Depression and suicide risk during the Covid-19 pandemic at a Brazilian public health psychosocial addiction care center: a preliminary report

Abstract Objective To evaluate the impact of the Covid-19 pandemic on depressive symptoms and suicide risk among patients receiving treatment at a Public Health Psychosocial Addiction Care Center (CAPS AD III) in Porto Alegre, Brazil. Methods Questions from the Coronavirus Health Impact Survey (CRISIS) translated into Brazilian Portuguese were used to evaluate 70 patients' perceptions of and behaviors during the Covid-19 pandemic. Validated Brazilian versions of the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7) were used to evaluate the severity of depressive symptoms, suicide risk, and anxiety symptoms. A multiple logistic regression model was used to evaluate predictors of suicide risk in the sample. Results Around 70% of patients reported moderate depressive symptoms and 30% reported severe depressive symptoms, 17% of patients reported having thoughts of suicide or death on more than half of days and 10% reported having them daily. The logistic regression model identified history of alcohol use as the main predictor of suicide risk in (OR 13.0, p = 0.03). Conclusions Individuals with a history of alcohol consumption had significantly higher suicide risk scores at a psychosocial public health care center in Brazil during the Covid-19 pandemic. This result may be important for devising better strategies and interventions to support this specific population profile.

Comportamento alimentar e imagem corporal em universitários da área de saúde / Eating behavior and body image in health sciences university students

OBJETIVO: Avaliar a associação da imagem corporal e o comportamento alimentar de universitários de uma capital do Nordeste do Brasil. MÉTODOS: Participaram da pesquisa universitários (n = 1570) da área da saúde de ambos os sexos, de quatro instituições de ensino superior. As dimensões da imagem corporal (i.e., perceptiva e atitudinal) foram avaliadas por meio da Escala de Silhuetas para adultos brasileiros; e o comportamento alimentar por meio da versão brasileira do Dutch Eating Behavior Questionnaire (DEBQ). Para a avaliação do estado nutricional, foram coletados peso corporal e estatura de modo autorreportado. A análise de associação foi feita pela regressão linear múltipla, após estratificação por sexo. RESULTADOS: Notou-se maior prevalência de universitárias do sexo feminino (72,9%), com idade média de 21,8 (DP = 4,1) anos. Foi encontrada associação entre percepção e (in)satisfação corporal com o comportamento alimentar em ambos os sexos. As mulheres que superestimaram o tamanho corporal obtiveram associação inversa com a dimensão alimentar restritiva (p = 0,001); e as insatisfeitas por magreza, associação direta entre alimentação restritiva; e inversa com o comportamento emocional (p < 0,001). Os homens que superestimaram seu tamanho corporal evidenciaram associação direta com a alimentação emocional; e entre os insatisfeitos por excesso de peso houve associação direta com a dimensão emocional (p = 0,032) e global (p = 0,046) do comportamento alimentar. CONCLUSÕES: O presente estudo demonstra que a imagem corporal negativa, considerando as duas dimensões avaliadas (i.e., perceptiva e atitudinal), foi associada ao comportamento alimentar entre universitários de ambos os sexos.

OBJECTIVE: To analyze an association of image and eating behavior of university students from a capital city in Northeast Brazil. METHODS: Participated in university research (n = 1570) in the health area of both sexes, from four higher education institutions. The dimensions of body image (that is, perceptual and attitudinal) were assessed using the Brazilian Adult Silhouettes Scale; and eating behavior using the Brazilian version of the Dutch eating behavior questionnaire (DEBQ). For an assessment of nutritional status, body weight and height were collected automatically reported. An association analysis was performed using the selected linear regression, after stratification by sex. RESULTS: There is no higher prevalence of women (72.9%), with a mean age of 21.8 (SD = 4.1) years. An association was found between perception and (in) body satisfaction with eating behavior in both sexes. Women who overestimated body size had an inverse association with the restrictive dietary dimension (p = 0.001); and as dissatisfied by law, direct association between restrictive eating; and inverse with emotional behavior (p < 0.001). Men who overestimate their body size, showed an association with emotional nutrition; among those dissatisfied with excess weight, there was an association with emotional (p = 0.032) and global (p = 0.046) dimensions of eating behavior. CONCLUSIONS: The present study demonstrates that a negative body image, considering two dimensions evaluated (that is, perceptual and attitudinal), was associated with eating behavior among university students of both sexes.

Atividade física e fatores associados em adolescentes estudantes de uma cidade de pequeno porte do sul do Brasil / Physical activity and associated factors in public high-school adolescents from a Southern city in Brazil

O objetivo do estudo foi verificar o nível de atividade física e os fatores associados em adolescentes. Foi realizado um estudo transversal com 114 indivíduos (14 a 21 anos), estudantes do ensino médio, da cidade de Morro Redondo - RS. A atividade física foi mensurada pelo questionário de prática de atividade física para adolescentes (PAQ-A). Os resultados apontaram que na atividade física total, 55,7% dos adolescentes alcançaram as recomendações de atividade física (300 minutos por semana). Sujeitos que relataram percepção de saúde excelente apresentaram uma probabilidade 140% maior de praticar atividade física total quando comparados aos com percepção de saúde regular/ruim. Estudantes que já fumaram em algum momento da vida (RP=1,44; IC 95%= 1,06; 1,96) e aqueles que ingeriram mais de cinco doses de bebidas alcoólicas nos últimos 30 dias foram mais ativos que seus pares (RP=1,40; IC 95%= 1,01; 1,96). Na atividade física de lazer, 43,4% foram considerados ativos. Indivíduos de cor da pele não branca apresentaram 85% mais probabilidade de praticar atividade física no lazer (RP = 1,85; IC 95% = 1,26; 2,72), e a medida que melhora a percepção de saúde dos adolescentes, maior foi a chance de serem ativos. A atividade física mais praticada foi a caminhada como meio de transporte (57,9 %), seguida de andar de bicicleta (33,3%), correr (33,3 %) e jogar futebol (32,5%). Conclui-se que a prevalência de atividade física de lazer e total é semelhante à de estudos com adolescentes em diferentes cidades do país, e sua prática esteve associada a percepção de saúde positiva, ao consumo de bebidas alcóolicas e tabaco. A atividade mais realizada foi a caminhada como meio de transporte.

The aim of the study was to verify the level of physical activity and associated factors in adolescents. A cross-sectional study was carried out with 114 individuals (age between 14 and 21 years), students of the high school, in the city of Morro Redondo - RS. The physical activity was measured using a physical activity questionnaire for adolescents (PAQ-A). The results showed that concerning total physical activity, 55.7% of the adolescents reached the recommendations of physical activity (300 minutes per week). Subjects who reported excellent health perception presented a 140% higher probability of practicing total physical activity when compared to those with regular/poor health perception. Subjects who have smoked at some point in their life (PR = 1.44, 95% CI = 1.06, 1.96) and those who have consumed more than five doses of alcohol in the last 30 days are more active than their peers (PR = 1.40, 95% CI = 1.01, 1.96). In the leisure time physical activity prevalence of active students was 43.4%. Individuals with non-white skin color had 85% more probability to practice physical activity during leisure time (PR = 1.85, 95% CI = 1.26, 2.72), whereas, as adolescents' health perception improves the greater the chance of being active. The most practiced physical activity was walking as a means of transportation (57.9%), followed by cycling (33.3%), running (33.3%) and playing soccer (32.5%). In conclusion, the prevalence of leisure and total physical activity is similar to studies with adolescents in different cities in the country, and its practice was associated with the positive health perception, consumption of alcoholic beverages and tobacco. The most performed activity was walking as a mode of transport....(AU)

Metal content in medicinal teas used in the Urubueua de Fátima river community, Abaetetuba-Pará State, Brazil / Contenido de metal en tés terapéuticos utilizados en la comunidad del Río Urubueua de Fátima, estado de Abaetetuba-Pará, Brasil

The content of certain metals in 13 medicinal teas made from 16 plant species was measured by flame photometer and atomic absorption spectrometer with flame methods. The measurements were evaluated against metal intake levels recommended by health authorities. The results indicate that the medicinal teas tested, regularly consumed by inhabitants of the Urubueua de Fátima River Community, Abaetetuba-Para, Brazil, present no risk of poisoning people older than six months. However, decoctions of Mentha sp., Eleutherine bulbosa, Euterpe oleracea, Piper callosum and Hyptis mutabilis, mostly given to children, had Mn values potentially exceeding the recommended maximum intake for infants in the 0-6 months age group, in the quantities customarily administered. Consequently, studies are needed to assess bioavailability for safe human consumption. Results also showed the consumption of medicinal tea alone is not enough to supply an adult's daily metal requirements or treat deficiencies. Additionally, cures emphasized by interviewed Community members might be associated with the bioactivity of organic substances that the medicinal teas contain.

El contenido de algunos metales en 13 tés medicinales de las 16 especies consumidas por los habitantes de la comunidad del Río Urubueua de Fátima, Abaetetuba-Para, Brasil, se evaluó mediante un fotómetro de llama y un espectrómetro de absorción atómica con métodos de llama, y se comparó con los niveles recomendados por las agencias de la salud. Los tés medicinales evaluados no mostraron riesgo de intoxicación para las personas mayores de seis meses de edad, sino las decocciones de Mentha sp., Eleutherine bulbosa, Euterpe oleracea, Piper callosum y Hyptis mutabilis, en su mayoría dirigidos a la ingesta de niños, informaron valores de Mn superiores a la ingesta máxima recomendada para el grupo de infantes (0-6 meses), debido a que estos estudios son necesarios para evaluar la biodisponibilidad para un consumo humano seguro. Los resultados también mostraron que solo el consumo de té medicinal no es suficiente para satisfacer las necesidades diarias recomendadas de ingesta de minerales o para tratar las deficiencias. Además, los informes de curación, enfatizados por los habitantes, indican que la bioactividad observada podría estar asociada a sustancias orgánicas presentes en el té.

Notas sobre uma ontologia em Lacan: um diálogo com Heidegger / Notes sur une ontologie dans Lacan: un dialogue avec Heidegge / Notas sobre una ontología en Lacan: un diálogo con Heidegger / Notes on an ontology in Lacan: a dialogue with Heidegger

Este estudo busca discutir a questão de uma possível ontologia na obra de Lacan a partir de seu estatuto do inconsciente ético de 1964. Procura-se estabelecer relações entre os conceitos lacanianos de inconsciente, ética e tempo e, através deles, dialogar com a concepção de temporalidade em Heidegger, a fim de demonstrar que o inconsciente lacaniano não é ético apenas por sua natureza linguística, mas também pela ontológica

Cette étude vise à discuter la question d'une ontologie possible dans l'œuvre de Lacan à partir de le statut éthique de l'inconscient présenté par lui en 1964. Nous cherchons à établir des relations entre les concepts lacaniens de l'inconscient, d'éthique et du temps et, à travers d'eux, dialoguer avec la conception de la temporalité chez Heidegger, afin de montrer que l'inconscient lacanien n'est pas éthique seulement du point de vue de la linguistique, mais aussi de la ontologie

Este estudio tiene como objetivo discutir la cuestión de una posible ontología en la obra de Lacan a partir de su estatuto del inconsciente ético de 1964. Tratando de establecer relaciones entre los conceptos lacanianos del inconsciente, ética y tiempo y, mediante estos, dialogar con la concepción de la temporalidad en Heidegger, con el fin de demostrar que el inconsciente lacaniano no es ético solo por su naturaleza lingüística, sino también por la ontológica

This study aims to discuss the possibility of an ontology in Lacan's work, based on the status of ethical unconscious presented by him in 1964. We try to establish relationships between the Lacanian concepts of unconscious, ethics and time and, through them, a dialogue with the conception of temporality in Heidegger, in order to demonstrate that the Lacanian unconscious is not only linguistic, but also ontological

Combined genotypes of the MBL2 gene related to low mannose-binding lectin levels are associated with vaso-occlusive events in children with sickle cell anemia

Abstract Sickle cell anemia (SCA) presents heterogenous clinical manifestations that cannot be explained solely by alterations to hemoglobin (Hb); other components such as endothelial adhesion, thrombosis and inflammation may be involved. The mannose-binding lectin (MBL) has an important role in innate immunity and inflammatory diseases. In this report, we describe an association between MBL2 polymorphism related to low production of serum MBL and the frequency of vasoocclusive events (FVOE) in children ≤ 5 years old with SCA (p = 0.0229; OR 5.55; CI 1.11-27.66). Further studies are needed to explore the role of low MBL2 in the pathophysiology of vasoocclusive events in SCA.

Primary dengue haemorrhagic fever in patients from northeast of Brazil is associated with high levels of interferon-β during acute phase

Dengue is an acute febrile disease caused by the mosquito-borne dengue virus (DENV) that according to clinical manifestations can be classified as asymptomatic, mild or severe dengue. Severe dengue cases have been associated with an unbalanced immune response characterised by an over secretion of inflammatory cytokines. In the present study we measured type I interferon (IFN-I) transcript and circulating levels in primary and secondary DENV infected patients. We observed that dengue fever (DF) and dengue haemorrhagic fever (DHF) patients express IFN-I differently. While DF and DHF patients express interferon-α similarly (52,71 ± 7,40 and 49,05 ± 7,70, respectively), IFN- β were associated with primary DHF patients. On the other hand, secondary DHF patients were not able to secrete large amounts of IFN- β which in turn may have influenced the high-level of viraemia. Our results suggest that, in patients from our cohort, infection by DENV serotype 3 elicits an innate response characterised by higher levels of IFN- β in the DHF patients with primary infection, which could contribute to control infection evidenced by the low-level of viraemia in these patients. The present findings may contribute to shed light in the role of innate immune response in dengue pathogenesis.

Comparison between unimodal and multimodal Physical Therapy interventions in frailty: a systematic review / Comparação entre intervenções fisioterapêuticas unimodais e multimodais na Síndrome da Fragilidade: revisão sistemática

Frailty can be defined as a biologic syndrome that results from decline in multiple systems leading to vulnerability, with poorer capacity of the organism to maintain homeostasis facing stressing events. Physical symptoms of frailty involve unintentional weight loss, decreased physical activity level, exhaustion, muscle weakness, impaired balance and gait. Together, these symptoms can compromise independence in activities of daily living. Physical Therapy can improve muscle strength, balance, gait and cardiorespiratory aptitude of frail elderly, but remains unclear what is the best intervention strategy: unimodal or multimodal interventions, with combined exercises. This systematic review aimed: (1) to compare the efficacy of unimodal and multimodal Physical Therapy interventions; (2) to analyze its effects on clinical outcomes and (3) to elucidate what is the best modality of exercise and its combination in order to improve physical symptoms and independence in frail elderly. Searches were conducted in PubMed, Medline, PEDro, Lilacs and Scielo databases. We obtained 2,579 studies and 17 were included in analysis. Studies analyzed the following clinical outcomes: mobility, muscle strength, balance, falls and fear of falling, quality of life and functional capacity. We conclude that both unimodal and multimodal interventions have potential to promote beneficial effects, but the analyzed studies have important methodological issues that negatively affect their quality. Although the beneficial effects of both interventions, the quality of studies analyzed does not allow us to generalize these effects. We suggest that new clinical trials should be conducted with a stronger methodology and according to current guidelines for randomized clinical trials.

A fragilidade pode ser definida como uma síndrome biológica que resulta da diminuição da função de diversos sistemas, conduzindo à vulnerabilidade e pior capacidade do organismo para manter a homeostase frente a eventos estressores. As características físicas da fragilidade envolvem perda involuntária de peso, diminuição do nível de atividade física, cansaço, fraqueza muscular, diminuição do equilíbrio e marcha. Esses sintomas podem comprometer a independência nas atividades de vida diária. A fisioterapia pode melhorar a força muscular, equilíbrio, marcha e aptidão cardiorrespiratória de idosos frágeis, mas não está claro qual é a melhor estratégia: intervenções unimodais ou multimodais, com exercícios combinados. Sendo assim, esta revisão sistemática objetivou: (1) comparar a eficácia de intervenções unimodais e multimodais; (2) analisar os efeitos sobre os resultados clínicos e (3) elucidar qual a melhor modalidade de exercício e suas combinações na melhora dos sintomas físicos e independência em idosos frágeis. Foram realizadas buscas nas bases de dados PubMed, Medline, Pedro, Lilacs e Scielo. Obtivemos 2.579 estudos e 17 foram incluídos na análise. Os estudos incluídos analisaram os desfechos mobilidade, força muscular, equilíbrio, quedas e medo de cair, qualidade de vida e capacidade funcional. Concluimos que as intervenções unimodais e multimodais têm potencial para promover efeitos benéficos, mas os estudos analisados apresentaram falhas metodológicas que afetam a qualidade dos mesmos. Apesar dos benefícios de ambas as intervenções, a qualidade dos estudos não nos permite generalizar esses efeitos. Sugerimos que novos ensaios clínicos devam ser conduzidos, com metodologia de acordo com as recomendações para ensaios clínicos randomizados.

Relation between leukocyte count, adiposity, and cardiorespiratory fitness in pubertal adolescents / Relação entre contagem de leucócitos, adiposidade e aptidão cardiorrespiratória em adolescentes púberes

Objective To compare the total and differential leukocyte count in obese and normal-weight adolescents, and to verify their possible relations with cardiorespiratory fitness and adiposity indicators. Methods A cross-sectional study conducted with 139 adolescents (107 obese and 32 normal weight) aged between 13 and 18 years. Cardiorespiratory fitness was determined by direct gas analysis during an incremental treadmill test. Total leukocytes and subsets were estimated by flow cytometry. Body composition was assessed by dual-energy X-ray absorptiometry. The t-test for independent samples was used for comparison between groups. The relation between leukocytes, cardiorespiratory fitness and adiposity indicators was verified by Pearson’s correlation and multiple linear regression (adjusted for age and body mass index) tests. Results Obese adolescents had higher leukocyte (8.12±2.36u/L x 103; p=0.001), neutrophil (4.33±1.86u/L x 103; p=0.002), and monocyte (0.70±0.22u/L x 103; p=0.002) counts compared to the levels of normal weight subjects. After the necessary adjustments, cardiorespiratory fitness had a negative association with leukocytes, neutrophils, and monocytes in boys. Conclusion Obese adolescents had higher total and differential leucocyte count when compared to normal weight individuals. We also observed a weak positive association between adiposity and total leukocyte, monocyte, and neutrophil counts, and in boys, a negative association between cardiorespiratory fitness and total count of leukocytes, monocytes, and neutrophils. .

Objetivo Comparar a contagem total e diferencial de leucócitos de adolescentes obesos e eutróficos, e verificar suas possíveis relações com a aptidão cardiorrespiratória e indicadores de adiposidade. Métodos Estudo transversal realizado com 139 adolescentes (107 obesos e 32 eutróficos), com idades entre 13 e 18 anos. A aptidão cardiorrespiratória foi determinada por análise direta de gases durante um teste incremental em esteira rolante. As contagens de leucócitos totais e subconjuntos foram estimadas por citometria de fluxo. A composição corporal foi avaliada pelo método de dupla energia de raios X. O teste t para amostras independentes foi utilizado para comparação entre os grupos. A relação entre leucócitos, aptidão cardiorrespiratória e indicadores de adiposidade foi verificada por meio dos testes de correlação de Pearson e regressão linear múltipla (ajustado para idade e índice de massa corporal). Resultados Os adolescentes obesos apresentaram leucócitos (8,12±2,36u/L x 103; p=0,001), neutrófilos (4,33±1,86u/L x 103; p=0,002) e monócitos (0,70±0,22u/L x 103; p=0,002) mais elevados em comparação com os níveis dos eutróficos. Após os ajustes necessários, a aptidão cardiorrespiratória foi negativamente associada com leucócitos, neutrófilos e monócitos em meninos. Conclusão Adolescentes obesos apresentaram maior contagem de leucócitos totais e subpopulações, quando comparados aos eutróficos. Observou-se também uma fraca relação positiva entre adiposidade e leucócitos totais, monócitos ...

Inadequações nutricionais são independentes do turno de trabalho entre profissionais de enfermagem / Nutritional inadequacies are independent of the work shift among nursing professionals

O objetivo deste estudo foi avaliar a associação entre consumo alimentar e estadonutricional de trabalhadoras de enfermagem com turno de trabalho. O estudo foi desenvolvidoem um hospital público com 160 profissionais. Para a avaliação nutricional foi utilizado oíndice de massa corporal, a relação cintura/quadril e a circunferência abdominal. Para registrodos dados alimentares foi aplicado o recordatório 24 horas em 3 dias não consecutivos.A análise da prevalência da inadequação nutricional foi feita pelo método da EAR como pontode corte. Os critérios de análise das variáveis antropométricas seguiram as recomendaçõesda Organização Mundial da Saúde. Os resultados mostraram ausência de associação entrevariáveis estudadas e turno de trabalho. Porém, mostraram situações preocupantes de risco àsaúde. A maioria das trabalhadoras apresenta sobrepeso e obesidade. Cerca de 25 por cento consumiamcarboidratos abaixo das recomendações e 15,6 por cento ingeriam lipídios acima do recomendado.Também foram elevadas as prevalências de inadequação no consumo de niacina, tiamina,riboflavina e fósforo. Independente do turno de trabalho, coexistem riscos à saúde relacionadosà falta da ingestão de nutrientes essenciais e ao consumo de alimentos calóricos e gordurosos...

The aim of this study was to assess the association between dietary intakeand nutritional status of nursing workers with work shift. The study was conducted in apublic hospital with 160 professionals. To perform nutritional assessment, the body massindex, waist/hip ratio and waist circumference were used. To record data of the 24-hourdietary, a recall was applied in three non-consecutive days. The analysis of the prevalenceof nutritional inadequacy was taken by the EAR method as cutoff. The criteria for analysis ofanthropometric variables followed the recommendations of the World Health Organization.The results showed no association between the variables studied and work shift. However,the results showed troubling health risk situations. The majority of workers were overweight orobese. About 25 percent of professionals consume below the recommended level of carbohydratesand 15.6 percent consume above the recommended level of lipids. The prevalence of inadequateconsumption of niacin, thiamin, riboflavin and phosphorus was also high. Regardless of thework shift, health risks related to the lack of intake of essential nutrients and the consumptionof caloric and fatty foods coexist...

El objetivo de este estudio fue evaluar la asociación entre consumoalimentario y el estado nutricional de trabajadoras de enfermería con el trabajo por turnos.El estudio fue desarrollado en un hospital público con 160 profesionales. Para la evaluaciónnutricional se utilizó el índice de masa corporal, el índice cintura/cadera y la circunferenciaabdominal. Para el registro datos alimentares se aplicó el recordatorio de 24 horas en3 días no consecutivos. El análisis de la prevalencia de la inadecuación nutricional fuehecho por el método del EAR como punto de corte. Los criterios de análisis de las variablesantropométricas siguieron las recomendaciones de la Organización Resultados Mundialde la Salud. Los resultados no mostraron asociación entre las variables estudiadas y turno de trabajo. Sin embargo, mostraron situaciones preocupantes de riesgo a la salud. La mayoría delas trabajadoras presenta sobrepeso y obesidad. Sobre 25 por ciento consumían carbohidratos abajode lo recomendado y el 15,6 por ciento consumían lípidos arriba de lo recomendado. Fueron tambiénaltas las prevalencias de consumo inadecuado de niacina, tiamina, riboflavina y fósforo.Independientemente del turno de trabajo, coexisten riesgos a la salud relacionados con la faltade consumo de nutrientes esenciales y el consumo de alimentos calóricos y grasos...

Inadequações nutricionais são independentes do turno de trabalho entre profissionais de enfermagem / Inadecuaciones nutricionales son independientes del turno de trabajo entre profesionales de enfermería / Nutritional inadequacies are independent of the work shift among nursing professionals

O objetivo deste estudo foi avaliar a associação entre consumo alimentar e estado nutricional de trabalhadoras de enfermagem com turno de trabalho. O estudo foi desenvolvido em um hospital público com 160 profissionais. Para a avaliação nutricional foi utilizado o índice de massa corporal, a relação cintura/quadril e a circunferência abdominal. Para registro dos dados alimentares foi aplicado o recordatório 24 horas em 3 dias não consecutivos. A análise da prevalência da inadequação nutricional foi feita pelo método da EAR como ponto de corte. Os critérios de análise das variáveis antropométricas seguiram as recomendações da Organização Mundial da Saúde. Os resultados mostraram ausência de associação entre variáveis estudadas e turno de trabalho. Porém, mostraram situações preocupantes de risco à saúde. A maioria das trabalhadoras apresenta sobrepeso e obesidade. Cerca de 25% consumiam carboidratos abaixo das recomendações e 15,6% ingeriam lipídios acima do recomendado. Também foram elevadas as prevalências de inadequação no consumo de niacina, tiamina, riboflavina e fósforo. Independente do turno de trabalho, coexistem riscos à saúde relacionados à falta da ingestão de nutrientes essenciais e ao consumo de alimentos calóricos e gordurosos.

The aim of this study was to assess the association between dietary intake and nutritional status of nursing workers with work shift. The study was conducted in a public hospital with 160 professionals. To perform nutritional assessment, the body mass index, waist/hip ratio and waist circumference were used. To record data of the 24-hour dietary, a recall was applied in three non-consecutive days. The analysis of the prevalence of nutritional inadequacy was taken by the EAR method as cutoff. The criteria for analysis of anthropometric variables followed the recommendations of the World Health Organization. The results showed no association between the variables studied and work shift. However, the results showed troubling health risk situations. The majority of workers were overweight or obese. About 25% of professionals consume below the recommended level of carbohydrates and 15.6% consume above the recommended level of lipids. The prevalence of inadequate consumption of niacin, thiamin, riboflavin and phosphorus was also high. Regardless of the work shift, health risks related to the lack of intake of essential nutrients and the consumption of caloric and fatty foods coexist.

El objetivo de este estudio fue evaluar la asociación entre consumo alimentario y el estado nutricional de trabajadoras de enfermería con el trabajo por turnos. El estudio fue desarrollado en un hospital público con 160 profesionales. Para la evaluación nutricional se utilizó el índice de masa corporal, el índice cintura/cadera y la circunferencia abdominal. Para el registro datos alimentares se aplicó el recordatorio de 24 horas en 3 días no consecutivos. El análisis de la prevalencia de la inadecuación nutricional fue hecho por el método del EAR como punto de corte. Los criterios de análisis de las variables antropométricas siguieron las recomendaciones de la Organización Resultados Mundial de la Salud. Los resultados no mostraron asociación entre las variables estudiadas y turno 186de trabajo. Sin embargo, mostraron situaciones preocupantes de riesgo a la salud. La mayoría de las trabajadoras presenta sobrepeso y obesidad. Sobre 25% consumían carbohidratos abajo de lo recomendado y el 15,6% consumían lípidos arriba de lo recomendado. Fueron también altas las prevalencias de consumo inadecuado de niacina, tiamina, riboflavina y fósforo. Independientemente del turno de trabajo, coexisten riesgos a la salud relacionados con la falta de consumo de nutrientes esenciales y el consumo de alimentos calóricos y grasos.

Mannose-binding lectin 2 (MBL2) gene polymorphisms do not influence frequency of infections in chronic lymphocytic leukemia patients

Background: Infectious complications represent the main cause of morbidity and mortality in chronic lymphocytic leukemia. It has been reported that polymorphisms of the mannosebinding lectin 2 (MBL2) genes are correlated with MBL protein serum levels and, consequently, are associated with the development of infectious diseases. Objective: The purpose of this study was to investigate the possible association between MBL2 gene polymorphisms and risk of infection in chronic lymphocytic leukemia patients. Methods: Peripheral blood samples from 116 chronic lymphocytic leukemia patients were collected; after genomic DNA extraction, real time polymerase chain reaction was used to determine the polymorphisms of the promoter region and exon 1 of the MBL2 gene. Results: A high frequency of Binet stage A (p-value = 0.005) and absence of splenomegaly (p-value = 0.002) were observed in patients with no infection; however, variant alleles/ genotypes and haplotypes of this gene had no impact on the risk of infection. Conclusion: To the authors' knowledge, this is the first study describing the association between MBL2 polymorphisms and infectious disease in chronic lymphocytic leukemia. Although it was not possible to demonstrate any influence of MBL2 polymorphisms as a genetic modulator of infection in chronic lymphocytic leukemia, the authors believe that the present data are clinically relevant and provide the basis for future studies. .

Abnormal transcranial Döppler ultrasonography in children with sickle cell disease

BACKGROUND: Stroke is a potentially fatal complication of sickle cell disease in children between 2-16 years and transcranial Döppler has been recommended as a screening method in these cases. OBJECTIVE: The main goal of this study was to correlate transcranial Döppler results to complications related to stroke in sickle cell disease and baseline characteristics of the population. METHODS: This was an observational study of children and adolescents with ages between 2-16 years with sickle cell disease who were followed in three centers. RESULTS: From January 2008 to July 2009, 902 patients were enrolled in this study. The median age was 6.5 years (range: 1.8-15.8), 52.3% were male, 74.4% had hemoglobin SS; 221 (28.6%) had at least one complication associated with sickle cell disease. A total of 773 patients performed transcranial Döppler; in 91.2% this was a method of screening. Conditional or abnormal transcranial Döppler results were more common in patients with sickle cell disease complications versus those without complications (ODDS ratio = 3.18; 95% Confidence interval = 1.92-5.27). There was a significant difference in the frequency of conditional or abnormal transcranial Döppler results in patients with abnormal laboratory results compared to those without abnormalities (OR=4.03); 95% confidence interval = 2.30-7.06. CONCLUSIONS: Conditional or abnormal transcranial Döppler results were significantly more frequent in patients with complications of sickle cell disease confirming the increased risk of stroke in this subgroup of patients. This observation reinforces the recommendation of transcranial Döppler as a screening test for all patients with sickle cell disease with ages between 2 and 16 years.

Sickle cell disease: acute clinical manifestations in early childhood and molecular characteristics in a group of children in Rio de Janeiro

OBJECTIVE: To describe clinical events of sickle cell disease and the correlation with β-globin haplotypes and α-thalassemia in under 6-year-old children. METHODS: A retrospective study was conducted of under 6-year-old children from the neonatal screening program in Rio de Janeiro. Forty-eight male and 48 female children were enrolled in this study, 79 with sickle cell anemia and 17 with hemoglobin SC. The mean age was 29.9 (standard deviation = 20.9) months, 62 (16.2 ± 8.6) were aged between 0-3 years old and 34 (54.9 ± 11.3) were from 3-6 years old. Painful events, acute splenic sequestration, hemolytic crises, hand-foot and acute chest syndromes and infections were evaluated. RESULTS: The events were more frequent in under 3-year-old children, 94% of children had at least one episode. Infection was the most common event affecting 88.5% of children. Acute splenic sequestration took place earlier, while painful crises and acute chest syndromes in under 6-year-old children. Thal-α 3.7 was observed in 20.9% of cases. Bantu was the most frequent haplotype found, followed by Benin. No correlation was observed between clinical events and β-globin haplotypes. Children with sickle cell anemia and α-thalassemia have less infectious events. No correlation was found among these polymorphisms and clinical events, however, the majority of children with Bantu/Bantu and without α-thalassemia had more clinical events.

Genetic polymorphisms and cerebrovascular disease in children with sickle cell anemia from Rio de Janeiro, Brazil / Polimorfismos genéticos e doença cerebrovascular em crianças com anemia falciforme do Rio do Janeiro, Brasil

The aim of the present work was to examine possible genetic risk factors related to the occurrence of cerebrovascular disease (CVD) in Brazilian population, the frequency of βS-globin gene haplotypes and co-inheritance with α-thalassemia (-α3.7kb) and single nucleotide polymorphism of methylenetetrahydrofolate reductase (MTHFR-C677T), Factor V Leiden (FV-G1691A) and prothrombin (PT-G20210A) genes in children from Rio de Janeiro. Ninety four children with sickle cell anemia (SCA) were included, 24 patients with cerebrovascular involvement and 70 patients without CVD as control group. The mean age of children at the time of the cerebrovascular event was similar to the control group. The frequency of -α3.7kb thalassemia was similar in both groups (p=0.751). Children with Bantu/Atypical βS-globin gene haplotype presented 15 times more chance (OR=15.4 CI 95 percent 2.9-81.6) of CVD than the other βS-globin gene haplotypes. The C677T polymorphism of MTHFR gene was similar in both groups (p=0.085). No mutation in the FV Leiden or PT genes was found. A large study seems necessary to establish the role of these genetic polymorphisms in Brazilian miscegenated population.

Avaliar o papel da talassemia alfa (-α3.7kb), dos haplótipos da globina βS, e mutações nos genes da metileno-tetrahidrofolato redutase (MTHFR-C677T), fator V de Leiden (FV-G1691A) e protrombina (PT-G20210A) como fatores de risco para a doença cerebrovascular em pacientes com anemia falciforme. Foi realizado um estudo de caso controle com 94 crianças portadoras de anemia falciforme, 24 com doença cerebrovascular (DCV) e 70 sem DCV como grupo controle. A frequência de talassemia -α3.7kb foi semelhante em ambos os grupos (p=0,751). Crianças portadoras do haplótipo Bantu/Atípico da globina βS apresentam 15 vezes mais chances de desenvolverem DCV (OR=15,4 IC 95 por cento 2,9-81,6) do que os outros haplótipos. A frequência do polimorfismo MTHFR-C677T foi semelhante em ambos os grupos (p=0,085) e não foi observada mutação nos genes fator V e protrombina. Estudos com maior número de casos são necessários para esclarecer o papel desses polimorfismos genéticos na nossa população.

Avaliação do complemento na doença meningocócica / Assessment of complement in meningococcical disease

Avaliar aspectos do sistema imunológico inato na doençameningocócica, com enfase nas frações C3, C4 e o CH50 do sistema imunológico e lectina ligadora de manose (MBL) com ênfase na pediatria. Fonte de dados: Revisão narrativa de periódicos na área de infectologia e imunologia sobre o assunto nos últimos 10 anos e pesquisas anteriores a esta data com relevância segundo a avaliação dos autores. Síntese dos dados: O acometimento da imunidade humoral é predominante nas Imunodeficiências Primárias, mas quando se considera apenas os casos de doença meningocócica as deficiências de complementosão presumivelmente as mais frequentes. Conclusões: A deficiência de componentes do sistema complementoe alterações decorrentes do polimorfismo gênico da MBL 2 são possíveis explicações para o desenvolvimento de doença meningocócica em algunspacientes. Assim a avaliação do complemento pode ser necessária para indivíduos que foram acometidos por esta grave doença.

Evaluate some aspects of the innate immune system of patients with a history of meningococcal disease, being chosen from among them the complement fractions C3, C4 and CH50 than the evaluation of the mannose-binding lectin (MBL) gene with emphasis on pediatrics. Data source: Review of journals in the field of infectious diseases and immunology on the subject in the last 10 years or before that dateby relevance. Data synthesis: Involvement of humoral immunity is predominant in primary immunodeficiencies, but complement deficiencies are presumably the most frequent when considering only cases of meningococcal disease.Epidemiological aspects, clinical and immunological designed to discuss the subject. Conclusions: Complement deficiency and polymorphism in the MBL2 gene are possible explanations for the development of meningococcaldisease in some patients. So the evaluation of the supplement maybe suggestible with exceptions for individuals affected by this seriousdisease.

Brazilian Guidelines for transcranial doppler in children and adolescents with sickle cell disease

BACKGROUND: Sickle cell disease is the most common monogenic hereditary disease in Brazil. Although strokes are one of the main causes of morbidity and mortality in these patients, the use of transcranial Doppler to identify children at risk is not universally used. OBJECTIVE: To develop Brazilian guidelines for the use of transcranial Doppler in sickle cell disease children and adolescents, so that related health policies can be expanded, and thus contribute to reduce morbidity and mortality. METHODS: The guidelines were formulated in a consensus meeting of experts in transcranial Doppler and sickle cell disease. The issues discussed were previously formulated and scientific articles in databases (MEDLINE, SciELO and Cochrane) were carefully analyzed. The consensus for each question was obtained by a vote of experts on the specific theme. RESULTS: Recommendations were made, including indications for the use of transcranial Doppler according to the sickle cell disease genotype and patients age; the necessary conditions to perform the exam and its periodicity depending on exam results; the criteria for the indication of blood transfusions and iron chelation therapy; the indication of hydroxyurea; and the therapeutic approach in cases of conditional transcranial Doppler. CONCLUSION: The Brazilian guidelines on the use of transcranial doppler in sickle cell disease patients may reduce the risk of strokes, and thus reduce the morbidity and mortality and improve the quality of life of sickle cell disease patients.

População indígena: uma reflexão sobre a influência da civilização urbana no estado nutricional e na saúde bucal / Indigenous peoples: reflection about the influence of urban civilization on nutritional status and oral health

Embora ainda existam sociedades indígenas que mantêm um modo tradicional de viver, nas quais uma alimentação adequada em quantidade e qualidade provém da caça e da prática de agricultura, a maioria dos índios vem sofrendo um processo de aculturação oriundo do contato com a civilização urbana, pois eles não mais dispõem de terra suficiente que garanta a subsistência. Desse modo, acabam tornando-se dependentes do comércio local e consumindo alimentos industrializados que podem ser prejudiciais à saúde bucal e ao estado nutricional. A presente comunicação tem como objetivo identificar a influência da transição alimentar, devido ao contato com a civilização urbana, no estado nutricional e na condição bucal da população indígena brasileira. Os dados relacionados nessa investigação foram obtidos na base de dados do SciELO e do MedLine, PubMed, pesquisando-se os termos de indexação: "índios sul-americanos", "comportamento alimentar", "estado nutricional", "saúde bucal". Estudos revelaram a prevalência de desnutrição infantil, sobrepeso e obesidade em adultos, índice de cárie elevado e doença periodontal nas comunidades indígenas que vêm passando por mudanças de hábitos culturais. Conclui-se que a transição alimentar pode levar a desordens nutricionais e ao desenvolvimento de doenças bucais, sugerindo a necessidade de uma intervenção e/ou monitoramento por meio de programas dirigidos à assistência à saúde, ao saneamento básico, ao acesso à terra e à educação.

Although there are still some indigenous societies that have maintained their traditional way of life, where food consumption in terms of amount and quality is based on hunting and agriculture, most indigenous peoples have been undergoing an acculturation process secondary to the contact with urban civilizations, since they no longer have enough land to guarantee their subsistence. Thus, they become dependent on local trade and consume processed foods that may be harmful to their oral health and nutritional status. The objective of this communication is to identify the influence of the dietary transition due to contact with urban civilization on the nutritional status and oral condition of native Brazilian populations. The data included in this investigation were obtained from the SciELO and MedLine, PubMed databases using the keywords: "South American natives", "dietary behavior", "nutritional status", "oral health". Studies have revealed a prevalence of childhood malnutrition, adult overweight and obesity, high caries rates and periodontal disease in the native Brazilian communities that have been experiencing changes in their cultural habits. In conclusion, dietary transition can lead to nutritional disorders and the development of oral diseases, suggesting the need for health care and basic sanitation programs and access to land and education, in order to intervene in or monitor these occurrences.

Restrição ao uso de tabaco e a prevenção do câncer bucal / Restriction of tobacco use and the prevention of oral cancer

A Organização Mundial da Saúde relata que a epidemia mundial de tabagismo é uma das maiores ameaças à saúde pública dos tempos modernos. O objetivo deste estudo foi relacionar a adoção de medidas restritivas ao uso do tabaco e suas implicações na prevenção ao câncer bucal, por meio de revisão crítica. As evidencias científicas apontam que o uso de tabaco é considerado como causa primária de muitos problemas e doenças bucais, dentre às quais se destacam o câncer bucal, doença periodontal, perdas dentárias e defeitos congênitos. No Brasil e no mundo os principais documentos que regulam a disposição, uso e estratégias de combate aotabaco são relacionados à legislação vigente, documentos internacionais e aos estudos epidemiológicos. Conclui-se que a prevenção ao câncer bucal está relacionada à conscientização das populações quanto aos malefícios causados por hábitos deletérios, como o uso de tabaco, à adoção de práticas saudáveis, bem como se evidencia a necessidade de desenvolvimento de ações abrangentes para o controle do câncer, nos diferentes níveis de atuação e a adoção de medidas mais amplas de restrição ao uso de tabaco pelos diversossetores da sociedade.

The World Health Organization reports that the worldwide epidemic of smoking is the major threat to the public health of modern times. The objective of this study was to relate the adoption of restrictive measures to tobacco use and its implications in the prevention of oral cancer, through critical review. The scientific evidence suggests that the use of tobacco is considered as the primary cause of many problems and oraldiseases, among which are the oral cancer, periodontal disease, tooth loss and congenital defects. In Brazil and the world the main documents regulating the provision, use and strategies to combat tobacco use are related to legislation, international documents and the epidemiological studies. It is concluded that prevention of oral cancer is related to awareness of people about the harm caused by deleterious habits such as use of tobacco, the adoption of healthy practices, and as well as highlighting the need for development ofcomprehensive actions to control the cancer, the different levels of performance and the adoption of furthermeasures to restrict the use of tobacco by the different sectors of society.