Effects of an interdisciplinary intervention on insulin resistance indicators in overweight and obese adolescents / Efeitos de uma intervenção interdisciplinar sobre indicadores de resistência à insulina em adolescentes com excesso de peso

INTRODUCTION: Overweight children and adolescents are more susceptible to metabolic disorders. However, changes in lifestyle can prevent or delay the appearance of risk factors, highlighting the importance of intervening early in this populationOBJECTIVE: To analyze the effects of a six months interdisciplinary intervention program on the indicators of insulin resistance and uric acid levels in overweight and obese studentsMETHODS: This is an interventional study in overweight adolescents, composed of a control group (n=19) and an intervention group (n=20). The group participated in a six-month program with nutritional, psychological and physical exercise intervention, three times a week. The values of waist circumference, glucose, insulin, uric acid assessment and HOMA-IR index, were evaluated before and after the programRESULTS: After 6 months, the intervention group had a significant reduction in waist circumference (p=0.007), HOMA-IR index (p=0.048) and uric acid (p=0.036); the control group did not present differences in the pre and post evaluationCONCLUSION: The intervention program was effective in reducing waist circumference, HOMA-IR and uric acid levels in overweight adolescents

INTRODUÇÃO: Crianças e adolescentes com excesso de peso são mais suscetíveis a apresentarem disfunções metabólicas. No entanto, mudanças no estilo de vida podem prevenir ou retardar o surgimento de fatores de risco, destacando a importância de intervir precocemente nesta populaçãoOBJETIVO: Analisar os efeitos de seis meses de um programa de intervenção interdisciplinar sobre os indicadores de resistência à insulina e os níveis de ácido úrico em escolares com sobrepeso e obesidadeMÉTODO: Estudo de intervenção, realizado com adolescentes com excesso de peso, composto por grupo controle (n=19) e grupo intervenção (n=20), que participou de programa de seis meses com intervenção nutricional, psicológica e de exercícios físicos, três vezes por semana. Foi avaliada a circunferência da cintura (CC), realizada coleta sanguínea para avaliação da glicose, insulina e ácido úrico e calculado o índice HOMA-IR, antes e após o programaRESULTADOS: O grupo intervenção apresentou redução significante da circunferência da cintura (p=0,007), índice HOMA-IR (p=0,048) e ácido úrico (p=0,036), após os seis meses do programa; já o grupo controle não apresentou diferenças na pré e pós avaliaçãoCONCLUSÃO: O programa de intervenção mostrou-se eficiente na redução da circunferência da cintura, HOMA-IR e níveis de ácido úrico em adolescentes com excesso de peso

A Predicted Mannoprotein Participates in Cryptococcus gattii Capsular Structure.

The yeast-like pathogen Cryptococcus gattii is an etiological agent of cryptococcosis. The major cryptococcal virulence factor is the polysaccharide capsule, which is composed of glucuronoxylomannan (GXM), galactoxylomannan (GalXM), and mannoproteins (MPs). The GXM and GalXM polysaccharides have been extensively characterized; however, there is little information about the role of mannoproteins in capsule assembly and their participation in yeast pathogenicity. The present study characterized the function of a predicted mannoprotein from C. gattii, designated Krp1. Loss-of-function and gain-of-function mutants were generated, and phenotypes associated with the capsular architecture were evaluated. The null mutant cells were more sensitive to a cell wall stressor that disrupts beta-glucan synthesis. Also, these cells displayed increased GXM release to the culture supernatant than the wild-type strain did. The loss of Krp1 influenced cell-associated cryptococcal polysaccharide thickness and phagocytosis by J774.A1 macrophages in the early hours of interaction, but no difference in virulence in a murine model of cryptococcosis was observed. In addition, recombinant Krp1 was antigenic and differentially recognized by serum from an individual with cryptococcosis, but not with serum from an individual with candidiasis. Taken together, these results indicate that C. gattii Krp1 is important for the cell wall structure, thereby influencing capsule assembly, but is not essential for virulence in vivoIMPORTANCECryptococcus gattii has the ability to escape from the host's immune system through poorly understood mechanisms and can lead to the death of healthy individuals. The role of mannoproteins in C. gattii pathogenicity is not completely understood. The present work characterized a protein, Kpr1, that is essential for the maintenance of C. gattii main virulence factor, the polysaccharide capsule. Our data contribute to the understanding of the role of Kpr1 in capsule structuring, mainly by modulating the distribution of glucans in C. gattii cell wall.

Activity of carbapenems and tigecycline against ESBL-producing Escherichia coli and Klebsiella spp / Atividade de carbapenêmicos e tigeciclina diante de Escherichia coli e Klebsiella spp. produtoras de ESBL

ABSTRACT The indiscriminate use of carbapenems in the fight against multidrug resistant Gram-negative bacteria leads to the emergence of resistance to these antimicrobial agents. We examine the in vitro activity of carbapenems and tigecycline against ESBL-producing E. coli and Klebsiella spp. isolated in a single hospital at two different periods eight years apart. Overall resistance to carbapenems ranged from 18.7% in 2007 to 19.1% in 2015/2016. We found no isolates resistant to tigecycline, but two intermediary profiles in the 2015/2016 period. Tigecycline is an important option for treating multidrug resistant Gram-negative infections and helps in the fight against global dissemination of resistance to carbapenems.

RESUMO O uso indiscriminado de carbapenêmicos na luta contra bactérias Gram-negativas multirresistentes favorece o aparecimento de resistência a esses agentes antimicrobianos. Examinamos a atividade in vitro de carbapenêmicos e tigeciclina em Escherichia coli e Klebsiella spp. isolados de um único hospital, em dois períodos diferentes, separados por oito anos. A resistência aos carbapenêmicos variou de 18,7% em 2007 a 19,1% em 2015/2016. Não encontramos isolados resistentes a tigeciclina, mas dois isolados intermediários no período 2015/2016. A tigeciclina é uma importante opção de tratamento para infecções causadas por bactérias Gram-negativas multirresistentes e ajuda na luta contra a disseminação da resistência aos carbapenêmicos.

Relationship between Cardiometabolic Parameters and Elevated Resting and Effort Heart Rate in Schoolchildren / Associação entre Indicadores Cardiometabólicos e Elevação da Frequência Cardíaca de Repouso e Esforço em Escolares

Abstract Background: Little has been studied on heart rate and its relationship with metabolic disorders. Objective: To identify possible association between heart rate (HR) and metabolic disorders in children and adolescents. Methods: This cross-sectional study evaluated 2.098 subjects, aged between 7 and 17 years. The variables evaluated were: HR, systolic (SBP) and diastolic blood pressure (DBP), pulse pressure (PP), double-product (DP), myocardial oxygen consumption (mVO2), lipids, glucose and uric acid levels, body mass index (BMI) and waist circumference (WC). The values of HR at rest and effort were divided into quartiles. The association between continuous values of HR and cardiometabolic indicators was tested by linear regression. Results: LDL cholesterol presented a significantly higher mean (p = 0.003) in schoolchildren with resting HR greater or equal to 91 bpm, compared to students with less than 75 bpm. Compared with the quartiles of effort HR, SBP, DBP, glucose and uric acid presented high values when HR was greater or equal than 185 bpm. SBP, glucose and HDL cholesterol demonstrated a significant association with resting HR. Uric acid was observed as a predictor of increased effort HR. Conclusion: Schoolchildren with a higher resting HR have higher mean of LDL cholesterol. For effort HR, there was an increase in blood pressure, glucose and uric acid levels. Uric acid has been shown to be a predictor of elevated effort HR.

Resumo Fundamento: Pouco se tem estudado sobre frequência cardíaca e suas relações com alterações metabólicas. Objetivo: Verificar se existe associação entre frequência cardíaca e disfunções metabólicas em crianças e adolescentes. Método: Estudo transversal com 2.098 escolares, com idade entre 7 e 17 anos. As variáveis avaliadas foram: frequência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD) e de pulso (PP), duplo-produto (DP), consumo de oxigênio pelo miocárdio (mVO2), perfil lipídico e glicêmico, níveis de ácido úrico, índice de massa corporal (IMC) e circunferência da cintura (CC). Os valores de FC de repouso e esforço foram divididos em quartis. A associação entre os valores contínuos de FC com indicadores cardiometabólicos foi testada por meio da regressão linear. Resultados: O colesterol LDL apresentou média significativamente superior (p = 0,003) nos escolares com FC de repouso maior ou igual a 91 bpm, em comparação aos escolares que apresentaram menos de 75 bpm. Comparados com os quartis da FC de esforço, a PAS, PAD, glicose e ácido úrico apresentaram valores elevados quando a FC foi igual ou superior a 185 bpm. A PAS, a glicose e o colesterol HDL demonstraram associação significativa com a FC de repouso. Observou-se o ácido úrico como um preditor do aumento da FC de esforço. Conclusão: Escolares com FC de repouso mais elevada apresentam médias superiores de colesterol LDL. Para FC de esforço, observou-se elevação na pressão arterial, nos níveis de glicose e de ácido úrico. O ácido úrico demonstrou ser preditor da elevação da FC de esforço.

Relationship between Cardiometabolic Parameters and Elevated Resting and Effort Heart Rate in Schoolchildren.

Background: Little has been studied on heart rate and its relationship with metabolic disorders. Objective: To identify possible association between heart rate (HR) and metabolic disorders in children and adolescents. Methods: This cross-sectional study evaluated 2.098 subjects, aged between 7 and 17 years. The variables evaluated were: HR, systolic (SBP) and diastolic blood pressure (DBP), pulse pressure (PP), double-product (DP), myocardial oxygen consumption (mVO2), lipids, glucose and uric acid levels, body mass index (BMI) and waist circumference (WC). The values of HR at rest and effort were divided into quartiles. The association between continuous values of HR and cardiometabolic indicators was tested by linear regression. Results: LDL cholesterol presented a significantly higher mean (p = 0.003) in schoolchildren with resting HR greater or equal to 91 bpm, compared to students with less than 75 bpm. Compared with the quartiles of effort HR, SBP, DBP, glucose and uric acid presented high values when HR was greater or equal than 185 bpm. SBP, glucose and HDL cholesterol demonstrated a significant association with resting HR. Uric acid was observed as a predictor of increased effort HR. Conclusion: Schoolchildren with a higher resting HR have higher mean of LDL cholesterol. For effort HR, there was an increase in blood pressure, glucose and uric acid levels. Uric acid has been shown to be a predictor of elevated effort HR.

Fundamento: Pouco se tem estudado sobre frequência cardíaca e suas relações com alterações metabólicas. Objetivo: Verificar se existe associação entre frequência cardíaca e disfunções metabólicas em crianças e adolescentes. Método: Estudo transversal com 2.098 escolares, com idade entre 7 e 17 anos. As variáveis avaliadas foram: frequência cardíaca (FC), pressão arterial sistólica (PAS), diastólica (PAD) e de pulso (PP), duplo-produto (DP), consumo de oxigênio pelo miocárdio (mVO2), perfil lipídico e glicêmico, níveis de ácido úrico, índice de massa corporal (IMC) e circunferência da cintura (CC). Os valores de FC de repouso e esforço foram divididos em quartis. A associação entre os valores contínuos de FC com indicadores cardiometabólicos foi testada por meio da regressão linear. Resultdos: O colesterol LDL apresentou média significativamente superior (p = 0,003) nos escolares com FC de repouso maior ou igual a 91 bpm, em comparação aos escolares que apresentaram menos de 75 bpm. Comparados com os quartis da FC de esforço, a PAS, PAD, glicose e ácido úrico apresentaram valores elevados quando a FC foi igual ou superior a 185 bpm. A PAS, a glicose e o colesterol HDL demonstraram associação significativa com a FC de repouso. Observou-se o ácido úrico como um preditor do aumento da FC de esforço. Conclusão: Escolares com FC de repouso mais elevada apresentam médias superiores de colesterol LDL. Para FC de esforço, observou-se elevação na pressão arterial, nos níveis de glicose e de ácido úrico. O ácido úrico demonstrou ser preditor da elevação da FC de esforço.

Neuropsychomotor development and genomic stability associated to folate and blood iron levels in preschool children / Desenvolvimento neuropsicomotor e estabilidade genômica associados aos níveis de folato e ferro sanguíneos de pré-escolares

Abstract Objectives: to evaluate the neuropsychomotor development and the genomic stability associated to folate and blood iron levels in preschool children. Methods: a cross-sectional study in which evaluated the biochemical exams (complete hemogram, serum ferritin, iron and folate), neuropsychomotor development (Denver II Test) and genotoxicity (micronuclei cytome in buccal mucosa cells) of 55 children aging 36-59 months old. Student´s T test, Kruskal-Wallis and Pearson's or Spearman's correlation tests were applied with a significance level of p<0.05 for data analysis. Results: the prevalence of anemia was 1.8%. The Denver II test classified 32.7% of the children as normal and 67.3% were suspected of having a delay. The children suspected of having a delay presented a slight reduction on hemoglobin and hematocrit (p=0.05 and p=0.14), intermediate reduction on iron and folate (p=0.29 and p=0.23) and a notable reduction on ferritin (p=0.03). Folate and iron were significantly associated to the frequency of cells with DNA damages (p<0.05). The frequency of binucleated cells was positively associated to the Red Cell Distribution Width (RDW) (r=0.56; p=0.02) in children without a delay and negatively with folate (r=-0.334; p=0.047) in children with a delay. Conclusions: this study showed a low prevalence of anemia, but a high rate of children suspected of having a neuropsychomotor, possibly associated to low ferritin levels. Additionally, iron and folate were associated to DNA damage which may have contributed to the psychomotor development delay.

Resumo Objetivos: avaliar o desenvolvimento neuropsicomotor e a estabilidade genômica associados ao folato e ferro sanguíneos em pré-escolares. Métodos: estudo transversal, no qual avaliou-se exames bioquímicos (hemograma completo, ferritina sérica, ferro e folato), desenvolvimento neuropsicomotor (Teste Denver II) e genotoxicidade (citoma de micronúcleos em células bucais esfoliadas) de 55 crianças com 36-59 meses de idade. Para a análise dos dados, empregou-se os testes T de Student, Kruskal-Wallis e correlação de Pearson ou Spearman, com nível de significância de p<0,05. Resultados: a prevalência de anemia foi de 1,8%. Pelo teste de Denver II foram classificadas 32,7% das crianças como normais e 67,3% como suspeita de atraso. As crianças com suspeita de atraso apresentaram pequena redução no hematócrito e hemoglobina (p=0,05 e p=0,14), redução intermediária de ferro e folato (p=0,29 e p=0,23) e redução marcante de ferritina (p=0,03). Ferro e folato associaram-se significativamente com a frequência de células com lesões no DNA (p<0,05). A frequência de células binucleadas associou-se positivamente com Red Cell Distribution Width (RDW) (r=0,56; p=0,02), nas crianças sem atraso e negativamente com folato (r=-0,33; p=0,05), nas crianças com atraso. Conclusões: este estudo mostrou baixa prevalência de anemia, mas elevada taxa de crianças com suspeita de atraso neuropsicomotor, possivelmente associada com baixos níveis de ferritina. Ademais, observou-se associação entre ferro e folato com dano no DNA, o que pode ter contribuído para o atraso neuropsicomotor.

Perfil sociodemográfico, ocupacional e avaliação das condições de saúde mental dos trabalhadores da Estratégia Saúde da Família em um município do Rio Grande do Sul, RS / Sociodemographic and occupational profile and evaluation of mental health disorders of employees of the Family Health Strategy in a city of Rio Grande do Sul, RS / Perfil sociodemografico, ocupacional y evaluación de las condiciones de salud mental de los trabajadores de Estrategia de Salud de la Familia en un municipio de Rio Grande do Sul, RS

Objetivo: Descrever os fatores sociodemográficos e ocupacionais e avaliar a prevalência de transtornos mentais comuns em trabalhadores das Estratégias de Saúde da Família (ESF) em Santa Cruz do Sul, RS. Métodos: Estudo com abordagem epidemiológica, de corte transversal e quantitativo, realizado no período de junho a agosto de 2013. Foram avaliados 83 trabalhadores, entre médicos, enfermeiros, técnicos/auxiliares de enfermagem e agentes comunitários de saúde, atuantes nas 11 unidades de saúde da família do município. O instrumento de pesquisa constituiu-se em um questionário autoaplicável, englobando aspectos sociodemográficos, ocupacionais e questões pertencentes ao Self-Reporting Questionnaire. Resultados: A idade média dos participantes foi de 37,1±8,9 anos, sendo a maioria agentes comunitários de saúde, do sexo feminino, casadas, com filhos, renda per capita de até 2 salários mínimos e ensino médio completo. A prevalência geral de transtorno mental comum foi de 19,7%, estando presente em todas as categorias profissionais, e mais frequente entre os enfermeiros (25%), porém sem diferenças estatísticas. Conclusão: O presente estudo, além de caracterizar a população de trabalhadores das ESF de Santa Cruz do Sul, RS, em seus aspectos sociodemográficos e ocupacionais, identificou que o sofrimento psíquico está presente, embora em graus variados, em todas as categorias profissionais avaliadas. Frente a esses achados relevantes, sugerem-se providências que visem à prevenção e promoção da saúde mental desses profissionais.

Objective: The purpose of this study was to measure the prevalence of common mental health disorders among employees of the Family Health Strategy in Santa Cruz do Sul, RS, and to describe sociodemographic and occupational factors associated with these disorders. Methods: This was a cross-sectional, quantitative study, conducted from June to August 2013. In total, 83 employees, who worked at 11 family health units in the city, participated. Participants included doctors, nurses, technicians/nursing assistants, and community health workers. The survey was conducted using a self-administered questionnaire about sociodemographic and occupational issues as well as the matters related to the Self-Reporting Questionnaire. Results: The average age of participants was 37.1±8.9 years. The majority of community health workers were female workers who were married, had children, had a per capita income of up to 2 minimum wages, and had completed high school. The general prevalence of common mental health disorders was 19.7%. Mental health disorders were present in all occupational categories, but were more frequent among male nurses (25%), although this was not statistically significant. Conclusion: This study, in addition to characterizing the population of employees of the Family Health Strategy in Santa Cruz do Sul, RS, in terms of demographic and occupational characteristics, found that psychological distress was present, to varying degrees, in all professional categories evaluated. Given the high prevalence of mental health disorders among these employees, measures are required to ensure the protection and promotion of mental health in this setting.

Objetivo: Se ha objetivado describir a los factores sociodemográficos y ocupacionales y evaluar la prevalencia de trastornos mentales comunes en trabajadores de las Estrategias de Salud de la Familia en Santa Cruz do Sul, RS. Métodos: Estudio con abordaje epidemiológico, de corte transversal y cuantitativo, llevado a efecto en el periodo de junio a agosto del 2013. Han sido evaluados 83 trabajadores, entre médicos, enfermeros, técnicos y auxiliares de enfermería y agentes comunitarios de salud pública, que actúan en las 11 unidades de salud de la familia en el municipio. El instrumento de investigación constituyó de un cuestionario auto aplicable, que abarca aspectos sociodemográficos, ocupacionales y cuestiones pertenecientes al Self-Reporting Questionnaire. Resultados: La edad promedia de los participantes fue de 37,1±8,9años, siendo los más, agentes comunitarios de salud, del sexo femenino, casadas, con hijos, ingreso per cápita de hasta dos sueldos mínimos y enseñanza media cumplida. La prevalencia general de trastorno mental común ha sido del 19, 7%, estando presente en todos los rangos profesionales y más frecuente entre los enfermeros (25%), pero sin distinciones estadísticas. Conclusión: Este estudio, además de la caracterización de la población de empleados de Estrategias de Salud de la Familia de Santa Cruz do Sul, RS, en sus características demográficas y ocupacionales, se encontró que la angustia psicológica se encuentra presente, aunque en distintos grados, en todas las categorías profesionales evaluados. Frente a la prevalencia elevada de trastornos mentales, se sugiere providencias con vistas a la prevención y promoción de la salud mental de esos profesionales.

Ischemic versus pharmacologic hepatic preconditioning.

BACKGROUND: Hepatic ischemia-reperfusion injury has a significant impact on liver resection and transplantation. Many strategies have been developed to reduce the effects of ischemia-reperfusion injury, including pharmacologic and ischemic preconditioning; however, studies comparing these two methods are lacking. MATERIAL AND METHODS: An experimental study was performed in a swine model. Eighteen swine were randomly assigned to three different groups: an ischemic preconditioning (IschPC) group, a pharmacologic preconditioning (PharmPC) group, and a control group. All animals underwent a 40-min liver ischemia, followed by 40 min of reperfusion. The IschPC group received a short period of ischemia (10 min) and a short period of reperfusion (15 min) before prolonged ischemia. The PharmPC group received inhaled sevoflurane for 30 min before prolonged ischemia. The control group did not receive any intervention before prolonged ischemia. Blood samples and liver tissue were obtained after ischemic and reperfusion periods. Injury was evaluated by measure of DNA damage (using COMET assay) and serum biochemical markers (transaminases, alkaline phosphatase, amylase, bilirubin, and C-reactive protein [CRP]). RESULTS: No significant difference was found in serum biochemical markers, except for the C-reactive protein level that was lower in the PharmPC group than in the control group soon after hepatic ischemia. Soon after prolonged ischemia, DNA damage index, both in blood samples and in liver tissue samples, was similar among the groups. However, an increase in DNA damage after reperfusion was higher in the control group than in the PharmPC group (P < 0.05). The increase in DNA damage in the IschPC group was half of that observed in the control, but this difference was not statistically significant. CONCLUSIONS: Our results suggest an early protective effect of PharmPC (lower levels of C-reactive protein soon after ischemia). The protective effect observed after reperfusion was higher with PharmPC than with ischemic preconditioning. The simultaneous use of both methods could potentiate protection for ischemia-reperfusion.

Vitamin C intake reduces the cytotoxicity associated with hyperglycemia in prediabetes and type 2 diabetes.

Hyperglycemia leads to the formation of free radicals and advanced glycation end-products (AGEs). Antioxidants can reduce the level of protein glycation and DNA damage. In this study, we compared the levels of vitamin C intake, which is among the most abundant antioxidants obtained from diet, with the levels of fasting plasma glucose (FPG), glycated hemoglobin (A1C), DNA damage, and cytotoxicity in prediabetic subjects and type 2 diabetic subjects. Our results indicated that there was no significant correlation between FPG or A1C and DNA damage parameters (micronuclei, nucleoplasmic bridges, and nuclear buds). FPG and A1C correlated with necrosis (r = 0.294; P = 0.013 and r = 0.401; P = 0.001, resp.). Vitamin C intake correlated negatively with necrosis and apoptosis (r = -0.246; P = 0.040, and r = -0.276; P = 0.021, resp.). The lack of a correlation between the FPG and A1C and DNA damage could be explained, at least in part, by the elimination of cells with DNA damage by either necrosis or apoptosis (cytotoxicity). Vitamin C appeared to improve cell survival by reducing cytotoxicity. Therefore, the present results indicate the need for clinical studies to evaluate the effect of low-dose vitamin C supplementation in type 2 diabetes.

DNA damage and cytotoxicity in adult subjects with prediabetes.

Prediabetes (intermediate hyperglycemia) is a high-risk state for diabetes that is defined by higher than normal glycemic levels that are below the level required for a diagnosis of diabetes. Prediabetes is characterized by oxidative stress, yet the associated DNA damage and cytotoxicity remain unknown to date. Therefore, we evaluated the relationship between glycemic alterations, DNA damage and cytotoxicity in the lymphocytes of individuals with pre-diabetes. Fasting plasma glucose (FPG) and glycated hemoglobin (A1C) levels were quantified and used as inclusion criteria. Anthropometric parameters were also evaluated. The cytokinesis-block micronucleus cytome assay (CBMN Cyt) was used to evaluate DNA damage and cytotoxicity. FPG correlated with A1C (r=0.562, p=0.002). Because A1C is the best predictor of diabetes complications, the association between A1C and the evaluated variables was assessed. The waist-hip ratio correlated with A1C (p<0.01). Regarding DNA damage, the frequency of nucleoplasmic bridges correlated with A1C (p<0.05). Both apoptosis and necrosis correlated with A1C (p<0.05). The overall frequency of DNA damage and cytotoxicity also correlated with A1C (p<0.01). Additional studies evaluating cell cycle and cell death patterns in prediabetes are necessary.

Iron intake, red cell indicators of iron status, and DNA damage in young subjects.

OBJECTIVE: This study evaluated the association between primary DNA damage and chromosomal damage with iron intake and red blood cell parameters of iron status in a sample of healthy children and adolescents from a low-socioeconomic community. METHODS: The level of primary DNA damage was assessed using an alkaline comet assay and the level of chromosomal damage was assessed using the cytokinesis-block micronucleus assay. A automated complete blood count was used to evaluate red blood cell status. The intake of iron was measured using a food-recall questionnaire. RESULTS: According to hemoglobin levels, only 1 of the 30 subjects evaluated was anemic. Nevertheless, 43% of the sampled subjects showed decreased mean corpuscular volume in addition to an increased amount of primary DNA damage (P < 0.05). Mean corpuscular volume was negatively correlated with primary DNA damage (r = -0.429, P = 0.020) but not with chromosomal damage. The association between iron and primary DNA damage showed a U-shaped curve, indicating that an intake of approximately 15 mg of iron per day (up to two-fold of the dietary recommended intake) could minimize primary DNA damage in this age group. The frequency of micronuclei and nucleoplasmic bridges, indicators of chromosomal breakage/loss and chromosomal end-fusions, respectively, showed a negative correlation with iron intake. These results indicate that an intake of iron >15 mg/d could increase genomic stability in binucleated lymphocytes of the same group. CONCLUSION: An intake of iron ≥ 15 mg/d can decrease DNA damage in young subjects.

Uma análise entre índices pressóricos, obesidade e capacidade cardiorrespiratória em escolares / Comparison analysis of blood pressure, obesity, and cardio-respiratory fitness in schoolchildren

FUNDAMENTO: Durante a infância e adolescência, o sedentarismo, o excesso de peso e a alimentação inadequada são fatores de risco para doenças crônicas, sobretudo obesidade, hipertensão arterial sistêmica e diabete melito. A intervenção precoce pode prevenir o desenvolvimento dessas complicações. OBJETIVO: Verificar a presença de fatores de risco cardiovasculares (obesidade e hipertensão arterial) e suas possíveis interações com a capacidade cardiorrespiratória. Métodos: Estudo transversal composto de amostra estratificada por conglomerados, de 1.666 escolares, com idades entre 7 e 17 anos, 873 (52,4 por cento) do sexo masculino e 793 (47,6 por cento) do sexo feminino. Avaliaram-se as pressões arteriais sistólica (PAS) e diastólica (PAD), índice de massa corporal (IMC), percentual de gordura ( por centoG) e capacidade cardiorrespiratória. Ainda, PAS e PAD foram correlacionadas com circunferência da cintura (CC), relação cintura-quadril (RCQ), somatório de dobras cutâneas (ΣDC) e capacidade cardiorrespiratória. RESULTADOS: A avaliação do IMC dos escolares evidenciou 26,7 por cento de sobrepeso ou obesidade e 35,9 por cento com o percentual de gordura acima de moderadamente alto. Com relação aos níveis pressóricos, encontraram-se 13,9 por cento e 12,1 por cento de escolares limítrofes e hipertensos, para PAS e PAD, respectivamente. Houve associação entre hipertensão, obesidade e capacidade cardiorrespiratória. Observou-se correlação significativa em relação à PAS e PAD, para todas as variáveis analisadas, apresentando, ainda, uma relação fraca a moderada com as variáveis idade, peso, estatura, IMC e circunferência da cintura. CONCLUSÃO: A presença da hipertensão arterial associada à obesidade e seu reflexo na capacidade cardiorrespiratória reforçam a importância de se propor, já na infância, um estilo de vida mais ativo e saudável.

BACKGROUND: During childhood and adolescence, physical inactivity, excess weight, and poor nutrition are risk factors for chronic diseases, especially obesity, hypertension, and diabetes mellitus. Early intervention can prevent the development of these complications. OBJECTIVE: To determine the presence of cardiovascular risk (obesity and hypertension) in schoolchildren and its potential interactions with cardio-respiratory fitness. METHODS: This was a cross-sectional study conducted in a stratified cluster sample of 1,666 schoolchildren, aged between 7 and 17 years, 873 (52.4 percent) of them male and 793 (47.6 percent) of them female. The following variables were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), body fat percentage (BF percent), and cardio-respiratory fitness. SBP and DBP were correlated with waist circumference (WC), waist-hip ratio (WHR), sum of skin folds (ΣSF), and cardio-respiratory fitness. RESULTS: A BMI assessment of the students showed that 26.7 percent of them were overweight or obese, and 35.9 percent had body fat percentage over moderately high. As to blood pressure, we found that 13.9 percent and 12.1 percent of the students were borderline or hypertensive, for SBP and DBP, respectively. There was an association among hypertension, obesity, and cardio-respiratory fitness. There was a significant correlation of SBP and DBP with all variables, and also a weak to moderate correlation with age, weight, height, BMI, and waist circumference. CONCLUSION: The presence of hypertension associated with obesity and its effects on cardio-respiratory fitness stress the importance of recommending, since childhood, a more active and healthy lifestyle.

Prevalence of extended-spectrum beta-lactamases-producing microorganisms in nosocomial patients and molecular characterization of the shv type isolates

The emergence of Extended-Spectrum Beta-Lactamase (ESBL)-producing microorganisms in Brazilian hospitals is a challenge that concerns scientists, clinicians and healthcare institutions due to the serious risk they pose to confined patients. The goal of this study was the detection of ESBL production by clinical strains of Escherichia coli and Klebsiella sp. isolated from pus, urine and blood of patients at Hospital Universitário Santa Maria, Rio Grande Sul, RS, Brazil and the genotyping of the isolates based on bla SHV genes. The ESBL study was carried out using the Combined Disc Method, while Polymerase Chain Reaction (PCR) was used to study the bla SHV genes. Of the 90 tested isolates, 55 (61.1 percent) were identified as ESBL-producing by the combined disk method. The bla SHV genes were found in 67.8 percent of these microorganisms. K. pneumoniae predominated in the samples, presenting the highest frequency of positive results from the combined disk and PCR.

[Comparison analysis of blood pressure, obesity, and cardio-respiratory fitness in schoolchildren].

BACKGROUND: During childhood and adolescence, physical inactivity, excess weight, and poor nutrition are risk factors for chronic diseases, especially obesity, hypertension, and diabetes mellitus. Early intervention can prevent the development of these complications. OBJECTIVE: To determine the presence of cardiovascular risk (obesity and hypertension) in schoolchildren and its potential interactions with cardio-respiratory fitness. METHODS: This was a cross-sectional study conducted in a stratified cluster sample of 1,666 schoolchildren, aged between 7 and 17 years, 873 (52.4%) of them male and 793 (47.6%) of them female. The following variables were evaluated: systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), body fat percentage (BF %), and cardio-respiratory fitness. SBP and DBP were correlated with waist circumference (WC), waist-hip ratio (WHR), sum of skin folds (SigmaSF), and cardio-respiratory fitness. RESULTS: A BMI assessment of the students showed that 26.7% of them were overweight or obese, and 35.9% had body fat percentage over moderately high. As to blood pressure, we found that 13.9% and 12.1% of the students were borderline or hypertensive, for SBP and DBP, respectively. There was an association among hypertension, obesity, and cardio-respiratory fitness. There was a significant correlation of SBP and DBP with all variables, and also a weak to moderate correlation with age, weight, height, BMI, and waist circumference. CONCLUSION: The presence of hypertension associated with obesity and its effects on cardio-respiratory fitness stress the importance of recommending, since childhood, a more active and healthy lifestyle.

Prevalence of extended-spectrum beta-lactamases-producing microorganisms in nosocomial patients and molecular characterization of the shv type isolates.

The emergence of Extended-Spectrum Beta-Lactamase (ESBL)-producing microorganisms in Brazilian hospitals is a challenge that concerns scientists, clinicians and healthcare institutions due to the serious risk they pose to confined patients. The goal of this study was the detection of ESBL production by clinical strains of Escherichia coli and Klebsiella sp. isolated from pus, urine and blood of patients at Hospital Universitário Santa Maria, Rio Grande Sul, RS, Brazil and the genotyping of the isolates based on bla SHV genes. The ESBL study was carried out using the Combined Disc Method, while Polymerase Chain Reaction (PCR) was used to study the bla SHV genes. Of the 90 tested isolates, 55 (61.1%) were identified as ESBL-producing by the combined disk method. The bla SHV genes were found in 67.8% of these microorganisms. K. pneumoniae predominated in the samples, presenting the highest frequency of positive results from the combined disk and PCR.

[Prevalence of the TEM, SHV and CTX-M families of extended-spectrum beta-lactamases in Escherichia coli and Klebsiella spp at the University Hospital of Santa Maria, State of Rio Grande do Sul]. / Prevalência das famílias TEM, SHV e CTX-M de beta-lactamases de espectro estendido em Escherichia coli e Klebsiella spp no Hospital Universitário de Santa Maria, Estado do Rio Grande do Sul.

In this study, the distribution and prevalence of extended-spectrum beta-lactamases belonging to the TEM, SHV and CTX-M families were estimated among samples of Escherichia coli and Klebsiella spp. at the university hospital of Santa Maria, Rio Grande do Sul. Over a 14-month period, 90 microorganisms were selected as likely ESBL producers. The isolates were subjected to confirmatory phenotype tests for the presence of ESBL. Through investigating the respective genes using the polymerase chain reaction, the ESBL types present in each microorganism were then determined. Fifty-five samples (61.1%) were confirmed as ESBL-positive by means of the combined disc method, and 57 (63.3%) were found to be ESBL producers by means of the double disc method. From the polymerase chain reaction, ESBLs of TEM and SHV types were more frequently present in Klebsiella pneumoniae, while ESBL of CTX-M type was more frequently present in Klebsiella oxytoca.

Prevalência das famílias TEM, SHV e CTX-M de -lactamases de espectro estendido em Escherichia coli e Klebsiella spp no Hospital Universitário de Santa Maria, Estado do Rio Grande do Sul / Prevalence of the TEM, SHV and CTX-M families of extended-spectrum -lactamases in Escherichia coli and Klebsiella spp at the University Hospital of Santa Maria, State of Rio Grande do Sul

Neste estudo estimou-se a distribuição e prevalência de β-lactamases de espectro estendido pertencentes às famílias TEM, SHV e CTX-M entre amostras de Escherichia coli e Klebsiella spp. no Hospital Universitário de Santa Maria, Rio Grande do Sul. Durante 14 meses, 90 microrganismos foram selecionados como prováveis produtores de ESBL. Os isolados foram submetidos a testes fenotípicos confirmatórios para a presença de ESBL. A seguir, os tipos de ESBLs presentes em cada microrganismo foram determinados através da pesquisa dos respectivos genes através da reação em cadeia da polimerase. Empregando-se o método do disco combinado, a presença de ESBLs foi confirmada em 55 (61,1 por cento) amostras; quando o método do duplo disco foi utilizado, 57 (63,3 por cento) amostras foramprodutoras de ESBLs. Com base na PCR, as ESBLs do tipo TEM e SHV foram mais presentes em Klebsiella pneumoniae enquanto que ESBL do tipo CTX-M foram mais presentes em Klebsiella oxytoca.

In this study, the distribution and prevalence of extended-spectrum β-lactamases belonging to the TEM, SHV and CTX-M families were estimated among samples of Escherichia coli and Klebsiella spp. at the university hospital of Santa Maria, Rio Grande do Sul. Over a 14-month period, 90 microorganisms were selected as likely ESBL producers. The isolates were subjected to confirmatory phenotype tests for the presence of ESBL. Through investigating the respective genes using the polymerase chain reaction, the ESBL types present in each microorganism were then determined. Fifty-five samples (61.1 percent) were confirmed as ESBL-positive by means of the combined disc method, and 57 (63.3 percent) were found to be ESBL producers by means of the double disc method. From the polymerase chain reaction, ESBLs of TEM and SHV types were more frequently present in Klebsiella pneumoniae, while ESBL of CTX-M type was more frequently present in Klebsiella oxytoca.

Prevalência de patógenos bacterianos e susceptibilidade aos antimicrobianos em infecções do trato urinário de amostras ambulatoriais / Bacterial pathogens prevalence and antimicrobial susceptibility in community-acquired urinary tract infection

Este estudo descreve a distribuição e a susceptibilidade de micro-organismos isolados de pacientes com infecção do trato urinário (ITU) em Santa Cruz do Sul-RS no período de 2001 a 2006. Das 7571 amostras de urinas analisadas, 1276 (16,8%) apresentaram bacteriúria significativa (≥105 UFC/mL). A maioria das amostras com crescimento significativo pertencia ao sexo feminino (91,4%). O micro-organismo mais frequente foi a Escherichia coli, isolada em 70,5% das uroculturas. Os antimicrobianos aos quais os uropatógenos foram mais resistentes foram ampicilina (31,0%), amoxilina (30,2%), ácido pipemídico (19,6%), sulfametoxazol-trimetoprim (19,2%) e ácido nalidíxico (18,8%). Este estudo contribui para o conhecimento de taxas de resistência locais, sendo essa uma das etapas básicas para o estabelecimento de estratégias particularizadas em relação ao uso racional de antimicrobianos. Estudos sistemáticos da resistência em uropatógenos causadores de ITUs não complicadas podem fornecer informações relevantes para médicos e outros profissionais da saúde no desenvolvimento de protocolos terapêuticos.