Association of polymorphisms in the erythropoietin gene with diabetic retinopathy: a case-control study and systematic review with meta-analysis.

BACKGROUND: Diabetic retinopathy (DR) is characterized by ischemia, hypoxia, and angiogenesis. Erythropoietin (EPO), an angiogenic hormone, is upregulated in DR, and the association of EPO genetic variants with DR is still uncertain, as conflicting results have been reported. Therefore, we performed a case-control study followed by a meta-analysis to investigate whether the rs1617640, rs507392, and rs551238 polymorphisms in EPO gene are associated with DR. METHODS: The case-control study included 1042 Southern Brazilians with type 2 diabetes (488 without DR and 554 with DR). Eligible studies for the meta-analysis were searched from electronic databases up to June 1, 2021. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for five genetic inheritance models. RESULTS: The minor alleles of the EPO polymorphisms had nearly the same frequency in all groups of patients (35%), and no association was detected with DR in the case-control study. The meta-analysis included 14 independent sets of cases and controls with 9117 subjects for the rs1617640 polymorphism and nine independent sets with more than 5000 subjects for the rs507392 and rs551238 polymorphisms. The G allele of the rs1617640 polymorphism was suggestively associated with DR under the dominant (OR = 0.82, 95% CI: 0.68-0.98), heterozygous additive (OR = 0.82, 95% CI: 0.69-0.97), and overdominant (OR = 0.88, 95% CI: 0.79-0.97) models. In the subgroup analyses, the G allele was also suggestively associated with proliferative DR (PDR), non-proliferative DR (NPDR), and DR (PDR + NPDR) among patients with type 1 diabetes (T1DM) or non-Asian ancestry. After considering the Bonferroni correction for multiple comparisons, the G allele remained associated with NPDR and DR in T1DM. Regarding the rs507392 and rs551238 polymorphisms, no association was found between these variants and DR. CONCLUSION: Our findings provide additional support to EPO as a susceptibility gene for DR, with the rs1617640 polymorphism deserving further investigation.

The Effect of Progressive Resistance Training on Functionality and Handgrip Strength in the Older Individuals of a Community: A Quasi-Experimental Study.

Muscle weakness is associated with negative outcomes, in addition to being related to the pathogenesis of frailty and functional disability in the older individuals. Muscle strength and functionality are considered biomarkers of aging. Progressive resistance training (PRT) is a type of training that has been the subject of studies as it presents itself as a therapeutic option to fight the reduction of muscle strength and functionality in older individuals. However, few studies have assessed the clinically relevant gains in the levels of muscle strength and functionality of older individuals after PRT, in addition to the need of testing new PRT approaches, including individualization and periodization in training programs. Therefore, this article aims to assess the effect of an individual and periodized PRT protocol on handgrip strength (HS) and functionality in older individuals. Thus, the study sample included 69 older individuals, divided into 2 groups: case (n = 41) and control (n = 28). The case group participated in a PRT protocol for 12 weeks, with two weekly sessions. When compared to the control group, which received only health education, the individuals in the case group had a greater magnitude of improvement in all variables related to the assessed functionality (Timed up and go test, gait speed, and HS), proving the applicability of the assessed protocol to improve strength and functionality in the older individuals of a community.

The sensitivity, specificity, and agreement of a point of care method: an assessment of the diagnostic accuracy.

The use of new technologies can improve screening in communities with difficult access to health. This article aims to evaluate the sensitivity, specificity, and agreement of a point of care test in comparison to laboratory methods for the determination of glucose (GLI), triglyceride (TG), and total cholesterol (TC) concentrations. This prospective study used data from the remaining adult population of quilombolas in Brazil. Laboratory tests using conventional methods for the analysis of venipuncture samples were used as a standard method to measure the concentrations of GLI (mg/dL), TG (mg/dL), and TC (mg/dL) and compared to the metered dose from the collection of fingertip capillary blood (point of care). Contingency tables (2x2) were used to estimate the sensitivity and specificity of the methods. Lin and Bland & Altman coefficients were used to statistically assess agreement, the level of significance was 5%. There was substantial agreement between the methods for measuring TG and poor agreement for of TC and GLI. Analysis of the Bland & Altman coefficients revealed that the fingertip method did not produce good measures. The point of care method did not offer a good ability to measure compared to that of the reference laboratory method.

Hemodynamics and functional outcomes after resistance training in hypertensive and normotensive elderly: An experimental study

Abstract Aim: To evaluate the chronic effects of resistance training on resting blood pressure, handgrip strength, gait speed, and Timed Up and Go test (TUG) in normotensive and hypertensive elderly individuals. Methods: Experimental study based on TREND. Hypertensive patients were diagnosed by an independent doctor. Before and after 12 weeks of progressive resistance training, we evaluated blood pressure, heart rate, body composition, Timed Up and Go test, gait speed, and handgrip strength. Results: Sample consisted of 41 participants divided into two groups (normotensive n = 28; hypertensive n = 13). We observed significant values in the reduction of blood pressure levels only in the group of hypertensive participants. In functionality outcomes, we observed significant values in all tests and both groups. Outcomes contemplate effect sizes ranging from small to moderate. Conclusion: Progressive resistance training lowers resting blood pressure levels, increases handgrip strength, and improves physical functional performance. Although the normotensive group did not show a reduction in blood pressure levels, an improvement was observed in the functional physical tests.

Prevalence and factors associated with metabolic syndrome in a vulnerable population in northern Brazil: a cross-sectional study / Prevalência e fatores associados à síndrome metabólica em população vulnerável do norte do Brasil: um estudo transversal

INTRODUCTION: metabolic syndrome (SM) is a set of metabolic imbalances that are associated with the development of cardiovascular diseases, type 2 diabetes mellitus, in addition to other chronic non-communicable diseases. SM has been gaining prominence in the scientific community mainly due to link with the increase of the obesity epidemic in the worldOBJECTIVE: To analyze the factors associated with metabolic syndrome and its prevalence in a vulnerable population in the Northern Region of BrazilMETHODS: This is a cross-sectional study with artisanal fishers from the state of Tocantins, and data collected between 2016 and 2017 were used. The outcome variable for MS was defined according to the criteria of the International Diabetes Federation. The following variables were assessed: socioeconomic and demographic information, fish consumption, and smoking. For statistical and data analysis, the Shapiro-Wilk test, Poisson regression, Student's t-test, and interquartile regression were evaluatedRESULTS: The general prevalence rate (PR) of MS was 31.9% higher in women than in men. The factors associated with MS were economic class and smoking, and there was an association between socioeconomic class and smoking (p=0.015). The most prevalent component was abdominal obesity with a rate of 62.5% (95% confidence interval [CI]: 54.5, 70.5). The prevalence of MS in terms of sex (PR=2.27, 95% 1.04 CI, 4.92, p=0.037), smoking (PR=2.40, 95% CI, 30, p=0.003) and years of professional experience (>10 PR=2.07, 95% CI 1.06, 4.05, p=0.033) was also assessedCONCLUSION: In the present study, the prevalence of SM was associated with smoking and socioeconomic status, which is considered high when compared to the worldwide prevalence. These findings highlight the importance of looking at public policies so that health services can develop actions that generate greater adherence to good health practices by the population

INTRODUÇÃO: A síndrome metabólica (SM) é um conjunto de desequilíbrios metabólicos que estão associados ao desenvolvimento de doenças cardiovasculares, diabetes mellitus tipo 2 além de outras doenças crônicas não transmissíveis. A SM vem ganhando destaque na comunidade científica principalmente por sua ligação com o aumento da epidemia de obesidade no mundoOBJETIVO: Analisar os fatores associados à síndrome metabólica e sua prevalência em população vulnerável da Região Norte do BrasilMÉTODO: Trata-se de um estudo transversal com pescadores artesanais do estado do Tocantins, e foram utilizados dados coletados entre 2016 e 2017. A variável desfecho para SM foi definida de acordo com os critérios da International Diabetes Federation. As seguintes variáveis foram avaliadas: informações socioeconômicas e demográficas, consumo de peixe e tabagismo. Para análise estatística e de dados, foram avaliados o teste de Shapiro - Wilk, regressão de Poisson, teste t de Student e regressão interquartilRESULTADOS: A taxa geral de prevalência (RP) da SM foi 31,9% maior em mulheres do que em homens. Os fatores associados à SM foram classe econômica e tabagismo e houve associação entre classe socioeconômica e tabagismo (p = 0,015). O componente mais prevalente foi obesidade abdominal com uma taxa de 62,5% (intervalo de confiança de 95% [IC]: 54,5, 70,5). A prevalência de SM em termos de sexo (RP = 2,27, IC 95% 1,04, 4,92, p = 0,037), tabagismo (RP = 2,40, IC 95%, 30, p = 0,003) e anos de experiência profissional (> 10 RP = 2,07, IC 95% 1,06, 4,05, p = 0,033) também foi avaliadoCONCLUSÃO: No presente estudo, a prevalência de SM esteve associada ao tabagismo e ao nível socioeconômico, sendo considerada elevada quando comparada a prevalência mundial. Esses achados assinalam a importância de um olhar das políticas públicas para que os serviços de saúde possam desenvolver ações que geram maior adesão as boas práticas de saúde pela população

The -308G>a polymorphism of the TNF gene is associated with proliferative diabetic retinopathy in Caucasian Brazilians with type 2 diabetes.

PURPOSE: We tested the hypothesis that tumor necrosis factor (TNF) gene polymorphisms are associated with diabetic retinopathy (DR) in Caucasians with type 2 diabetes mellitus. METHODS: In a case-control study, the -238G>A (rs361525), -308G>A (rs1800629), and -857C>T (rs1799724) polymorphisms of the TNF gene were genotyped in 745 outpatients with type 2 diabetes, including 331 subjects without DR, 246 with nonproliferative DR (NPDR), and 168 with proliferative DR (PDR). RESULTS: Genotype and allele frequencies of the -238G>A, -308G>A, and -857C>T polymorphisms in subjects with NPDR were not significantly different from those of subjects without DR (P > 0.05 for all comparisons). However, the A allele of the -308G>A polymorphism was more frequent in subjects with PDR than in those with no DR (18.1% vs. 11.5%, corrected P = 0.035). Multivariate logistic regression analysis showed that the -308A allele was independently associated with an increased risk of PDR, under a dominant model (adjusted odds ratio [aOR], 1.82; 95% confidence interval [CI], 1.11-2.98). The combined analysis of the three polymorphisms also showed that haplotypes containing the -308A allele were associated with an increased risk of PDR (aOR, 2.36; 95% CI, 1.29-4.32). CONCLUSIONS: This study detected, for the first time to our knowledge, an independent association of the -308G>A polymorphism in the TNF gene with PDR in Caucasian Brazilians with type 2 diabetes. This finding suggests that TNF is a potential susceptibility gene for PDR.

The sensitivity, specificity, and agreement of a point of care method: an assessment of the diagnostic accuracy / Sensibilidade, especificidade e concordância do método point of care: um estudo de precisão diagnóstica

Abstract The use of new technologies can improve screening in communities with difficult access to health. This article aims to evaluate the sensitivity, specificity, and agreement of a point of care test in comparison to laboratory methods for the determination of glucose (GLI), triglyceride (TG), and total cholesterol (TC) concentrations. This prospective study used data from the remaining adult population of quilombolas in Brazil. Laboratory tests using conventional methods for the analysis of venipuncture samples were used as a standard method to measure the concentrations of GLI (mg/dL), TG (mg/dL), and TC (mg/dL) and compared to the metered dose from the collection of fingertip capillary blood (point of care). Contingency tables (2x2) were used to estimate the sensitivity and specificity of the methods. Lin and Bland & Altman coefficients were used to statistically assess agreement, the level of significance was 5%. There was substantial agreement between the methods for measuring TG and poor agreement for of TC and GLI. Analysis of the Bland & Altman coefficients revealed that the fingertip method did not produce good measures. The point of care method did not offer a good ability to measure compared to that of the reference laboratory method.

Resumo O uso de novas tecnologias pode melhorar o screening em comunidades de difícil acesso à saúde. O objetivo deste artigo é avaliar a sensibilidade, especificidade e concordância do teste de point of care em comparação com método laboratorial para dosagem de Glicose (GLI), Triglicerídeo (TG) e Colesterol total (CT). Estudo prospectivo com dados de população de adultos remanescentes de quilombolas no Brasil. Exames laboratoriais convencionais para análise foram obtidos por venopunção, utilizados como método padrão para mensuração das concentrações de GLI (mg/dL), TG (mg/dL) e CT (mg/dL) e comparados a mensuração por meio de técnica de ponta de dedo (point of care). Tabelas de contingência (2x2) foram utilizadas para estimar sensibilidade e especificidade dos métodos e o coeficiente de Lin e análises de Bland & Altman foram métodos de concordância com nível de significância de 5%. Houve concordância substancial entre os métodos para mensuração de TG e fraca concordância para mensuração de CT e GLI. Os coeficientes de Bland & Altman indicam que o método de ponta de dedo não apresentou boa mensuração. O método point of care não apresentou boa capacidade de mensuração de Glicose, Triglicerídeo e Colesterol total tendo como referência o método laboratorial.

Estudo qualitativo de dermatófitos isolados em tatames em academia de artes marciais / Qualitative study of isolated dermatophytes on mats at martial arts academy

Introdução: as dermatofitoses são micoses causadas por fungos, denominados dermatófitos, que produzem lesões na pele, pelos ou unhas. Nas academias, o risco de contaminação é maior pois trata-se de um ambiente fechado com grande fluxo de pessoas, constante uso dos mesmos equipamentos, além do suor proveniente de atividade física e limpeza inadequada que influenciam na proliferação desses fungos. Objetivos: a realização desta pesquisa teve como objetivo identificar a presença de dermatófitos nos tatames e sacos de pancada das academias de artes marciais localizadas na região central, norte e sul do município de Palmas ­ TO. Metodologia: utilizou-se a técnica de "swab umedecido" para a coleta de 18 amostras em três academias de artes marciais, posteriormente semeadas e isoladas em duplicata, em meios Sabouraud Dextrose Ágar e Batata Dextrose Ágar para identificação macroscópica das colônias com características filamentosas ou leveduriformes. Posteriormente foram realizadas identificações presuntivas das estruturas microscópicas para análise morfológicas dos fungos dermatófitos de interesse. Resultados: verificou-se que das 36 amostras submetidas à análise, observando-se apenas o gênero Trichophyton sp. em 4,6% das amostras, Zygomicetes sp. em 5,4%, entretanto, o gênero Aspergillus sp. com 89.8% de presença, apresentou-se com maior frequência nesse estudo. Conclusão: de acordo com os resultados do estudo, os produtos de limpeza que são utilizados diariamente, sendo o álcool um dos principais, pode ter contribuído para a inibição do crescimento fúngico de dermatófitos.

Introduction: dermatophytoses are fungal mycoses, called dermatophytes, that produce lesions on the skin, hair or nails. In the academies, the risk of contamination is higher because it is a closed environment with a great flow of people, constant use of the same equipment, besides the sweat coming from physical activity and inadequate cleaning that influence the proliferation of these fungi. Objectives: the objective of this research was to identify the presence of dermatophytes on the tatami mats and punching bags of the martial arts academies located in the central, northern and southern regions of the municipality of Palmas ­ TO. Methodology: the "swab moistened" technique was used to collect 18 samples in three academies of soft arts, later sown and isolated in duplicate, in media Sabouraud Dextrose Agar and Potato Dextrose Agar for macroscopic identification of colonies with filamentous or yeast characteristics. Subsequently, presumptive identifications of the microscopic structures for morphological analysis of the dermatophytic fungi of interest were carried out. Results: it was verified that of the 36 samples submitted to the analysis, observing only the genus Trichophyton sp. in 4,6% of the samples, Zygomicetes sp. in 5,4%, however, the genus Aspergillus sp. with a 89,8% presence, was more frequent in this study. Conclusion: according to the results of the study, cleaning products that are used daily, being the alcohol one of the main ones, may have contributed to the inhibition of the fungal growth of dermatophytes.

Performance, serologic and tracheal responses of laying hens exposed to F strain of Mycoplasma gallisepticum / Desempenho, sorologia e respostas traqueias de galinhas poedeiras expostas a cepa F de Mycoplasma gallisepticum

The F strain of Mycoplasma gallisepticum (MG-F) protects chickens against mycoplasma infections, in which monitoring is made by serology and histopathology of trachea. This trial used 90 chickens, being 30 unvaccinated (G1 group), 30 eye-drop vaccinated at 8 weeks of age with MG-F (Ceva Animal Health, São Paulo, SP, Brazil) (G2), and 30 immunized at 8 and 11 weeks of age (G3). Samples were obtained from chickens on the 8, 12, 15, 18, 20 and 24th weeks of age for the enzyme-linked immunosorbent assay (ELISA) test. Tracheal fragments were collected after necropsies on the 15 and 24th weeks of age. Up to 12 weeks, the ELISA reactions in optical density (OD) were 0.165 (G1), 0.151 (G2) and 0.151(G3), all below 0.20 and with no significant difference among groups (p > 0.05). After the 15th week, the ELISA reactions rose, yielding the following group averages by collecting dates: G1 (0.18, 0.19, 0.18, and 0.16), G2 (0.36, 0.49, 0.47, and 0.44) and G3 (0.41, 0.52, 0.59, 0.60), being the means in G2 and G3 not significantly different between than, but significantly different from G1. The initial weight (592.71, 621.33, and 594.40), the final weight (1,932.58, 1,987.59, and 1,875.20) and the weekly weight gain (11.65, 11.90, and 11.14) were not significantly different among groups. At necropsy the gross tracheal score means by group and dates were: 15th week (0.25, 0.61, and 0.54) and 24th week (0.54, 0.58, and 0.67), being these difference not significantly (p > 0.05). On microscopy, the tracheal score averages by groups G1, G2 and G3, respectively, were: 15th week (0.25, 0.32, and 0.47) and 24th week (0.07, 0.75, and 0.08). G2 yielded higher score average than G1 and G3 on the 24th week. Higher tracheal changes for G2 and G3 as compared to G1 could be ascribed to MG-F infection. There were no evident prejudicial effects on live weight, weight gain and tissue changes by applying one or two vaccination doses.(AU)

A cepa F de Mycoplasma gallisepticum (MG-F) protege as galinhas de micoplasmose, e sua monitorização é feita por sorologia e histopatologia de traqueia. Este estudo utilizou 90 frangos, sendo 30 não vacinados (grupo G1); 30 vacinados via gota ocular a 8 semanas de idade com MG-F (Ceva Saúde Animal, São Paulo, SP, Brasil) (G2); e 30 imunizados em 8 e 11 semanas de idade (G3). As amostras foram obtidas nas 8ª, 12ª, 15ª, 18ª, 20ª e 24ª semanas para ensaio de imunoabsorção enzimática (ELISA). Fragmentos traqueais foram coletados após necropsias nas 15ª e 24ª semanas. Até a 12ª semana, as reações de ELISA em densidade óptica (DO) foram 0,165 (G1), 0,151 (G2) e 0,151 (G3), todas abaixo de 0,20, e não houve diferença significativa entre os grupos (p > 0,05). Após a 15ª semana , a reação de ELISA subiu, produzindo as seguintes médias dos grupos por datas de coleta: G1 (0,18, 0,19, 0,18 e 0,16), G2 (0,36, 0,49, 0,47 e 0,44) e G3 (0,41, 0,52, 0,59, 0,60), sendo as médias de G2 e G3 não significativamente diferentes entre si, mas significativamente diferentes da de G1. O peso inicial (592,71, 621,33, 594,40), o peso final (1.932,58, 1.987,59, 1.875,20) e o ganho de peso semanal (11,65, 11,90, 11,14) não foram significativamente diferentes entre os grupos. Na necropsia, as médias do escore da macroscopia de traqueia por grupo e data foram: 15ª semana (0,25, 0,61 e 0,54) e 24ª semana (0,54, 0,58 e 0,67), e não se apresentou diferença significativa (p > 0,05). Na microscopia, a média de escores de traqueia por grupos G1, G2 e G3, respectivamente, foram: 15ª semana (0,25, 0,32 e 0,47) e 24ª semana (0,07, 0,75 e 0,08). G2 apresentou maior média de escore do que G1 e G3 na 24ª semana. Alterações traqueais mais elevadas para G2 e G3 em relação a G1 poderiam ser atribuídas à vacinação por MG-F. Não houve efeitos prejudiciais evidentes no peso vivo nem no ganho de peso, tampouco alterações teciduais na aplicação de uma ou duas doses de vacinação.(AU)