ratio was related to lower 10-year CVD risk, as well as a reduction in systolic blood pressure, total cholesterol, and antihypertensive drug use, also an increasing HDL-cholesterol in both genders, but this relationship was stronger in women. Besides, a protective relationship to diabetes was observed in women. Higher fat accumulation in the lower body, when compared to the trunk, seems to have a lower risk of CVD and associated risk factors - even in the presence of fat in the abdominal region - with women presenting lower risks than men.

A distribuição de gordura no corpo parece ter efeitos diferentes nas doenças cardiovasculares (DCV). Objetivou-se estimar as associações da razão de gordura entre membros inferiores e tronco com o risco de DCV em 10 anos e os fatores de risco independentes em homens e mulheres. Um total de 10.917 participantes do ELSA-Brasil eram elegíveis para este estudo transversal. As associações da razão de gordura entre os membros inferiores e tronco com o percentual de risco de DCV em 10 anos, de acordo com a Escala de Risco de Framingham, e os respectivos fatores de risco (pressão arterial sistólica, colesterol total e HDL colesterol, diabetes e uso de medicação anti-hipertensiva), foram avaliados com modelos lineares generalizados, lineares e de regressão logística. Todas as análises foram estratificadas por sexo, e os ajustes foram feitos por idade, raça/cor, escolaridade, consumo de álcool, atividade física, uso de medicação hipolipemiante e, para as mulheres, estado de menopausa. Na amostra do estudo atual, 55,91% eram mulheres, com média de idade de 52,68 anos (DP = 6,57). A maior diferença entre a gordura dos membros inferiores e tronco foi associada com menor risco de DCV em 10 anos e com redução na pressão arterial sistólica, colesterol total e uso de medicação anti-hipertensiva, assim como um aumento no HDL colesterol em ambos os sexos (mas essa correlação foi mais forte em mulheres). Além disso, foi observada uma relação protetora contra diabetes, apenas em mulheres. O acúmulo maior de gordura nos membros inferiores, comparado com o tronco, parece estar associado a um risco menor de DCV e aos fatores de risco, mesmo na presença de gordura na região abdominal, e esse efeito é mais forte nas mulheres que nos homens.

Las distribuciones de grasa corporal parecen tener diferentes efectos en las enfermedades cardiovasculares (ECV). Nuestro objetivo fue estimar las asociaciones entre extremidades inferiores/ratio de grasa troncal y el riesgo de ECV a los 10 años, y sus factores de riesgo aislados, en hombres y mujeres. Un total de 10.917 participantes de ELSA-Brasil fueron elegibles para este estudio transversal. Las asociaciones de la ratio de grasa entre la parte inferior del cuerpo y el tronco, con el porcentaje de riesgo de ECV a los 10 años, según la Escala de Riesgo de Framingham, y sus factores de riesgo (presión sanguínea sistólica, colesterol total y colesterol HDL, diabetes, y uso de medicación antihipertensiva), se realizaron usando modelos lineales generalizados, regresiones lineales y logísticas. Todos los análisis fueron estratificados por sexo y los ajustes se hicieron por edad, raza/color de piel autoinformado, nivel educativo, consumo de alcohol, actividad física durante el ocio, uso de medicamentos hipolipemiantes y, para mujeres, estatus menopáusico. En este estudio, un 55,91% fueron mujeres, con una media de edad de 52,68 (SD = 6,57) años. Una ratio de masa adiposa más alta entre las extremidades inferiores/tronco estuvo asociada a un riesgo menor de ECV en 10 años, también una reducción en la presión sistólica sanguínea, colesterol total, y el consumo de medicamentos antihipertensivos, también en un incremento del colesterol HDL en ambos sexos, pero esta relación fue más fuerte en mujeres. Asimismo, una relación protectora frente a la diabetes se observó solo en mujeres. Una acumulación más alta de grasa en las extremidades inferiores, comparada con la del tronco, parece tener un riego más bajo de ECV y sus factores de riesgo, incluso con la presencia de grasa en la región abdominal, además este efecto es más fuerte en mujeres comparadas con los hombres.