Problemas com o sono e fatores associados na população brasileira: Pesquisa Nacional de Saúde, 2013 / Sleep-related problems and associated factors among the Brazilian population: National Health Survey, 2013

Resumo O objetivo deste estudo foi estimar a frequência de problemas com o sono e os fatores associados, analisando dados da Pesquisa Nacional de Saúde, realizado em 2013 no Brasil. Os problemas com o sono foram avaliados com a pergunta "Nas duas últimas semanas, com que frequência o(a) sr(a) teve problemas no sono, como dificuldade para adormecer, acordar frequentemente à noite ou dormir mais do que de costume?", as respostas foram agrupadas em: nenhum dia, menos da metade dos dias e mais da metade dos dias. Dos indivíduos avaliados, 71,1% relataram não ter problemas com o sono em nenhum dia, 14,0% em pelo menos metade dos dias e 14,9% em mais da metade dos dias. As maiores frequências de problemas com o sono foram relatadas pelas mulheres e com o aumento da idade. Para homens e mulheres, tabagismo, consumo de bebidas alcoólicas, inatividade física, comportamento sedentário e hipertensão arterial apresentaram associação significativa com a frequência de problemas com o sono em mais da metade dos dias, e o excesso de peso para as mulheres. Assim, foi elevada a frequência de problemas com o sono na população brasileira. Mulheres, indivíduos mais velhos, com comportamentos de risco relacionados ao estilo de vida, hipertensão arterial e excesso de peso corporal foram os subgrupos em maior risco.

Abstract The scope of this study was to estimate the frequency of sleep-related problems and associated factors. It was a study based on data from the National Health Survey conducted in Brazil in 2013. Sleep-related problems were assessed with the question "How often have you had sleep problems in the last two weeks, such as difficulty falling asleep, waking up frequently during the night or sleeping more than usual?" The answers were grouped into: none of the days, less than half of the days and more than half of the days. Of the individuals evaluated, 71.1% reported having no problems with sleep on any day, 14.0% on at least half of the days and 14.9% on more than half of the days. The highest frequencies of sleep-related problems were reported by women and more advanced age. For men and women, smoking, alcohol abuse, physical inactivity, sedentary behavior, and high blood pressure were significantly associated with the frequency of sleep problems on more than half of the days, and also excess weight for women. Thus, the frequency of sleep-related problems in the Brazilian population was high. Women, older individuals with lifestyle-related risk behaviors, high blood pressure, and overweight were the highest risk subgroups.

Genome sequence of a multidrug-resistant Corynebacterium striatum isolated from bloodstream infection from a nosocomial outbreak in Rio de Janeiro, Brazil

Multidrug-resistant (MDR) Corynebacterium striatum has been cited with increased frequency as pathogen of nosocomial infections. In this study, we report the draft genome of a C. striatum isolated from a patient with bloodstream infection in a hospital of Rio de Janeiro, Brazil. The isolate presented susceptibility only to tetracycline, vancomycin and linezolid. The detection of various antibiotic resistance genes is fully consistent with previously observed multidrug-resistant pattern in Corynebacterium spp. A large part of the pTP10 plasmid of MDR C. striatum M82B is present in the genome of our isolate. A SpaDEF cluster and seven arrays of CRISPR-Cas were found.

Sphygmomanometers and thermometers as potential fomites of Staphylococcus haemolyticus: biofilm formation in the presence of antibiotics

BACKGROUND The association between Staphylococcus haemolyticus and severe nosocomial infections is increasing. However, the extent to which fomites contribute to the dissemination of this pathogen through patients and hospital wards remains unknown. OBJECTIVES In the present study, sphygmomanometers and thermometers were evaluated as potential fomites of oxacillin-resistant S. haemolyticus (ORSH). The influence of oxacillin and vancomycin on biofilm formation by ORSH strains isolated from fomites was also investigated. METHODS The presence of ORSH on swabs taken from fomite surfaces in a Brazilian hospital was assessed using standard microbiological procedures. Antibiotic susceptibility profiles were determined by the disk diffusion method, and clonal distribution was assessed in pulsed-field gel electrophoresis (PFGE) assays. Minimum inhibitory concentrations (MICs) of oxacillin and vancomycin were evaluated via the broth microdilution method. Polymerase chain reaction (PCR) assays were performed to detect the mecA and icaAD genes. ORSH strains grown in media containing 1/4 MIC of vancomycin or oxacillin were investigated for slime production and biofilm formation on glass, polystyrene and polyurethane catheter surfaces. FINDINGS ORSH strains comprising five distinct PFGE types were isolated from sphygmomanometers (n = 5) and a thermometer (n = 1) used in intensive care units and surgical wards. ORSH strains isolated from fomites showed susceptibility to only linezolid and vancomycin and were characterised as multi-drug resistant (MDR). Slime production, biofilm formation and the survival of sessile bacteria differed and were independent of the presence of the icaAD and mecA genes, PFGE type and subtype. Vancomycin and oxacillin did not inhibit biofilm formation by vancomycin-susceptible ORSH strains on abiotic surfaces, including on the catheter surface. Enhanced biofilm formation was observed in some situations. Moreover, a sub-lethal dose of vancomycin induced biofilm formation by an ORSH strain on polystyrene. MAIN CONCLUSIONS Sphygmomanometers and thermometers are fomites for the transmission of ORSH. A sub-lethal dose of vancomycin may favor biofilm formation by ORSH on fomites and catheter surfaces.

Clonal multidrug-resistant Corynebacterium striatum within a nosocomial environment, Rio de Janeiro, Brazil

Corynebacterium striatum is a potentially pathogenic microorganism with the ability to produce outbreaks of nosocomial infections. Here, we document a nosocomial outbreak caused by multidrug-resistant (MDR) C. striatum in Rio de Janeiro, Brazil. C. striatum identification was confirmed by 16S rRNA and rpoB gene sequencing. Fifteen C. striatum strains were isolated from adults (half of whom were 50 years of age and older). C. striatum was mostly isolated in pure culture from tracheal aspirates of patients undergoing endotracheal intubation procedures. The analysis by pulsed-field gel electrophoresis (PFGE) indicated the presence of four PFGE profiles, including two related clones of MDR strains (PFGE I and II). The data demonstrated the predominance of PFGE type I, comprising 11 MDR isolates that were mostly isolated from intensive care units and surgical wards. A potential causal link between death and MDR C. striatum (PFGE types I and II) infection was observed in five cases.

Perfil socioeconômico, antropométrico, bioquímico e estilo de vida de pacientes atendidos no programa “controle de peso” / Socioeconomic status, anthropometric, biochemical and life style profile of patients assisted in “weight control” program

Objetivo: analisar os prontuários dos participantes do Programa “Controle de Peso” do Hospital das Clínicas da Universidade Federal de Goiás. Método: estudo transversal de 199 prontuários para avaliação do perfil socioeconômico, antropométrico, bioquímico e estilo de vida dos pacientes. Resultados: observou-se que 93,97 por cento eram de pacientes do sexo feminino, com idade média de 42 ± 11,9 anos, 65,33 por cento dos pacientes tinham apenas o ensino fundamental e 76,38 por cento possuíam uma renda mensal familiar de até 5 salários mínimos. A freqüência de sobrepeso, obesidade graus I, II e III foi de 20,10 por cento; 38,69 por cento; 21,61 por cento e 19,60 por cento, respectivamente. A circunferência da cintura foi mensurada em 159 indivíduos e, dentre eles, 89 por cento das mulheres e 83 por cento dos homens apresentavam valores acima da referência. A intolerância à glicose foi constatada em 13,26 por cento, diabetes em 8,04 por cento, níveis de HDL-c diminuídos em 28 por cento e níveis de colesterol total, LDL-c e triglicérides elevados em 56 por cento, 49 por cento e 36 por cento, respectivamente. Verificou-se que 68 por cento dos pacientes tinham história familiar de obesidade. Em relação às atividades laborais 97,5 por cento dos pacientes trabalhavam e 55 por cento não praticavam atividade física. O apetite elevado foi relatado por 71 por cento dos indivíduos e 60 por cento realizavam de 3 a 4 refeições por dia, além de se alimentar com freqüência entre as refeições. Observou-se que 93 por cento dos indivíduos não fumavam e 80 por cento não consumiam bebidas alcoólicas. O número médio de retornos foi de 5,5 por paciente. Conclusões: a maioria dos pacientes possuía baixo nível socioeconômico, obesidade grau I, alteração da glicemia e do colesterol sérico, hábitos alimentares inadequados e não praticava atividade física, sendo difícil a aderência ao tratamento. Palavras-chave: obesidade, perfil de saúde, testes laboratoriais, estilo de vida.