Immunogenicity and safety of inactivated SARS-CoV-2 vaccine (CoronaVac) using two-dose primary protocol in children and adolescents (Immunita-002, Brazil): A phase IV six-month follow up.

Introduction: Vaccines are essential for the prevention and control of several diseases, indeed, monitoring the immune response generated by vaccines is crucial. The immune response generated by vaccination against SARS-CoV-2 in children and adolescents is not well defined regarding to the intensity and medium to long-term duration of a protective immune response, which may point out the need of booster doses and might support the decisions in public health. Objective: The study aims to evaluate the immunogenicity and safety of inactivated SARS-CoV-2 vaccine (CoronaVac) in a two-dose primary protocol in children and adolescent aging from 3 to 17 years old in Brazil. Methods: Participants were invited to participate in the research at two public healthcare centers located in Serrana (São Paulo) and Belo Horizonte (Minas Gerais), Brazil. Participants underwent medical interviews to gather their medical history, including COVID-19 history and medical records. Physical exams were conducted, including weight, blood pressure, temperature, and pulse rate measurements. Blood samples were obtained from the participants before vaccination, 1 month after the first dose, and 1, 3, and 6 months after the second dose and were followed by a virtual platform for monitoring post-vaccination reactions and symptoms of COVID-19. SARS-CoV-2 genome from Swab samples of COVID-19 positive individuals were sequenced by NGS. Total antibodies were measured by ELISA and neutralizing antibodies to B.1 lineage and Omicron variant (BA.1) quantified by PRNT and VNT. The cellular immune response was evaluated by flow cytometry by the quantification of systemic soluble immune mediators. Results: The follow-up of 640 participants showed that the CoronaVac vaccine (Sinovac/Butantan Institute) was able to significantly induce the production of total IgG antibodies to SARS-CoV-2 and the production of neutralizing antibodies to B.1 lineage and Omicron variant. In addition, a robust cellular immune response was observed with wide release of pro-inflammatory and regulatory mediators in the early post-immunization moments. Adverse events recorded so far have been mild and transient except for seven serious adverse events reported on VigiMed. Conclusions: The results indicate a robust and sustained immune response induced by the CoronaVac vaccine in children and adolescents up to six months, providing evidences to support the safety and immunogenicity of this effective immunizer.

Utilization of bioelectrical impedance vector analysis (BIVA) in children and adolescents without diagnosed diseases: a systematic review.

Introduction. Bioelectrical impedance vector analysis (BIVA) emerges as a technique that utilizes raw parameters of bioelectrical impedance analysis and assumes the use of a reference population for information analysis.Objective. To summarize the reference values, main studies objectives, approaches, pre-test recommendations and technical characteristics of the devices employed in studies utilizing BIVA among children and adolescents without diagnosed diseases.Methods. A systematic search was conducted in nine electronic databases (CINAHL, LILACS, PubMed, SciELO, Scopus, SPORTDiscus, Science Direct, MEDLINE, and Web of Science). Studies with different designs which allowed extracting information regarding reference values of BIVA in children and adolescents without diagnosed diseases, aged 19 years or younger, were included. The systematic review followed PRISMA procedures and was registered in PROSPERO (registration: CRD42023391069).Results. After applying the eligibility criteria, 36 studies were included. Twenty studies (55.6%) analyzed body composition using BIVA, thirteen studies (36.1%) aimed to establish reference values for BIVA, and three studies (8.3%) investigated the association of physical performance with BIVA. There was heterogeneity regarding the reference populations employed by the studies. Fifteen studies used their own sample as a reference (41.6%), four studies used the adult population as a reference (11.1%), and five studies used reference values from athletes (13.9%).Conclusion. Nutricional status and body composition were the main studies objectives. References values were not always adequate or specific for the sample and population. Furthermore, there was no pattern of pre-test recommendations among the studies.

Association between Phase Angle and Body Composition of Children and Adolescents Diagnosed with HIV Infection.

The aim of the study was to investigate how phase angle (PhA) is associated with subtotal and lumbar spine bone mineral density [BMD], lean soft tissue mass [LSTM], total body fat mass, android and gynoid in children and adolescents with HIV according to sex. A cross-sectional study was conducted in Florianópolis, Brazil, involving 64 children and adolescents vertically transmitted with HIV. Resistance and reactance values were obtained using bioelectrical impedance analysis, and PhA was subsequently calculated. Dual emission X-ray absorptiometry was used to assess body composition. Antiretroviral medication, physical activity (accelerometers) and skeletal maturation (wrist-carpal radiography) were used in the adjusted model. In males, PhA was directly associated with subtotal BMD (ßadj: 0.65; R²: 0.38, p < 0.01) and lumbar spine BMD (ßadj: 0.53; R²: 0.22, p = 0.01), directly associated with LSTM (ßadj: 0.76; R²: 0.46, p < 0.01), and inversely associated with gynoid fat (ßadj: -0.47; R²: 0.2, p = 0.01), in adjusted models. In females, PhA was directly associated with subtotal BMD (ßadj: 0.46; R²: 0.17, p < 0.01) and lumbar spine BMD (ßadj: 0.48; R²: 0.19, p < 0.01). It is concluded that PhA was directly associated with subtotal and regional BMD, LSTM, and inversely with gynoid fat in boys with HIV. In girls, PA was directly associated only with subtotal and regional BMD.

Phase angle and body composition: A scoping review.

The aim of the study was to map evidence on the association between phase angle (PhA) and body composition in populations healthy and clinical populations). A systematic search for information regarding the topic was conducted in nine electronic databases (CINAHL, LILACS, PubMed, SciELO, Scopus, SPORTDiscus, Science Direct, MEDLINE and Web of Science) between October and November 2021. Studies with different designs, which allowed extracting information about the relationship between PhA and body composition (body cell mass [BCM], muscle tissue, bone mineral content, lean mass, total fat mass, visceral fat, and lean soft tissue mass [LSTM]) were included. Of the total of 11,913 initially identified studies, 59 were included after reading titles, abstracts, full texts and references. Most studies (40.67%; n = 24) presented data from Brazilian samples. With regard to the design of studies, 15 (25.42%) had longitudinal design. The age group of studies was wide, with studies involved 3-year-old children and 88-year-old adults. Body fat mass was evaluated by 31 studies (52.54%) in which 11 observed inverse relationships, nine studies showed direct relationships and 11 observed no relationship. Regarding lean mass, muscle mass, and fat-free mass components, most studies observed direct relationship with PhA (n = 37; 86.04%). It could be concluded that the phase angle was directly associated with lean mass and muscle mass in different age groups (children, adolescents, adults and older adults) and in people with different health diagnoses (HIV, cancer, hemodialysis, sarcopenia and without the diagnosis of diseases). Regarding body fat and the other investigated components, there is not enough evidence to establish the direction of associations.

Oral health education for systemic sclerosis patients: A booklet report.

Purpose/objectives: Systemic sclerosis (SSc) is a rare chronic autoimmune disease characterized by vascular abnormalities and connective tissue disorders. In 2021, the multidisciplinary team of the university hospital recognized a demand for oral health information among SSc patients. This study aims to describe the development of an SSc oral health booklet and its validation by people with SSc. Methods: For the development of the booklet, the project creators employed the action research methodology involving ten stages. SSc patients evaluated the material by filling out a digital form. Results: One hundred and thirty-one people with SSc evaluated the booklet. It received an average score of 9.73 (SD: 0.80) in relevance, 9.82 (SD: 0.47) in explicitness, and 9.49 (SD: 0.93) in aesthetics. The final version was emailed to the participants and posted on social media. Innovation: This is the first booklet that deeply addresses these issues in Portuguese and constitutes a soft technology to instruct and assist patients with SSc. Conclusion: The production of high-quality educational materials on oral health for patients with SSc is necessary. The online distribution increased its reach and had great importance in the context of the COVID-19 pandemic.

Reference growth curves to identify weight status (underweight, overweight or obesity) in children and adolescents: systematic review.

The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as malnutrition and obesity and to identify underweight, overweight and obesity. The purpose of this systematic review was to identify studies providing reference growth curves for weight status in children and adolescents. A systematic search was conducted in eight databases and in gray literature (Google scholar). To assess the risk of bias/methodological quality of studies, the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-sectional Studies (NHLBI) was used. Overall, 86 studies that met the inclusion criteria were included. Through the values   of reference growth curves for the identification of underweight, overweight and obesity, it was possible to verify that there is great variability among percentiles for the identification of underweight, overweight and obesity. The most prevalent percentiles for underweight were P3 and P5; for overweight, the most prevalent was P85 and the most prevalent percentiles for obesity were P95 and P97. The most prevalent anthropometric indicators were Body Mass Index (BMI), Waist Circumference (WC), Body Mass (BM) for age and height for age. Conclusion: Such data can demonstrate that the optimal growth must be reached, through the standard growth curves, but that the reference curves demonstrate a cut of the population growth, raising possible variables that can influence the optimal growth, such as an increase in the practice of physical activities and an awareness of proper nutrition.

Association between lipid and glycemic profile and total body and trunk fat in children and adolescents diagnosed with HIV.

INTRODUCTION: Metabolic alterations and body fat redistribution are common in people living with HIV using antiretroviral therapy and increase the risk of premature cardiovascular diseases. AIM: To verify the presence of difference in the lipid and glycemic profile in relation to different total body and trunk fat phenotypes in children and adolescents diagnosed with HIV+. METHOD: This is a cross-sectional study carried out with 62 children and adolescents diagnosed with HIV+. Lipid and glycemic profiles were obtained from blood samples. Total and trunk fat mass (FM) was obtained by DXA. Analysis of covariance was used to verify if there is difference in the lipid and glycemic profile between total body and trunk fat phenotypes. RESULTS: In males, in the covariate-adjusted model, it was observed that boys with high total FM had higher triglyceride values (mean: 164.9 mg/dl-1 ±31.2) compared to those with low and adequate total FM. In females, in adjusted models, it was observed that girls with high total FM had higher total cholesterol (mean: 181.6 mg/dl-1 ±13.8) and LDL-C values (mean: 111.8 mg/dl-1 ±12.0), compared to those with low and adequate total FM. Girls with trunk FM had higher total cholesterol (mean: 181.6 mg/dl-1 ± 13.8), LDL-C (mean: 71.3 mg/dl-1 ± 9.6) and blood glucose values (91.6 mg/dl-1 ± 2.2). CONCLUSION: Boys with high total FM had higher triglyceride levels, while in females, it was observed that girls with high total FM and high trunk FM had higher total cholesterol, LDL-C and blood glucose values. High body fat in children and adolescents living with HIV is related to metabolic changes in the lipid and glycemic profile, with specificities of sex and fat location.

Regional phase angle, not whole-body, is augmented in response to pre-season in professional soccer players.

The objective of this article was to assess the effects of six-week pre-season training on whole-body and regional bioelectrical impedance analysis (BIA)-derived parameters, body composition, power, and aerobic performance in professional soccer players. Ten professional soccer athletes participated in the present study. Whole-body and regional hamstrings BIA-derived parameters [resistance, reactance, impedance, phase angle (PhA)], body composition, total body water (TBW), intracellular (ICW), and extracellular (ECW) were measured before, at mid-point, and after sixth week of the pre-season. Power (countermovement jump and squat jump) and aerobic capacity (Yo-Yo test) were measured before and after pre-season. There was a significant increase in the regional PhA (+13.9%) but not in the whole-body. There was a reduction in fat mass (-4.1%), an increase in fat-free mass (+1.7%), TBW (+8.3%), ICW (+8.8%), and ECW (+7.6%), as well as an increase in jump height (+11.0%) and distance covered in the Yo-Yo test (+34.7%). From our results, it is possible to suggest that pre-season training can induce an increase in hamstring PhA as well as body recomposition and improvement of physical fitness in professional soccer players.

Association between bone mineral density and content and physical growth parameters among children and adolescents diagnosed with HIV: a cross-sectional study

ABSTRACT BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

Association between bone mineral density and content and physical growth parameters among children and adolescents diagnosed with HIV: a cross-sectional study.

BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

Previous biological therapy and impairment of the IFN-γ/IL-10 axis are associated with low immune response to 17DD-YF vaccination in patients with spondyloarthritis.

Yellow fever (YF) vaccination is known to induce a suboptimal response in patients with autoimmune diseases (AIDs). To date, few studies have focused on the performance of 17DD-YF vaccination in patients with spondyloarthritis (SpA). In general, patients with SpA are young and have less comorbidities than other patients with AIDs, and frequently receive biological disease-modifying antirheumatic drugs (DMARDs) that may impact their response to vaccines. Taking this background information, the present study aimed to investigate whether the use of biological DMARDs, even after planned washout, or disease activity measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), would impact the overall performance of planned 17DD-YF primary vaccination in patients with SpA. For this purpose, 74 subjects were enrolled in a prospective study, including adult patients with SpA (SpA; n = 51) and a healthy control (HC; n = 23) group. Analysis of YF specific neutralizing antibodies test (PRNT), along with YF viremia and the levels of serum chemokines, cytokines, and growth factors were performed at distinct time points (D0, D3, D4, D5, D6, D7, D14, and D28). The BASDAI scores were evaluated at D0 and D180. Data demonstrated that overall, the SpA group presented lower PRNT titers and seropositivity rates as compared to the HC group (GeoMean = 112 vs. 440; 73% vs. 96%, respectively). In SpA subgroup analyses, previous biological DMARDs (BIO-IT) led to a lower PRNT titers (BIO-IT 79, 95% CI [39-150] vs. without biological DMARDs [non-BIO-IT] 159, 95% CI [94-267], p < 0.001). The non-BIO-IT group achieved a response similar to the HC group (81% vs. 96%, p = 0.112), whereas the BIO-IT group had a lower seroconversion rate (64% vs. 96% HC, p = 0.007). The BASDAI was not associated with PRNT levels and did not change after 6 months of follow-up. No differences in YF viremia were observed amongst subgroups. Higher baseline levels of serum biomarkers were observed in the BIO-IT group vs. the non-BIO-IT group, as well as in those with a BASDAI ≥ 4 vs. those with a BASDAI < 4. Increasing levels of several biomarkers were observed in SpA, especially in the BIO-IT and BASDAI ≥ 4 subgroups throughout the timeline kinetics, with impairment/disturbance in the IFN-γ/IL-10 axis around the peak of viremia (D5). Altogether, these findings suggested that the use of biological DMARDs impacts the response to the 17DD-YF vaccine, even after planned washout. Therefore, previous biological DMARD therapy, the inflammatory status prior vaccination, and impairment of the IFN-γ/IL-10 axis at the peak of viremia may determine the immunogenicity of 17DD-YF vaccination in patients with SpA.

Muscle mass indicators as fat-free mass and lean soft tissue mass are associated with handgrip strength in HIV-diagnosed children and adolescents.

OBJECTIVE: To verify the association between fat free mass (FFM) and lean soft tissue mass (LSTM) with handgrip strength (HGS) in HIV children and adolescents, according to sex. METHOD: This cross-sectional study included 65 HIV children and adolescents, aged from 8-15 years (30 boys and 35 girls). FFM and LSTM were measured by dual-energy X-ray absorptiometry (DXA). HGS was measured with hydraulic dynamometer. Bone age was assessed by radiography of the wrist of the left carpus and moderate to vigorous physical activity was obtained through the use of accelerometers. The use of antiretroviral drugs (ART) was obtained from the medical records of each participant. RESULTS: For boys, the FFM model explained 86% the HGS variability (p < 0.001). For girls, the FFM model explained 90% the HGS variability (p < 0.001). LSTM explained 88% the HGS variability for both sexes. CONCLUSION: FFM and LSTM were directly associated with HGS. However, models with bone age, physical activity level and type of ART improved the explanatory power of LLM and LSTM in HGS.

Cytotoxic Activity and Lymphocyte Subtypes in Mice Selected for Maximal and Minimal Inflammatory Response after Transplantation of B16F10 and S91 Melanoma Cells.

AIRmax and AIRmin mice strains were selected according to the intensity of their acute inflammatory responsiveness. Previous studies have shown that AIR mice differ in their resistance to chemically induced skin tumors and in the development of melanoma metastases, in addition to differences in neutrophil and NK cells activity. In the present work, we aimed to evaluate whether the difference of susceptibility to murine melanoma is associated with NK cytotoxic activity against Yac.1 cells and lymphocyte subsets. Mice were subcutaneously inoculated with B16F10 or S91 melanoma cells. After 7, 14, or 30 days, the animals were euthanized to analyze the number of lymphocyte subsets, cytotoxic activity, and number of cytokine-producing spleen cells. AIRmax mice presented a higher number of CD4+/CD25+ cells than that of AIRmin mice following inoculation of B16F10 cells, whereas inoculation of S91 cells reduced CD4+/CD25+ and increased TCD8+ cell subsets in the AIRmax mice. AIRmax mice had a higher number of interleukin (IL)-10- and IL-12-producing cells and a lower number of interferon-γ-producing cells than those of AIRmin mice at 30 days. The cytotoxic activity of nonadherent spleen cells was similar in both the AIR strains. These results suggest that melanoma cells can induce different responses in AIR mice, possibly owing to alterations in regulatory mechanisms, such as the action of CD4+/CD25+ regulatory T cells and IL-10, in AIRmax mice.

Excesso de adiposidade corporal periférica, central e geral em adolescentes de uma cidade do sul do Brasil / Excess of peripheral, central and general body adiposity in adolescents in a city in southern Brazil

Objetivo: estimar a prevalência e analisar os fatores sociodemográficos e de estilo de vida associados ao excesso de adiposidade periférica, central e geral em adolescentes. Método: estudo transversal, realizado na cidade de São José/Santa Catarina, Brasil, com 1.132 adolescentes (14-19 anos). As variáveis dependentes foram adiposidade periférica (dobra cutânea [DC] do tríceps), central (DC subescapular) e geral (presença de adiposidade periférica e central), classificadas pelo percentil 90 do Centers for Disease Control and Prevention. As variáveis independentes foram nível econômico, atividade física (AF) e hábitos alimentares, obtidos por meio de questionários. A maturação sexual foi avaliada segundo critérios de Tanner. Resultados: o excesso de adiposidade periférica, central e geral, foi de 11,1%, 10,3% e 7,1%, respectivamente, para adolescentes do sexo masculino e, 13,1%,14,7% e 9,8%, respectivamente, para adolescentes do sexo feminino. Os adolescentes do sexo masculino com baixos níveis de AF apresentaram maiores chances de excesso de adiposidade periférica (OR:2,32; IC95%: 1,09-5,37). As adolescentes do sexo feminino, no estágio maturacional pós-púbere apresentaram maiores chances de excesso de adiposidade central (OR:3,80; IC95%:2,25-6,41) e geral (OR:3,31; IC95%:1,79-6,10), e aquelas que estudavam no período noturno apresentaram menores chances de ter excesso de adiposidade central (OR:0,35; IC95%:0,18-0,71) e geral (OR:0,43; IC95%:0,19-0,95). Conclusão: o excesso de adiposidade se fez presente, sendo que o baixo nível de AF para os adolescentes do sexo masculino, o estágio maturacional póspúbere e o turno de estudo diurno foram fatores associados ao excesso de adiposidade para as adolescentes do sexo feminino. (AU)

Objective: to estimate the prevalence and to analyze sociodemographic and lifestyle factors associated with excess peripheral, central and general adiposity in adolescents. Method: a cross-sectional study, conducted in the city of São José/Santa Catarina, Brazil, with 1,132 adolescents (14-19 years old). The dependent variables were peripheral adiposity (tríceps skinfold), central (subscapular skinfold) and general (presence of peripheral and central adiposity), classified from the 90th percentile of the Centers for Disease Control and Prevention curve. The independent variables were economic level, physical activity (PA) and eating habits, obtained through questionnaires. The sexual maturation was evaluated according to Tanner criteria. Results: the excess of central and general peripheral adiposity was 11.1%, 10.3% and 7.1%, respectively, for male adolescents and 13.1%, 14.7% and 9.8%, respectively, for adolescent females. Males with low PA l evels presented higher odds of excess peripheral adiposity (OR: 2.32; 95% CI: 1.09-5.37). The female adolescents in the post-pubertal maturational stage presented higher odds of excess central adiposity (OR: 3.80; 95% CI: 2.25-6.41) and general adiposity (OR: 3.31; 95% CI: 1.79-6.10), and those who studied at night had a lower chance of having excess central adiposity (OR: 0.35, 95% CI: 0.18-0.71) and general adiposity (OR: 0.43; 95% CI: 0.19-0.95). Conclusion: the excess of adiposity was present and that the low level of PA for the male adolescents, the post-pubertal maturational stage and the daytime shift were factors associated with excess adiposity for female adolescents. (AU)

Does antiretroviral therapy change the relationship between body composition and muscle strength in children and adolescents diagnosed with HIV?

Background: HIV infection and prolonged use of antiretroviral therapy (ART) can impact the body composition and muscle strength of HIV-infected children and adolescents. Therefore, the aim was to verify the association between lean soft tissue mass (LSTM) and handgrip strength (HGS) in children and adolescents diagnosed with HIV using or not using ART (with or without protease inhibitors [PI]).Method: Cross-sectional study with 65 children and adolescents diagnosed with HIV aged 8-15 years of both sexes. LSTM was obtained through dual X-ray absorptiometry (DXA) and HGS using hydraulic dynamometer. Information on viral load, CD4+ T lymphocytes and type of ART (with or without [PI]) were obtained from medical records. Simple and multiple linear regression (adjusted for viral load and CD4+ T lymphocytes) was used, with p < 0.05.Results: For children and adolescents diagnosed with HIV using ART without PI, the model (LSTM, viral load and CD4+ T lymphocytes) explained 68% of HGS variability. For group with ART and PI, the model explained 73%. For group that did not use ART, the model was not associated with HGS.Conclusion: The magnitude of the association between LSTM and HGS was greater than in children and adolescents using ART with PI. ImpactIt is recognized that in the long-term antiretroviral drugs can negatively impact the body composition of children and adolescents diagnosed with HIV. However, few studies have investigated the short-term impact of drug use.The use of antiretroviral therapy (ART) with protease inhibitor (PI) increased the explanatory power of lean soft tissue mass with muscle strength in children and adolescents diagnosed with HIV.These results demonstrate the importance of antiretroviral drugs in the short term. Further studies are needed to identify how and when interventions are needed to reduce the negative effects of drugs in the long term.

What anthropometric indicators are associated with insulin resistance? Cross-sectional study on children and adolescents with diagnosed human immunodeficiency virus

ABSTRACT BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.

Crystal structure of the Cys-NO modified YopH tyrosine phosphatase.

Protein tyrosine phosphatases (PTPs) are key virulence factors in pathogenic bacteria, consequently, they have become important targets for new approaches against these pathogens, especially in the fight against antibiotic resistance. Among these targets of interest YopH (Yersinia outer protein H) from virulent species of Yersinia is an example. PTPs can be reversibly inhibited by nitric oxide (NO) since the oxidative modification of cysteine residues may influence the protein structure and catalytic activity. We therefore investigated the effects of NO on the structure and enzymatic activity of Yersinia enterocolitica YopH in vitro. Through phosphatase activity assays, we observe that in the presence of NO YopH activity was inhibited by 50%, and that this oxidative modification is partially reversible in the presence of DTT. Furthermore, YopH S-nitrosylation was clearly confirmed by a biotin switch assay, high resolution mass spectrometry (MS) and X-ray crystallography approaches. The crystal structure confirmed the S-nitrosylation of the catalytic cysteine residue, Cys403, while the MS data provide evidence that Cys221 and Cys234 might also be modified by NO. Interestingly, circular dichroism spectroscopy shows that the S-nitrosylation affects secondary structure of wild type YopH, though to a lesser extent on the catalytic cysteine to serine YopH mutant. The data obtained demonstrate that S-nitrosylation inhibits the catalytic activity of YopH, with effects beyond the catalytic cysteine. These findings are helpful for designing effective YopH inhibitors and potential therapeutic strategies to fight this pathogen or others that use similar mechanisms to interfere in the signal transduction pathways of their hosts.

What anthropometric indicators are associated with insulin resistance? Cross-sectional study on children and adolescents with diagnosed human immunodeficiency virus.

BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.

Muscular Fitness and Cardiometabolic Variables in Children and Adolescents: A Systematic Review.

BACKGROUND: The importance of muscular fitness (MF) in the performance of activities of daily living is unequivocal. Additionally, emerging evidence has shown MF can reduce cardiometabolic risk in children and adolescents. OBJECTIVES: The purpose of this study was to examine and summarize the evidence regarding the relationship between MF phenotypes (i.e., maximum muscular strength/power, muscular endurance, and maximum muscular strength/power/endurance) and cardiometabolic variables (obesity, blood pressure, lipids, glucose homeostasis, inflammatory markers, and clustered cardiometabolic variables) in children and adolescents. DESIGN: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with PROSPERO, number CRD42020179273. DATA SOURCES: A systematic review was performed on five databases (PubMed, EMBASE, SciELO, Scopus, and Web of Knowledge) from database inception to May 2020, with complementary searches in reference lists. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Eligibility criteria included (1) a study sample of youth aged ≤ 19 years, (2) an assessment of MF with individual or clustered cardiometabolic variables derived from adjusted models (regardless of test/measurement adopted or direction of reported association), and (3) a report of the association between both, using observational studies. Only original articles published in peer-reviewed journals in English, Portuguese, and Spanish languages were considered. The quality of the included studies was assessed by using the National Heart, Lung, and Blood Institute checklist. The percentage of results reporting a statistically significant inverse association between each MF phenotype and cardiometabolic variables was calculated. RESULTS: Of the 23,686 articles initially identified, 96 were included (77 cross-sectional and 19 longitudinal), with data from children and adolescents from 35 countries. The score for the quality of evidence ranged from 0.33 to 0.92 (1.00 maximum). MF assessed by maximum muscular strength/power was inversely associated with lower obesity (64/113 total results (56.6%)) and reduction in clustered cardiometabolic risk (28/48 total results (58.3%)). When assessed by muscular endurance, an inverse association with obesity (30/44 total results (68.1%)) and cardiometabolic risk (5/8 total results (62.5%)) was identified. Most of the results for the relationship between MF phenotypes with blood pressure, lipids, glucose homeostasis, and inflammatory markers indicated a paucity of evidence for these interrelationships (percentage of results below 50.0%). CONCLUSION: MF assessed by maximum muscular strength/power or muscular endurance is potentially associated with lower obesity and lower risk related to clustered cardiometabolic variables in children and adolescents. There is limited support for an inverse association between MF with blood pressure, lipids, glucose homeostasis biomarkers, and inflammatory markers in children and adolescents.

Association between excess peripheral, central and general adiposity with high blood pressure in adolescents in southern Brazil / Associação entre excesso de adiposidade periférica, central e geral com pressão alta em adolescentes do Sul do Brasil

Introduction: Excess adiposity is one of the main risk factors for cardiovascular diseases, including high blood pressure. Children and adolescents with obesity and hypertension are at greater risk of morbidity and mortality in adulthood. Objective: To analyze the association between excess peripheral, central and general adiposity with high blood pressure in adolescents in southern Brazil.Methods: This is a cross-sectional study with 1,132 adolescents (16.50 ± 1.14 years) of both sexes. Measurements were performed with the oscillometric method using digital sphygmomanometer, considering high systolic and diastolic blood pressure, values above the 95th percentile for sex and age. Peripheral adiposity (triceps skinfold) and central adiposity (subscapular skinfold) were classified as high from the 90th percentile of the Centers for Disease Control and Prevention reference distribution. For excess general adiposity, triceps and subscapular skinfold above the 90th percentile were simultaneously considered. Logistic regression was used with 5% significance level. Results: Male adolescents with high peripheral, central and general adiposity were, respectively, 2.43 (95% CI: 1.14; 5.19), 3.50 (95% CI: 1.66; 7.41) and 2.47 (95% CI: 1.01; 6.18) times more likely of having high SBP. Male adolescents with excess general adiposity were more likely of developing high diastolic blood pressure (OR: 3.31; 95% CI: 1.41; 7.70). Female adolescents with excess central and general adiposity were 4.15 (95% CI: 1.97; 8.77) and 3.30 (95% CI: 1.41; 7.77) times more likely of developing high diastolic blood pressure, respectively. Conclusion: Male adolescents with excess peripheral, central and general adiposity were more likely of having high systolic blood pressure and high diastolic blood pressure when presenting high general adiposity. In addition, female adolescents with high excess central and general adiposity were more likely of having high diastolic blood pressure.

Introdução: o excesso de adiposidade é um dos principais fatores de risco para doenças cardiovasculares, incluindo a hipertensão arterial. Crianças e adolescentes com obesidade e hipertensão apresentam maiores riscos de morbidez e mortalidade na vida adulta. Objetivo: analisar a associação entre excesso de adiposidade periférica, central e geral com pressão arterial (PA) elevada em adolescentes do Sul do Brasil. Método: estudo transversal com 1.132 adolescentes (16,50 ±1,14 anos) de ambos os sexos. As mensurações foram por método oscilométrico com esfigmomanômetro digital considerando como PA sistólica (PAS) e PA diastólica (PAD) elevadas, valores acima do percentil 95 para sexo e idade. A adiposidade periférica (dobra cutânea do tríceps) e central (dobra cutânea subescapular) foram classificadas em elevada a partir do percentil 90 da distribuição de referência do Centers for Disease Control and Prevention. Para excesso de adiposidade geral foram consideradas a dobra cutânea tricipital e subescapular acima do percentil 90, simultaneamente. Empregou-se regressão logística com nível de significância de 5%. Resultados: adolescentes do sexo masculino com adiposidade periférica, central e geral elevada apresentaram, respectivamente, 2,43 (IC95%: 1,14; 5,19), 3,50 (IC95%: 1,66; 7,41) e 2,47 (IC95%: 1,01; 6,18) vezes mais chances de PAS elevada. Adolescentes do sexo masculino com adiposidade geral elevada apresentaram maiores chances de desenvolver PAD elevada (OR: 3,31; IC95%: 1,41; 7,70). Adolescentes do sexo feminino com adiposidade central e geral elevada obtiveram 4,15 (IC95%: 1,97; 8,77) e 3,30 (IC95%: 1,41; 7,77) vezes mais chances de desenvolver PAD elevada, respectivamente. Conclusão: adolescentes do sexo masculino com adiposidade periférica, central e geral elevada tiveram mais chances de pressão arterial sistólica elevada e pressão arterial diastólica elevada quando apresentavam adiposidade geral elevada. Adolescentes do sexo feminino com adiposidade central e geral elevada apresentaram mais chances de pressão arterial diastólica elevada.