Adenovirus 36 Coinfection in People Living with HIV and its Impact on Lipohypertrophy.

BACKGROUND: Previous studies have implicated human adenovirus 36 (Adv36) as a potential contributor to overweight and obesity. People living with HIV have an altered body composition compared to healthy individuals. There is still no evidence to confirm the relationship of Adv36 as one of the causes of lipohypertrophy. The main objective of this study was to verify the viral Adv36 infection as a factor associated with the presence of lipohypertrophy in HIV-infected individuals. METHODS: A case-control study on people with HIV treated at a specialized public health service in southern Brazil. Subjects underwent interviews, diagnostic tests, and anthropometry to determine lipodystrophy and its classification. Demographic and clinical data were examined to investigate the presence of Adv36. The cases were participants with lipohypertrophy, and the controls were eutrophic participants. RESULTS: 101 participants were included (38 cases and 63 controls), and the frequency of Adv36 infection was 10.9%. There was a statistically significant association between lipohypertrophy and the female sex (p < 0.001), and a trend for the presence of Adv36 (p = 0.059) and lipohypertrophy. After adjustment for confounders, Adv36 has not considered an independent risk factor for lipohypertrophy. Lower levels of glucose were associated with Adv36 infection. CONCLUSION: There was a significant association between lipohypertrophy and the female sex, and no association with lipohypertrophy and Adv36, perhaps due to the small sample size.

Adenovirus 36 prevalence and association with human obesity: a systematic review.

INTRODUCTION: Obesity has numerous etiologies and includes biological factors. Studies have demonstrated that the human adenovirus subtype 36 (Adv36) is an adipogenic agent and causes metabolic alterations. Study results on the prevalence of Adv36 and clinical effects in humans vary substantially. This was a systematic review to summarize the studies on the prevalence of Adv36 infection and its association with human obesity. METHODS: A systematic literature review was conducted using the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Observational or experimental studies found in the Medline, Embase, LILACS, Science Direct and SciELO databases that presented results on the prevalence of Adv36 in humans were included. RESULTS: Thirty-seven studies were screened. A total of 10,300 adults aged 18-70 years and 4585 children and adolescents aged 3-18 years were assessed. The average prevalence of Adv36 among adults was 22.9%, ranging from 5.5% to 49.8%. Among children and adolescents, the average prevalence of Adv36 was 28.9%, ranging from 7.5% to 73.9%. There was a positive statistical relationship between Adv36 and weight gain, obesity, or metabolic changes in 31 studies. However, in four studies there was no association with obesity, and in one, no association was described. One of the studies showed an inverse correlation, i.e., Adv36 was a protective factor against obesity. CONCLUSION: Strong evidence suggested a positive association between viral infection and obesity. However, due to the multi-causality of obesity and heterogeneity of studies, diagnostic tests should be standardized and easily accessible by the population to estimate the overall prevalence of Adv36 infection and its association with obesity.

Meningite no Brasil em 2015: o panorama da atualidade / Meningitis in Brazil in 2015: overview of current

Este estudo objetiva determinar o perfil epidemiológico dos pacientes com diagnóstico confirmado de meningite no Brasil em 2015. Trata-se de estudo de delineamento ecológico caracterizado por abordagem quantitativa a partir de pesquisa junto à base de dado SINAN ­ Sistema Nacional de Agravos e Notificações - dos casos notificados por meningite no país, de acordo com as cinco regiões brasileiras. Ao todo, 9.282 casos de meningite foram notificados no ano de 2015. Observou-se o maior número de casos nas mulheres, em pessoas da raça branca, em crianças na faixa etária de 1 a 9 anos e na região sudeste, porém a maior incidência se deu na região Sul com 7,2 casos/100.000 habitantes. Verificou-se que a meningite viral foi a mais prevalente atingindo mais de 42% dos afetados. Das etiologias bacterianas o meningococo sorotipo C foi responsável por 60% das infecções. No que se refere ao diagnóstico da doença, o exame quimiocitológico foi o mais empregado. Em relação à evolução da doença, mais de 80% dos pacientes evoluíram com alta hospitalar e apenas 3% dos pacientes com meningite viral foram a óbito. Em contrapartida, quase 60% dos pacientes com meningite bacteriana foram a óbito pela doença.

This study has the goal to determine the epidemiological profile of the patients diagnosed with meningitis in Brazil in 2015. The study has an ecological outline characterized by a quantitative approach from the research of the SINAN ­ Sistema Nacional de Agravos e Notificações ­ database of the confirmed cases of meningitis in Brazil according to its five regions. 9.828 cases of meningitis have been notified in 2015. It was observed a greater number of cases in women, white people, children between the age of 1 and 9 and in the southeast region of Brazil. However, a greater incidence occurred in the south region with 7,2 cases/100.000 habitants. It was verified that the viral cause was the most prevalent affecting 42% of the people diagnosed with this disease. Of the bacterial causes, the serotype C meningococcus was responsible for 60% of the infections. Regarding its diagnosis, the chemocitological exam was the most used. As to the evolution of the disease, more than 80% of the patients were discharged and only 3% of the patients who had viral meningitis evolved to death. On the other hand, almost 60% of the ones with bacterial meningitis died because of the disease.

Carga de doença por sífilis gestacional em Santa Catarina no ano de 2014 / Burden of disease by gestacional syphilis in Santa Catarina State, Brazil, in 2014

Estimar a carga de doença por sífilis gestacional em Santa Catarina no ano de 2014, em seus componentes de morbidade, mortalidade, casos notificados, faixas etárias e macrorregiões do Estado. Utilizando o indicador: DALY (Disability Adjusted Life Years), para calcular a carga de Doença de uma população. Estudo epidemiológico de delineamento transversal, caracterizado por abordagem quantitativa a partir de pesquisa junto às bases de dados: SINAN ­ Sistema Nacional de Agravos e Notificações ­ nos casos notificados por sífilis gestacional; e SIM ­ Sistema de Informações sobre Mortalidade ­ nos casos que foram a óbito pela mesma causa. Não houve registro de óbito por sífilis gestacional em Santa Catarina no ano de 2014, de maneira que o número de YLL (Years of Life Lost due to premature mortality) foi igual a zero e, por conseguinte, o indicador de DALY exclusivamente composto pelo indicador de morbidade YLD (Years Lost due to Disabity). A carga de doença por sífilis gestacional em Santa Catarina no ano de 2014 foi estimada em 16,37 DALYs (entre 10 e 49 anos). E a taxa no Estado foi estimada em 45,79 DALYs/100 mil habitantes. Com 309 casos de sífilis gestacional notificados no mesmo ano no Estado. O maior número de casos notificados e a maior taxa de carga de doença encontram-se na faixa etária entre 20 e 29 anos: 146 casos notificados e 19,79 DALYs/100 mil habitantes. A macrorregião com maior carga de sífilis gestacional foi Grande Florianópolis (14,25 DALYs/100 mil habitantes), seguida de Foz do Rio Itajaí (10,81 DALYs/100 mil habitantes).

To estimate the burden of disease due to gestational syphilis in Santa Catarina state, Brazil, in 2014, analysing the component: morbidity, mortality, reported cases, age groups and state's health macro-regions. Using the indicator: DALY (Disability Adjusted Life Years), to calculate the Burden of Disease in a population. An epidemiological study, characterized by quantitative approach from the SINAN survey database ­ (National System of Diseases and Notifications) ­ for the reported cases by gestational syphilis; and SIM ­ Mortality Information System ­ for the reported gestational syphilis deaths cases. No gestational syphilis deaths were reported in Santa Catarina state, Brazil, in 2014, as such, YLL (Years of Life Lost due to premature mortality) was zero and DALY was equal to YLD (Years Lost due to Disabity). The Burden of Disease due to gestational syphilis was estimated of 16.37 DALYs (between 10 and 49 years). And the rate in the state was estimated of 45.79 DALYs /100,000 inhabitants. Altogether, 309 cases of gestational syphilis reported in the same year in the state. The largest number of reported cases and the highest burden of disease rate are at the age group between 20 and 29 years: 146 reported cases and 19.79 DALYs /100,000 inhabitants. The highest burden of gestational syphilis was estimated at macro-region Grande Florianópolis (14.25 DALYs / 100,000 inhabitants), the second was Foz do Rio Itajaí (10.81 DALYs / 100,000 inhabitants).

Incidência de sífilis congênita no estado de Santa Catarina no ano de 2012 / Congenital syphilis incidence in the state of Santa Catarina in 2012

Introdução ­ A sífilis congênita, apesar de prevenível, vem se mantendo como um problema de saúde pública desafiador até os dias atuais. Objetivos ­ Descrever a incidência da sífilis congênita no estado de Santa Catarina no ano de 2012. Métodos ­ Estudo ecológico onde a população estudada foram os casos notificados nas macrorregiões de Santa Catarina, de acordo com os dados obtidos do SINAN acessados em base de dados de acesso público por sífilis congênita no ano de 2012. Os dados foram apresentados na forma de taxas de incidência e também por números absolutos e porcentagens. Resultados ­ No ano de 2012 a maior taxa de incidência por 100000 nascidos vivos foi na macrorregião Grande Florianópolis (3,64), seguida das macrorregiões Foz do rio Itajaí (3,62) e Sul (1,62). A macrorregião Nordeste também apresentou um alto índice (1,45), seguido das macrorregiões Extremo Oeste (1,34) e Meio Oeste (1,16). O número de parceiros não tratados foi maior (60,9%) e 85,5% das mães realizaram o pré-natal. A taxa de incidência total de casos no estado de Santa Catarina no ano de 2012 foi de 1,72. Discussão ­ As falhas na assistência do pré-natal, a realização do diagnóstico tardio ou tratamento inadequado são fatores importantes que poderiam explicar que ainda exista um elevado número de casos de sífilis congênita. Apesar de possuir diagnóstico e tratamento de fácil acesso, verificou-se que o processo não acontece como previsto, provavelmente pela falta real da implementação das orientações do Ministério da Saúde.

Background - Congenital syphilis, although preventable, has remained as a challenging public health problem until today. Objectives - To describe the incidence of congenital syphilis in the state of Santa Catarina, South Brazil, in 2012. Methods - Ecological study where the population studied were the cases reported in the macro-regions of Santa Catarina, according to data obtained from SINAN accessed database public access due to congenital syphilis in 2012. The data were presented as incidence rates and also by absolute numbers and percentages. Results - In the year 2012 the highest incidence rate per 100,000 newborns was in the macro-region Florianópolis (3.64), followed by macro-regions Foz do Itajaí (3.62) and South (1.62). The Northeast macro-region also had a high rate (1.45), followed by macro-Far West (1.34) and Midwest (1.16). The number of untreated partners was higher (60.9%) and 85.5% of the mothers had prenatal care. The total incidence rate in the state of Santa Catarina in 2012 was 1.72. Discussion - The flaws in prenatal care, the delayed diagnosis or inadequate treatment are important factors that could explain that there is still a high number of cases of congenital syphilis. Despite having the diagnosis and treatment of easily accessible, it was found that the process does not happen as expected, probably due to lack of real implementation of the Health Ministry guidelines.

Perfil das mulheres portadoras de sífilis gestacional em Santa Catarina no ano de 2012 / Profile of the women with syphilis gestational in the state of Santa Catarina in 2012

Determinar o perfil das mulheres portadoras de Sífilis Gestacional em Santa Catarina no ano de 2012. Trata-se de estudo de delineamento ecológico caracterizado por abordagem quantitativa a partir de pesquisa junto à base de dado SINAN ­ Sistema Nacional de Agravos e Notificações - dos casos notificados por sífilis gestacional no Estado de Santa Catarina, por nove macrorregiões de saúde, determinadas pela Secretaria de Estado de Saúde de Santa Catarina. Ao todo, 328 casos de sífilis gestacional foram notificados no ano de 2012. Observou-se o diagnóstico de sífilis secundária em 42% das gestantes. No que se refere à triagem pré-natal (VDRL), verificou-se que 95% das sorologias positivas foram identificadas logo no primeiro teste, contudo após a realização do teste confirmatório constatou-se um valor de 51% positivos. A conduta terapêutica preferencialmente usada foi Penicilina G Benzatina 7.200.000UI (43%) para as gestantes e apenas 37% dos parceiros foram submetidos ao tratamento. A taxa de incidência de sífilis em Santa Catarina foi de 5,14 casos por 100.000. Constatouse de maneira indireta um aumento na incidência dos casos de sífilis gestacional com um perfil de acometimento mais relacionado a mulheres jovens acima de 20 anos em idade fértil, brancas e de baixa escolaridade.

The aim of this study is to determine the profile of the women with gestational syphilis in Santa Catarina in 2012. This is an ecological study characterized by quantitative approach from the SINAN survey database ­ (National System of Diseases and Notifications) ­ from the reported cases by gestational syphilis in the state of Santa Catarina, in nine health macro-regions, determined by the State health Department of Santa Catarina. Altogether, 328 cases of gestational syphilis were reported in 2012. Secondary syphilis diagnoses were observed in 42% of the pregnant women. About prenatal selection (VDRL), it was found that 95% of the positive serology were quickly identified in the first test, however after confirmatory test was performed, it showed a value of 51% positive cases. The therapeutic approach used was preferably Penicillin G Benzathine 7.200.000UI (43%) for pregnant women and only 37% of the partners underwent treatment. The syphilis incidence rate in Santa Catarina was 5.14 cases per 100,000. It was indirectly found an increase in the incidence of gestational syphilis with involvement profile more related to young women over 20 years old within childbearing age, white and low education.

Burden of AIDS in a Brazilian state.

BACKGROUND: To estimate the burden of a disease implies the simultaneous quantification of the impact of early mortality and the health problems that affect the individual's quality of life, and this evaluation can be particularly important in a disease such as AIDS that has become a long-term disease. The purpose of this study was to determine the burden of disease due to AIDS in the Brazilian Southern State of Santa Catarina. METHODS: An ecological designed study was performed using death and AIDS notifications data for 2009. The disability adjusted life years (DALYs) were estimated by the sum of years of life lost (YLL) and the years lived with disability (YLD). The YLL was estimated as the difference between the life expectancy from birth and the age at death with the application of a discount rate of 3% per year. The YLD was estimated as the product of the Burden of Disease Study's weight for AIDS of 0.167 and its average duration of 108 months in Brazil for the incident cases. The YLL, YLD and DALY rates were calculated per 100,000 inhabitants by sex and age groups. RESULTS: There were 2034 notified cases and 689 deaths due to AIDS reported. There were 15,756.5 YLLs estimated, resulting in 257.5 YLLs/100,000 inhabitants, and 4554.1 YLDs were estimated, resulting in 74.4 YLDs/100,000 inhabitants. The DALY was estimated at 20,310.6, with a rate of 331.9 DALYs/100,000 inhabitants. The highest rates were observed in males in the age groups 30-44 and 45-59 years. CONCLUSIONS: The burden of AIDS was high and was observed mainly in adults, with a predominance in males.