Association between frailty phenotype, quantification of plasma HIV-1 RNA, CD4 cell count and HAART in HIV-positive subjects: a systematic review and meta-analysis of observational studies.

HIV infection causes a constant activation of the immune system and contributes to an enhanced systemic pro-inflammatory cytokine milieu, which has been associated with premature aging and frailty. We performed a systematic review and meta-analysis to analyze whether the HIV-1 RNA load, CD4+ T-lymphocyte counts and exposure to HAART in HIV-positive subjects are associated with frailty phenotype. Searches were performed in PubMed, SCOPUS, Lilacs, Web of Science, Google Scholar, and OpenThesis databases. We used the odds ratio as a measure of the association. We used either a fixed or random-effects model to pool the results of individual studies depending on the presence of heterogeneity. Eleven studies were included in the review. Data from 8035 HIV-positive subjects were analyzed; 2413 of the subjects had viral load detectable, 981 had a CD4T-cell count <350 cells/µL, and 1342 had HAART exposure information. We found an association between frailty and CD4T-cell count <350 cells/µL (OR 2.68, CI 95% 1.68-4.26, I2 = 46%), HIV-1 RNA load detectable (OR 1.71, CI 95% 1.38-2.12, I2 = 0%), and protease inhibitor-containing HAART regimen (OR 2.21, CI 95% 1.26-3.89, I2 = 0%). Further studies are necessary to evaluate the effects of other factors on the development of clinical features related to frailty.

Surveillance of adverse events associated with 145 000 doses of COVID-19 vaccines in a Brazilian municipality.

There is a lack of real-world surveillance studies on reports of adverse events associated with COVID-19 vaccination, as well as comparative analyses of adverse events from vaccines with different platforms. This observational, descriptive, retrospective study based on secondary data describes the adverse events following immunization (AEFIs) related to the first 145 000 doses of COVID-19 vaccines delivered in Aracaju municipality, Sergipe state, northeast Brazil. Records of AEFIs were collected using the e-SUS Notifica database for January 19 to April 30, 2021. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for AEFIs and the type of COVID-19 vaccine, either CoronaVac (Sinovac-Butantan) or Oxford-AstraZeneca (Fiocruz). A total of 474 AEFIs (32.7 events/10 000 doses) from 254 individuals were reported and analyzed, and all of them were classified as non-serious. There was an association between the use of the CoronaVac vaccine and headache (OR = 2.1; 95% CI: 1.4-3.2), pain at the injection site (OR = 9.6; 95% CI: 3.9-23.8), lethargy (OR = 5.2; 95% CI: 1.8-14.8), fatigue (OR = 10.1; 95% CI: 2.4-42.3), diarrhea (OR = 4.4; 95% CI: 1.5-12.5) and cold-like symptoms (OR = 8.0; 95% CI: 1.9-34.0). However, the proportion of individuals reporting fever was higher among those who received the Oxford-AstraZeneca vaccine (OR = 3.1; 95% CI 1.5-6.4). This population-based observational study strengthens the evidence for the safety and tolerability of the CoronaVac and Oxford-AstraZeneca vaccines used against COVID-19.

Hay una carencia de estudios de vigilancia en el mundo real sobre la notificación de eventos adversos asociados a la vacunación contra la COVID-19, así como de análisis comparativos de los eventos adversos de vacunas con diferentes plataformas. En este estudio observacional, descriptivo y retrospectivo basado en datos secundarios se describen los eventos adversos supuestamente atribuibles a la vacunación o inmunización (ESAVI) relacionados con las primeras 145 000 dosis de vacunas contra la COVID-19 administradas en el municipio de Aracaju, estado de Sergipe, en la región Noreste de Brasil. Se recopilaron registros de los ESAVI del 19 de enero al 30 de abril del 2021 con la base de datos e-SUS Notifica. Se calcularon las razones de posibilidades (OR, por su sigla en inglés) y los intervalos de confianza (IC) del 95 % para los ESAVI y el tipo de vacuna contra la COVID-19 (CoronaVac [Sinovac-Butantan] o bien Oxford-AstraZeneca [Fiocruz]). Se notificaron y analizaron un total de 474 ESAVI (32,7 eventos/10 000 dosis) de 254 personas, y todos se clasificaron como no graves. Se encontró una relación entre el empleo de la vacuna CoronaVac y la cefalea (OR = 2,1; IC del 95 %: 1,4­3,2), dolor en el lugar de la inyección (OR = 9,6; IC del 95 %: 3,9­23,8), letargo (OR = 5,2; IC del 95 %: 1,8­14,8), cansancio (OR = 10,1; IC del 95 %: 2,4­42,3), diarrea (OR = 4,4; IC del 95 %: 1,5­12,5) y síntomas similares al resfriado (OR = 8,0; IC del 95 %: 1,9 a 34,0). Sin embargo, la proporción de pacientes que notificaron fiebre fue mayor entre los que recibieron la vacuna de Oxford-AstraZeneca (OR = 3,1; IC del 95 %: 1,5 a 6,4). Este estudio observacional poblacional refuerza la evidencia sobre la seguridad y tolerabilidad de las vacunas CoronaVac y Oxford-AstraZeneca empleadas contra la COVID-19.

Faltam estudos de vigilância no mundo real sobre relatórios de eventos adversos associados à vacinação contra a COVID-19, bem como análises comparativas de eventos adversos decorrentes de vacinas com diferentes plataformas. Este estudo observacional, descritivo e retrospectivo baseado em dados secundários descreve os eventos adversos pós-vacinação (EAPV) relacionados com as primeiras 145 mil doses de vacinas contra a COVID-19 entregues no município de Aracaju, capital do estado de Sergipe, na região Nordeste do Brasil. Os registros de EAPV foram coletados usando o sistema e-SUS Notifica com referência ao período de 19 de janeiro a 30 de abril de 2021. Razões de chances (odds ratios, ORs) e intervalos de confiança (IC) de 95% foram calculados para os EAPV e o tipo de vacina contra a COVID-19: CoronaVac (Sinovac-Butantan) ou Oxford-AstraZeneca (Fiocruz). Um total de 474 EAPV (32,7 eventos/10 mil doses) de 254 indivíduos foram relatados e analisados, e todos foram classificados como não graves. Houve uma associação entre o uso da vacina CoronaVac e cefaleia (OR = 2,1; IC 95%: 1,4-3,2), dor no local da injeção (OR = 9,6; IC 95%: 3,9-23,8), letargia (OR = 5,2; IC 95%: 1,8-14,8), cansaço (OR = 10,1; IC 95%: 2,4-42,3), diarreia (OR = 4,4; IC 95%: 1,5-12,5 e sintomas gripais (OR = 8,0; IC 95%: 1,9-34,0). Contudo, a proporção de indivíduos que relataram febre foi superior entre os que receberam a vacina Oxford-AstraZeneca (OR = 3,1; IC 95%: 1,5-6,4). Este estudo observacional de base populacional reforça as evidências da segurança e tolerabilidade das vacinas CoronaVac e Oxford-AstraZeneca usadas contra a COVID-19.

Association between chemosensory dysfunctions and inflammatory biomarkers in patients with SARS-CoV-2 infection: a systematic review and meta-analysis.

BACKGROUND: There is evidence that chemosensory dysfunctions, including smell and taste disorders, are common findings in patients with SARS-CoV-2 infection. However, the underlying biological mechanisms and the role of inflammatory markers are still poorly understood. AIM: To investigate the inflammatory biomarkers levels in patients with COVID-19 presenting chemosensory dysfunctions. METHODS: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A systematic literature search was performed from January 1, 2020, to May 12, 2022. Observational studies that provided data on hematological, biochemical, infection-related indices and cellular immunity, and coagulation function in patients with COVID-19 experiencing smell and/or taste disorders were considered eligible. Effect sizes were reported as standardized mean difference (SMD) with 95% confidence intervals (CI). A negative effect size indicated that the inflammatory biomarker levels were lower among patients with chemosensory dysfunctions. RESULTS: Eleven studies were included. Patients with chemosensory disturbances had lower levels of leukocytes (SMD - 0.18, 95% CI - 0.35 to - 0.01, p = 0.04), lactate dehydrogenase (SMD - 0.45, 95% CI - 0.82 to - 0.09, p = 0.01), IL-6 (SMD - 0.25, 95% CI - 0.44 to - 0.06, p < 0.01), and C-reactive protein (SMD - 0.33, 95% CI - 0.58 to - 0.08, p < 0.01) than patients without chemosensory disturbances. CONCLUSION: Patients with SARS-CoV-2 infection who have olfactory and gustatory disorders have a lower inflammatory response than patients who do not have chemosensory alterations. The presence of these symptoms may indicate a more favorable clinical course for COVID-19.

Antimony resistance associated with persistence of Leishmania (Leishmania) infantum infection in macrophages.

Visceral leishmaniasis is a severe disease caused by protozoan parasites that include Leishmania (L.) infantum. The disease is established when parasites subvert the immune response of the host. Notably, chemotherapy-based use of antimonial compounds can partially alleviate disease burden. Unfortunately, the resistance to drug treatments is increasing in areas endemic to the disease. In this report, we investigated immune responses within macrophages infected with antimony-resistant L. infantum isolates from patients with a relapse in the disease. Results revealed that antimony-resistant parasites persist in the first 24 h of infection. Activation of macrophage or blocking of thiol production during infection shows enhanced clearance of parasites, which is coordinately associated with increased production of pro-inflammatory cytokines. Taken together, these results suggest that the mechanism of antimony resistance in L. infantum isolates may be related to a decrease in macrophage microbicidal functions.

Spatial patterns and temporal tendency of mortality related to Chagas disease in an endemic area of northeastern Brazil.

OBJECTIVE: To analyse spatial patterns and the temporal tendency of mortality related to Chagas disease, in order to identify priority control areas in the state of Sergipe, Northeast Brazil. METHODS: We conducted an ecological and time-series study with spatial analysis techniques on deaths from Chagas disease in the state of Sergipe (1996-2016). We used data from the Mortality Information System (SIM). The temporal analysis was performed using a statistical technique capable of describing changes in the trend pattern for the period. Thematic maps were elaborated from point and polygonal analyses. RESULTS: There were 247 deaths related to Chagas disease, with a mean of 11.7 deaths/year, most of them male (64%), and aged 50-59 years (21%) and 60-69 years (26%). Two segments with increasing, non-constant and significant trends were identified: 1996-2005 (APC = 21.6%; P = 0.01) and 2005-2016 (APC = 4.4%; P = 0.01), with APPC = 11.8% (P = 0.01). A positive and significant spatial autocorrelation with areas of higher risk of death was found in the southern region of the state. CONCLUSIONS: The trend of mortality related to Chagas disease in the state of Sergipe was increasing during the period analysed, with a heterogeneous distribution of cases. A main risk area was identified in the southern region of the state.

OBJECTIF: Analyser les profils spatiaux et la tendance temporelle de la mortalité liée à la maladie de Chagas, afin d'identifier les domaines de priorité de lutte dans l'Etat de Sergipe, dans le nord-est du Brésil. MÉTHODES: Nous avons mené une étude écologique et de séries chronologiques avec des techniques d'analyse spatiale sur les décès dus à la maladie de Chagas dans l'état de Sergipe (1996-2016). Nous avons utilisé les données du système d'information sur la mortalité (SIM). L'analyse temporelle a été réalisée à l'aide d'une technique statistique capable de décrire les changements dans le profil de tendance pour la période. Des cartes thématiques ont été élaborées à partir d'analyses ponctuelles et polygonales. RÉSULTATS: Il y a eu 247 décès liés à la maladie de Chagas, avec une moyenne de 11,7 décès/an, pour la plupart de sexe masculin (64%), et âgés de 50 à 59 ans (21%) et de 60 à 69 ans (26%). Deux segments avec des tendances à la hausse, non constantes et significatives ont été identifiés: 1996-2005 (APC = 21,6%; p = 0,01) et 2005-2016 (APC = 4,4%; p = 0,01), avec APPC = 11,8% (p = 0,01). Une autocorrélation spatiale positive et significative avec des zones à haut risque de décès a été trouvée dans la région sud de l'Etat. CONCLUSIONS: La tendance de la mortalité liée à la maladie de Chagas dans l'état de Sergipe a augmenté au cours de la période analysée , avec une répartition hétérogène des cas. Une principale zone à risque a été identifiée dans la région sud de l'Etat.

Telomere length and frailty in older adults-A systematic review and meta-analysis.

Telomere shortening has been proposed as a potentially useful biomarker of human ageing and age-related morbidity and mortality. We performed a systematic review and meta-analysis to summarize results from individual studies on the telomere length according to the frailty status and frailty index in older adults. We searched the PubMed, SCOPUS and Web of Science databases to identify studies that evaluated the telomere length in frail and non-frail older adults and the relationship between telomere length and frailty index score. We used the base pairs (bp) as a measure of the telomere length. Summary estimates were calculated using random-effects models. Nine studies were included in the present systematic review and a total of 10,079 older adults were analyzed. We found that the frail older adults (n = 355) had shorter telomeres than the non-frail (n = 1894) (Standardized Mean Difference [SMD] -0.41; 95% CI -0.73 to -0.09; P = 0.01; I2 = 82%). Significant differences in telomere length between frail and non-frail older adults were identified in Hispanic (SMD -1.31; 95% CI -1.71 to -0.92; P < 0.0001; I2 = 0%) but not in Non-Hispanic countries (SMD -0.13; 95% CI -0.26 to 0.00; P = 0.06; I2 = 0%). Similar results were found in the adjusted meta-analysis (SMD -0.56; 95% -1.12 to 0.00; P = 0.05; I2 = 85%). A significant but weak relationship was found between telomere length and frailty index analyzing 8244 individuals (SMD -0.06; 95% IC -0.10 to 0.01; P = 0.01; I2 = 0%). The current available evidence suggests that telomere length may be not a meaningful biomarker for frailty. Because the potential influence of ethnicity in shortening of telomeres and decline in physiologic reserves associated with aging, additional multiethnic studies are needed.

Association between human herpes virus seropositivity and frailty in the elderly: A systematic review and meta-analysis.

Frailty is an emerging geriatric syndrome characterized by decreased physiologic reserve and increased vulnerability to environmental factors. Several studies have examined the association between persistent cytomegalovirus (CMV) infection and poor clinical outcomes in the elderly, but the results are often contradictory. Here, we performed a systematic review and meta-analysis to analyze the association between human herpesvirus seropositivity [CMV, Epstein-Barr virus (EBV), Varicella zoster virus (VZV), and Herpes simplex virus (HSV)] and frailty in elderly people. Searches were performed in PubMed, SCOPUS, Lilacs, IBECS, and Web of Science databases. We used the odds ratio (OR) as a measure of the association between herpesvirus infections and frailty. Summary estimates were calculated using random-effects models. Six studies were included in the present systematic review. The data from 2559 elderly subjects were analyzed; 1571 of the subjects had ages between 60 and 79 years, and 988 of the subjects were older than 80. We found an association between CMV seropositivity and frailty in the elderly aged 60-79 years (OR 2.33, CI 95% 1.48-3.67) but not in the oldest-old subjects (OR 0.67, CI 95% 0.42-1.05). Moreover, no association was found between EBV, VZV, and HSV infections and frailty. Current evidence suggests an association between CMV seropositivity and frailty in individuals aged 60-79 years old.

Surveillance of adverse events associated with 145 000 doses of COVID-19 vaccines in a Brazilian municipality

[ABSTRACT]. There is a lack of real-world surveillance studies on reports of adverse events associated with COVID-19 vaccination, as well as comparative analyses of adverse events from vaccines with different platforms. This observational, descriptive, retrospective study based on secondary data describes the adverse events following immunization (AEFIs) related to the first 145 000 doses of COVID-19 vaccines delivered in Aracaju municipality, Sergipe state, northeast Brazil. Records of AEFIs were collected using the e-SUS Notifica database for January 19 to April 30, 2021. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for AEFIs and the type of COVID-19 vaccine, either CoronaVac (Sinovac–Butantan) or Oxford–AstraZeneca (Fiocruz). A total of 474 AEFIs (32.7 events/10 000 doses) from 254 individuals were reported and analyzed, and all of them were classified as non-serious. There was an association between the use of the CoronaVac vaccine and headache (OR = 2.1; 95% CI: 1.4–3.2), pain at the injection site (OR = 9.6; 95% CI: 3.9–23.8), lethargy (OR = 5.2; 95% CI: 1.8–14.8), fatigue (OR = 10.1; 95% CI: 2.4–42.3), diarrhea (OR = 4.4; 95% CI: 1.5– 12.5) and cold-like symptoms (OR = 8.0; 95% CI: 1.9–34.0). However, the proportion of individuals reporting fever was higher among those who received the Oxford–AstraZeneca vaccine (OR = 3.1; 95% CI 1.5–6.4). This population-based observational study strengthens the evidence for the safety and tolerability of the CoronaVac and Oxford–AstraZeneca vaccines used against COVID-19.

[RESUMEN]. Hay una carencia de estudios de vigilancia en el mundo real sobre la notificación de eventos adversos asociados a la vacunación contra la COVID-19, así como de análisis comparativos de los eventos adversos de vacunas con diferentes plataformas. En este estudio observacional, descriptivo y retrospectivo basado en datos secundarios se describen los eventos adversos supuestamente atribuibles a la vacunación o inmunización (ESAVI) relacionados con las primeras 145 000 dosis de vacunas contra la COVID-19 administradas en el municipio de Aracaju, estado de Sergipe, en la región Noreste de Brasil. Se recopilaron registros de los ESAVI del 19 de enero al 30 de abril del 2021 con la base de datos e-SUS Notifica. Se calcularon las razones de posibilidades (OR, por su sigla en inglés) y los intervalos de confianza (IC) del 95 % para los ESAVI y el tipo de vacuna contra la COVID-19 (CoronaVac [Sinovac-Butantan] o bien Oxford-AstraZeneca [Fiocruz]). Se notificaron y analizaron un total de 474 ESAVI (32,7 eventos/10 000 dosis) de 254 personas, y todos se clasificaron como no graves. Se encontró una relación entre el empleo de la vacuna CoronaVac y la cefalea (OR = 2,1; IC del 95 %: 1,4–3,2), dolor en el lugar de la inyección (OR = 9,6; IC del 95 %: 3,9–23,8), letargo (OR = 5,2; IC del 95 %: 1,8–14,8), cansancio (OR = 10,1; IC del 95 %: 2,4–42,3), diarrea (OR = 4,4; IC del 95 %: 1,5–12,5) y síntomas similares al resfriado (OR = 8,0; IC del 95 %: 1,9 a 34,0). Sin embargo, la proporción de pacientes que notificaron fiebre fue mayor entre los que recibieron la vacuna de Oxford-AstraZeneca (OR = 3,1; IC del 95 %: 1,5 a 6,4). Este estudio observacional poblacional refuerza la evidencia sobre la seguridad y tolerabilidad de las vacunas CoronaVac y Oxford-AstraZeneca empleadas contra la COVID-19. Palabras clave COVID-19; SARS-CoV-2; vacunas contra la COVID-19; efectos colaterales y reacciones adversas relacionados

[RESUMO]. Faltam estudos de vigilância no mundo real sobre relatórios de eventos adversos associados à vacinação contra a COVID-19, bem como análises comparativas de eventos adversos decorrentes de vacinas com diferentes plataformas. Este estudo observacional, descritivo e retrospectivo baseado em dados secundários descreve os eventos adversos pós-vacinação (EAPV) relacionados com as primeiras 145 mil doses de vacinas contra a COVID-19 entregues no município de Aracaju, capital do estado de Sergipe, na região Nordeste do Brasil. Os registros de EAPV foram coletados usando o sistema e-SUS Notifica com referência ao período de 19 de janeiro a 30 de abril de 2021. Razões de chances (odds ratios, ORs) e intervalos de confiança (IC) de 95% foram calculados para os EAPV e o tipo de vacina contra a COVID-19: CoronaVac (Sinovac-Butantan) ou Oxford-AstraZeneca (Fiocruz). Um total de 474 EAPV (32,7 eventos/10 mil doses) de 254 indivíduos foram relatados e analisados, e todos foram classificados como não graves. Houve uma associação entre o uso da vacina CoronaVac e cefaleia (OR = 2,1; IC 95%: 1,4-3,2), dor no local da injeção (OR = 9,6; IC 95%: 3,9-23,8), letargia (OR = 5,2; IC 95%: 1,8-14,8), cansaço (OR = 10,1; IC 95%: 2,4-42,3), diarreia (OR = 4,4; IC 95%: 1,5-12,5 e sintomas gripais (OR = 8,0; IC 95%: 1,9-34,0). Contudo, a proporção de indivíduos que relataram febre foi superior entre os que receberam a vacina Oxford-AstraZeneca (OR = 3,1; IC 95%: 1,5-6,4). Este estudo observacional de base populacional reforça as evidências da segurança e tolerabilidade das vacinas CoronaVac e Oxford-AstraZeneca usadas contra a COVID-19.

Surveillance of adverse events associated with 145 000 doses of COVID-19 vaccines in a Brazilian municipality / Vigilancia de eventos adversos asociados a 145 000 dosis de vacunas contra la COVID-19 en un municipio brasileño / Vigilância de eventos adversos associados a 145 mil doses de vacinas contra a COVID-19 em um município brasileiro

ABSTRACT There is a lack of real-world surveillance studies on reports of adverse events associated with COVID-19 vaccination, as well as comparative analyses of adverse events from vaccines with different platforms. This observational, descriptive, retrospective study based on secondary data describes the adverse events following immunization (AEFIs) related to the first 145 000 doses of COVID-19 vaccines delivered in Aracaju municipality, Sergipe state, northeast Brazil. Records of AEFIs were collected using the e-SUS Notifica database for January 19 to April 30, 2021. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for AEFIs and the type of COVID-19 vaccine, either CoronaVac (Sinovac-Butantan) or Oxford-AstraZeneca (Fiocruz). A total of 474 AEFIs (32.7 events/10 000 doses) from 254 individuals were reported and analyzed, and all of them were classified as non-serious. There was an association between the use of the CoronaVac vaccine and headache (OR = 2.1; 95% CI: 1.4-3.2), pain at the injection site (OR = 9.6; 95% CI: 3.9-23.8), lethargy (OR = 5.2; 95% CI: 1.8-14.8), fatigue (OR = 10.1; 95% CI: 2.4-42.3), diarrhea (OR = 4.4; 95% CI: 1.5-12.5) and cold-like symptoms (OR = 8.0; 95% CI: 1.9-34.0). However, the proportion of individuals reporting fever was higher among those who received the Oxford-AstraZeneca vaccine (OR = 3.1; 95% CI 1.5-6.4). This population-based observational study strengthens the evidence for the safety and tolerability of the CoronaVac and Oxford-AstraZeneca vaccines used against COVID-19.

RESUMEN Hay una carencia de estudios de vigilancia en el mundo real sobre la notificación de eventos adversos asociados a la vacunación contra la COVID-19, así como de análisis comparativos de los eventos adversos de vacunas con diferentes plataformas. En este estudio observacional, descriptivo y retrospectivo basado en datos secundarios se describen los eventos adversos supuestamente atribuibles a la vacunación o inmunización (ESAVI) relacionados con las primeras 145 000 dosis de vacunas contra la COVID-19 administradas en el municipio de Aracaju, estado de Sergipe, en la región Noreste de Brasil. Se recopilaron registros de los ESAVI del 19 de enero al 30 de abril del 2021 con la base de datos e-SUS Notifica. Se calcularon las razones de posibilidades (OR, por su sigla en inglés) y los intervalos de confianza (IC) del 95 % para los ESAVI y el tipo de vacuna contra la COVID-19 (CoronaVac [Sinovac-Butantan] o bien Oxford-AstraZeneca [Fiocruz]). Se notificaron y analizaron un total de 474 ESAVI (32,7 eventos/10 000 dosis) de 254 personas, y todos se clasificaron como no graves. Se encontró una relación entre el empleo de la vacuna CoronaVac y la cefalea (OR = 2,1; IC del 95 %: 1,4-3,2), dolor en el lugar de la inyección (OR = 9,6; IC del 95 %: 3,9-23,8), letargo (OR = 5,2; IC del 95 %: 1,8-14,8), cansancio (OR = 10,1; IC del 95 %: 2,4-42,3), diarrea (OR = 4,4; IC del 95 %: 1,5-12,5) y síntomas similares al resfriado (OR = 8,0; IC del 95 %: 1,9 a 34,0). Sin embargo, la proporción de pacientes que notificaron fiebre fue mayor entre los que recibieron la vacuna de Oxford-AstraZeneca (OR = 3,1; IC del 95 %: 1,5 a 6,4). Este estudio observacional poblacional refuerza la evidencia sobre la seguridad y tolerabilidad de las vacunas CoronaVac y Oxford-AstraZeneca empleadas contra la COVID-19.

RESUMO Faltam estudos de vigilância no mundo real sobre relatórios de eventos adversos associados à vacinação contra a COVID-19, bem como análises comparativas de eventos adversos decorrentes de vacinas com diferentes plataformas. Este estudo observacional, descritivo e retrospectivo baseado em dados secundários descreve os eventos adversos pós-vacinação (EAPV) relacionados com as primeiras 145 mil doses de vacinas contra a COVID-19 entregues no município de Aracaju, capital do estado de Sergipe, na região Nordeste do Brasil. Os registros de EAPV foram coletados usando o sistema e-SUS Notifica com referência ao período de 19 de janeiro a 30 de abril de 2021. Razões de chances (odds ratios, ORs) e intervalos de confiança (IC) de 95% foram calculados para os EAPV e o tipo de vacina contra a COVID-19: CoronaVac (Sinovac-Butantan) ou Oxford-AstraZeneca (Fiocruz). Um total de 474 EAPV (32,7 eventos/10 mil doses) de 254 indivíduos foram relatados e analisados, e todos foram classificados como não graves. Houve uma associação entre o uso da vacina CoronaVac e cefaleia (OR = 2,1; IC 95%: 1,4-3,2), dor no local da injeção (OR = 9,6; IC 95%: 3,9-23,8), letargia (OR = 5,2; IC 95%: 1,8-14,8), cansaço (OR = 10,1; IC 95%: 2,4-42,3), diarreia (OR = 4,4; IC 95%: 1,5-12,5 e sintomas gripais (OR = 8,0; IC 95%: 1,9-34,0). Contudo, a proporção de indivíduos que relataram febre foi superior entre os que receberam a vacina Oxford-AstraZeneca (OR = 3,1; IC 95%: 1,5-6,4). Este estudo observacional de base populacional reforça as evidências da segurança e tolerabilidade das vacinas CoronaVac e Oxford-AstraZeneca usadas contra a COVID-19.

Frailty and risk of complications in head and neck oncologic surgery. Systematic review and dose-response meta-analysis / Fragilidad y riesgo de complicaciones en cirugía oncológica de cabeza y cuello. Revisión sistemática y metanálisis dosis-respuesta.

Background: There is emerging evidence that frail individuals present a decreased physiological reserve, de-creased ability to maintain homeostasis, and increased vulnerability to stressors. The concept of frailty has be-come increasingly recognized as a valuable measure in oncological surgical patients, including those with headand neck cancer. Preoperative screening for frailty may provide an individualized risk assessment that can be usedby an interdisciplinary team for preoperative counseling and to improve outcomes. The aim of this meta-analysiswas to evaluate the relationship between frailty and the risk of major postoperative complications in frail individu-als submitted to head and neck oncologic surgery.Material and Methods: PubMed, SCOPUS, Web of Science, Google Scholar and OpenThesis were systematicallysearched to identify studies that evaluated the risk of major postoperative complications in frail individuals under-going head and neck oncologic surgery. The search was performed on August 31, 2020, without language or daterestrictions. Two independent investigators screened the searched studies based on each paper’s title and abstract.Relevant studies were read in full and selected according to the eligibility criteria. Frailty was assessed by modi-fied Frailty Index (mFI-11) and major postoperative complications were measured by the Clavien-Dindo classifica-tion. We performed a categorical and dose-response meta-analysis using a random-effects model to evaluate theassociation between frailty and the risk of major postoperative complications in patients submitted to head andneck oncologic surgery. The results of the meta-analysis were expressed as relative risk (RR) and 95% confidenceinterval (95% CI). The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Results: Four studies (9,947 patients) were included in this systematic...(AU)

Avaliação dos níveis pressóricos e antropométricos de escolares no interior do nordeste brasileiro / Evaluation of pressoric and anthropometric levels of school children in the brazilian northeastern countryside

Objetivo: Avaliar a influência do excesso de peso nos valores de pressão arterial (PA) de escolares 4 a 17 anos em uma cidade no interior de Sergipe. Metodologia: Trata-se de um estudo transversal, em que foram avaliados 119 estudantes de 5 escolas, por meio de avaliação antropométrica e obtenção dos valores da PA. Os estudantes foram classificados quanto seu estado nutricional e a presença de níveis pressóricos alte-rados de acordo com os percentis propostos pela Organização Mundial da Saúde e da Sociedade Brasileira de Cardiologia, respectivamente. Em seguida, os dados foram analisados estatisticamente com o programa GraphPad Prism V7.0., utilizando-se o teste de Mann Whitney para comparação e o coeficiente de Spearman para correlação entre duas variáveis, sendo adotado como nível de significância, 5%. Resultados:Dos 119 estudantes avaliados, 8,41% foram considerados com baixo peso, 38,32% eutróficos e 53,27% com excesso de peso. Os estudantes com excesso de peso apresentaram maiores medidas de circunferência abdominal. Observou-se uma correlação forte e positiva entre os valores de IMC-z e a razão CA/A, em que os estudantes com maiores valores de IMC-z possuíam também valores maiores da relação CA/A. Além disso, foi constatado maior número de estudantes com níveis considerados PA alterados, dentre aqueles que pos-suíam maiores medidas tanto de IMC-z e quanto da relação CA/A. Conclusão: Crianças e adolescentes com PA alterada apresentaram maior média de IMC e maior relação CA/A em comparação com as que possuíam PA normal, o que evidencia a necessidade de intervenção nessa população para prevenção e promoção da saúde.(AU)

Objective: To evaluate the influence of overweight on blood pressure (BP) values of schoolers aged 4 to 17 years in a city in the Sergipe countryside. Methodology: This is a cross-sectional study, in which 119 students from 5 schools were evaluated through anthropometric evaluation and BP values. The students were classified as their nutritional status and the presence of BP levels altered according to the percentiles proposed by the World Health Organization and the Brazilian Society of Cardi-ology, respectively. Data were then analyzed statistically in the GraphPad Prism V7.0 program, using the Mann Whitney test for comparison and the Spearman coefficient for correlation between two variables, being adopted as a significance level of 5%. Results: Of the 119 students evaluated, 8.41% were con-sidered underweight, 38.32% were eutrophic and 53.27% were overweight. Overweight students presented greater measures of Abdominal Circumference. A strong and positive correlation was also observed between the values of BMI-z and the CA/A ratio, where students with higher BMI-z values also had higher values of the CA/A ratio. In addition, a greater number of stu-dents with altered BP levels were observed among those who had greater measures of both BMI-z and CA/A ratio. Conclusion:Children and adolescents with altered BP had a higher mean BMI and higher CA/A ratio compared to those with normal BP, which reveals the need for intervention in this population for prevention and health promotion. (AU)

Prevalência de Sobrepeso e Obesidade em Pré-Escolares do Município de Frei Paulo-SE: Um Estudo Longitudinal / Prevalence of Overweight and Obesity Among Preschool Children in the Municipality of Frei Paulo, SE: A Longitudinal Study

Objetivos: Avaliar o perfil antropométrico de pré-escolares de quatro a seis anos da Escola Municipal Juvina Moreira, em Frei Paulo-SE. Materiais e métodos: Trata-se de um estudo longitudinal que acompanhou 42 crianças durante seis meses, no qual foram realizadas duas coletas de dados antropométricos. Os dados de peso e altura foram avaliados segundo os percentis propostos pela Organização Mundial da Saúde para o Índice de Massa Corporal. Os pontos de corte utilizados foram: percentil menor que três para déficit de peso; percentil entre três e 85 para eutróficos; e percentil e" 85 para risco ou excesso de peso. Para análise estatística foi utilizado o programa Graph Pad Prism V.5.0. O teste de Mann Whitney foi usado para comparação entre duas variáveis e o coeficiente de Spearman para correlação entre o índice CA/altura e o escore-Z do IMC. O nível de significância adotado foi de 5%. Resultados: Das 42 crianças que participaram do estudo, 18 (42,86%) foram do sexo feminino e 24 (57,14%) do sexo masculino. No primeiro semestre, 26,19% dos pré-escolares foram classificados com risco de sobrepeso ou excesso de peso (sobrepeso ou obesidade). No segundo semestre, esse número caiu para 16,67%. A prevalência de circunferência alterada se manteve em 19% nos dois semestres, e foi encontrada uma correlação positiva entre a relação circunferência abdominal por altura e o escore-z do Índice de Massa Corporal. Conclusão: Percebeuse que as taxas de sobrepeso e obesidade nos pré-escolares de Frei Paulo são relevantes e compatíveis com o encontrado em outras regiões do Brasil. Apesar da redução dessas taxas no segundo semestre, os números evidenciam a necessidade de intervenção nessa população através da educação e promoção da saúde. (AU)

Objective: To evaluate the anthropometric profile of preschool children aged four to six years at Juvina Moreira Municipal School, in the city of Frei Paulo, SE, Brazil. Material and Methods: This was a longitudinal study that followed up 42 children for six months, in which two anthropometric data collections were performed. The data obtained were analyzed based on cut-off points established by the World Health Organization for Body Mass Index. The cut-off points used were: percentile lower than three for weight deficit; percentile between three and 85 for eutrophic; and percentile e"85 for risk or development of overweight. Mann-Whitney test was used to compare two variables and the Spearman coefficient was used to test a correlation between waist: height ration and the BMI Z-score. The data were analyzed using GraphPad Prism version 5.0, with a 5% significance level. Results: Out of the 42 children who participated in the study, 18 (42.86%) were females and 24 (57.14%) were males. In the first semester, 26.19% of the pre-school children were classified as at risk of overweight or out of weight range (overweight or obesity). In the second semester, this number decreased to 16.67%. The prevalence of altered circumference remained at 19% in both semesters, and a positive correlation was found between the waist circumference ratio and the BMI Z-score. Conclusion: The overweight and obesity rates observed among pre-school children from Frei Paulo are relevant and compatible to what is found in other regions of Brazil. Despite the reduction of these rates in the second semester, the numbers show the need for intervention in this population through education and health promotion. (AU)

Pesquisa científica: conhecimento, atitudes e barreiras entre estudantes de medicina brasileiros / Scientific research: knowledge, attitudes and barriers among brazilian medical students

Introdução:O contato extracurricular com a pesquisa científica pode ajudar a melhorar as habilidades dos alunos e são muitos os potenciais influenciadores na adesão dos estudantes. Objetivo: Identificar níveis de conhecimento científico e atitudes científicas de estudantes de medicina bem como as principais barreiras para a prática científica. Casuística e Métodos: Estudo transversal realizado com acadêmicos de medicina do Campus Prof. Antônio Garcia Filho da Universidade Federal de Sergipe, Brasil. Aplicaram-se questionários validados a 90 estudantes que em seguida, foram agrupados em quatro classificações (não envolvidos em projetos; envolvidos em extensão; envolvidos em pesquisa e envolvidos em ambos (pesquisa e extensão). Resultados:Parcela significativa dos estudantes envolveu-se com projetos de pesquisa e extensão (43,33%) e as médias gerais de atitude e conhecimento científicos foram moderadas (56,85 ± 14,35; 47,28 ± 16,69). Os grupos de estudantes que participaram de pesquisa junto com extensão, apresentaram maiores pontuações de atitude científica (63,10 ± 13,69) e o conhecimento científico de todos os grupos foi similar. As barreiras, para a prática científica, mais citadas foram a falta de estrutura (73,33%), de tempo (70%), de orientação (67,78%), o foco nas atividades curriculares (54,44%) e falta de familiaridade com estatística (50%). Conclusão: Estudantes que apresentavam contato com pesquisa cientifica e extensão apresentaram atitudes mais positivas para pesquisa, demonstrando a importância do estímulo a essa prática. As barreiras, para as práticas científicas, mostraram-se similares à literatura mundial, mostrando que devem ser feitas medidas para reduzi-las e estimular a prática científica.

Introduction: Extracurricular contact with scientific research can help to improve students' skills and there are many potential influencers of students'adhesion. Objectives: Identify levels of scientific knowledge and attitudes towards scientific research among medical students, as well as the main barriers to scientific practice. C asuistic and methods:This is a cross-sectional study involving medical students from the Federal University of Sergipe, Brazil, Campus Prof. Antônio Garcia Filho. Validated questionnaires were applied to 90 students. Then, they were grouped in four classifications (not involved in projects; involved in non-degree projects; involved in research projects, and involved in both non-degree and research projects). Results: Significant parcel of students was involved on research and non-degree projects (43.33%). The overall averages of scientific knowledge and attitudes were moderate (56.85 ±14.35; 47.28 ±16.69). Groups of students involved in scientific research and community outreach, presented higher scores of scientific attitudes (63.10 ± 13.69). The scientific knowledge of all groups was similar. The most cited barriers for scientific practice were lacked of structure (73.33%), lack of time (70%), lack of orientation (67.78%), the focus on curricular activities (54.44%), and the lack of familiarity with statistics (50%). Conclusion: Students who had contact with scientific research and community outreach had more positive attitudes towards research, showing the importance of stimuli to this practice. The barriers for scientific practice were similar to world's data, showing that measures have to be taken to reduce them and stimulate the scientific research.

Antropometria e estilo de vida de crianças e adolescentes no interior do Nordeste do Brasil / Anthropometry and lifestyle of children and adolescent in inland of northeastern Brazil

INTRODUCTION: Brazil is going through a nutritional transition, which is observed decrease in malnutrition and increased excess weight. OBJETIVE: To evaluate the nutritional status and lifestyle of school children and adolescents from 4 to 17 years old resident in the interior of the Brazilian Northeast. METHODS: This is a longitudinal study performed in two stages. The first stage took place during the School Health Program and anthropometric data were collected from 975 schoolchildren. In the second stage, it was used a questionnaire to assess lifestyle and diet. Participants were classified into "not overweight" and "overweight". The significant level for the statistical tests was set at 5%. RESULTS: In the first stage, less than 2% of students had low height for age. The prevalence of overweight and malnutrition was 22.15% and 5.23%, respectively. Of the 134 participants of the second stage, 47.76% were not overweight and 52.24% overweight. Regarding the lifestyle, the not overweight group had a higher percentage of insufficiently active members (p = 0.017) and a lower intake of vegetables and salads (p=0.015). CONCLUSION: The results revealed low short stature in the population studied and overweight was more prevalent than malnutrition. Children and adolescents had sedentary habits that associated with inappropriate dietary practices favor the occurrence of overweight.

INTRODUÇÃO: O Brasil passa por uma transição nutricional, no qual observa-se diminuição da desnutrição e aumento do excesso de peso. OBJETIVO: Avaliar os dados antropométricos e o estilo de vida de escolares entre 4 a 17 anos do interior do Nordeste brasileiro. MÉTODO: Estudo longitudinal realizado em duas etapas. A primeira ocorreu durante ação do Programa Saúde na Escola e foram coletados os dados antropométricos de 975 escolares. Na segunda etapa foi aplicado questionário para avaliar estilo de vida e alimentação. Os participantes foram estratificados em "sem excesso de peso" e "com excesso de peso" para fins de análise. O nível de significância usado nos testes estatísticos foi de 5%. RESULTADOS: Na primeira etapa, menos de 2,0% dos alunos apresentaram baixa estatura para a idade. A prevalência de excesso de peso e desnutrição foi de 22,15% e 5,23%, respectivamente. Dos 134 participantes da segunda etapa, 47,76% estavam sem excesso de peso e 52,24% com excesso de peso. Com relação ao estilo de vida, o grupo sem excesso de peso apresentou maior porcentagem de integrantes insuficientemente ativos (p = 0,017) e um menor consumo de verduras, legumes e saladas (p = 0,015) CONCLUSÃO: Os resultados demonstraram baixo déficit de estatura na população estudada e o excesso de peso foi mais prevalente que a desnutrição. As crianças e adolescentes apresentaram hábitos sedentários que associados às práticas alimentares inadequadas favorecem a ocorrência do excesso de peso.

Evaluation of the the attitudes towards use of drugs in an urban Northeastern population of Brazil / Avaliação das atitudes de uma população urbana do nordeste do Brasil com relação ao uso de fármacos

ABSTRACT BACKGROUND AND OBJECTIVES: The use of drugs has improved general population quality of life and health conditions. However, pharmaceutical industries spread a purely curative view and total well-being associated to its use. This study aimed at evaluating population attitudes with regard to the use of drugs in the city of Frei Paulo/SE, Brazil. METHODS: Data were collected by means of a questionnaire applied by trained people and in the presence of the community health agent, in the micro-regions of the Family Health Strategy. RESULTS: Participated in the study 186 people, predominantly females (77.95%) with mean age of 45.25±14.91 years. 73.12% of respondents have reported reading patient information leaflets, however approximately 40.0% of respondents have not completed elementary school, which might have impaired the understanding of such information. 31.72% have stated knowing that drugs in high doses may harm health. However, 9.14% of participants have confirmed using drugs in doses higher than those prescribed, and from them, 29.41% had complications. CONCLUSION: It is imperative the development of public policies focusing on population information and awareness with regard to the responsible use of drugs.

RESUMO JUSTIFICATIVA E OBJETIVOS: A utilização de fármacos tem aumentado a qualidade de vida e as condições de saúde da população em geral. Entretanto, as indústrias farmacêuticas propagandeiam uma visão puramente curativista e de pleno bem-estar associado ao seu uso. O objetivo deste estudo foi avaliar as atitudes da população frente ao uso de fármacos no município de Frei Paulo/SE, Brasil. METODOS: Os dados foram coletados por meio da aplicação de um questionário por pessoas treinadas e na presença do agente comunitário de saúde, nas microrregiões da Estratégia de Saúde da Família. RESULTADOS: Foram entrevistadas 186 pessoas, com predominância do gênero feminino (77,95%) com média de idade de 45,25±14,91 anos. 73,12% da população relataram praticar a leitura da bula, todavia, aproximadamente 40,0% da população não completaram o primeiro grau, o que pode ter prejudicado a compreensão das informações presentes nela. 31,72% afirmaram conhecer que os fármacos, em doses elevadas, podem causar lesões à saúde. Entretanto, 9,14% dos participantes confirmaram a utilização de fármacos em dose maiores do que as prescritas e, destes, 29,41% apresentaram complicações. CONCLUSÃO: Dessa forma, é imperativo o desenvolvimento de políticas públicas com foco na informação e conscientização da população quanto ao uso responsável de fármacos.