Association of uric acid with cardiovascular risk in Brazilian children and adolescents.

BACKGROUND AND AIM: Hyperuricemia in adults is associated with cardiovascular risk factors. However, there is less data regarding this association in children and adolescents. Our purpose was to determine association between serum uric acid (SUA) and cardiovascular risk. METHODS AND RESULTS: A fasting blood sample was collected from 1750 participants aged 6-17 years enrolled in a social project and public schools in Espírito Santo, Brazil. Internal cut-offs were generated to define high SUA (≥90th percentile of SUA concentration for sex and age group). Body mass index percentile (pBMI), body fat percentage (BFP) and muscle mass were determined by bioimpedance. Data are given as mean ± standard deviation. High SUA was associated with overweight/obesity (OR 3.7 CI 95% 2.7-5.0), high waist circumference (WC) (OR 3.9 CI 95% 2.9-5.4), low HDL (OR 2.0 CI 95% 1.5-2.8), high blood pressure (BP) (OR 1.8 CI 95% 1.1-3.2), high BFP (OR 4.1 CI 95% 2.7-6.4), metabolic syndrome (MetS) (OR 3.6 CI 95% 1.8-7.1) and insulin resistance (OR 1.7 CI 95% 1.1-2.7). Individuals in the fourth quartile of SUA, compared to those in the first quartile, showed higher age, pBMI, WC, BFP and muscle mass. Using a reference value of 5.5 mg/dL, the prevalence of hyperuricemia in the sample was 10.3% (CI 95% 8.9-11.7%). CONCLUSION: Higher SUA values are associated with higher cardiovascular risk in childhood and adolescence. The main cardiovascular risk factors associated with hyperuricemia were overweight/obesity, high WC, dyslipidemia, high BFP, high BP, insulin resistance and MetS.

Gray matter volume in left rostral middle frontal and left cerebellar cortices predicts frontal executive performance in alcoholic subjects.

BACKGROUND: Alcoholic subjects manifest important deficits in frontal executive function, yet maintain cognitive mental status within normal range. METHODS: This study searched for volumetric measurements of segmented brain structures obtained from magnetic resonance imaging (MRI) that would predict executive functions and cognitive mental status in alcoholic subjects. The frontal assessment battery (FAB) and the Mini-Mental State Examination (MMSE) were applied to alcoholic subjects who underwent MRI. Cortical and subcortical segmentation and corrections were performed using FreeSurfer. Multiple linear regressions analyses having volumetric measures of segmented brain structures as predictors for FAB or MMSE scores as dependent measures were conducted. Sixty alcoholic subjects, 52 males, mean age of 47.2 ± SD 10.4 years, with heavy use of alcohol (mean 284.4 ± SD 275.9 g of alcohol/d) over a long time (mean 32.4 ± SD 11.1 years), showed FAB 11.1 ± SD 3.2 and MMSE of 25.2 ± SD 4.1. RESULTS: Multiple regression analyses having left and right side of each segment as predictors showed that gray matter volumes of rostral middle frontal cortex and cerebellar cortex (p < 0.001), in which only the left side of these structures showed significant partial effects in the full model (p < 0.05), showed to predict FAB performance. They were even more predictive when considered together (p < 0.001), in which both left rostral middle frontal cortex (p < 0.05) and left cerebellar cortex (p < 0.01) predictors had significant partial effects in the full model. None of brain structures was predictive of MMSE performance. CONCLUSIONS: We have concluded that volumetric measurements of left rostral middle frontal and cerebellar cortices seem to be able to predict the frontal executive performance but not the cognitive mental status in alcoholic subjects.

Prevalence of anti-hepatits A antibodies in children of different socioeconomic conditions in Vila Velha, ES.

This report describes the prevalence of anti-HAV antibodies in children from elementary school in the Municipality of Vila Velha, ES, Brazil. Anti-HAV antibodies were investigated by ELISA method in the serum of 606 children (four to fourteen years old) from three elementary schools, located in neighborhoods with varying household monthly income levels: São José School, 200 children, household income higher than US$700; São Torquato School, 273 children, US$200 to 300; and Cobi School, 133 children, less than US$200. From each children data on age, gender, skin color, sanitary conditions, frequency of contact with sea or river water and family history of hepatitis were recorded. Anti-HAV antibodies were present in 38.6% of all children, 9% in São José School, 49.1% in São Torquato School and 61.7% in Cobi School. Logistic regression analysis demonstrated a positive correlation of positive anti-HAV test with age, non white color of the skin, absence of sewage treatment and domestic water filter, and a past history of hepatitis. The prevalence of anti-HAV antibodies in school children in Vila Velha, ES, was lower than that observed in the same age group in North and Northeast Brazil and was significantly higher in children from families with low socioeconomic status. In addition the results indicate a changing epidemiologic pattern of hepatitis A in our country, with an increasing number of children and adolescents with high risk for HAV infection, mainly in high socioeconomic class. A consideration must be given to the feasibility of vaccination programs for children and adolescents in our country.

Prevalence of anti-hepatits A antibodies in children of different socioeconomic conditions in Vila Velha, ES

É descrita a prevalência de anticorpos antivírus da hepatite A em crianças de diferentes condições socioeconômicas matriculadas em escolas de ensino fundamental no Município de Vila Velha, na região metropolitana de Vitória, Estado do Espírito Santo. Os anticorpos anti-VHA foram pesquisados por ELISA no soro de 606 crianças (quatro a catorze anos de idade) de escolas fundamentais localizadas em bairros com diferentes rendas familiares: Escola São José, 200 crianças, renda familiar acima de US$700; Escola São Torquato, 273 crianças renda familiar entre US$200 e US$300; e Escola Cobi, 133 crianças, renda familiar menor do que US$200. De cada criança foram tomados dados sobre idade, sexo, cor da pele, condições sanitárias, freqüência de contacto com água de rio ou de mar e história de hepatite na família. Anticorpos anti-VHA estavam presentes em 38,6% de todas as crianças, 9% na Escola São José, 49,1% na Escola São Torquato e 61,7% na Escola Cobi. Análise de regressão logística demonstrou correlação entre o teste anti-HAV positivo com idade, pele preta ou mulata, ausência de esgoto domiciliar e de água filtrada e história de hepatite na família. A prevalência de anticorpos anti-HAV em Vila Velha foi menor do que a observada, no mesmo grupo etário, no Norte e Nordeste do Brasil, e foi maior nas crianças de piores condições socioeconômicas. Também, os dados indicam uma mudança no perfil epidemiológico da hepatite A no nosso meio, com um aumento do número de crianças e adolescentes com alto risco de infecção, especialmente nas classes socioeconômicas mais altas. Deve-se discutir a necessidade de vacinação para hepatite A nas crianças e adolescentes no nosso meio.

Prevalence of intestinal nematodes in alcoholic patients

We report the results of a retrospective study on the frequency of intestinal nematodes among 198 alcoholic and 440 nonalcoholic patients at the University Hospital Cassiano Antonio Moraes in Vitória, ES, Brazil. The control sample included 194 nonalcoholic patients matched according to age, sex and neighborhood and a random sample of 296 adults admitted at the same hospital. Stool examination by sedimentation method (three samples) was performed in all patients. There was a significantly higher frequency of intestinal nematodes in alcoholics than in controls (35.3 percent and 19.2 percent, respectively), due to a higher frequency of Strongyloides stercoralis (21.7 percent and 4.1 percent, respectively). Disregarding this parasite, the frequency of the other nematodes was similar in both groups. The higher frequency of S. stercoralis infection in alcoholics could be explained by immune modulation and/or by some alteration in corticosteroid metabolism induced by chronic ethanol ingestion. Corticosteroid metabolites would mimic the worm ecdisteroids, that would in turn increase the fecundity of females in duodenum and survival of larvae. Consequently, the higher frequency of Strongyloides larvae in stool of alcoholics does not necessarily reflect an increased frequency of infection rate, but only an increased chance to present a positive stool examination using sedimentation methods

Prevalence of intestinal nematodes in alcoholic patients.

We report the results of a retrospective study on the frequency of intestinal nematodes among 198 alcoholic and 440 nonalcoholic patients at the University Hospital Cassiano Antonio Moraes in Vit ria, ES, Brazil. The control sample included 194 nonalcoholic patients matched according to age, sex and neighborhood and a random sample of 296 adults admitted at the same hospital. Stool examination by sedimentation method (three samples) was performed in all patients. There was a significantly higher frequency of intestinal nematodes in alcoholics than in controls (35.3% and 19.2%, respectively), due to a higher frequency of Strongyloides stercoralis (21.7% and 4.1%, respectively). Disregarding this parasite, the frequency of the other nematodes was similar in both groups. The higher frequency of S. stercoralis infection in alcoholics could be explained by immune modulation and/or by some alteration in corticosteroid metabolism induced by chronic ethanol ingestion. Corticosteroid metabolites would mimic the worm ecdisteroids, that would in turn increase the fecundity of females in duodenum and survival of larvae. Consequently, the higher frequency of Strongyloides larvae in stool of alcoholics does not necessarily reflect an increased frequency of infection rate, but only an increased chance to present a positive stool examination using sedimentation methods.