Longitudinal Assessment of Virological Failure and Antiretroviral Drug Resistance among Treatment-naive Subjects Living with HIV.

INTRODUCTION: Human immunodeficiency virus (HIV) infection, the etiological agent of acquired immunodeficiency syndrome (AIDS), is a serious public health issue. Therapeutic measures have been successful in increasing the survival and improving the quality of life. However, some treatment-naive subjects living with HIV present resistance-associated mutations as a result of late diagnosis and/or mutant strain infections. The objective of this study was to identify the virus genotype and assess the antiretroviral resistance profile based on the results of HIV genotyping in treatment-naive subjects living with HIV, after six months of taking antiretroviral therapy. METHODS: This was a prospective cohort study on treatment-naive adults living with HIV attending a specialized outpatient clinic in southern Santa Catarina State, Brazil. The participants were interviewed and had blood samples drawn. The genotypic antiretroviral drug resistance profile was examined in patients with detectable viral loads. RESULTS: 65 treatment-naive subjects living with HIV were recruited for this study. After six months of taking antiretroviral therapy, resistance-associated mutations were observed in 3 (4.6%) subjects living with HIV. CONCLUSION: Subtype C was identified as the circulating subtype in southern Santa Catarina State, and L10V, K103N, A98G, and Y179D were the most common mutations found in treatment-naive subjects.

Reflexoterapia e auriculoterapia para lombalgia aguda em docentes e discentes universitários: Ensaio clínico duplo-cego / Reflexotherapy and auriculotherapy for acute lumbalgia in university teachers and students: A double-blind clinical trial

Objetivo: comparar os efeitos da auriculoterapia e reflexoterapia podal para lombalgia aguda inespecífica em docentes e discentes universitários da área da saúde. Método: ensaio clínico, randomizado, controlado, duplo-cego, com 189 participantes distribuídos em três grupos: auriculoterapia experimental, reflexoterapia experimental e combinadas. Fora realizados 3 intervenções. Para a coleta foram utilizados: Questionário Sociodemográfico; Escala Visual e Analógica de intensidade na avaliação da dor; e Questionário para Lombalgia. Os dados foram analisados no programa IBM SPSS Statistics versão 18.0 Foram aplicados: teste de normalidade Kolmogorov-Smirnov; testes Qui-quadrado ou Exato de Fisher para comparação entre os grupos, e Análise de variância com post hoc ou Kruskal-Wallis, conforme apropriado. Resultados: evidenciou-se redução significativa da dor nos três protocolos (p=<0,001) para o Questionário de lombalgia, mas na comparaçãoda escala da dor, houve menor eficácia no grupo combinado (p=0,006). Conclusão: Ambas as terapias são eficazes e indicadas para controle da lombalgia aguda(AU)

Objective: to compare the effects of auriculotherapy and foot reflex therapy for nonspecific acute low back pain in university professors and students in the health area. Method: clinical trial, randomized, controlled, double-blind, with 189 participants divided into three groups: experimental auriculotherapy, experimental reflex therapy and combined therapy. Three interventions were performed. For data collection, the following were used: Sociodemographic Questionnaire; Visual and Analog Scale of intensity in pain assessment; and Low Back Pain Questionnaire. Data were analyzed using the IBM SPSS Statistics program, version 18.0. The following were applied: Kolmogorov-Smirnov normality test; Chi-square or Fisher's Exact tests for comparison between groups, and Analysis of variance with post hoc or Kruskal-Wallis, as appropriate. Results: there was a significant reduction in pain in the three protocols (p=<0.001) for the Low Back Pain Questionnaire, but when comparing the pain scale, there was less efficacy in the combined group (p=0.006). Conclusion: Both therapies are effective and indicated for the control of acute low back pain(AU)

Objetivo: comparar los efectos de la auriculoterapia y la terapia refleja podal en el dolor lumbar agudo inespecífico en profesores y estudiantes universitarios del área de la salud. Método: ensayo clínico, aleatorizado, controlado, doble ciego, con 189 participantes divididos en tres grupos: auriculoterapia experimental, terapia refleja experimental y terapia combinada. Se realizaron tres intervenciones. Para la recolección de datos, se utilizaron: Cuestionario Sociodemográfico; Escala Visual y Analógica de intensidad en la valoración del dolor; y Cuestionario de dolor lumbar. Los datos fueron analizados mediante el programa IBM SPSS Statistics, versión 18.0, se aplicaron: prueba de normalidad de Kolmogorov-Smirnov; Pruebas Chi-cuadrado o Exacto de Fisher para comparación entre grupos, y Análisis de varianza con post hoc o Kruskal-Wallis, según corresponda. Resultados: hubo reducción significativa del dolor en los tres protocolos (p=<0,001) para el Low Back Pain Questionnaire, pero al comparar la escala de dolor, hubo menor eficacia en el grupo combinado (p=0,006). Conclusión: Ambas terapias son efectivas e indicadas para el control del dolor lumbar agudo(AU)

Reflexoterapia e auriculoterapia para lombalgia aguda em docentes e discentes universitários: Ensaio clínico duplo-cego / Reflexoterapia y auriculoterapia para la lumbalgia aguda en universitarios: Un ensayo clínico doble ciego / Reflexotherapy and auriculotherapy for acute lumbalgia in university teachers and students: A double-blind clinical trial

Objetivo: comparar os efeitos da auriculoterapia e reflexoterapia podal para lombalgia aguda inespecífica em docentes e discentes universitários da área da saúde. Método: ensaio clínico, randomizado, controlado, duplo-cego, com 189 participantes distribuídos em três grupos: auriculoterapia experimental, reflexoterapia experimental e combinadas. Fora realizados 3 intervenções. Para a coleta foram utilizados: Questionário Sociodemográfico; Escala Visual e Analógica de intensidade na avaliação da dor; e Questionário para Lombalgia. Os dados foram analisados no programa IBM SPSS Statistics versão 18.0 Foram aplicados: teste de normalidade Kolmogorov-Smirnov; testes Qui-quadrado ou Exato de Fisher para comparação entre os grupos, e Análise de variância com post hoc ou Kruskal-Wallis, conforme apropriado. Resultados: evidenciou-se redução significativa da dor nos três protocolos (p=<0,001) para o Questionário de lombalgia, mas na comparaçãoda escala da dor, houve menor eficácia no grupo combinado (p=0,006). Conclusão: Ambas as terapias são eficazes e indicadas para controle da lombalgia aguda(AU)

Objective: to compare the effects of auriculotherapy and foot reflex therapy for nonspecific acute low back pain in university professors and students in the health area. Method: clinical trial, randomized, controlled, double-blind, with 189 participants divided into three groups: experimental auriculotherapy, experimental reflex therapy and combined therapy. Three interventions were performed. For data collection, the following were used: Sociodemographic Questionnaire; Visual and Analog Scale of intensity in pain assessment; and Low Back Pain Questionnaire. Data were analyzed using the IBM SPSS Statistics program, version 18.0. The following were applied: Kolmogorov-Smirnov normality test; Chi-square or Fisher's Exact tests for comparison between groups, and Analysis of variance with post hoc or Kruskal-Wallis, as appropriate. Results: there was a significant reduction in pain in the three protocols (p=<0.001) for the Low Back Pain Questionnaire, but when comparing the pain scale, there was less efficacy in the combined group (p=0.006). Conclusion: Both therapies are effective and indicated for the control of acute low back pain.(AU)

Objetivo: comparar los efectos de la auriculoterapia y la terapia refleja podal en el dolor lumbar agudo inespecífico en profesores y estudiantes universitarios del área de la salud. Método: ensayo clínico, aleatorizado, controlado, doble ciego, con 189 participantes divididos en tres grupos: auriculoterapia experimental, terapia refleja experimental y terapia combinada. Se realizaron tres intervenciones. Para la recolección de datos, se utilizaron: Cuestionario Sociodemográfico; Escala Visual y Analógica de intensidad en la valoración del dolor; y Cuestionario de dolor lumbar. Los datos fueron analizados mediante el programa IBM SPSS Statistics, versión 18.0, se aplicaron: prueba de normalidad de Kolmogorov-Smirnov; Pruebas Chi-cuadrado o Exacto de Fisher para comparación entre grupos, y Análisis de varianza con post hoc o Kruskal-Wallis, según corresponda. Resultados: hubo reducción significativa del dolor en los tres protocolos (p=<0,001) para el Low Back Pain Questionnaire, pero al comparar la escala de dolor, hubo menor eficacia en el grupo combinado (p=0,006). Conclusión: Ambas terapias son efectivas e indicadas para el control del dolor lumbar agudo.(AU)

Emergence of Two Distinct SARS-CoV-2 Gamma Variants and the Rapid Spread of P.1-like-II SARS-CoV-2 during the Second Wave of COVID-19 in Santa Catarina, Southern Brazil.

The western mesoregion of the state of Santa Catarina (SC), Southern Brazil, was heavily affected as a whole by the COVID-19 pandemic in early 2021. This study aimed to evaluate the dynamics of the SARS-CoV-2 virus spreading patterns in the SC state from March 2020 to April 2021 using genomic surveillance. During this period, there were 23 distinct variants, including Beta and Gamma, among which the Gamma and related lineages were predominant in the second pandemic wave within SC. A regionalization of P.1-like-II in the Western SC region was observed, concomitant to the increase in cases, mortality, and the case fatality rate (CFR) index. This is the first evidence of the regionalization of the SARS-CoV-2 transmission in SC and it highlights the importance of tracking the variants, dispersion, and impact of SARS-CoV-2 on the public health systems.

Maternal and early childhood factors associated with asthma and obesity in children aged 6 to 7 years: a case control study.

OBJECTIVE: To determine the maternal and early childhood factors associated with asthma and obesity in children aged 6 to 7 years. METHODS: A case-control study conducted with children aged 6 to 7 years. Applications with questions about asthma symptoms in the last 12 months, maternal and childhood data in the first 2 years of life, and anthropometric data were collected. Children who presented asthma symptoms were considered as cases and those without asthma symptoms were considered as controls, later divided into two subgroups that were eutrophic or overweight/obesity. Logistic regression was performed to estimate the association between asthma symptoms (adequate weight and overweight/obesity) and gestational and personal factors, calculating odds ratio and 95% confidence interval (95%CI). Values of p<0.05 were considered significant. RESULTS: Two hundred and one children were evaluated, 25.4% had asthma symptoms, 37.2% of them were overweight/obesity. Waist circumference, triceps skinfold, and body mass index were higher in the group with overweight/obesity asthma symptoms compared to no asthma symptoms (p<0.05). Factors significantly associated with asthma and overweight/obesity symptoms included: the maternal history of asthma (odds ratio of 3.73; 95%CI: 1.10-12.6) and hypertension during pregnancy (odds ratio of 3.29; 95%CI: 1.08-9.94). CONCLUSION: Maternal history of asthma and hypertension during pregnancy increased the chances of children, at 6 and 7 years of age, having symptoms of asthma and obesity.

Maternal and early childhood factors associated with asthma and obesity in children aged 6 to 7 years: a case control study

ABSTRACT Objective To determine the maternal and early childhood factors associated with asthma and obesity in children aged 6 to 7 years. Methods A case-control study conducted with children aged 6 to 7 years. Applications with questions about asthma symptoms in the last 12 months, maternal and childhood data in the first 2 years of life, and anthropometric data were collected. Children who presented asthma symptoms were considered as cases and those without asthma symptoms were considered as controls, later divided into two subgroups that were eutrophic or overweight/obesity. Logistic regression was performed to estimate the association between asthma symptoms (adequate weight and overweight/obesity) and gestational and personal factors, calculating odds ratio and 95% confidence interval (95%CI). Values of p<0.05 were considered significant. Results Two hundred and one children were evaluated, 25.4% had asthma symptoms, 37.2% of them were overweight/obesity. Waist circumference, triceps skinfold, and body mass index were higher in the group with overweight/obesity asthma symptoms compared to no asthma symptoms (p<0.05). Factors significantly associated with asthma and overweight/obesity symptoms included: the maternal history of asthma (odds ratio of 3.73; 95%CI: 1.10-12.6) and hypertension during pregnancy (odds ratio of 3.29; 95%CI: 1.08-9.94). Conclusion Maternal history of asthma and hypertension during pregnancy increased the chances of children, at 6 and 7 years of age, having symptoms of asthma and obesity.

Preferência por comportamentos favoráveis à prática de atividade física em crianças com sintomas de asma e/ou rinite / Preference for behavior conducive to physical activity in children with symptoms of asthma and/or rhinitis

Introdução: A asma e a rinite parecem influenciar de diversas formas aspectos da vida das crianças, incluindo o comprometimento do nível de atividade física. Objetivo: Analisar a preferência por comportamentos favoráveis à prática de atividade física e o nível de atividade física de crianças de 6 a 7 anos com sintomas de asma e/ou rinite em uma cidade do Sul do Brasil. Método: Foi realizado um estudo transversal, que estimou a presença de sintomas de asma e de rinite através do questionário International Study of Asthma and Allergy in Childhood e sua relação com a preferência por comportamentos favoráveis à prática de atividade física e com o nível de atividade física avaliados com o Netherlands Physical Activity Questionnaire. O teste t de Student foi utilizado para verificar a associação entre as variáveis independentes e os comportamentos favoráveis à prática de atividade física e o nível de atividade física. ANOVA uma via, seguida do teste post hoc de Tukey foram utilizados para comparar os comportamentos favoráveis à prática de atividade física e o nível de atividade física entre grupos. Resultados: Participaram do estudo 282 crianças, nestas os sintomas de rinite foram os mais prevalentes, presentes em 20,2% das crianças. A associação de sintomas de asma e rinite foi constatada em 17,7% das crianças, e a presença isolada de sintomas de asma em 12,1%. Em relação ao nível de atividade física, os meninos obtiveram pontuação significativamente maior em relação à preferência por brincadeiras agitadas (p = 0,02) e prática de esportes (p = 0,01), o mesmo para crianças com sintomas de asma ou rinite. Conclusão: Não foi detectada relação entre o nível de atividade física e os sintomas de asma e rinite entre os participantes.

Introduction: Asthma and rhinitis seem to influence different aspects of children's lives, including impairment of physical activity level. Objective: To analyze preference for behaviors conducive to physical activity and level of physical activity in children aged 6 to 7 years with symptoms of asthma and/or rhinitis in a city in southern Brazil. Methods: This cross-sectional study evaluated the presence of symptoms of asthma and rhinitis using the International Study of Asthma and Allergy in Childhood questionnaire and its association with behavior conducive to physical activity and with physical activity levels, which were evaluated with the Netherlands Physical Activity Questionnaire. Student's t-test was used to assess if independent variables were associated with behavior conducive to physical activity and physical activity levels. One-way ANOVA followed by Tukey's post hoc test were used to compare behavior conducive to physical activity and physical activity levels between groups. Results: In total, 282 children participated in the study, and the most prevalent symptoms were those of rhinitis, present in 20.2% of children. The association of asthma and rhinitis symptoms was found in 17.7% of children, and the presence of asthma symptoms alone was found in 12.1%. Regarding the level of physical activity, boys obtained a significantly higher score in relation to their preference for active games (p = 0.02) and sports (p = 0.01), the same for children with symptoms of asthma or rhinitis. Conclusion: There was no relationship between level of physical activity and symptoms of asthma and rhinitis among the participants.

Benzodiazepine deprescription strategies in chronic users: a systematic review.

BACKGROUND: As long-term use of benzodiazepines increases, adverse effects also become more frequent, especially in elderly adults. Due the potential of causing dependence, poor patient adherence and a lack of awareness of side effects, deprescription is challenging. OBJECTIVE: This study aimed to identify what are the effective approaches to motivate and promote deprescription of benzodiazepines. METHODS: We used MeSH terms to search in five databases that were MEDLINE, Cochrane CENTRAL, LILACS, SCIELO and Science Direct. Then, we selected articles accordingly to inclusion and exclusion criteria. Risk of bias assessment for randomized controlled trials and prospective interventional studies was made using RoB 2.0 and ROBINS-I tools, respectively. For cohort studies, we used the clarity group by McMaster University tool. RESULTS: Database search retrieved 412 results, and 11 studies were selected for analysis. Interventions focusing on patient education to improve community awareness about deprescription presented better discontinuation rates and more potential on motivating discussions about deprescribing with physicians. Interventions based on counselling by different health professionals were not well evaluated as they presented four of six studies as high, serious or critical risk of bias. CONCLUSIONS: Although the comparison of different strategies was impaired by the high risk of bias in some studies, patient education focused interventions presented good results. Future studies should consider doing a follow-up of 6 months or longer with evaluation of withdrawal symptoms and sleep patterns, inclusion of young adults on the sample and some form of cognitive evaluation that might influence the results of the intervention.

Green medicinal clay in the treatment of the unspecified lumbar pain: clinical trial / Argila medicinal verde no tratamento da dor lombar inespecífica: ensaio clínico

ABSTRACT BACKGROUND AND OBJECTIVES: Lower back pain is one of the musculoskeletal diseases with the highest incidence all over the world. In approximately 85% of the cases it is classified as unspecified, which means that it has no evident cause. With that in mind, geotherapy is a non-invasive technique that allows control over the lower back pain. The goal of this study was to evaluate the results of geotherapy on the relief of the unspecified lower back pain. METHODS: Semi-experimental quantitative clinical trial, comparing before and after states, including 26 participants who received four applications of green clay cataplasm on the lower back region with an interval of seven days. The pain intensities before and after the interventions were evaluated by a visual analogical scale and an Oswestry Disability Index questionnaire. For the data analysis, the Kolmogorov-Smirnov and t Student methods were used, with a significance level of 5% (p<0.05). RESULTS: There was significant statistics that showed lower back pain relief with the cataplasm mode geotherapy using green clay, reaching p = 0.0001 in the visual analog scale. CONCLUSION: The geotherapy with green clay applied on the lower back region of the body was effective on diminishing of the unspecified chronic lower back pain.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor lombar é uma das doenças musculoesqueléticas de alta incidência em todo o mundo. Aproximadamente em 85% dos casos ela é classificada como inespecífica, significando que não tem causa evidente. Diante disso, a geoterapia é uma técnica não invasiva que possibilita controle da dor lombar. O objetivo deste estudo foi avaliar os resultados da geoterapia no alívio da dor lombar inespecífica. MÉTODOS: Ensaio clínico, semi-experimental, do tipo antes e depois, de natureza quantitativa, que incluiu 26 participantes que receberam quatro sessões de cataplasma de argila verde na região lombar com intervalo de sete dias. A intensidade da dor antes e depois das intervenções foi avaliada pela escala analógica visual e o questionário Oswestry Disability Index. Para análise dos dados foram utilizados os testes Kolmogorov-Smirnov e t de Student, com nível de significância de 5% (p<0,05). RESULTADOS: Houve significância estatística com a geoterapia na modalidade cataplasma lombar com argila verde no alívio da dor lombar, obtendo-se p=0,0001 para a escala analógica visual. CONCLUSÃO: A geoterapia com argila verde aplicada na região lombar foi efetiva na redução da intensidade da dor lombar crônica inespecífica.

Temporal analysis of leptospirosis incidence according to rainfall levels

The aim of this study was to analyze the temporal trend of leptospirosis incidence according to rainfall levels in Santa Catarina State between 2005 and 2015. This is an ecological time-series study involving data on leptospirosis incidence and rainfall indexes in Santa Catarina State Health Regions. The distribution of leptospirosis, rainfall indexes, and cases/rainfall ratios, according to seasonality and stratified by Health Regions, were evaluated. There were 5,274 cases, with an average rate of 7.03 cases/100,000 inhabitants per year, varying from 24 to 1,458 cases (Serra Catarinense and Northeast regions, respectively) in Santa Catarina, revealing an increase in the rates of 0.70 cases/100,000 inhabitants in Serra Catarinense and 13.99 cases/100,000 inhabitants in the Northeast. Four regions (Foz do Rio Itajaí, Médio Vale do Itajaí, Grande Florianópolis and Northeast) were responsible for 71.8% of the cases, particularly in the Northeast region (38.5%). The five regions with the highest rates presented greater risk of leptospirosis (RR > 1), ranging from 10.9 to 19.9 more new cases of the disease. The average rainfall volume for Santa Catarina State was 158.69 mm, ranging from 136.44 mm in Laguna to 186.81 mm in the Northeast. The five regions contributed with 32.8% of the rainfall index accumulated in the period. In conclusion, leptospirosis occurred all around Santa Catarina State, differing its temporal trend according to the Health Regions. The aim of this study was to analyze the temporal trend of leptospirosis incidence according to rainfall levels in Santa Catarina State between 2005 and 2015. This is an ecological time-series study involving data on leptospirosis incidence and rainfall indexes in Santa Catarina State Health Regions. The distribution of leptospirosis, rainfall indexes, and cases/rainfall ratios, according to seasonality and stratified by Health Regions, were evaluated. There were 5,274 cases, with an average rate of 7.03 cases/100,000 inhabitants per year, varying from 24 to 1,458 cases (Serra Catarinense and Northeast regions, respectively) in Santa Catarina, revealing an increase in the rates of 0.70 cases/100,000 inhabitants in Serra Catarinense and 13.99 cases/100,000 inhabitants in the Northeast. Four regions (Foz do Rio Itajaí, Médio Vale do Itajaí, Grande Florianópolis and Northeast) were responsible for 71.8% of the cases, particularly in the Northeast region (38.5%). The five regions with the highest rates presented greater risk of leptospirosis (RR > 1), ranging from 10.9 to 19.9 more new cases of the disease. The average rainfall volume for Santa Catarina State was 158.69 mm, ranging from 136.44 mm in Laguna to 186.81 mm in the Northeast. The five regions contributed with 32.8% of the rainfall index accumulated in the period. In conclusion, leptospirosis occurred all around Santa Catarina State, differing its temporal trend according to the Health Regions.

Fatores associados aos sintomas de doenças atópicas em crianças de 6-7 anos em um município da Região Sul do Brasil / Factors associated with the symptoms of atopic diseases in children aged 6-7 years in a municipality in southern Brazil

Introdução: Considerando que os mecanismos pelos quais as doenças atópicas têm aumentado em frequência e gravidade não são inteiramente conhecidos, o presente estudo tem por objetivo analisar os fatores associados aos sintomas das doenças atópicas em crianças de 6-7 anos. Método: Estudo observacional do tipo caso-controle realizado com crianças de 6-7 anos em uma cidade do Sul do Brasil. Questionários foram aplicados às mães das crianças, e os sintomas de doenças atópicas foram triados pelo questionário do International Study of Asthma and Allergy in Childhood (ISAAC). Resultados: Participaram do estudo 255 crianças (85 casos e 170 controles). Os fatores associados às doenças atópicas foram: história familiar de asma (OR: 4,61; IC95% 2,63-0,73), rinite (OR: 3,46; IC95% 1,90-3,26) e eczema (OR: 3,42; IC95% 1,91-6,14), corrimento vaginal na gestação (OR: 4,25; IC95% 2,31-7,84), icterícia neonatal (OR: 2,38; IC95% 1,21-4,68), infecções respiratórias dos tratos superior e inferior (OR: 3,75; IC95% 2,13-3,62; OR: 3,68; IC95% 2,00-6,76, respectivamente), refluxo gastroesofágico (OR: 3,83; IC95% 1,87-7,82), além do tabagismo domiciliar (OR: 2,00; IC95% 1,10-3,64), mofo/umidade no quarto (OR = 3,34; IC95% 1,82-6,12) e animais em casa (OR: 1,77 IC95% 1,04-3,02). Conclusão: Casos de atopia estão associados a história familiar, infecções gestacionais maternas e neonatal, além de variáveis ambientais como o tabagismo e mofo.

Introduction: Considering that the mechanisms by which atopic diseases have increased in frequency and severity are not entirely known, the present study aims to analyze the factors associated with symptoms of atopic diseases in children aged 6-7 years. Method: This case-control observational study recruited children aged 6-7 years in a city in southern Brazil. The questionnaires were administered to the children's mothers and the symptoms of atopic diseases were screened through the International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire. Results: The study included 255 children (85 cases and 170 controls). Factors associated with atopic diseases were family history of asthma (OR: 4.61; 95% CI: 2.63-0.73), rhinitis (OR: 3.46; 95% CI: 1.90- 3.26), eczema (OR: 3.25; 95% CI: 1.91-6.14), vaginal discharge during pregnancy (OR: 4.25; 95% CI: 2.31-7.84), neonatal hyperbilirubinemia (OR: 2.38; 95% CI: 1.21-4.68), upper and lower respiratory infections (OR: 3.75; 95% CI: 2.13-3.62; and OR: 3.68; 95% CI: 2.00-6.76, respectively), gastroesophageal reflux (OR: 3.83; 95% CI: 1.87-7.82), in addition to household smoking (OR: 2.00; 95% CI: 1.10-3.64), mold in the bedroom (OR: 3.34; 95% CI: 1.82-6.12) and pets at home (OR: 1.77; 95% CI: 1.04-3.02). Conclusion: Cases of atopic diseases are associated with family history, maternal and neonatal infections, and environmental exposures such as smoking and mold.

Effects of using Stiper® for cervical pain treatment in dentistry students: pilot trial / Efeitos do Stiper® no tratamento de cervicalgia em acadêmicos de odontologia: ensaio piloto

ABSTRACT BACKGROUND AND OBJECTIVES: Pain in the cervical region is a major cause of absenteeism, and one of the professions most susceptible to this risk is dental surgeons. The pain usually begins during the period of academic training, and ergonomic and postural factors add up to the emotional ones. The Stiper® silicon oxide tablets are painless, non-invasive and quickly applied, offering prolonged stimulation. This study aimed to verify the possible effects of using Stiper® in cases of nonspecific neck pain in students in their dental clinical practices training in a Dentistry course in Southern Brazil. METHODS: A pilot clinical trial of a quantitative nature, in a before-and-after setting, almost experimental. The sample consisted of nine dentistry students to whom Stiper® was applied at the acupuncture points Jianjing, Tianliao, Jianyu, and Dazhui, for three consecutive weeks, with a 7-day interval between sessions. The data was collected through a sociodemographic questionnaire, the visual analog scale of pain, before and after the interventions, and the completion of a form. The statistical analysis used the Shapiro Wilk normality test and the Student's t-test. RESULTS: The Stiper® application provided a significant pain reduction (p<0.05) in the cervical region. CONCLUSION: The use of Stiper® was effective in reducing the neck pain reported by dentistry students.

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor na região cervical é uma das maiores causas de afastamento laboral e uma das profissões mais suscetível ao risco é a dos cirurgiões-dentistas. As dores geralmente começam durante o período de formação acadêmica e aos fatores ergonômicos e posturais associam-se também os emocionais. As pastilhas de óxido de silício Stiper® apresentam-se como terapêutica indolor, não invasiva e de rápida aplicação oferecendo estímulo prolongado. O objetivo deste estudo foi verificar os possíveis efeitos do uso do Stiper® em casos de cervicalgia inespecífica em acadêmicos em fases de práticas clínicas de um curso de Odontologia no Sul do Brasil. MÉTODOS: Ensaio clínico piloto de natureza quantitativa, do tipo antes e depois, quase experimental. A amostra foi constituída por nove acadêmicos do curso de Odontologia, os quais receberam a aplicação de Stiper® nos pontos de acupuntura Jianjing, Tianliao, Jianyu e Dazhui, durante três semanas consecutivas, com intervalo de sete dias entre as sessões. A coleta de dados foi realizada com a aplicação de questionário sociodemográfico, escala analógica visual de dor antes e depois das intervenções e preenchimento de formulário. Análise estatística pelo teste de normalidade de Shapiro Wilk e teste t de Student. RESULTADOS: A aplicação do Stiper® propiciou redução significativa (p<0,05) da dor na região cervical. CONCLUSÃO: O uso do Stiper® foi eficaz na redução da cervicalgia referida pelos acadêmicos de Odontologia.

The first survey of human T-cell lymphotropic viruses (HTLV) in HIV/AIDS patients in Santa Catarina State, Brazil.

Santa Catarina is a Brazilian State that has reported the lowest prevalence of human T-cell lymphotropic viruses (HTLV-1/2) in blood donors (0.04%). Although it presents ports, airports and roads that facilitate the entrance and dissemination of new infectious agents, no information exists concerning the HTLV-1/2 infections in HIV/AIDS patients. This study searched for HTLV-1/2 antibodies in plasma samples of 625 HIV/AIDS patients from the municipality of Tubarao (Southern Santa Catarina), and disclosed 1.1% of positivity (0.48% HTLV-1, 0.48% HTLV-2 and 0.16% untypeable HTLV), and a positive correlation with the male sex (OR 4.16) and intravenous drug use (OR 35.18). Although the percentage of 1.1% appears to be low, it is 27.5 times higher than the percentage detected in blood donors. Since HTLV-1 and HTLV-2 are circulating in HIV-infected individuals in Southern Santa Catarina, and these retroviruses could cause a differently impact on the HIV/AIDS outcomes, the surveillance of HTLV-1/2 is necessary, and it could support public health policies in preventing the transmission and dissemination of these viruses in this State.

Reflexoterapia podal para lombalgia aguda ocupacional: ensaio clínico randomizado duplo cego / Foot reflexology for acute occupational low back pain: a double-blind randomized clinical trial / Reflexoterapia podal para lumbago agudo ocupacional: ensayo clínico aleatorizado doble-ciego

OBJETIVO: Comparar os efeitos da reflexoterapia podal no alívio da lombalgia aguda ocupacional da equipe de enfermagem. MÉTODO: ensaio clínico randomizado, controlado, duplo-cego. Participaram 36 profissionais efetivos, randomicamente alocados. A coleta de dados foi realizada com a Escala Visual e Analógica de intensidade da dor, antes e depois das aplicações do protocolo de reflexoterapia e Questionário para Lombalgia, aplicado no início e fim da pesquisa. Para normalidade da amostra utilizou-se o teste Shapiro Wilk; teste Qui-quadrado ou Exato de Fisher para verificar a significância da associação entre variáveis categóricas; teste de Wilcoxon (dados não paramétricos) e teste t (dados paramétricos). RESULTADO: reflexoterapia podal apresentou efeito significativo (p=0,000) nas etapas de intervenção para alívio da intensidade da dor lombar aguda, tanto no escore do EVA, quanto no Questionário para Lombalgia (p=0,0002). CONCLUSÕES: a reflexoterapia apresentou efeitos estatisticamente significativos na redução da lombalgia aguda dos profissionais da Enfermagem

AIM: To compare the effects of foot reflexology in relieving acute occupational low back pain in the nursing team. METHOD: randomized, controlled, double-blind clinical trial. Participants included 36 randomly allocated, effective professionals. Data collection was performed with the Visual and Analogue Scale of pain intensity, before and after the applications of the reflexotherapy protocol and Questionnaire for Low Back Pain, applied at the beginning and end of the research. For normality of the sample the Shapiro Wilk test, Chi-square test or Fisher's exact test was used to verify the significance of the association between categorical variables; Wilcoxon test (non-parametric data) and t-test (parametric data). RESULT: reflexotherapy showed significant effect (p=0.000) in the intervention stages to alleviate the intensity of acute low back pain, both in the VAS score and in the Low Back Pain Questionnaire (p=0.0002). CONCLUSIONS: reflexotherapy showed statistically significant effects on the reduction of acute low back pain in Nursing professionals.

OBJETIVO: Comparar los efectos de la reflexoterapia podal en el alivio del lumbago agudo ocupacional del equipo de enfermería. MÉTODO: ensayo clínico aleatorizado, controlado, doble-ciego. Participaron 36 profesionales efectivos, asignados aleatoriamente. El muestreo se realizó con la Escala Visual y Analógica de intensidad del dolor, antes y después de las aplicaciones del protocolo de reflexoterapia y con el Cuestionario para Lumbago, aplicado al inicio y fin de la investigación. Para normalizar la muestra se utilizó el test Shapiro Wilk; test Chi-cuadrado o Exacto de Fisher para verificar la significancia de la asociación entre las variables categóricas; test de Wilcoxon (datos no paramétricos) y test t (datos paramétricos). RESULTADO: La reflexoterapia podal presentó efecto significativo (p=0,000) en las etapas de intervención para aliviar la intensidad del dolor lumbar agudo, tanto en el escore del EVA, como en el Cuestionario para Lumbago (p=0,0002). CONCLUSIONES: La reflexoterapia presentó efectos estadísticamente significativos en la reducción del lumbago agudo de los profesionales de Enfermería.

Análise temporal da relação entre leptospirose, níveis pluviométricos e sazonalidade, na região da Grande Florianópolis, Santa Catarina, Brasil, 2005-2015 / Temporal analysis of the relationship between leptospirose, pluviometric levels and seasonality, in the region of Grande Florianópolis, Santa Catarina, Brazil, 2005-2015

O objetivo do estudo é analisar a tendência temporal da incidência de leptospirose, de acordo com índices pluviométricos na Região da Grande Florianópolis, conforme sazonalidade - 2005 a 2015. Trata-se de estudo ecológico de séries temporais, com dados de leptospirose, índices pluviométricos e população. Foram analisadas taxas de incidência de leptospirose, excesso relativo da incidência, coeficiente de correlação de Pearson (r), coeficiente angular (ß), a partir do ajuste da regressão linear, com nível de significância de 95%. Apresenta distribuição dos casos de leptospirose, índices pluviométricos e razão casos/índices pluviométricos, estratificados por mês de ocorrência. Foram registrados 1.001 casos de leptospirose, média mensal de 83 casos, com variação de 43, nos meses de agosto, a 146, nos meses de fevereiro. A taxa média de leptospirose foi 8,24/100 mil habitantes. O índice pluviométrico médio foi 154,83 mm, os índices mais baixos ocorreram nos meses de junho, média de 99,48 mm, e, os mais elevados nos meses de janeiro, média de 226,16 mm. Uma correlação positiva entre taxas de leptospirose e níveis pluviométricos, ao longo do período, janeiro a dezembro (r=0,64; p=0,003), aponta para associação temporal positiva entre quantidade de chuva e casos da doença. A doença ocorreu o ano todo e apresentou nítida sazonalidade no período de outubro a março.

Temporal analysis of the relationship between leptospirosis, rainfall levels and seasonality, Santa Catarina, Brazil, 2005-2015.

The objective of the study is to analyze the temporal trend of leptospirosis incidence, according to rainfall levels in Santa Catarina, according to seasonality, from 2005 to 2015. This is an ecological study of time series, with date of leptospirosis, rainfall levels and population. The incidence rates of leptospirosis, relative excess of incidence, Pearson's correlation coefficient (r) and an angular coefficient (ß) were analyzed from the linear regression adjustment, with a 5% significance level. Distribution of leptospirosis cases, rainfall levels and cases reason/rainfall levels, stratified by month of occurrence were presented. There were 5,274 cases of leptospirosis, with the monthly average being 439 cases, ranging from 211 in September to 770 in January. The mean rate of leptospirosis was 7.03 per 100,000 habitants. The average rainfall level was 158.68 mm, with the lowest levels occurring in August, average of 124.9 mm, and the highest in January average of 213.20 mm. The positive correlation between leptospirosis rates and rainfall levels, during the period from January to December (r = 0.68, p = 0.023), indicates a positive temporal association between the amount of rainfall and the cases of the disease. The disease occurred all year round and presented a distinct seasonality from October to March.

Mycobacteria mobility shift assay: a method for the rapid identification of Mycobacterium tuberculosis and nontuberculous mycobacteria

The identification of mycobacteria is essential because tuberculosis (TB) and mycobacteriosis are clinically indistinguishable and require different therapeutic regimens. The traditional phenotypic method is time consuming and may last up to 60 days. Indeed, rapid, affordable, specific and easy-to-perform identification methods are needed. We have previously described a polymerase chain reaction-based method called a mycobacteria mobility shift assay (MMSA) that was designed for Mycobacterium tuberculosis complex (MTC) and nontuberculous mycobacteria (NTM) species identification. The aim of this study was to assess the MMSA for the identification of MTC and NTM clinical isolates and to compare its performance with that of the PRA-hsp65 method. A total of 204 clinical isolates (102 NTM and 102 MTC) were identified by the MMSA and PRA-hsp65. For isolates for which these methods gave discordant results, definitive species identification was obtained by sequencing fragments of the 16S rRNA and hsp65 genes. Both methods correctly identified all MTC isolates. Among the NTM isolates, the MMSA alone assigned 94 (92.2%) to a complex or species, whereas the PRA-hsp65 method assigned 100% to a species. A 91.5% agreement was observed for the 94 NTM isolates identified by both methods. The MMSA provided correct identification for 96.8% of the NTM isolates compared with 94.7% for PRA-hsp65. The MMSA is a suitable auxiliary method for routine use for the rapid identification of mycobacteria.

Mycobacteria mobility shift assay: a method for the rapid identification of Mycobacterium tuberculosis and nontuberculous mycobacteria.

The identification of mycobacteria is essential because tuberculosis (TB) and mycobacteriosis are clinically indistinguishable and require different therapeutic regimens. The traditional phenotypic method is time consuming and may last up to 60 days. Indeed, rapid, affordable, specific and easy-to-perform identification methods are needed. We have previously described a polymerase chain reaction-based method called a mycobacteria mobility shift assay (MMSA) that was designed for Mycobacterium tuberculosis complex (MTC) and nontuberculous mycobacteria (NTM) species identification. The aim of this study was to assess the MMSA for the identification of MTC and NTM clinical isolates and to compare its performance with that of the PRA-hsp65 method. A total of 204 clinical isolates (102 NTM and 102 MTC) were identified by the MMSA and PRA-hsp65. For isolates for which these methods gave discordant results, definitive species identification was obtained by sequencing fragments of the 16S rRNA and hsp65 genes. Both methods correctly identified all MTC isolates. Among the NTM isolates, the MMSA alone assigned 94 (92.2%) to a complex or species, whereas the PRA-hsp65 method assigned 100% to a species. A 91.5% agreement was observed for the 94 NTM isolates identified by both methods. The MMSA provided correct identification for 96.8% of the NTM isolates compared with 94.7% for PRA-hsp65. The MMSA is a suitable auxiliary method for routine use for the rapid identification of mycobacteria.

The genome of Anopheles darlingi, the main neotropical malaria vector.

Anopheles darlingi is the principal neotropical malaria vector, responsible for more than a million cases of malaria per year on the American continent. Anopheles darlingi diverged from the African and Asian malaria vectors ∼100 million years ago (mya) and successfully adapted to the New World environment. Here we present an annotated reference A. darlingi genome, sequenced from a wild population of males and females collected in the Brazilian Amazon. A total of 10 481 predicted protein-coding genes were annotated, 72% of which have their closest counterpart in Anopheles gambiae and 21% have highest similarity with other mosquito species. In spite of a long period of divergent evolution, conserved gene synteny was observed between A. darlingi and A. gambiae. More than 10 million single nucleotide polymorphisms and short indels with potential use as genetic markers were identified. Transposable elements correspond to 2.3% of the A. darlingi genome. Genes associated with hematophagy, immunity and insecticide resistance, directly involved in vector-human and vector-parasite interactions, were identified and discussed. This study represents the first effort to sequence the genome of a neotropical malaria vector, and opens a new window through which we can contemplate the evolutionary history of anopheline mosquitoes. It also provides valuable information that may lead to novel strategies to reduce malaria transmission on the South American continent. The A. darlingi genome is accessible at www.labinfo.lncc.br/index.php/anopheles-darlingi.

Immunological responses of the mangrove oysters Crassostrea gasar naturally infected by Perkinsus sp. in the Mamanguape Estuary, Paraíba state (Northeastern, Brazil).

Perkinsus genus includes protozoan parasites of marine mollusks, especially bivalves. In the last four years, this parasite has been detected in mangrove oysters Crassostrea rhizophorae and Crassostrea gasar from the Northeastern region of Brazil. Hemocytes are the key cells of the oyster immune system, being responsible for a variety of cellular and humoral reactions, such as phagocytosis, encapsulation and the release of several effector molecules that control the invasion and proliferation of microorganisms. In Brazil, there is little information on perkinsosis and none on the immune responses of native oysters' species against Perkinsus spp. The objective of this study was to determine the effects of natural infection by Perkinsus sp. on the immunological parameters of mangrove oysters C. gasar cultured in the Mamanguape River Estuary (Paraíba, Brazil). Adults oysters (N = 40/month) were sampled in December 2011, March, May, August and October 2012. Gills were removed and used to determine the presence and intensity of the Perkinsus sp. infection, according to a scale of four levels (1-4), using the Ray's fluid thioglycollate medium assay. Immunological parameters were measured in hemolymph samples by flow cytometry, including: total hemocyte count (THC), differential hemocyte count (DHC), cell mortality, phagocytic capacity, and production of Reactive Oxygen Species (ROS). The plasma was used to determine the hemagglutination activity. The results showed the occurrence of Perkinsus sp. with the highest mean prevalence (93.3%) seen so far in oyster populations in Brazil. Despite that, no oyster mortality was associated. In contrast, we observed an increase in hemocyte mortality and a suppression of two of the main defense mechanisms, phagocytosis and ROS production in infected oysters. The increase in the percentage of blast-like cells on the hemolymph, and the increase in THC in oysters heavily infected (at the maximum intensity, 4) suggest an induction of hemocytes proliferation. The immunological parameters varied over the studied months, which may be attributed to the dynamics of infection by Perkinsus sp. The results of the present study demonstrate that Perkinsus sp. has a deleterious effect on C. gasar immune system, mainly in high intensities, which likely renders oysters more susceptible to other pathogens and diseases.