Physical fitness attenuates the genetic predisposition to obesity in children and adolescents.

Obesity is an important risk factor associated with non-communicable cardiometabolic diseases. Previous studies have indicated that children and adolescents with a predisposed genetic risk for obesity could benefit from an active lifestyle, but there are no studies investigating whether physical fitness moderates the association of genetics and obesity. The aim of this study was to verify the moderating role of physical fitness in the relationship between genetic risk score (GRS) and body mass index (BMI) in children and adolescents. This cross-sectional study was carried out with 1471 children and adolescents, aged between 6 and 17 years from Santa Cruz do Sul, Brazil. Weight and height were assessed to determine BMI. Physical fitness components (cardiorespiratory fitness [CRF], lower limb strength [LLS], upper limb strength, and abdominal strength) were evaluated. The GRS was based on previously associated obesity single-nucleotide polymorphism rs9939609 (FTO), rs6548238 (TMEM18), and rs16835198 (FNDC5). Moderation analyses were tested using linear regression models, and the interactions were represented by physical fitness components X GRS (categorical variable). All analyses were adjusted for skin color/ethnicity, sex, and sexual maturation. Significant interactions for CRF (P = 0.041), LLS (P = 0.041), and abdominal strength (P = 0.046) X 5 and 6 risk alleles with BMI were found only in adolescents. In addition, there was evidence that fitness components attenuated the high genetic predisposition to high BMI. Physical fitness components are moderators in the relationship between GRS and BMI in adolescents. These findings highlight the need for interventions targeting to improve this aspect, which is an important health indicator in all ages.

Low-grade inflammation markers in children and adolescents: Influence of anthropometric characteristics and CRP and IL6 polymorphisms.

Overweight and obesity are associated with chronic and subclinical inflammation due to an imbalance of inflammatory mediators. However, the association with gene polymorphism has been rarely studied in children. The aim of this study was to determine if serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) are related to the IL6 rs1800795, IL6 rs2069845 and CRP rs1205 polymorphisms (SNPs) according to body mass index (BMI) in a sample of children and adolescents. A cross-sectional study in 470 students between 7 and 17yearsof age of anthropometric characteristics, high sensitivity-CRP (Hs-CRP) and IL-6 levels and three SNPs genotyped. The prevalence ratio of hs-CRP>3mg/L in obese individuals was 4.15 (CI 2.43-7.06; p=0.01), and it was 1.91 (CI 1.03-3.55; p=0.03) in overweight individuals and 1.74 (CI 1.05-2.88 p=0.03) in females. Individuals with waist circumference (WC) and body fat percentage (BF%) alterations showed elevated levels of hs-CRP (p=4.3×10-5 and p=5.3×10-6). The combination of any two anthropometric measurement increases CRP levels, especially combinations with obesity body mass index (BMI): BMI+WC and BMI+BF%. Among the overweight/obesity group, T allele carriers of CRP rs1205 showed lower levels of hs-CRP (0.5, IQR=0.3-1.8mg/L) than CC homozygotes (1.5, IQR=0.4-3.4mg/L, p=0.018). Additionally, considering subjects with two or three anthropometric alterations for CRP rs1205: rs1205 T allele carriers had lower levels of hs-CRP (0.7, IQR=0.3-2.7mg/L) than CC homozygotes (1.2, IQR=0.5-3.5mg/L, p=0.02). In conclusion, carriers of the rs1205/T allele with higher BMIs had lower levels of hs-CRP. Schoolchildren who were overweight/obese had higher levels of CRP and IL-6, whereas individuals with WC and BF% alterations had higher levels of CRP.

Evaluation of DNA damage in COPD patients and its correlation with polymorphisms in repair genes.

BACKGROUND: We investigated a potential link between genetic polymorphisms in genes XRCC1 (Arg399Gln), OGG1 (Ser326Cys), XRCC3 (Thr241Met), and XRCC4 (Ile401Thr) with the level of DNA damage and repair, accessed by comet and micronucleus test, in 51 COPD patients and 51 controls. METHODS: Peripheral blood was used to perform the alkaline and neutral comet assay; and genetic polymorphisms by PCR/RFLP. To assess the susceptibility to exogenous DNA damage, the cells were treated with methyl methanesulphonate for 1-h or 3-h. After 3-h treatment the % residual damage was calculated assuming the value of 1-h treatment as 100%. The cytogenetic damage was evaluated by buccal micronucleus cytome assay (BMCyt). RESULTS: COPD patients with the risk allele XRCC1 (Arg399Gln) and XRCC3 (Thr241Met) showed higher DNA damage by comet assay. The residual damage was higher for COPD with risk allele in the four genes. In COPD patients was showed negative correlation between BMCyt (binucleated, nuclear bud, condensed chromatin and karyorrhexic cells) with pulmonary function and some variant genotypes. CONCLUSION: Our results suggest a possible association between variant genotypes in XRCC1 (Arg399Gln), OGG1 (Ser326Cys), XRCC3 (Thr241Met), and XRCC4 (Ile401Thr), DNA damage and progression of COPD.

Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents. / Incidência de Hipertensão Arterial está Associada com Adiposidade em Crianças e Adolescentes.

BACKGROUND: The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. OBJECTIVES: To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. METHODS: This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. RESULTS: After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). CONCLUSIONS: We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.

FUNDAMENTO: O aumento de hipertensão em crianças e adolescentes tem atraído a atenção da comunidade científica, especialmente por sua associação com a epidemia da obesidade. OBJETIVOS: Descrever a incidência de hipertensão e sua relação com o perfil cardiometabólico e genético em crianças e adolescentes de uma cidade do sul do Brasil em um período de três anos. MÉTODOS: Este estudo longitudinal acompanhou 469 crianças e adolescentes com idade entre 7 e 17 anos (43,1% do sexo masculino), avaliados em dois momentos. Avaliamos pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), circunferência da cintura (CC), índice de massa corporal (IMC), porcentagem de gordura corporal (%GC), perfil lipídico, glicemia, aptidão cardiorrespiratória (APCR), e polimorfismo rs9939609 (gene FTO ) ( fat mass and obesity - associated gene ). A incidência cumulativa da hipertensão foi calculada, e realizada regressão logística multinominal. A diferença estatística foi estabelecida em p<0,05. RESULTADOS: Após três anos, a incidência de hipertensão foi de 11,5%. Indivíduos com sobrepeso e indivíduos obesos apresentaram maior probabilidade de se tornarem indivíduos classificados como borderline para hipertensão (sobrepeso OR: 3,22; IC95%: 1,08-9,55; obesidade OR: 4,05; IC95%: 1,68-9,75), e indivíduos obesos apresentaram maior probabilidade de se tornarem hipertensos (obesidade OR: 4,84; IC95%: 1,57-14,95). Valores de CC e de %GC considerados de alto risco foram associados com o desenvolvimento de hipertensão (OR: 3,41; IC95%: 126-9,19; OR: 2,49, IC95%: 1,08-5,75, respectivamente). CONCLUSÃO: Encontramos uma incidência de hipertensão em crianças e adolescentes mais alta em comparação a estudos anteriores. Indivíduos com valores mais altos de IMC, CC e %GC no baseline apresentaram maior probabilidade de desenvolverem hipertensão, sugerindo a importância da adiposidade no desenvolvimento de hipertensão, mesmo em uma população tão jovem.

The Omicron Lineages BA.1 and BA.2 (Betacoronavirus SARS-CoV-2) Have Repeatedly Entered Brazil through a Single Dispersal Hub.

Brazil currently ranks second in absolute deaths by COVID-19, even though most of its population has completed the vaccination protocol. With the introduction of Omicron in late 2021, the number of COVID-19 cases soared once again in the country. We investigated in this work how lineages BA.1 and BA.2 entered and spread in the country by sequencing 2173 new SARS-CoV-2 genomes collected between October 2021 and April 2022 and analyzing them in addition to more than 18,000 publicly available sequences with phylodynamic methods. We registered that Omicron was present in Brazil as early as 16 November 2021 and by January 2022 was already more than 99% of samples. More importantly, we detected that Omicron has been mostly imported through the state of São Paulo, which in turn dispersed the lineages to other states and regions of Brazil. This knowledge can be used to implement more efficient non-pharmaceutical interventions against the introduction of new SARS-CoV variants focused on surveillance of airports and ground transportation.

Early introduction, dispersal and evolution of Delta SARS-CoV-2 in Southern Brazil, late predominance of AY.99.2 and AY.101 related lineages.

The emergence of Variants of Concern (VOC) presenting an unusual number of new mutations is one of the most remarkable features of SARS-CoV-2. The Delta variant, since its appearance, replaced the VOC Gamma, which was responsible for the major COVID-19 wave in Brazil. In this study, we performed a Delta whole-genome sequencing of 183 samples as part of a major genomic surveillance study performed since the beginning of the pandemic. Here, we showed an emergence, widespread dispersion and consolidation of the Delta variant in Rio Grande do Sul State, completely replacing the Gamma variant in a four to five months period. Performing the phylogenetic and phylodynamic analysis, the majority of the sequences generated herein were classified as AY.99.2, AY.99.2-like and AY.101. AY.99.2 Delta-related lineage has been widely reported in Brazil and in the Americas as well. Altogether, our findings provided a mutational profile of the sequences and presented high substitutions per site in the root-to-tip phylogenetic tree, corroborating studies that show the high mutational rate of SARS-CoV-2 over time.

Biochemical profile, eating habits, and telomere length among Brazilian children and adolescents.

OBJECTIVES: Lifestyle, obesity, and eating habits are emerging as determinants for the instability of telomeres. The increase in childhood and adolescent obesity and the association of biochemical profiles and dietary components with telomere length (TL) makes it an important issue in nutritional research. The aim of the present study was to investigate TL and its association with ethnic background, adiposity, clinical and biochemical parameters, and dietary patterns among Brazilian children and adolescents. METHODS: A cross-sectional study encompassing 981 children and adolescents between 7 and 17 y of age was performed. Dietary intake habits, anthropometry, and clinical data were collected. TL analysis was performed by quantitative polymerase chain reaction. RESULTS: Children presented significantly longer TL than adolescents (P = 0.046). Participants who self-declared as black, mulatto, or brown (P < 0.001) also showed longer TL than those who were white. Regarding biochemical parameters, individuals with altered glucose levels had shorter TL than normoglycemic participants in the total sample (P = 0.014). Such difference remained statistically significant in adolescents (P = 0.019). Participants who reported eating fruits and vegetables regularly had longer TL than those who did not (P < 0.001). CONCLUSION: The results suggested that both biochemical parameters and the intake of antioxidant-rich food, such as fruits and vegetables, are associated with the stability of telomere biology among young Brazilians.

Tuberculosis: health care and surveillance in prisons.

OBJECTIVE: To identify tuberculosis-related health care and surveillance actions in Prison Health Units. METHOD: Cross-sectional study, of quantitative, exploratory and descriptive character. We visited 13 Teams of Prison Health, and nurses and technicians were interviewed regarding epidemiological surveillance instruments, physical structure and materials. RESULTS: Search for respiratory symptoms in admission was reported by 6 (46.2%) of the teams, and the smear microscopy was the most requested test. The Logbook of Respiratory Symptoms and the Logbook for Monitoring Tuberculosis Cases were used in 7 (53.8%) institutions. Two of them (15.4%) had a location for sputum collection and 1 (7.7%) had a radiographer. The Directly Observed Therapy was reported in 7 (53.8%) units. CONCLUSION: Health care actions related to the search for respiratory symptoms and Directly Observed Therapy should be expanded, as well as surveillance actions and recording in official documents of the National Tuberculosis Control Program.

CARDIOMETABOLIC RISK FACTORS ASSOCIATED WITH ACTIVE COMMUTING TO SCHOOL.

OBJECTIVE: To verify if there is an association between cardiometabolic risk factors and active daily commuting to school among children and adolescents. METHODS: A total of 1,743 schoolchildren aged 7 to 17 years old were evaluated in the city of Santa Cruz do Sul (RS). The way of commuting to school was investigated with a questionnaire, and the cardiometabolic risk factors analyzed were body mass index (BMI), waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, blood glucose, triglycerides, total cholesterol (TC) and fractions, LDL and HDL. RESULTS: The prevalence of active commuting among schoolchildren was 48.0% (95%CI 45.7-50.4), and it was associated, in the crude analysis, with blood glucose and LDL cholesterol levels. Passive schoolchildren had a 1.1 higher prevalence ratio of high glucose and LDL cholesterol levels. However, when sociodemographic variables were included in the model, these associations were not maintained. CONCLUSIONS: The prevalence of active commuting in the sample studied is low and it was shown to have a crude association with glucose and LDL cholesterol levels in students. However, sociodemographic factors seem to influence these associations.

Clinical and sociodemographic aspects of cases of severe acute respiratory syndrome in southern Brazil / Aspectos clínicos e sociodemográficos dos casos de Síndrome Respiratória Aguda Grave no sul do Brasil / Aspectos clínicos y sociodemográficos de casos de Síndrome Respiratorio Agudo Severo en el sur de Brasil

Background and objectives: to compare the clinical and sociodemographic aspects of individuals with SARS reported in the countryside of Rio Grande do Sul in 2020 and 2021. Methods: a cross-sectional study, from March 2020 to October 2021. Clinical and sociodemographic variables of individuals with SARS symptoms were analyzed, compared through descriptive, univariate analyses, according to the year of reporting. Results: a total of 4,710 cases of SARS were reported; 53.4% were SARS related to COVID-19 in 2020 and 87.5% in 2021 (p<0.001). Comparing 2020 and 2021, the sociodemographic profile changed in terms of age group, skin color and education (p<0.001). Regarding clinical aspects, there was a reduction in prevalence of pre-existing health conditions, except obesity, changes in reported signs and symptoms and reduction in hospital and Intensive Care Unit admissions. Conclusion: the changes in the profile may reflect the effect of the different variants and the start of immunization for SARS-CoV-2.(AU)

Justificativa e objetivos: comparar, entre os anos de 2020 e 2021, os aspectos clínicos e sociodemográficos dos indivíduos com Síndrome Respiratória Aguda Grave (SRAG) notificados em uma região de saúde do interior do Rio Grande do Sul. Métodos: estudo transversal descritivo, realizado de março de 2020 a outubro de 2021. Foram analisadas variáveis clínicas e sociodemográficas de indivíduos com sintomas de SRAG, comparadas através de análises descritivas, univariadas, conforme o ano de notificação. Resultados: foram notificados 4.710 casos com SRAG; 53,4% foram SRAG relacionados à COVID-19 em 2020 e, 87,5%, em 2021 (p<0,001). Comparando os anos 2020 e 2021, o perfil sociodemográfico modificou quanto faixa etária, cor da pele e escolaridade (p<0,001). Quanto aos aspectos clínicos, houve redução da prevalência de condições de saúde preexistente, exceto obesidade, alterações nos sinais e sintomas relatados e diminuição de internações hospitalares e na Unidade de Terapia Intensiva. Conclusão: as mudanças no perfil podem refletir o efeito das diferentes variantes e o início da imunização para SARS-CoV-2.(AU)

Justificación y objetivos: comparar los aspectos clínicos y sociodemográficos de individuos con SARS notificados en el interior de Rio Grande do Sul en los años 2020 y 2021. Métodos: estudio descriptivo transversal, realizado de marzo de 2020 a octubre de 2021. Se analizaron variables clínicas y sociodemográficas de individuos con síntomas de SARS, comparadas mediante análisis descriptivos univariados, según el año de notificación. Resultados: se notificaron 4.710 casos de SARS; el 53,4% fueron SARS relacionados con COVID-19 en 2020 y el 87,5% en 2021 (p<0,001). Comparando los años 2020 y 2021, el perfil sociodemográfico cambió en cuanto a grupo de edad, color de piel y escolaridad (p<0,001). En cuanto a los aspectos clínicos, hubo reducción en la prevalencia de condiciones de salud preexistentes, excepto obesidad, cambios en los signos y síntomas reportados y reducción en los ingresos hospitalarios y en la Unidad de Cuidados Intensivos. Conclusión: los cambios en el perfil pueden reflejar el efecto de las diferentes variantes y el inicio de la inmunización para el SARS-CoV-2.(AU)

Incidência de Hipertensão Arterial está Associada com Adiposidade em Crianças e Adolescentes / Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents

Resumo Fundamento O aumento de hipertensão em crianças e adolescentes tem atraído a atenção da comunidade científica, especialmente por sua associação com a epidemia da obesidade. Objetivos Descrever a incidência de hipertensão e sua relação com o perfil cardiometabólico e genético em crianças e adolescentes de uma cidade do sul do Brasil em um período de três anos. Métodos Este estudo longitudinal acompanhou 469 crianças e adolescentes com idade entre 7 e 17 anos (43,1% do sexo masculino), avaliados em dois momentos. Avaliamos pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), circunferência da cintura (CC), índice de massa corporal (IMC), porcentagem de gordura corporal (%GC), perfil lipídico, glicemia, aptidão cardiorrespiratória (APCR), e polimorfismo rs9939609 (gene FTO ) ( fat mass and obesity - associated gene ). A incidência cumulativa da hipertensão foi calculada, e realizada regressão logística multinominal. A diferença estatística foi estabelecida em p<0,05. Resultados Após três anos, a incidência de hipertensão foi de 11,5%. Indivíduos com sobrepeso e indivíduos obesos apresentaram maior probabilidade de se tornarem indivíduos classificados como borderline para hipertensão (sobrepeso OR: 3,22; IC95%: 1,08-9,55; obesidade OR: 4,05; IC95%: 1,68-9,75), e indivíduos obesos apresentaram maior probabilidade de se tornarem hipertensos (obesidade OR: 4,84; IC95%: 1,57-14,95). Valores de CC e de %GC considerados de alto risco foram associados com o desenvolvimento de hipertensão (OR: 3,41; IC95%: 126-9,19; OR: 2,49, IC95%: 1,08-5,75, respectivamente). Conclusão Encontramos uma incidência de hipertensão em crianças e adolescentes mais alta em comparação a estudos anteriores. Indivíduos com valores mais altos de IMC, CC e %GC no baseline apresentaram maior probabilidade de desenvolverem hipertensão, sugerindo a importância da adiposidade no desenvolvimento de hipertensão, mesmo em uma população tão jovem.

Abstract Background The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. Objectives To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. Methods This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. Results After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). Conclusions We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.

A Educação Permanente em Saúde e os atores do sistema prisional no cenário pandêmico / Permanent Education in Health and prison system actors in the pandemic scenario / La Educación Permanente en Salud y los actores del sistema penitenciario en el escenario pandémico

Resumo A Educação Permanente em Saúde legitimou a educação na saúde com base na aprendizagem significativa, em vivências no cotidiano de trabalho e na solução de problemas de forma coletiva, além de estar pautada no Quadrilátero Ensino-Gestão-Atenção-Controle Social. A pandemia da Covid-19 exigiu novas formas de fazer saúde e educação, principalmente no sistema prisional, onde a superlotação é um impeditivo ao isolamento social. Este estudo teve como objetivo identificar, por meio de rodas de conversa virtuais, os desafios encontrados no cotidiano de trabalho e discutir propostas de intervenção com os atores do sistema prisional no período pandêmico, na perspectiva da Educação Permanente em Saúde. Foi utilizada abordagem qualitativa de investigação com caráter descritivo, interpretativo e compreensivo de análise do fenômeno social, por meio da análise de conteúdo temático de Minayo. Da análise temática de conteúdo emergiram quatro categorias: desafios da assistência em saúde no sistema prisional no contexto da pandemia da Covid-19; desafios para a gestão da saúde nos estabelecimentos prisionais; interlocução entre instituições de ensino e sistema prisional; e o controle social e a representação familiar. As rodas de conversa virtuais propiciaram discussões aprofundadas e construções coletivas, propondo encaminhamentos pautados no Quadrilátero da Educação Permanente em Saúde.

Abstract Permanent Education in Health legitimized health education based on meaningful learning, experiences in daily work and collective problem solving, in addition to being based on the four-way approach, based on teaching, management, attention and social control. The COVID-19 pandemic has required new ways of doing health and education, especially in the prison system, where overcrowding is an impediment to social isolation. This study aimed to identify, through virtual conversation circles, the challenges encountered in daily work and discuss proposals for intervention with the actors of the prison system in the pandemic period, from the perspective of Permanent Education in Health. It was used a qualitative research approach with descriptive, interpretative and comprehensive analysis of the social phenomenon, through Minayo's thematic analysis of content. From the thematic analysis of content, four categories emerged: challenges of health care in the prison system in the context of the COVID-19 pandemic; challenges for health management in prisons; dialogue between educational institutions and the prison system; and social control and family representation. The virtual conversation rounds provided in-depth discussions and collective constructions, proposing referrals based on the four-way approach of Permanent Education in Health.

Resumen La Educación Permanente en Salud legitimó la educación en salud basada en el aprendizaje significativo, en experiencias en el cotidiano de trabajo y en la resolución colectiva de problemas, además de basarse en el Cuadrilátero Enseñanza-Gestión-Atención-Control Social. La pandemia del Covid-19 requirió nuevas formas de hacer salud y educación, especialmente en el sistema penitenciario, donde el amontonamiento es un impedimento para el aislamiento social. Este estudio tuvo como objetivo identificar, a través de círculos de conversación virtuales, los desafíos encontrados en el trabajo diario y discutir propuestas de intervención con los actores del sistema penitenciario en el período pandémico, en la perspectiva de la Educación Permanente en Salud. Se utilizó un enfoque de investigación cualitativo con un análisis descriptivo, interpretativo y comprensivo del análisis del fenómeno social, a través del análisis de contenido temático de Minayo. Del análisis temático de contenido surgieron cuatro categorías: desafíos de la atención en salud en el sistema penitenciario en el contexto de la pandemia de la Covid-19; desafíos para la gestión de la salud en las cárceles; diálogo entre las instituciones educativas y el sistema penitenciario; y el control social y la representación familiar. Los círculos de conversación virtuales proporcionaron discusiones profundas y construcciones colectivas, proponiendo encaminamientos basados en el Quadrilátero de la Educación Permanente en Salud.

Tuberculosis among prison staff in Rio Grande do Sul.

OBJECTIVE: to evaluate the risk of infection and illness caused by Mycobacterium tuberculosis among health care and security staff in prisons in two regions of Rio Grande do Sul (RS). METHOD: cross-sectional study involving prison staff. An interview and sputum smear microscopy and culture were performed. Latent infection was evaluated according to the result of the tuberculin test (TT), self-referred. RESULTS: among staff who had a TT, 10 (83.3%) in the central region and 2 (16.7%) in the southern region were considered reactors. Length of employment among prison officers who reacted to TT was 15.3 years, and among health care workers, 4.1 years (p = 0.01). No cases of active tuberculosis (TB) were identified. CONCLUSION: prevalence of latent TB was 27.9%. Length of employment between different professional categories and their working regions was considered a risk factor for latent TB.

Caracterização genética, clínica e epidemiológica de pacientes com Covid-19 em uma região do Sul do Brasil / Genetic, clinical and epidemiological characterization of Covid-19 patients in South Brazil

Caracterizar o perfil epidemiológico, clínico e genético de pacientes com Covid-19. Realizou-se um estudo observacional e transversal com voluntários que tiveram diagnóstico de Covid-19 no período de abril de 2020 a maio de 2021 no município de Santa Cruz do Sul (RS, Brasil), no qual foram coletados dados clínicos e epidemiológicos, além de amostras de sangue para a identificação de polimorfismos no gene ACE2. Foram recrutados 87 indivíduos e destes, 16,7% necessitaram de internação hospitalar, sendo a maioria do sexo masculino. A obesidade foi a comorbidade mais frequente, no entanto, doenças cardiovasculares, hipertensão e diabetes apresentaram maior significância quando associadas às internações. Em relação à características genéticas, entre os voluntários não foram encontrados polimorfismos no gene ACE2. A pesquisa sugere que o sexo masculino e presença de comorbidades são importantes fatores de risco para a severidade da Covid-19.

Current paper characterizes the epidemiological, clinical and genetic profile of patients with Covid-19. An observational and cross-sectional study was carried out with volunteers diagnosed with Covid-19 between April 2021 and May 2021 in the municipality of Santa Cruz do Sul, Brazil; a blood sample also identified polymorphism in the ACE2 gene. 87 patients were recruited; 6.7% required hospitalization, the majority being male. Although obesity was a more frequent co-morbidity, cardiovascular diseases, hypertension and diabetes were more significant when associated with hospitalizations. In the case of genetic characteristics, polymorphisms were found in the ACE2 gene among volunteers. Important research suggests male gender and co-morbidities are risk factors for the severity of Covid-19.

Evaluation and genotyping of multidrug-resistant cases of tuberculosis in southern Brazil.

Sixty isolates of Mycobacterium tuberculosis identified as multidrug-resistant (MDR) at a reference laboratory in Rio Grande do Sul State during the years 1999 and 2000 were analyzed using the IS6110-restriction fragment length polymorphism (RFLP) technique. We also genotyped 202 susceptible strains to compare the genotyping results, as well as the clinical and demographic data. Spacer oligotyping (spoligotyping) analysis was performed for isolates presenting low IS6110 copy number. Patients with identical DNA pattern strains were considered clustered. From 262 isolates, 94 (36%) belonged to 20 distinct RFLP clusters, and after spoligotyping analysis, 89 of the isolates (34%) remained in cluster. MDR isolates did not differ statistically in clustering proportion from susceptible strains. A significant association between the occurrence of MDR and previous tuberculosis (TB) treatment was observed (p < 0.001), as well as failure on TB treatment (p < 0.001). Human immunodeficiency virus (HIV)-positive patients were associated with susceptible tuberculosis (p = 0.024). We also identified that unmarried patients were more likely to develop TB due to recent transmission than married patients (p < 0.005). The introduction of directly observed therapy short-course (DOTS) strategy will be important in decreasing default and failure rates and avoiding the development of new MDR strains.

Metabolic risk in schoolchildren is associated with low levels of cardiorespiratory fitness, obesity, and parents' nutritional profile.

OBJECTIVE: Verify the association between metabolic risk profile in students with different levels of cardiorespiratory fitness and body mass index, as well as the nutritional status of their parents. METHODS: A cross-sectional study comprising 1.254 schoolchildren aged between seven and 17 years. The metabolic risk profile was calculated by summing the standardized values of high density lipoproteins and low density lipoproteins, triglycerides, glucose and systolic blood pressure. The parents' nutritional status was evaluated by self-reported weight and height data, for body mass index calculating. The body mass index of schoolchildren was classified as underweight/normal weight and overweight/obesity. The cardiorespiratory fitness was assessed by 9-minute running/walk test, being categorized as fit (good levels) and unfit (low levels). Data were analyzed using prevalence ratio values (PR). RESULTS: The data indicates a higher occurrence of developing metabolic risk in schoolchildren whose mother is obese (PR: 1.50; 95% CI: 1.01, 2.23), and even higher for those whose father and mother are obese (PR: 2, 79, 95% CI: 1.41; 5.51). Students who have low levels of cardiorespiratory fitness and overweight/obesity have higher occurrence of presenting metabolic risk profile (PR: 5.25; 95% CI: 3.31; 8.16). CONCLUSION: the occurrence of developing metabolic risk in schoolchildren increase when they have low levels of cardiorespiratory fitness and overweight/obesity, and the presence of parental obesity.

Recent transmission of drug-resistant Mycobacterium tuberculosis in a prison population in southern Brazil.

We conducted a cross-sectional, retrospective study, characterized by classical and molecular epidemiology, involving M. tuberculosis isolates from a regional prison in southern Brazil. Between January of 2011 and August of 2014, 379 prisoners underwent sputum smear microscopy and culture; 53 (13.9%) were diagnosed with active tuberculosis. Of those, 8 (22.9%) presented with isoniazid-resistant tuberculosis. Strain genotyping was carried out by 15-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat analysis; 68.6% of the patients were distributed into five clusters, and 87.5% of the resistant cases were in the same cluster. The frequency of drug-resistant tuberculosis cases and the rate of recent transmission were high. Our data suggest the need to implement an effective tuberculosis control program within the prison system. RESUMO Estudo transversal, retrospectivo, com isolados de M. tuberculosis de pacientes de um presídio regional no sul do Brasil, caracterizado através de epidemiologia clássica e molecular. Entre janeiro de 2011 e agosto de 2014, 379 detentos foram submetidos a baciloscopia e cultura, sendo 53 (13,9%) diagnosticados com tuberculose ativa. Desses, 8 (22,9%) apresentavam tuberculose resistente a isoniazida. A genotipagem das cepas foi realizada por 15-locus mycobacterial interspersed repetitive units-variable number of tandem repeat analysis; 68,6% dos pacientes estavam distribuídos em cinco clusters, e 87,5% dos casos resistentes estavam em um mesmo cluster. Verificou-se uma frequência elevada de casos de resistência e alta taxa de transmissão recente. Estes dados sugerem a necessidade da implantação de um programa efetivo de controle da tuberculose no sistema prisional.

Medidas de distanciamento social como fator de proteção contra a COVID-19 no interior do Rio Grande do Sul, Brasil

[RESUMO]. Objetivo. Investigar a soroprevalência de SARS-CoV-2 na região do Vale do Rio Pardo, Rio Grande do Sul, Brasil, e analisar a associação entre soroprevalência e adesão por parte da população às medidas de distanciamento social. Método. Este estudo transversal de base populacional compreendeu quatro etapas de coleta domiciliar de dados entre agosto e outubro de 2020. A soroprevalência foi avaliada utilizando teste rápido de anticorpos IgM e IgG. Foram coletados, ainda, dados demográficos, socioeconômicos, clínicos e comportamentais, com aplicação de um questionário de três perguntas sobre adesão a medidas de distanciamento social, com foco no nível de distanciamento social que o entrevistado conseguia praticar, rotina de atividades do entrevistado e circulação de pessoas na casa. A associação entre os dados sociodemográficos e a prática de distanciamento social foi avaliada pelo teste do qui-quadrado para tendência linear e heterogeneidade de proporções, e a associação entre o distanciamento social e a soroprevalência foi avaliada pela regressão de Poisson (intervalo de confiança de 95% [IC95%]; P < 0,05). Resultados. Dos 4 252 indivíduos testados e entrevistados, 11,8% (IC95%: 10,8; 12,8) não aderiram ao distanciamento social. A prevalência de teste rápido reagente foi de 4,7% entre aqueles que não realizaram distanciamento social e de 1,9% entre aqueles que realizaram distanciamento social (P < 0,05). As variáveis sexo masculino, faixa etária de 20 a 59 anos, ensino médio, renda familiar mensal de R$ 3 136,00 a R$ 6 270,00 e morar na zona urbana apresentaram associação com a não adesão ao distanciamento social (P < 0,05). A adesão a todas as medidas de distanciamento social foi fator de proteção contra a infecção de SARS-CoV-2 (razão de prevalência: 0,37; IC95%: 0,19; 0,73). Conclusões. Os resultados indicam uma redução da soroprevalência pelas medidas de distanciamento social.

[ABSTRACT]. Objective. To estimate the SARS-CoV-2 seroprevalence in a non-metropolitan area (Vale do Rio Pardo) in the state of Rio Grande do Sul, Brazil, and determine the association between seroprevalence and adherence to social distancing measures. Method. For the present population-based, cross-sectional study, data were collected in four stages from August to October 2020. SARS-CoV-2 seroprevalence was assessed using an IgG/IgM rapid test. Demographic, socioeconomic, clinical, and behavioral data were also collected, with administration of a three-question survey to determine adherence to social distancing measures with a focus on the level of social distancing practiced by participants, their routine activities, and circulation of people in the home. The association between sociodemographic data and social distancing was assessed using the chi-square test for linear trends in proportions, and the association between social distancing and seroprevalence was assessed using Poisson regression (95% confidence interval [95%CI]; P < 0.05). Results. Of 4 252 tested and interviewed participants, 11.8% (95%CI: 10.8; 12.8) did not adhere to social distancing measures. The prevalence of a positive rapid test was 4.7% in participants who did not practice social distancing and 1.9% in participants who adhered to social distancing measures (P < 0.05). The variables male sex, age 20 to 59 years, having completed high school, monthly family income ranging from R$ 3 136.00 to R$ 6 270.00, and living in rural areas were associated with non-adherence to social distancing (P < 0.05). Adherence to all social distancing measures provided protection against SARS-CoV-2 infection (prevalence ratio: 0.37; 95%CI: 0.19; 0.73). Conclusions. The results indicate a reduction in seroprevalence with the adherence to social distancing measures.

[RESUMEN]. Objetivo. Investigar la seroprevalencia del SARS-CoV-2 en la zona del Vale do Rio Pardo (Rio Grande do Sul, Brasil), y analizar la relación entre la seroprevalencia y el cumplimiento de las medidas de distanciamiento social por parte de la población. Método. Este estudio transversal basado en la población comprendió cuatro etapas de recopilación domiciliaria de datos entre agosto y octubre del 2020. La seroprevalencia se evaluó con la prueba rápida de anticuerpos IgM e IgG. Además, se recopilaron datos demográficos, socioeconómicos, clínicos y comportamentales por medio de un cuestionario de tres preguntas sobre el cumplimiento de las medidas de distanciamiento social, centrado en el grado de distanciamiento social que la persona entrevistada lograba tener, la rutina de las actividades de la persona entrevistada y la circulación de personas en el hogar. La relación entre los datos sociodemográficos y la práctica de distanciamiento social se evaluó con la prueba del ji cuadrado para determinar la tendencia lineal y la heterogeneidad de las proporciones, y la relación entre el distanciamiento social y la seroprevalencia se evaluó con el modelo de regresión de Poisson (intervalo de confianza de 95% [IC95%]; P < 0,05). Resultados. De las 4 252 personas que se entrevistaron y a las que se les realizó la prueba, 11,8% (IC95%: 10,8; 12,8) no cumplían el distanciamiento social. La prevalencia de la realización de la prueba rápida con reactivo fue de 4,7% entre quienes no cumplían el distanciamiento social y de 1,9% entre quienes cumplían con esa medida (P < 0,05). Las variables relacionadas con el sexo masculino, el grupo etario de 20 a 59 años, la escolaridad de nivel medio, los ingresos familiares mensuales de R$ 3 136,00 a R$ 6 270,00 y la residencia en zonas urbanas guardaron relación con el incumplimiento del distanciamiento social (P < 0,05). El cumplimiento con todas las medidas de distanciamiento social fue un factor de protección contra la infección por SARS-CoV-2 (razón de prevalencia: 0,37; IC95%: 0,19; 0,73). Conclusiones. Los resultados indican una reducción de la seroprevalencia a causa de las medidas de distanciamiento social.