Screening of latent tuberculosis infection among patients with diabetes mellitus from a high-burden area in Brazil.

Although several cohort studies have raised the important association between diabetes mellitus (DM) and latent tuberculosis infection (LTBI), evidences are limited and controversial. Furthermore, it is well documented that the poor glycemic control may exacerbate the risk for active TB. Thus, the monitoring of diabetic patients living in high-incidence areas for TB is an important concern in views of available diagnostic tests for LTBI. In this cross-sectional study, we estimate the association of DM and LTBI among diabetic patients classified as type-1 DM (T1D) or type-2 DM (T2D) living in Rio de Janeiro, RJ, Brazil - considered a high TB burden region of these country. Non-DM volunteers were included as endemic area healthy controls. All participants were screened for DM using glycosylated-hemoglobin (HbA1c) and for LTBI using the QuantiFERON-TB Gold in Tube (QFT-GIT). Demographic, socioeconomic, clinical and laboratorial data were also assessed. Among 553 included participants, 88 (15.9%) had QFT-GIT positive test, of which 18 (20.5%) were non-DM, 30 (34.1%) T1D and 40 (45.4%) T2D. After adjustments for potential baseline confounders, age, self-reported non-white skin color and an active TB case in the family were significantly associated with LTBI among the studied population by using a hierarchical multivariate logistic regression analysis. Additionally, we verified that T2D patients were able to produce significant increased interferon-gamma (IFN-γ) plasma levels in response to Mycobacterium tuberculosis-specific antigens, when compared to non-DM individuals. Altogether, our data showed an increased prevalence of LTBI among DM patients, albeit non-statistically significant, and point out to important independent factors associated with LTBI, which deserve attention in monitoring patients with DM. Moreover, QFT-GIT test seems to be a good tool to screening LTBI in this population, even in a high TB burden area.

Alpha thalassemia, but not ßS-globin haplotypes, influence sickle cell anemia clinical outcome in a large, single-center Brazilian cohort.

Alpha thalassemia and beta-globin haplotype are considered classical genetic disease modifiers in sickle cell anemia (SCA) causing clinical heterogeneity. Nevertheless, their functional impact on SCA disease emergence and progression remains elusive. To better understand the role of alpha thalassemia and beta-globin haplotype in SCA, we performed a retrospective study evaluating the clinical manifestations of 614 patients. The univariate analysis showed that the presence of alpha-thalassemia -3.7-kb mutation (αα/-α and -α/-α) decreased the risk of stroke development (p = 0.046), priapism (p = 0.033), and cholelithiasis (p = 0.021). Furthermore, the cumulative incidence of stroke (p = 0.023) and cholelithiasis (p = 0.006) was also significantly lower for patients carrying the alpha thalassemia -3.7-kb mutation. No clinical effects were associated with the beta-globin haplotype analysis, which could be explained by the relatively homogeneous haplotype composition in our cohort. Our results reinforce that alpha thalassemia can provide protective functions against hemolysis-related symptoms in SCA. Although, several genetic modifiers can impact the inflammatory state of SCA patients, the alpha thalassemia mutation remains one of the most recurrent genetic aberration and should therefore always be considered first.

Microplastics in subsurface waters of the western equatorial Atlantic (Brazil).

We provide a baseline assessment of the density and types of microplastics in the western equatorial Atlantic. The highest microplastics density was found in coastal stations near urbanized sites, large tropical estuaries, and fishing grounds. With regard to microplastics composition, most of the identified particles were fibers/filaments, styrofoam, hard and soft plastic, paint, and glass/acrylic. Fibers/filaments were the most abundant (~80%) and occurred at all stations, in both types of mesh nets. Hard plastic particles were frequent (78%) only in the 120 µm mesh net. The mean density recorded in the 120 µm mesh net was about seven times greater than that in the 300 µm mesh net, suggesting that the larger mesh size net did not lead to an accurate description of microplastics density in the pelagic environment or the degree of risk to which organisms are exposed.

Efeito da cinesioterapia no equilíbrio e na qualidade de vida em um grupo da terceira idade / Effect of kinesiotherapy on balance and quality of life in a third age group

Os grupos da terceira idade são formados por indivíduos que buscam envelhecer de forma saudável, com independência e autonomia, portanto, se fazem importantes as estratégias para promoção tanto do equilíbrio quanto da qualidade de vida dos idosos. O objetivo do estudo foi verificar o efeito de um programa de exercícios de cinesioterapia no equilíbrio e na qualidade de vida em um grupo da terceira idade. Caracterizou-se por ser um estudo de campo, aplicado, de caráter quantitativo, descritivo. Empregou-se um programa de cinesioterapia para sete indivíduos participantes de um grupo da terceira idade durante um período de sete semanas, com análise de resultados na pré e pós-intervenção, por meio de estatística descritiva (média, variância, desvio padrão e erro padrão) pelo programa Bio Estat 5.3 e de estatística inferencial, onde foram aplicados os testes de Shapiro-Wilk e de Wilcoxon, e apresentados os dados em gráficos e tabelas pelo programa Microsoft Excel 2010 e pelo gráfico de Boxplot. Os resultados encontrados apresentaram um aumento do equilíbrio dos participantes na pós-intervenção de 1,72 pontos, com um p-valor de 0,02; enquanto que apenas os escores dos domínios da qualidade de vida limitação por aspectos físicos e vitalidade, obtiveram um aumento de 17,86 e 8,58 pontos, respectivamente, sem diferença significativa. Concluiu-se assim, que a aplicação de um programa de cinesioterapia em um grupo da terceira idade parece exercer efeito positivo sobre o equilíbrio de idosos, embora não tenha apresentado diferença estatística nos domínios da qualidade de vida. (AU)

Third age groups are made up of individuals who seek to age in a healthy way, with independence and autonomy. Therefore, strategies for promoting both balance and quality of life of older adults are important. The aim of the study was to verify the effect of a kinesiotherapy exercise program on balance and quality of life in a third age group. It was characterized as a field study, applied, of quantitative, descriptive character. A kinesiotherapy program was used for seven individuals from a third age group during a seven-week period, with pre and post intervention, with analysis using descriptive statistics (mean, variance, standard deviation and standard error) by the Bio Estat 5.3 program and inferential statistics, the Shapiro-Wilk and Wilcoxon tests were applied, and data presented in graphs and tables by the Microsoft Excel 2010 program and by the Boxplot chart. The results showed an increase in post intervention balance of 1.72 points, with a p-value of 0.02; while only the scores of quality of life's domains limitation by physical aspects and vitality, obtained an increase of 17.86 and 8.58 points, respectively, without significant difference. It was concluded the application of a kinesiotherapy program in a third age group seems to exert a positive effect on the balance of older adults, although it did not present statistical difference in the quality of life's domains. (AU)

Intoxicação exógena: fatores desencadeantes e ações imediatas no momento do acidente / Exogenous intoxication: triggering factors and immediate actions at the time of the accident

O artigo tem como objetivo identificar os fatores desencadeantes de intoxicação exógena por ingestão na faixa etária de 0 a quatro anos de idade. É um estudo quantitativo do tipo exploratório e descritivo realizado com 17 responsáveis de crianças na idade mencionada. A maioria das crianças (87%) estava na presença de um adulto. Das crianças atendidadas, a maioria (88%) era a primeira vez que ingeria substância tóxica. Em relação ao conhecimento sobre o efeito tóxico dos produtos químicos, que as crianças ingeriram, nove responsáveis (53%) afirmaram ter conhecimento, e oito (47%) desconheciam tal efeito. Quanto ao conhecimento da substância ingerida pela criança 11 (55%) dos responsáveis relataram conhecer e diante da conduta a ser tomada no momento do acidente. Dez responsáveis (59%) afirmaram não saber, e sobre a atitude tomada nessa situação, 39% procuraram ajuda. Os resultados evidenciaram que o contexto socioeconômico influenciou na quantidade e qualidade dos casos atendidos.

The article aims to identify the triggering factors of exogenous intoxication by ingestion among children from 0 to four years old. It is an exploratory and descriptive quantitative study with 17 guardians of children between 0-4 years. Most children (87%) were in the presence of an adult. Among the children treated, the majority (88%) had ingested toxic substances for the first time. Concerning the knowledge about the effects of toxic chemicals for the children, 9 (53%) guardians claimed to have knowledge and 8 (47%) were unaware of such an effect. Concerning the knowledge of the substance ingested by the child, 11 (55%) of those guardians reported to know it. Concerning the actions to be taken at the time of the accident, 10 (59%) guardians said they did not know. In this situation, 39% informed they sought help. The results showed that the social and economic context influence on the quantity and quality of cases treated.

El artículo tiene como objetivo identificar los factores desencadenantes de la intoxicación por ingestión entre niños de 0 a cuatro años de edad. Estudio cuantitativo del estudio exploratorio y descriptivo, con 17 tutores de niños entre 0-4 años. La mayoría de los niños (87%) estaba en la presencia de un adulto. De los niños tratados, la mayoría (88%) había ingerido sustancias tóxicas por la primera vez. En relación a los conocimientos sobre el efecto de sustancias químicas tóxicas en los niños, 9 (53%) de los responsables afirmaran haber conocimientos. 8 (47%) no tenían conocimiento de tal efecto. En relación a la sustancia ingerida por el niño, 11 (55%) de los responsables informaran conocerla, y 10 líderes dijeron que no sabían informar sobre las medidas que deben adoptarse en el momento del accidente. En esta situación, 39% dijeran tener buscado ayuda. Los resultados mostraron una influencia socioeconómica en la cantidad y calidad de los casos tratados.