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Introduction: At least one-third of the identified risk alleles from Genome-Wide Association Studies (GWAS) of Alzheimer's disease (AD) are involved in lipid metabolism, lipid transport, or direct lipid binding. In fact, a common genetic variant (ε4) in a cholesterol and phospholipid transporter, Apolipoprotein E (APOEε4), is the primary genetic risk factor for late-onset AD. In addition to genetic variants, lipidomic studies have reported severe metabolic dysregulation in human autopsy brain tissue, cerebrospinal fluid, blood, and multiple mouse models of AD. Methods: We aimed to identify an overarching metabolic pathway in lipid metabolism by integrating analyses of lipidomics and transcriptomics from the Religious Order Study and Rush Memory Aging Project (ROSMAP) using differential analysis and network correlation analysis. Results: Coordinated differences in lipids were found to be dysregulated in association with both mild cognitive impairment (MCI) and APOEε4 carriers. Interestingly, these correlations were weakened when adjusting for education. Indeed, the cognitively non-impaired APOEε4 carriers have higher education levels in the ROSMAP cohort, suggesting that this lipid signature may be associated with a resilience phenotype. Network correlation analysis identified multiple differential lipids within a single module that are substrates and products in the Lands Cycle for acyl chain remodeling. In addition, our analyses identified multiple genes in the Lands Cycle acyl chain remodeling pathway, which were associated with cognitive decline independent of amyloid-ß (Aß) load and tau tangle pathologies. Discussion: Our studies highlight the critical differences in acyl chain remodeling in brain tissue from APOEε4 carriers and individual non-carriers with MCI. A coordinated lipid profile shift in dorsolateral prefrontal cortex from both APOEε4 carriers and MCI suggests differences in lipid metabolism occur early in disease stage and highlights lipid homeostasis as a tractable target for early disease modifying intervention.
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Serological assays emerged as complementary tools to RT-PCR in the diagnosis of SARS-CoV-2 as well as being needed for epidemiological studies. This study aimed to assess the performance of a rapid test (RT) compared to that of serological tests using finger prick blood samples. A total of 183 samples were evaluated, 88 of which were collected from individuals with negative RT-PCR and 95 from positive RT-PCR individuals. The diagnostic performance of RT (WONDFO®) and LUMIT (PROMEGA®) were compared to that of ELISA (EUROIMMUN®) for detecting antibodies against SARS-CoV-2 according to time from symptoms onset. The IgG antibody tests were detected in 77.4% (LUMIT), 77.9% (RT), and 80.0% (ELISA) of individuals. The detection of antibodies against SARS-CoV-2 increases in accordance with increasing time from symptoms onset. Considering only time from symptoms onset >21 days, the positivity rate ranged from 81.8 to 97.0% between the three tests. The RT and LUMIT showed high agreement with ELISA (agreement = 91.5%, k = 0.83, and agreement = 96.3%, k = 0.9, respectively) in individuals who had symptoms 15 to 21 days before sample collection. Compared to that of the ELISA assay, our results show sensitivity ranged from 95% to 100% for IgG antibody detection in individuals with symptoms onset between 15 and 21 days before sample collection. The specificity was 100% in individuals with symptoms onset >15 days before serological tests. This study shows good performance and high level of agreement of three immunoassays for the detection of SARS-CoV-2 antibodies.
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Human T-lymphotropic virus type 1 (HTLV-1) infection may cause serious disease, while pathogenicity of HTLV-2 is less certain. There are no screening or surveillance programs for HTLV-1/-2 infection in Brazil. By performing this systematic review, we aimed to estimate the prevalence of HTLV-1/-2 infections in pregnant women in Brazil. This review included cohort and cross-sectional studies that assessed the presence of either HTLV-1/-2 infection in pregnant women in Brazil. We searched BVS/LILACS, Cochrane Library/CENTRAL, EMBASE, PubMed/MEDLINE, Scopus, Web of Science and gray literature from inception to August 2020. We identified 246 records in total. Twenty-six of those were included in the qualitative synthesis, while 17 of them were included in the meta-analysis. The prevalence of HTLV-1 in Brazilian pregnant women, as diagnosed by a positive screening test and a subsequent positive confirmatory test, was 0.32% (95% CI 0.19-1.54), while of HTLV-2 was 0.04% (95% CI 0.02-0.08). Subgroup analysis by region showed the highest prevalence in the Northeast region (0.60%; 95% CI 0.37-0.97) for HTLV-1 and in the South region (0.16%; 95% CI 0.02-1.10) for HTLV-2. The prevalence of HTLV-1 is much higher than HTLV-2 infection in pregnant Brazilian women with important differences between regions. The prevalence of both HTLV-1/-2 are higher in the Northeast compared to Center-West region.
Subject(s)
HTLV-I Infections/epidemiology , HTLV-II Infections/epidemiology , Human T-lymphotropic virus 1/pathogenicity , Human T-lymphotropic virus 2/pathogenicity , Brazil/epidemiology , Female , HTLV-I Infections/pathology , HTLV-I Infections/virology , HTLV-II Infections/pathology , HTLV-II Infections/virology , Humans , Pregnancy , Pregnant WomenABSTRACT
BACKGROUND: We evaluated the prevalence and the factors associated with repeated high systolic (SBP) and diastolic blood pressure (DBP) at 6- and 11-year follow-ups of children from the Pelotas (Brazil) 2004 Birth Cohort. METHODS: All live births to mothers living in the urban area of Pelotas were enrolled in the cohort. Blood pressure (BP) values were transformed into Z-scores by sex, age, and height. High SBP and DBP were defined as repeated systolic and diastolic BP Z-scores on the ≥95th percentile at the two follow-ups. Prevalence (95% confidence interval) of repeated high SBP, DBP, and both (SDBP) were calculated. Associations with maternal and child characteristics were explored in crude and adjusted logistic regression analyses. RESULTS: A total of 3182 cohort participants were analyzed. Prevalence of repeated high SBP, DBP and SDBP was 1.7% (1.2-2.1%), 2.3% (1.8-2.9%) and 1.2% (0.9-1.6%), respectively. Repeated high SBP was associated with males, gestational diabetes mellitus (2.92; 1.13-7.58) and obesity at 11 years (2.44; 1.29-4.59); while repeated high DBP was associated with females, family history of hypertension from both sides (3.95; 1.59-9.85) and gestational age < 34 weeks (4.08; 1.52-10.96). Repeated high SDBP was not associated with any of the characteristics investigated. CONCLUSION: Prevalence of repeated high SBP, DBP, and SDBP were within the expected distribution at the population level. Nonetheless, gestational diabetes mellitus, obesity, family history of hypertension, and prematurity increased the risk of repeated high blood pressure measured at two occasions 5 years apart.
Subject(s)
Hypertension/epidemiology , Brazil/epidemiology , Child , Cohort Studies , Female , Humans , Male , Prevalence , Risk FactorsABSTRACT
BACKGROUND: Investigation of alterations to retinal microvasculature may contribute towards understanding the role of such changes in the pathophysiology of several chronic non-communicable diseases. The objective here was to evaluate the validity and reproducibility of retinal arteriole and venule diameter measurements made by Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) graders. DESIGN AND SETTING: Cross-sectional study at six teaching and research institutions. METHODS: To evaluate validity, each of 25 retinal images from the University of Wisconsin (gold standard) was measured by five ELSA-Brasil graders. To evaluate reproducibility, 105 images across the spectrum of vessel diameters were selected from 12,257 retinal images that had been obtained between 2010 and 2012, and each image was reexamined by the same grader and by an independent grader. All measurements were made using the Interactive Vessel Analysis (IVAN) software. Bland-Altman plots, paired t tests and intraclass correlation coefficients (ICCs) were analyzed. RESULTS: Mean differences between ELSA-Brasil and gold-standard readings were 0.16 µm (95% CI -0.17-0.50; P = 0.31) for central retinal artery equivalent (CRAE), -0.21 µm (95% CI -0.56-0.14; P = 0.22) for central retinal vein equivalent (CRVE) and 0.0005 (95% CI -0.008-0.009; P = 0.55) for arteriole/venule ratio (AVR). Intragrader ICCs were 0.77 (95% CI 0.67-0.86) for CRAE, 0.90 (95% CI 0.780.96) for CRVE and 0.70 (0.55-0.83) for AVR. Intergrader ICCs were 0.75 (95% CI 0.64-0.85) for CRAE, 0.90 (95% CI 0.79-0.96) for CRVE and 0.68 (95% CI 0.55-0.82) for AVR. CONCLUSIONS: Retinal microvascular diameter measurements are valid and present moderate to high intra and intergrader reproducibility in ELSA-Brasil.
Subject(s)
Arterioles/anatomy & histology , Image Interpretation, Computer-Assisted , Retinal Vessels/anatomy & histology , Venules/anatomy & histology , Adult , Aged , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , Reproducibility of Results , Socioeconomic FactorsABSTRACT
ABSTRACT BACKGROUND: Investigation of alterations to retinal microvasculature may contribute towards understanding the role of such changes in the pathophysiology of several chronic non-communicable diseases. The objective here was to evaluate the validity and reproducibility of retinal arteriole and venule diameter measurements made by Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) graders. DESIGN AND SETTING: Cross-sectional study at six teaching and research institutions. METHODS: To evaluate validity, each of 25 retinal images from the University of Wisconsin (gold standard) was measured by five ELSA-Brasil graders. To evaluate reproducibility, 105 images across the spectrum of vessel diameters were selected from 12,257 retinal images that had been obtained between 2010 and 2012, and each image was reexamined by the same grader and by an independent grader. All measurements were made using the Interactive Vessel Analysis (IVAN) software. Bland-Altman plots, paired t tests and intraclass correlation coefficients (ICCs) were analyzed. RESULTS: Mean differences between ELSA-Brasil and gold-standard readings were 0.16 µm (95% CI -0.17-0.50; P = 0.31) for central retinal artery equivalent (CRAE), -0.21 µm (95% CI -0.56-0.14; P = 0.22) for central retinal vein equivalent (CRVE) and 0.0005 (95% CI -0.008-0.009; P = 0.55) for arteriole/venule ratio (AVR). Intragrader ICCs were 0.77 (95% CI 0.67-0.86) for CRAE, 0.90 (95% CI 0.780.96) for CRVE and 0.70 (0.55-0.83) for AVR. Intergrader ICCs were 0.75 (95% CI 0.64-0.85) for CRAE, 0.90 (95% CI 0.79-0.96) for CRVE and 0.68 (95% CI 0.55-0.82) for AVR. CONCLUSIONS: Retinal microvascular diameter measurements are valid and present moderate to high intra and intergrader reproducibility in ELSA-Brasil.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Arterioles/anatomy & histology , Retinal Vessels/anatomy & histology , Venules/anatomy & histology , Image Interpretation, Computer-Assisted , Socioeconomic Factors , Cross-Sectional Studies , Reproducibility of Results , Longitudinal StudiesABSTRACT
INTRODUÇÃO: O HIV, tornou-se um dos maiores problemas da saúde pública no mundo. O Brasil tem apresentado avanços em relação ao tratamento, porém teve alguns retrocessos. O objetivo do estudo foi descrever a prevalência do HIV no Brasil no período de 2005-2015. MATERIAIS E MÉTODOS: Estudo transversal com dados secundários do Sistema Único de Saúde (DATASUS) sobre notificações de HIV. A análise estatística se deu por meio do teste de qui-quadrado para comparar a frequência do número de casos de acordo com as variáveis de notificação de casos e obtenção das taxas de HIV. RESULTADOS: O Brasil apresentou entre os anos de 2005-2015 aumento nas taxas de notificações de HIV, passando de 11 casos em para 18 casos/100 mil habitantes. A região sul apresentou aumento de 16,6 para 28,9 casos/100 mil habitantes. Homens possuem as taxas mais altas de notificações, sendo a faixa etária mais prevalente a dos 30-49 anos. A Cor/Raça branca teve o maior percentual médio (46,9%) de pessoas com notificação entre os anos de 2005-2012. Pessoas com menores níveis educacionais tiveram queda nas taxas de notificações entre 2005-2015, passando de 45,4%-27,9%. DISCUSSÃO: No Brasil, observa-se no período avaliado o aumento nas taxas de prevalência de HIV, com predomínio de novos casos na faixa etária dos 30 aos 49 anos e do sexo masculino. CONCLUSÕES: São necessárias medidas de prevenção e educação em saúde desta população mais exposta ao risco sejam realizadas no país com maior frequência, principalmente nas regiões que se tem maior número de registros do país.
INTRODUCTION: HIV has become one of the biggest public health problems in the world. Brazil has progressed in relation to treatment; however, it has had some setbacks. The aim of this study was to describe the prevalence of HIV in Brazil for the period from 2005-2015. MATERIALS AND METHODS: Cross-sectional study with secondary data from the Unified Health System (DATASUS) on HIV notifications. Statistical analysis was performed by using the chi-square test to compare the frequency of the number of cases, according to the variables of case reporting and obtaining HIV rates. RESULTS: Between 2005 and 2015, Brazil had an increase in the rates of HIV notifications, going from 11 cases to 18 cases per 100-thousand inhabitants. The southern region had an increase from 16.6 to 28.9 cases per 100-thousand inhabitants. Men had the highest rates of notifications, with the age range from 30 to 49 years of age being the most prevalent. The white color/race had the highest average percentage (46.9%) of people with notification between 2005 and 2012. People with lower educational levels had a drop in reporting rates between 2005 and 2015, from 45.4% to 27.9%. DISCUSSION: In Brazil, increased HIV prevalence rates were observed during the period evaluated, with a prevalence of new cases in males 30 to 49 age group. CONCLUSIONS: Health prevention and education measures in this population most exposed to the risk are needed in the country with higher frequency, especially in regions with the highest number of records in the country.
INTRODUCCIÓN: El VIH, se ha convertido en uno de los mayores problemas de salud pública en el mundo. Brasil ha presentado avances en relación al tratamiento, sin embargo tuvo algunos retrocesos. El objetivo del estudio fue describir la prevalencia del VIH en Brasil en el período 2005-2015. MATERIALES Y MÉTODOS: Estudio transversal con datos secundarios del Sistema Único de Salud (DATASUS) sobre notificaciones de VIH. El análisis estadístico se dio por medio de la prueba de chi-cuadrado para comparar la frecuencia del número de casos de acuerdo con las variables de notificación de casos y obtención de las tasas de VIH. RESULTADOS: Brasil presentó entre los años 2005-2015 un aumento en las tasas de notificaciones de VIH, pasando de 11 casos a 18 casos/100 mil habitantes. La región sur presentó un aumento de 16.6 a 28.9 casos/100 mil habitantes. Los hombres poseen las tasas más altas de notificaciones, siendo el grupo de edad más prevalente de los 30-49 años. El color/raza blanca tuvo el mayor porcentaje medio (46.9%) de personas con notificación entre los años 2005-2012. Las personas con menores niveles educativos cayeron en las tasas de notificaciones entre 2005-2015, pasando del 45.4%-27.9%. DISCUSIÓN: En Brasil, se observa en el período evaluado el aumento en las tasas de prevalencia del VIH, con predominio de nuevos casos en la franja etaria de los 30 a los 49 años y del sexo masculino. CONCLUSIONES: Son necesarias medidas de prevención y educación en salud de esta población más expuesta al riesgo se realicen en el país con mayor frecuencia, principalmente en las regiones que se tienen mayor número de registros del país.
Subject(s)
Humans , Prevalence , Acquired Immunodeficiency Syndrome , HIVABSTRACT
Introdução: Os esteroides anabolizantes (EA) são derivados da testosterona, utilizados para tratar algumas doenças. Começou a ser utilizados por atletas, para o aumento de massa muscular e força física em atividades, porém nos últimos anos há um aumento de pessoas em uso de EA, jovens que praticam atividade física como meio de lazer, mas com o intuito de melhorar sua aparência acabam fazendo uso destas substâncias indiscriminadamente. O objetivo deste estudo foi refletir o uso indiscriminado de EA, e sua repercussão como um problema de saúde pública. Materiais e Métodos: Artigo de reflexão, que apresenta uma abordagem a partir da literatura e também da realidade sobre a perspectiva do problema de saúde pelo uso de anabolizantes por esportistas e jovens praticantes de atividade física. Resultados: A presente reflexão mostra que pessoas adeptas de EA, são esportistas, adolescentes e pessoas que gostam de manter uma imagem corporal baseada em estereótipos imposta pela sociedade. Discussão: O estereótipo criado pela sociedade atual e a busca pelo bom rendimento na atividade física, estimulam que as pessoas utilizem EA sem controle, gerando um problema que está crescendo gradualmente, sem que até hoje exista uma maior abordagem do tema por parte das autoridades governamentais. Conclusões: Apesar de existir um controle para a compra deste tipo de medicamento, este não é de todo efetivo, originando um alto risco no surgimento de doenças nos usuários, além do crescente número de adeptos sem controle na população. Portanto, necessita-se de mais estudos que abordem esta problemática, maior controle na comercialização destes produtos e intervenção por parte dos entes governamentais responsáveis.
Introducción: Los esteroides anabolizantes (EA) son derivados de la testosterona, utilizados para el tratamiento de algunas enfermedades. Comenzó a ser usado por atletas, en la mayoría fisicoculturistas para el aumento de la masa muscular y fuerza física en actividades, sin embargo, en los últimos años hay un aumento de personas que han usado EA, en la mayoría jóvenes, que practican actividad física como medio de distracción, pero con la intención de mejorar su apariencia acaban haciendo uso de estas sustancias indiscriminadamente. El objetivo de este estudio fue reflejar el uso indiscriminado de EA, y su repercusión como un problema de salud pública. Materiales y Métodos: Se trata de un artículo de reflexión, que presenta un abordaje a partir de la literatura y de la realidad sobre la perspectiva del problema de salud por el uso de anabolizantes por deportistas de alto nivel y jóvenes practicantes de actividad física regular. Resultados: La presente reflexión muestra que personas adictas a los EA, son deportistas de alto nivel, adolescentes y personas que les gusta mantener una imagen corporal basada en los estereotipos que impone la sociedad moderna. Discusión: El estereotipo creado por la sociedad actual y la búsqueda por el buen rendimiento físico, estimulan que las personas utilicen los EA sin control, generando un problema que está creciendo gradualmente, sin que hasta hoy exista un abordaje del tema por parte de las autoridades gubernamentales. Conclusiones: A pesar de existir un control para la compra de este tipo de medicamentos, este no es del todo efectivo, originando un alto riesgo de desarrollar enfermedades en los diferentes sistemas, además de un creciente número de adictos sin control en la población. Por tanto, se necesita de más estudios que aborden la problemática, mayor control en la comercialización de estos productos e intervención por parte de los entes gubernamentales responsables.
Introduction: Anabolic steroids (AS) are derivatives of testosterone, used to treat some diseases. Athletes began using to increase muscle mass and physical strength in activities, but in recent years there is an increase of people using EA, young people who engage in physical activity as a means of pleasure, but in order to improve their appearance and up making use these substances indiscriminately. The purpose of this was to reflect on the indiscriminate use of AS and their consequences while a public health problem. Materials and Methods: Is a reflection paper, which presents an approach from the literature and the reality from the perspective of the health problem by the use of anabolic steroids by athletes and young practitioner of physical activity. Results: The present reflection shows that people adept AS are athletes, young pleople and people who like to maintain a body image based on stereotypes. Discussion: The stereotype created by current society and the looking-for good performance in physical activity, encourage people to use AS, creating a problem that is growing up today without any greater approach to the subject by government authorities. Conclusions: Although have a control to purchase this type of medicine, this is not at all effective, yielding a high risk in the occurrence of diseases in users, and the growing number of users without control in the population. Therefore, it requires further studies that address this issue, greater control in marketing them and intervention by government entities responsible.