Prevalence of childhood obesity in Brazil: a systematic review.

The present study aimed to analyze the prevalence of childhood obesity in Brazil and compare it between boys and girls. This systematic review was conducted and reported according to the guidelines outlined in the PRISMA statement. A systematic search of electronic databases, including PubMed, LILACS, and SciELO, was performed in November 2021. Studies that met the following criteria were included: (i) original quantitative studies regardless of their design; (ii) childhood obesity was clearly defined; (iii) prevalence of childhood obesity was reported or it was possible to extract from tables or figures in the text; and (iv) eligible population included children under 12 years of age. A total of 112 articles were included in the systematic review. The prevalence of childhood obesity in Brazil was of 12.2%, being 10.8% in girls and 12.3% in boys. In addition, wide heterogeneity in the childhood obesity prevalence was observed between the states, since it was 2.6% in Pará, while it was 15.8% in Rondônia. Thus, the importance of urgently implementing measures to prevent and treat childhood obesity should be emphasized aiming to reduce obese children and adolescents and future health problems in adult life resulting from this cardiovascular risk factor.

Simultaneous analysis of multiple T helper subsets in leprosy reveals distinct patterns of Th1, Th2, Th17 and Tregs markers expression in clinical forms and reactional events.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Previous studies have demonstrated that the difference among clinical forms of leprosy can be associated with the immune response of patients, mainly by T helper (Th) and regulatory T cells (Tregs). Then, aiming at clarifying the immune response, the expression of cytokines related to Th1, Th2, Th17 and Tregs profiles were evaluated by qPCR in 87 skin biopsies from leprosy patients. Additionally, cytokines and anti-PGL-1 antibodies were determined in serum by ELISA. The results showed that the expression of various targets (mRNA) related to Th1, Th2, Th17 and Tregs were significantly modulated in leprosy when compared with healthy individuals, suggesting the presence of a mixed profile. In addition, the targets related to Th1 predominated in the tuberculoid pole and side and Th2 and Tregs predominated in the lepromatous pole and side; however, Th17 targets showed a mixed profile. Concerning reactional events, Tregs markers were decreased and IL-15 was increased in reversal reaction and IL-17F, CCL20 and IL-8 in erythema nodosum leprosum, when compared with the respective non-reactional leprosy patients. Additionally, ELISA analysis demonstrated that IL-22, IL-6, IL-10 and anti-PGL-1 antibody levels were significantly higher in the serum of patients when compared with healthy individuals, and IL-10 and anti-PGL-1 antibodies were also increased in the lepromatous pole and side. Together, these results indicate that Th1, Th2 and Th17 are involved in the determination of clinical forms of leprosy and suggest that decreased Tregs activity may be involved in the pathogenesis of reactional events.

Seroreactivity to new Mycobacterium leprae protein antigens in different leprosy-endemic regions in Brazil.

New Mycobacterium leprae protein antigens can contribute to improved serologic tests for leprosy diagnosis/classification and multidrug therapy (MDT) monitoring. This study describes seroreactivity to M. leprae proteins among participants from three highly endemic leprosy areas in Brazil: central-western Goiânia/Goiás (GO) (n = 225), Rondonópolis/Mato Grosso (MT) (n = 764) and northern Prata Village/Pará (PA) (n = 93). ELISA was performed to detect IgG to proteins (92f, 46f, leprosy IDRI diagnostic-1, ML0405, ML1213) and IgM to phenolic glycolipid-I (PGL-I). Multibacillary (MB) leprosy had positive rates for PGL-I that were similar to those for proteins; however, some anti-PGL-I-negative subjects were positive for proteins, suggesting that adding protein antigen to PGL-I can enhance the sensitivity of MB leprosy detection. In MT, different degrees of seroreactivity were observed and ranked for MB, former patients after MDT, paucibacillary (PB) leprosy, household contact (HHC) and endemic control (EC) groups. The seroreactivity of PB patients was low in GO and MT. HHCs from different endemic sites had similar IgG antibody responses to proteins. 46f and 92f were not recognised by most tuberculosis patients, ECs or HHCs within GO, an area with high BCG vaccination coverage. Low positivity in EC and HHC was observed in PA and MT. Our results provide evidence for the development of an improved serologic test that could be widely applicable for MB leprosy testing in Brazil.

High rate of sensitization to Kathon CG, detected by patch tests in patients with suspected allergic contact dermatitis.

BACKGROUND: Kathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. OBJECTIVES: This study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. METHODS: The patients were submitted to standard series of epicutaneous tests, standardized by the Brazilian Group Studies on Contact Dermatitis. RESULTS: Out the 267 patients tested, 192 presented positivity to at least one substance and 29 of the patients (15.10%) presented reaction to Kathon CG, with predominance of the female gender (n=27); main professional activity associated with Kathon CG sensibilization was cleaning (17.24%), followed by aesthetic areas (13.79%) and health care (10.34%). The most prevalent sensitizations among the substances tested were nickel sulphate (56.3%), followed by cobalt chloride (23.4%), neomycin (18.2%), potassium dichromate (17.7%), thimerosal (14.5%), formaldehyde (13.2%), paraphenylenediamine (9.3%), and fragrance mix (8.3%). STUDY LIMITATIONS: We do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased. CONCLUSION: High positivity to Kathon CG corroborates the recent findings in the literature, suggesting more attention to concentration of this substance, used in cosmetics and products for domestic use.

Association between NDO-LID and PGL-1 for leprosy and class I and II human leukocyte antigen alleles in an indigenous community in Southwest Amazon.

The frequencies of the Human leukocyte antigen (HLA) alleles in the Puyanawa indigenous reserve population and their association with the NDO-LID and ELISA PGL-1 rapid serological test was assessed. This was a cross-sectional study with an epidemiological clinical design conducted in two indigenous communities in the state of Acre, Brazil. Blood was collected in a tube with EDTA to identify HLA alleles and perform serological tests. DNA was obtained using the salting out procedure. The LabType™ technique (One-Lambda-USA) was used for HLA class I (loci A*, B* and C*) and II (loci DRB1*, DQA1* and DQB1*) typing. Allele frequency was obtained by direct count, and the chi-square test was used to assess the association with the NDO-LID and PGL-1 tests. The most frequent alleles in the two communities were: HLA-A*02:01, HLA-B*40:02, HLA-DRB1*16:02, HLA-DQA1*05:05 and HLA-DQB1*03:01. The allele HLA-C*04:01 was the most common in the Barão community, and the allele HLA-C*07:01 in Ipiranga. Among individuals who presented seropositivity to the NDO-LID test, the association with alleles HLA-A*02 (43.18% vs 24.8%, p=0.03, OR=2.35) and HLA-B*53 (6.83% vs 0.0%, p=0.03, OR=8.95) was observed in the Barão community. HLA-B*15 was associated with non-seroconversion to the NDO-LID test in Ipiranga. In both communities, HLA-B*40 and HLA-C*03 were associated with positive serological response to ELISA PGL-1. The HLA class I and II alleles most frequently found in this study have already been described among Terena indigenous groups, and HLA class I contributes to seroconversion to NDO-LID and PGL-1 tests in inhabitants of the Barão and Ipiranga communities.

Leprosy: prevalence and factors associated with seropositivity for anti-NDO-LID antibodies in children under 15 years of age.

BACKGROUND: A high prevalence of leprosy among children under 15 years of age indicates the need to implement actions to prevent new cases of the disease. Serological tests have been developed with the aim of helping to control the disease by indicating, through seropositivity, the presence of infection. OBJECTIVE: To analyze the prevalence and factors associated with seropositivity rate for anti-NDO-LID antibodies in children under 15 years of age, contacts of leprosy patients. METHOD: We performed a cross-sectional study with 210 children under 15 years old of age. Of them, 50 were household contacts and 160 were neighborhood contacts living in the municipality of Cuiabá, state of Mato Grosso, in 2016. The data were obtained from interviews and the NDO-LID rapid test during home visits from February to July 2016. For the analysis, we used Poisson regression and prevalence ratio. RESULTS: Seropositivity in contacts was 6.2%. Variables associated with seropositive tests included sex (PR = 1.05; 95% CI: 1.01 - 1.08), race/skin color (PR = 0.95; 95% CI: 0.90 - 0.99), residence area (PR = 1.05; 95% CI: 1.01 - 1.09), and number of people per household (PR = 1.06; 95% CI: 1.02 - 1.08). STUDY LIMITATIONS: The small sample size, besides leading to wide confidence intervals, may have been a limitation for the identification of associated factors. CONCLUSIONS: The prevalence of seropositivity was high. Variables associated with NDO-LID seropositivity included female sex, not to be brown skinned, live in urban areas, and live with five or more people.

Can anti-PGL-1 and anti-NDO-LID-1 antibody titers be used to predict the risk of reactions in leprosy patients?

Leprosy patients may present reactional episodes classified as type I or reversal reaction and type II or erythema nodosum leprosum. Early diagnosis of these reactions is hampered by lack of diagnostic tests. This study aimed at evaluating anti-Mycobacterium leprae antibody levels in reactional and nonreactional leprosy patients at the time of diagnosis. Clinical data and serum samples of 224 patients diagnosed between 2009 and 2010 were collected in the municipality of Rondonópolis-MTBR. Quantification of anti-phenolic glycolipid-1 (PGL-1) IgM antibodies of M. leprae was obtained by the enzyme-linked immunosorbent assay method and anti-natural octyl disacharide-leprosy IDRI diagnostic (NDO-LID-1) IgM/IgG semiquantitative rapid test. We obtained low serological levels of anti-PGL-1 and anti-NDO-LID-1 for tuberculoid (T) (1.56% and 15.62%) and borderline tuberculoid (BT) patients (7.95% and 26.13%), medium levels in the borderline-borderline (BB) (47.91% and 68.75%), and high levels in lepromatous (LL) (93.33% and 100%) and borderline-lepromatous (BL) (88.0% and 100%). When comparing the reactional groups (RI and RII) with without reaction (WR) group at the time of diagnosis, we observed a statistically significant difference between the groups; patients with RII presented higher serological response: 66.66% anti-PGL-1 and 91.66% anti-NDO-LID-1. In respect to patients who developed a reaction after the initial diagnosis, they also showed significant positivity for both anti-PGL-1 and anti-NDO-LID-1 in comparison to the patients who stayed without reaction in the study period (P<0.0001). These results allow us to conclude that serological tests may contribute to an early diagnosis of RII and that the anti-NDO-LID-1 test was demonstrated to be a better indicator.

High rate of sensitization to Kathon CG, detected by patch tests in patients with suspected allergic contact dermatitis

Abstract Background: Kathon CG, a combination of methylchloroisothiazolinone and methylisothiazolinone, is widely used as preservative in cosmetics, as well in household cleaning products, industrial products such as paints and glues. It has emerged as an important sensitizing agent in allergic contact dermatitis. Objectives: This study evaluated the reactivity to this substance in patients subjected to patch tests at the Dermatology Institute in Bauru, São Paulo from 2015 to 2017 and its correlation with other preservatives, the professional activity and location of the lesions. Methods: The patients were submitted to standard series of epicutaneous tests, standardized by the Brazilian Group Studies on Contact Dermatitis. Results: Out the 267 patients tested, 192 presented positivity to at least one substance and 29 of the patients (15.10%) presented reaction to Kathon CG, with predominance of the female gender (n = 27); main professional activity associated with Kathon CG sensibilization was cleaning (17.24%), followed by aesthetic areas (13.79%) and health care (10.34%). The most prevalent sensitizations among the substances tested were nickel sulphate (56.3%), followed by cobalt chloride (23.4%), neomycin (18.2%), potassium dichromate (17.7%), thimerosal (14.5%), formaldehyde (13.2%), paraphenylenediamine (9.3%), and fragrance mix (8.3%). Study limitations: We do not have data from patients that were submitted to patch test a decade ago in order to confront to current data and establish whether or no sensitization to Kathon CG has increased. Conclusion: High positivity to Kathon CG corroborates the recent findings in the literature, suggesting more attention to concentration of this substance, used in cosmetics and products for domestic use.

Association between NDO-LID and PGL-1 for leprosy and class I and II human leukocyte antigen alleles in an indigenous community in Southwest Amazon

The frequencies of the Human leukocyte antigen (HLA) alleles in the Puyanawa indigenous reserve population and their association with the NDO-LID and ELISA PGL-1 rapid serological test was assessed. This was a cross-sectional study with an epidemiological clinical design conducted in two indigenous communities in the state of Acre, Brazil. Blood was collected in a tube with EDTA to identify HLA alleles and perform serological tests. DNA was obtained using the salting out procedure. The LabType™ technique (One-Lambda-USA) was used for HLA class I (loci A*, B* and C*) and II (loci DRB1*, DQA1* and DQB1*) typing. Allele frequency was obtained by direct count, and the chi-square test was used to assess the association with the NDO-LID and PGL-1 tests. The most frequent alleles in the two communities were: HLA-A*02:01, HLA-B*40:02, HLA-DRB1*16:02, HLA-DQA1*05:05 and HLA-DQB1*03:01. The allele HLA-C*04:01 was the most common in the Barão community, and the allele HLA-C*07:01 in Ipiranga. Among individuals who presented seropositivity to the NDO-LID test, the association with alleles HLA-A*02 (43.18% vs 24.8%, p = 0.03, OR = 2.35) and HLA-B*53 (6.83% vs 0.0%, p = 0.03, OR = 8.95) was observed in the Barão community. HLA-B*15 was associated with non-seroconversion to the NDO-LID test in Ipiranga. In both communities, HLA-B*40 and HLA-C*03 were associated with positive serological response to ELISA PGL-1. The HLA class I and II alleles most frequently found in this study have already been described among Terena indigenous groups, and HLA class I contributes to seroconversion to NDO-LID and PGL-1 tests in inhabitants of the Barão and Ipiranga communities(AU).

Leprosy: prevalence and factors associated with seropositivity for anti-NDO-LID antibodies in children under 15 years of age

Abstract: Background: A high prevalence of leprosy among children under 15 years of age indicates the need to implement actions to prevent new cases of the disease. Serological tests have been developed with the aim of helping to control the disease by indicating, through seropositivity, the presence of infection. Objective: To analyze the prevalence and factors associated with seropositivity rate for anti-NDO-LID antibodies in children under 15 years of age, contacts of leprosy patients. Method: We performed a cross-sectional study with 210 children under 15 years old of age. Of them, 50 were household contacts and 160 were neighborhood contacts living in the municipality of Cuiabá, state of Mato Grosso, in 2016. The data were obtained from interviews and the NDO-LID rapid test during home visits from February to July 2016. For the analysis, we used Poisson regression and prevalence ratio. Results: Seropositivity in contacts was 6.2%. Variables associated with seropositive tests included sex (PR = 1.05; 95% CI: 1.01 - 1.08), race/skin color (PR = 0.95; 95% CI: 0.90 - 0.99), residence area (PR = 1.05; 95% CI: 1.01 - 1.09), and number of people per household (PR = 1.06; 95% CI: 1.02 - 1.08). Study Limitations: The small sample size, besides leading to wide confidence intervals, may have been a limitation for the identification of associated factors. Conclusions: The prevalence of seropositivity was high. Variables associated with NDO-LID seropositivity included female sex, not to be brown skinned, live in urban areas, and live with five or more people.

Standardized ileal digestible lysine requirement of white commercial layers in peak egg production / Níveis de lisina digestível em rações para galinhas poedeiras leves no pico de produção

This study was conducted to determine the standardized ileal digestible lysine (SID Lys) requirements for white commercial layers in peak egg production phase. A total of two hundred eighty-eight 24 week-old Hy-Line W-36 layers were randomly assigned to one of six treatments groups, with eight replicates of six hens each. A basal diet, SID Lys-deficient, was graded supplemented with L-Lysine HCl (78.4%) in order to produce experimental treatments (6.0, 6.6, 7.2, 7.8, 8.4 and 9.0 g SID Lys/kg diet). Throughout the 16-week-feeding trial (24 to 40 weeks of age) hens had free access to water and mash feed. Data were analyzed as one-way ANOVA and optimum SID Lys level for each dependent variable assessed were estimated using polynomial and linear broken-line regression model. Feed intake and SID Lys intake were both linearly enhanced by graded SID Lys levels. According to linear broken-line regression model, the breakpoint for egg production, egg weight, and egg mass occurred at 8.14, 8.56 and 8.35 g SID Lys/kg diet, respectively. The breakpoint for feed conversion per egg mass (kg/kg) and per dozen of eggs (kg/dozen) occurred at 8.48 and 7.80 g SID Lys/kg diet, respectively. Eggshell weight and albumen weight were unaffected by dietary SID Lys supply. Weight gain and yolk weight reached optimum values at 8.33 and 8.03 g SID Lys/kg diet, respectively, according to linear broken-line regression model. In conclusion, SID Lys requirement for white commercial layers in peak egg production phase is 8.48 g/kg diet, which corresponds to an average daily SID Lys intake of 813 mg/hen.

Este estudo foi realizado para determinar a exigência de lisina digestível para galinhas poedeiras leves no pico de postura. Foram utilizadas 288 poedeiras Hy Line W-36 durante o período de 24 a 40 semanas de idade. As poedeiras foram distribuídas em delineamento inteiramente casualizado, com seis níveis de lisina digestível (6,0; 6,6; 7,2; 7,8; 8,4 e 9,0 g/kg de ração), oito repetições e seis aves por unidade experimental. Os níveis de lisina digestível na ração proporcionaram aumento linear do consumo de ração e de lisina digestível. O modelo Linear Response Plateau (LRP) foi o que melhor representou a distribuição dos dados para produção e peso dos ovos, ocorrendo os platôs nos níveis de lisina digestível de 8,14 e 8,56 g/kg, respectivamente. Para massa dos ovos e conversões alimentares por massa e por dúzia de ovos, os platôs ocorreram nos níveis de 8,35; 8,48 e 7,80 g/kg de lisina digestível, respectivamente. Os pesos de casca e de albúmen não foram influenciados pelos níveis de lisina da ração. O ganho de peso das aves e o peso de gema atingiram, respectivamente, os platôs nos níveis de 8,33 e 8,03 g/kg de lisina digestível. A exigência de lisina digestível para galinhas poedeiras leves no pico de postura é de 8,48 g/kg de ração, que corresponde ao consumo diário de lisina digestível de 813 mg/ave.

Study of the frequency of allergens in cosmetics components in patients with suspected allergic contact dermatitis.

BACKGROUND: Contact dermatitis to cosmetics is a common dermatosis, especially in adults and professionals who handle them. OBJECTIVE: The objective of this study was to evaluate the frequency of sensitization to cosmetics' components in patients with suspected allergic contact dermatitis and to identify the main sensitizers related to occupational contact dermatitis. METHODS: During the period of January 2008 to June 2010, all the patients with a presumptive diagnosis of allergic contact dermatitis to cosmetics were selected. The patients were submitted to the patch tests of cosmetics series, composed by ten substances. RESULTS: Among the 147 patients studied sensitization to cosmetics components occurred in 31,29% of the cases, 14 of those (19,18%) equally corresponding to BHT and triethanolamine substances, 13 (17,81%) to ammonium thioglycolate, 09 to sorbic acid (12,33%), 08 to tosilamida (10,95%), 06 to germall (8,22%). The other elements tested showed indices of 5% or less. A higher frequency of contact dermatitis to cosmetics was observed in women and the age most affected was concordant with the age range of greatest professional activity of the population. CONCLUSION: Allergic contact dermatitis was more frequently associated with Triethanolamine, BHT and ammonium thioglycolate, and the relation with occupational contact dermatitis was discreet.

Digestible threonine-to-lysine ideal ratio for laying hens fed with low-protein diets from 24 to 40 weeks of age / Relação treonina: lisina digestíveis em rações com baixo nível de proteína bruta para galinhas poedeiras leves de 24 a 40 semanas de idade

ABSTRACT: This trial was performed to determine the dietary digestible threonine-to-lysine (dig. Thr-to-Lys) ideal ratio for laying hens fed with low-protein diets from 24 to 40 weeks of age. At 24 weeks of age, two hundred forty Hy Line W-36 laying hens were randomly assigned to five treatments, represented by five dig Thr-to-Lys ratios (60; 67; 74; 81 and 88%), with eight replicates each one with six hens per experimental unit. Digestible Thr-to-Lys did not affect laying hen performance and egg quality, except for digestible Threonine intake, which showed linear increase as dig. Thr-to-Lys ratios increased. Linear broken-line model was chosen to analyze data according to lack of fit. According to linear broken-linen estimates, digestible Threonine ideal levels for optimum egg production, egg mass, feed efficiency of lysine utilization for egg mass, feed conversion per egg mass and dozens of eggs and nitrogen balance were 0.610; 0.580; 0.614; 0.599; 0.599 and 0.643%, which correspond respectively to dig Thr-to-Lys ratios of 80; 75; 80; 78; 78 and 83%. The digestible threonine-to-lysine ideal ratio for laying hens from 24 to 40 weeks of age is 80%.

RESUMO: Este estudo foi realizado para determinar a relação ideal de treonina:lisina digestíveis em rações com baixo nível de proteína bruta para galinhas poedeiras leves de 24 a 40 semanas de idade. Utilizaram-se 240 poedeiras Hy Line W-36 distribuídas em delineamento inteiramente casualizado, com cinco relações treonina:lisina digestíveis (60; 67; 74; 81 e 88%), oito repetições e seis aves por unidade experimental. As relações treonina:lisina digestíveis não influenciaram o consumo de ração e de lisina; peso médio dos ovos e seus componentes; ganho de peso e peso corporal final das aves, mas houve efeito linear para o consumo de treonina. O modelo Linear Response Plateau (LRP) foi o que melhor representou a distribuição dos dados para taxa de postura; massa de ovos; eficiência de utilização da lisina por massa; conversão alimentar por massa e por dúzia de ovos; e balanço de nitrogênio. Os platôs ocorrem nos níveis de treonina de 0.61; 0.580; 0.614; 0.599; 0.599 e 0.643%, que corresponde às relações treonina:lisina digestíveis de 80; 75; 80; 78; 78 e 83%, respectivamente. A relação ideal de treonina:lisina digestíveis em rações para galinhas poedeiras leves de 24 a 40 semanas de idade é de 80%.

Exigência nutricional de lisina digestível para galinhas poedeiras leves em produção / Nutritional requirement of digestible lysine for white-egg laying hens in production

O objetivo com este trabalho foi determinar a exigência nutricional de lisina digestível para galinhas poedeiras leves em idade avançada. Foram utilizadas 288 galinhas poedeiras Hy Line W-36 com 60 semanas de idade, distribuídas em delineamento inteiramente casualizado, com seis níveis de lisina digestível (6,0; 6,6; 7,2; 7,8; 8,4 e 9,0g kg-1), oito repetições e seis aves por unidade experimental. Os níveis de lisina digestível na ração influenciaram de forma linear o consumo de lisina e a eficiência de utilização da lisina. Para a produção e massa de ovos, os platôs ocorreram a partir dos níveis de 6,57g kg-1 e de 7,10g kg-1 de lisina digestível, respectivamente. Houve efeito quadrático dos níveis de lisina sobre o peso de gema, com o nível estimado em 7,6g kg-1 de lisina digestível. A exigência de lisina digestível de galinhas poedeiras leves no período de 60 a 76 semanas de idade é de 7,10g kg-1 de ração, correspondendo ao consumo diário de 690mg ave-1 de lisina digestível.

The objective of this research was to determine the nutritional requirement of digestible lysine for white laying hens in old age. Two hundred eighty-eight Hy Line W-36 laying hens at 60 weeks of age were distributed in a completely randomized design, with six levels of digestible lysine (6.0; 6.6; 7.2; 7.8; 8.4 and 9.0g kg-1) and eight replications with six birds per experimental unit. There was linear effect of lysine levels on lysine intake and efficiency of utilization of lysine. For the production and egg mass, the levels of digestible lysine in the diet from which the plateaus occurred were of 6.57g kg-1 and 7.10g kg-1, respectively. There was quadratic effect of lysine levels on yolk weight, with the estimated level of 7.6g kg-1 of digestible lysine. The digestible lysine requirement of white laying hens from 60 to 76 weeks of age is 7.10g kg-1 in diet, corresponding to daily intake of 690mg bird-1 of digestible lysine.

Study of the frequency of allergens in cosmetics components in patients with suspected allergic contact dermatitis / Estudo da frequência dos alérgenos da bateria de cosméticos em pacientes com suspeita de dermatite alérgica de contato

BACKGROUND: Contact dermatitis to cosmetics is a common dermatosis, especially in adults and professionals who handle them. OBJECTIVE: The objective of this study was to evaluate the frequency of sensitization to cosmetics' components in patients with suspected allergic contact dermatitis and to identify the main sensitizers related to occupational contact dermatitis. METHODS: During the period of January 2008 to June 2010, all the patients with a presumptive diagnosis of allergic contact dermatitis to cosmetics were selected. The patients were submitted to the patch tests of cosmetics series, composed by ten substances. RESULTS: Among the 147 patients studied sensitization to cosmetics components occurred in 31,29% of the cases, 14 of those (19,18%) equally corresponding to BHT and triethanolamine substances, 13 (17,81%) to ammonium thioglycolate, 09 to sorbic acid (12,33%), 08 to tosilamida (10,95%), 06 to germall (8,22%). The other elements tested showed indices of 5% or less. A higher frequency of contact dermatitis to cosmetics was observed in women and the age most affected was concordant with the age range of greatest professional activity of the population. CONCLUSION: Allergic contact dermatitis was more frequently associated with Triethanolamine, BHT and ammonium thioglycolate, and the relation with occupational contact dermatitis was discreet.

FUNDAMENTOS: A dermatite de contato por cosméticos é uma dermatose relativamente comum, sobretudo em adultos e em profissionais que os manipulam. OBJETIVO: O objetivo do estudo foi avaliar a freqüência de positividade aos componentes de cosméticos, em pacientes com suspeita de dermatite alérgica; e identificar os principais sensibilizantes relacionados à dermatite de contato ocupacional. MÉTODOS: Durante o período de janeiro de 2008 a junho de 2010 foram selecionados todos os pacientes com hipótese de dermatite alérgica de contato a cosméticos. Os pacientes foram submetidos aos testes epicutâneos com bateria de cosméticos, composta por dez substâncias. RESULTADOS: Dos 147 pacientes estudados, a sensibilização aos componentes do cosmético ocorreu em 31,29% dos casos, sendo 14 (19,18%) corresponderam igualmente às substâncias BHT e trietanolamina, 13 (17,81%) ao tioglicolato de amônia, 09 ao ácido sórbico (12,33%), 08 tonsilamida (10,95%), 06 germal (8,22%). Os demais elementos testados proporcionaram índices iguais ou inferiores a 5%. Observou-se maior freqüência de dermatite de contato aos componentes da bateria de cosméticos em mulheres e a idade mais acometida foi concordante com a faixa etária de maior atividade profissional da população. CONCLUSÕES: Houve maior freqüência de dermatite alérgica de contato pelas substâncias trietanolamina, BHT e tioglicolato de amônia, demonstrando pouca associação à dermatite de contato ocupacional.

Seroreactivity to new Mycobacterium leprae protein antigens in different leprosy-endemic regions in Brazil

New Mycobacterium leprae protein antigens can contribute to improved serologic tests for leprosy diagnosis/classification and multidrug therapy (MDT) monitoring. This study describes seroreactivity to M. leprae proteins among participants from three highly endemic leprosy areas in Brazil: central-western Goiânia/Goiás (GO) (n = 225), Rondonópolis/Mato Grosso (MT) (n = 764) and northern Prata Village/Pará (PA) (n = 93). ELISA was performed to detect IgG to proteins (92f, 46f, leprosy IDRI diagnostic-1, ML0405, ML1213) and IgM to phenolic glycolipid-I (PGL-I). Multibacillary (MB) leprosy had positive rates for PGL-I that were similar to those for proteins; however, some anti-PGL-I-negative subjects were positive for proteins, suggesting that adding protein antigen to PGL-I can enhance the sensitivity of MB leprosy detection. In MT, different degrees of seroreactivity were observed and ranked for MB, former patients after MDT, paucibacillary (PB) leprosy, household contact (HHC) and endemic control (EC) groups. The seroreactivity of PB patients was low in GO and MT. HHCs from different endemic sites had similar IgG antibody responses to proteins. 46f and 92f were not recognised by most tuberculosis patients, ECs or HHCs within GO, an area with high BCG vaccination coverage. Low positivity in EC and HHC was observed in PA and MT. Our results provide evidence for the development of an improved serologic test that could be widely applicable for MB leprosy testing in Brazil.

The effect of iron supplementation in the diet of Dasypus novemcinctus (Linnaeus, 1758) armadillos in captivity / O efeito da suplementação com ferro na dieta de tatus Dasypus novemcinctus (Linnaeus, 1758) em cativeiro

Armadillos of the species Dasypus novemcinctus have been used as an experimental model of leprosy. Besides non-human primates, they are the only species naturally infected with Mycobacterium leprae and when experimentally inoculated, reproduce the lepromatous form of the disease producing large quantities of bacilli. This species has been maintained in captivity by numerous researchers and specific housing and feeding requirements have been developed to guarantee their survival during long experimental periods. In the "Lauro de Souza Lima" Institute, armadillos receive dog food, ground beef, boiled eggs and vitamin C. However, despite the balanced diet, anemia has been observed in some captive animals, especially in armadillos inoculated with M. leprae in advanced stages of infection. Thus, the objective of the present study was to evaluate the effect of iron sulfate supplementation in the feed provided for armadillos, both inoculated and non-inoculated with M. leprae, by means of the evaluation of their hematological profile. Fourteen armadillos received 10 mg/animal of iron sulfate (Hematofer®) diluted in sterile water mixed with their daily feed for 50 days. Hemograms and serum iron dosages for each armadillo were performed before and after supplementation. The hematocrit values increased significantly after iron supplementation, both in armadillos inoculated and non-inoculated with M. leprae. It is possible that the amount of iron in the feed is insufficient for the formation of hemoglobin, leading to microcytic anemia. Dietary supplementation with iron sulfate reversed this state, showing the importance of understanding the metabolism of exotic species for their maintenance in captivity, and thus ensuring their well-being.

O tatu da espécie Dasypus novemcinctus tem sido utilizado como modelo experimental para a hanseníase. Eles são a única espécie, além de primatas não humanos, que se apresentam naturalmente infectados pelo Mycobacterium leprae. Estes tatus, quando experimentalmente inoculados, reproduzem a forma virchoviana da hanseníase produzindo grandes quantidades de bacilos. Esta espécie tem sido mantida em cativeiro por vários pesquisadores, no entanto, alguns cuidados são necessários para garantir a sobrevivência destes por longos períodos experimentais, tais como alojamento e alimentação. No Instituto Lauro de Souza Lima, os animais em cativeiro recebem ração canina, carne bovina, ovos cozidos e vitamina C, mesmo assim, tem-se observado o desenvolvimento de quadros de anemia nestes animais, principalmente nos inoculados com o M. leprae, em estados avançados da infecção. Sendo assim, o objetivo deste estudo foi avaliar o efeito da suplementação com sulfato ferroso na alimentação fornecida aos tatus, inoculados e não inoculados com M. leprae, por meio de avaliação de seu perfil hematológico. Foram utilizados 14 animais que receberam 10 mg/animal de sulfato ferroso (Hematofer®) diluídos em água estéril e misturados diariamente à ração por 50 dias. Foram feitos hemograma e dosagem de ferro sérico de cada animal antes e após a suplementação. Os valores de hematócrito aumentaram significativamente após a suplementação, tanto nos animais inoculados como nos não inoculados com M. leprae. É possível que a quantidade de ferro na alimentação seja insuficiente para a formação da hemoglobina, levando a um quadro de anemia microcítica. A suplementação da dieta com sulfato ferroso reverteu este quadro, mostrando a importância de se conhecer o metabolismo de espécies exóticas para manutenção destas em cativeiro, assegurando seu bem estar.

Distribuição fenotípica e a freqüência genotípica do sistema sangüíneo Duffy em pacientes com a doença de Jorge Lobo / Phenotypic distribution and genotypic frequency of the Duffy blood group system in Jorge Lobo's disease patients

A doença de Jorge Lobo é uma micose cutânea e subcutânea de evolução crônica, causada pelo Lacazia loboi. Os mecanismos envolvidos na suscetibilidade/resistência do hospedeiro frente ao agente não estão ainda elucidados, dentre eles encontra-se a constituição genética. Portanto, o objetivo deste trabalho é avaliar a distribuição fenotípica do grupo sangüíneo Duffy em pacientes com doença de Jorge Lobo e calcular suas freqüências gênicas. Foram analisados 21 pacientes, 13 caucasóides e oito mestiços (tipo moreno claro), provenientes do estado do Acre, e 44 indivíduos, não acometidos por esta doença, habitantes da cidade de Rio Branco (AC), como grupo controle. O fenótipo Duffy foi definido pela presença dos antígenos nas hemácias pela reação de aglutinação dos eritrócitos com anti-soros anti-Fya e anti-Fyb incubando-se a 37ºC e aplicando-se o teste da antiglobulina humana. Os resultados mostram que a distribuição fenotípica do sistema Duffy nos pacientes difere significativamente daquela observada nos controles, pela alta freqüência de indivíduos com fenótipo Fy(a-b-). Observa-se claramente que os pacientes apresentam maior freqüência do alelo FY e menor do alelo FYA do que os controles. O alelo FYB (não inclui os alelos que não são expressos) tem praticamente a mesma freqüência nos dois grupos. Com relação à comparação entre distribuição do grupo sangüíneo Duffy com as formas clínicas, sugere maior número de pacientes com forma localizada da doença de Jorge Lobo apresentando um predomínio do fenótipo Fy(a-b+) seguido do fenótipo Fy(a-b-) e inexistência do fenótipo Fy(a+b-). Por outro lado, temos a forma disseminada com maior incidência de fenótipo Fy(a+b-). A forma multifocal foi menos expressiva. Desse modo, podemos inferir uma provável prevalência de fenótipo Duffy negativo na região por nós estudada e os poucos dados disponíveis até o momento tornam clara a necessidade de elaborar tabelas de freqüências fenotípicas para a população...

Jorge Lobo's disease is a chronic cutaneous-subcutaneous mycosis caused by the fungus Lacazia loboi. The mechanisms involved in susceptibility and resistance to infection by this pathogen, especially genetic background, are yet to be understood. The objective of the present study was to evaluate the phenotypic distribution of the Duffy blood group in Jorge Lobo's disease patients and calculate its gene frequencies. Twenty one patients were analyzed, among them 13 Caucasoid and 8 from mixed ethnical backgrounds (Afro-Brazilians) originating from the State of Acre. The control group consisted of 44 healthy individuals from the city of Rio Branco (AC). The Duffy phenotype was defined by the presence of antigens in erythrocytes as visualized by the agglutination reaction of erythrocytes in the presence of anti-Fya and anti-Fyb antisera incubated at 37ºC by the human antiglobulin test. Results showed that the phenotypic distribution of the Duffy blood group system in patients was significantly different from controls, with the frequency of individuals with phenotype Fy(a-b-) being very high. Patients presented remarkably higher frequencies of the allele FY and ower frequencies of the allele FYA compared to controls. Frequencies of the allele FYB (not including non-expressed alleles) were similar in both groups. The comparison between Duffy blood group distribution with clinical forms of the disease suggests predominance of the phenotype Fy(a-b+) in patients with the localized form of Jorge Lobo's disease, followed by phenotype Fy(a-b-) and absence of phenotype (a+b-). On the other hand, we observed a higher incidence of phenotype Fy(a+b-) in patients with the disseminated form of the disease. The multifocal forms were less expressive. Therefore, we may infer that the negative Duffy phenotype is probably more prevalent in the region studied. There is scarce data available on phenotype distributions, it is necessary to develop similar studies...

Leprosy: prevalence and factors associated with seropositivity for anti-NDO-LID antibodies in children under 15 years of age

Abstract: Background: A high prevalence of leprosy among children under 15 years of age indicates the need to implement actions to prevent new cases of the disease. Serological tests have been developed with the aim of helping to control the disease by indicating, through seropositivity, the presence of infection. Objective: To analyze the prevalence and factors associated with seropositivity rate for anti-NDO-LID antibodies in children under 15 years of age, contacts of leprosy patients. Method: We performed a cross-sectional study with 210 children under 15 years old of age. Of them, 50 were household contacts and 160 were neighborhood contacts living in the municipality of Cuiabá, state of Mato Grosso, in 2016. The data were obtained from interviews and the NDO-LID rapid test during home visits from February to July 2016. For the analysis, we used Poisson regression and prevalence ratio. Results: Seropositivity in contacts was 6.2%. Variables associated with seropositive tests included sex (PR = 1.05; 95% CI: 1.01 - 1.08), race/skin color (PR = 0.95; 95% CI: 0.90 - 0.99), residence area (PR = 1.05; 95% CI: 1.01 - 1.09), and number of people per household (PR = 1.06; 95% CI: 1.02 - 1.08). Study Limitations: The small sample size, besides leading to wide confidence intervals, may have been a limitation for the identification of associated factors. Conclusions: The prevalence of seropositivity was high. Variables associated with NDO-LID seropositivity included female sex, not to be brown skinned, live in urban areas, and live with five or more people.

Factors associated with leprosy in children contacts of notified adults in an endemic region of Midwest Brazil

OBJECTIVES: To analyze the factors associated with leprosy in children who were intradomiciliary contacts of notified adults with the disease in an endemic municipality in Mato Grosso, Brazil. METHOD: Case-control study with 204 children under 15 years of age, living in an endemic municipality. Cases (n=40) were considered as the children with leprosy registered at the National Information System of Notifiable Diseases in 2014 and 2015, who were intradomiciliary contacts of at least one adult diagnosed with the disease in the family, and as a control group (n=164) of children living within a radius of up to 100m of the notified cases. Data were obtained through medical file analysis, interviews, and blood samples for anti-PGL-I serological test by the ELISA method. The binary logistic regression technique was used, with p≤0.05. RESULTS: After adjustments, the following were associated with leprosy age (95% CI 1.24-9.39, p=0.018), area of residence (95% CI 1.11-6.09, p=0.027), waste disposal (95% CI 1.91-27.98, p=0.004), family history of the disease (95% CI 3.41-22.50, p=0.000), and time of residence (95% CI 1.45-7.78, p=0.005). CONCLUSION: Factors associated with the disease indicate greater vulnerability of children aged 8-14 years, associated with living conditions and time of residence, as well as the family history of the disease.