Factors associated with cure when treating tuberculosis in the state of Rio de Janeiro, Brazil, 2011-2014. / Fatores associados à cura no tratamento da tuberculose no estado do Rio de Janeiro, 2011-2014.

OBJECTIVE: to analyze factors associated with cure when treating tuberculosis (TB) in the state of Rio de Janeiro, Brazil, from 2011 to 2014. METHODS: this was a cross-sectional study with data from the Notifiable Diseases Information System (SINAN); logistic regression was used for data analysis. RESULTS: of the 57,142 cases reported, 49,691 (86.96%) were included in the study; schooling ≥13 years (odds ratio (OR) 3.48; 95%CI 2.74;4.41) and residing in rural areas (OR 2.27; 95%CI 1.38; 3.73) were factors associated with a higher chance of cure; being male (OR 0.71; 95%CI 0.66;0.76) and brown skin color/race (OR 0.73; 95%CI 0.68;0.78) stood out as factors associated with less chance of cure. CONCLUSION: social and economic determinants were identified that influence the treatment outcome, evidencing the need for social support and guaranteed access to health services.

Fatores associados à cura no tratamento da tuberculose no estado do Rio de Janeiro, 2011-2014 / Factores asociados a cura por tratamiento de tuberculosis en el estado de Río de Janeiro, Brasil, 2011-2014 / Factors associated with cure when treating tuberculosis in the state of Rio de Janeiro, Brazil, 2011-2014

Objetivo: analisar os fatores associados à cura no tratamento da tuberculose (TB) no estado do Rio de Janeiro, Brasil, no período de 2011 a 2014. Métodos: estudo transversal, com dados do Sistema de Informação de Agravos de Notificação (Sinan); empregou-se regressão logística para análise dos dados. Resultados: dos 57.142 casos notificados, 49.691 (86,96%) foram incluídos; revelaram-se fatores associados a maior chance de cura da TB ter ≥13 anos de escolaridade (odds ratio [OR] 3,48; IC95% 2,74;4,41) e residir em zona rural (OR 2,27; IC95% 1,38;3,73); entre os fatores associados a menor chance de cura, destacaram-se o sexo masculino (OR 0,71; IC95% 0,66;0,76) e a raça/cor da pele parda (OR 0,73; IC95% 0,68;0,78). Conclusão: foram identificados determinantes sociais e econômicos que influenciam no desfecho do tratamento, evidenciando a necessidade de apoio social e garantia de acesso aos serviços de saúde.

Objetivo: analizar los factores asociados a cura por tratamiento de tuberculosis (TB) en el estado de Río de Janeiro, Brasil, entre 2011 e 2014. Métodos: estudio transversal con datos del Sistema de Información de Agravios de Notificación (Sinan); se empleó regresión logística. Resultados: de los 57.142 casos notificados, 49.691 (86,96%) fueron incluidos; se revelaron como factores asociados a mayor probabilidad de cura tener ≥13 años de estudio (odds ratio [OR] 3,48; IC 2,74;4,41) y residir en zona rural (OR 2,27; IC95% 1,38;3,73); entre los factores asociados a menor probabilidad de cura se han destacado el sexo masculino (OR 0,71; IC95% 0,66;0,76) y la raza/color de la piel parda (OR 0,73; IC95% 0,68, 0,78). Conclusión: se identificaron determinantes sociales y económicos que influencian en el desenlace del tratamiento, evidenciando la necesidad de apoyo social y garantía de acceso a los servicios de salud.

Objective: to analyze factors associated with cure when treating tuberculosis (TB) in the state of Rio de Janeiro, Brazil, from 2011 to 2014. Methods: this was a cross-sectional study with data from the Notifiable Diseases Information System (SINAN); logistic regression was used for data analysis. Results: of the 57,142 cases reported, 49,691 (86.96%) were included in the study; schooling ≥13 years (odds ratio (OR) 3.48; 95%CI 2.74;4.41) and residing in rural areas (OR 2.27; 95%CI 1.38; 3.73) were factors associated with a higher chance of cure; being male (OR 0.71; 95%CI 0.66;0.76) and brown skin color/race (OR 0.73; 95%CI 0.68;0.78) stood out as factors associated with less chance of cure. Conclusion: social and economic determinants were identified that influence the treatment outcome, evidencing the need for social support and guaranteed access to health services.

Hyperglycemia Differentially Affects Maternal and Fetal DNA Integrity and DNA Damage Response.

OBJECTIVE: Investigate the DNA damage and its cellular response in blood samples from both mother and the umbilical cord of pregnancies complicated by hyperglycemia. METHODS: A total of 144 subjects were divided into 4 groups: normoglycemia (ND; 46 cases), mild gestational hyperglycemia (MGH; 30 cases), gestational diabetes mellitus (GDM; 45 cases) and type-2 diabetes mellitus (DM2; 23 cases). Peripheral blood mononuclear cell (PBMC) isolation and/or leukocytes from whole maternal and umbilical cord blood were obtained from all groups at delivery. Nuclear and mitochondrial DNA damage were measured by gene-specific quantitative PCR, and the expression of mRNA and proteins involved in the base excision repair (BER) pathway were assessed by real-time qPCR and Western blot, respectively. Apoptosis was measured in vitro experiments by caspase 3/7 activity and ATP levels. RESULTS: GDM and DM2 groups were characterized by an increase in oxidative stress biomarkers, an increase in nuclear and mitochondrial DNA damage, and decreased expression of mRNA (APE1, POLß and FEN1) and proteins (hOGG1, APE1) involved in BER. The levels of hyperglycemia were associated with the in vitro apoptosis pathway. Blood levels of DNA damage in umbilical cord were similar among the groups. Newborns of diabetic mothers had increased expression of BER mRNA (APE1, POLß and FEN1) and proteins (hOGG1, APE1, POLß and FEN1). A diabetes-like environment was unable to induce apoptosis in the umbilical cord blood cells. CONCLUSIONS: Our data show relevant asymmetry between maternal and fetal blood cell susceptibility to DNA damage and apoptosis induction. Maternal cells seem to be more predisposed to changes in an adverse glucose environment. This may be due to differential ability in upregulating multiple genes involved in the activation of DNA repair response, especially the BER mechanism. However if this study shows a more effective adaptive response by the fetal organism, it also calls for further studies to determine the limit of this response that definitely changes the fate of a fetus under these conditions of cellular stress.

DNA damage and its cellular response in mother and fetus exposed to hyperglycemic environment.

The increased production of reactive oxygen species (ROS) plays a key role in pathogenesis of diabetic complications. ROS are generated by exogenous and endogenous factors such as during hyperglycemia. When ROS production exceeds the detoxification and scavenging capacity of the cell, oxidative stress ensues. Oxidative stress induces DNA damage and when DNA damage exceeds the cellular capacity to repair it, the accumulation of errors can overwhelm the cell resulting in cell death or fixation of genome mutations that can be transmitted to future cell generations. These mutations can lead to and/or play a role in cancer development. This review aims at (i) understanding the types and consequences of DNA damage during hyperglycemic pregnancy; (ii) identifying the biological role of DNA repair during pregnancy, and (iii) proposing clinical interventions to maintain genome integrity. While hyperglycemia can damage the maternal genetic material, the impact of hyperglycemia on fetal cells is still unclear. DNA repair mechanisms may be important to prevent the deleterious effects of hyperglycemia both in mother and in fetus DNA and, as such, prevent the development of diseases in adulthood. Hence, in clinical practice, maternal glycemic control may represent an important point of intervention to prevent the deleterious effects of maternal hyperglycemia to DNA.

Impact of temperature and time storage on the microbial detection of oral samples by Checkerboard DNA-DNA hybridization method.

PURPOSE: Molecular diagnosis methods have been largely used in epidemiological or clinical studies to detect and quantify microbial species that may colonize the oral cavity in healthy or disease. The preservation of genetic material from samples remains the major challenge to ensure the feasibility of these methodologies. Long-term storage may compromise the final result. The aim of this study was to evaluate the effect of temperature and time storage on the microbial detection of oral samples by Checkerboard DNA-DNA hybridization. METHODS: Saliva and supragingival biofilm were taken from 10 healthy subjects, aliquoted (n=364) and processed according to proposed protocols: immediate processing and processed after 2 or 4 weeks, and 6 or 12 months of storage at 4°C, -20°C and -80°C. RESULTS: Either total or individual microbial counts were recorded in lower values for samples processed after 12 months of storage, irrespective of temperatures tested. Samples stored up to 6 months at cold temperatures showed similar counts to those immediately processed. The microbial incidence was also significantly reduced in samples stored during 12 months in all temperatures. CONCLUSIONS: Temperature and time of oral samples storage have relevant impact in the detection and quantification of bacterial and fungal species by Checkerboard DNA-DNA hybridization method. Samples should be processed immediately after collection or up to 6 months if conserved at cold temperatures to avoid false-negative results.

Sintoma vocal e sua provável causa: levantamento de dados em uma população / Vocal sympton and its probable cause: data colleting in a population

TEMA: refletir sobre uma faceta da constituição da relação mãe-bebê, que se fez presente no uso criativo da voz cantada da mãe, na comunicação com o seu bebê. PROCEDIMENTOS: o único sujeito desse estudo é uma mãe, que se submeteu a oito sessões de terapias corporais associadas à emissão da voz cantada, sempre dirigidas ao bebê; as sessões transcorreram com a possibilidade de expressão livre pela fala e gesto da mãe e a escuta do terapeuta. RESULTADOS: o quadro que a mãe apresentava em relação ao seu bebê, no início do tratamento, se encaixa na descrição de depressão pós-parto. Após as sessões, a mãe conseguiu estabelecer contato com seu bebê, de modo prazeroso; por meio da emissão da voz cantada, ela estabeleceu a primeira forma de comunicação e não mais apresentou o quadro de dor e perda da voz. CONCLUSÃO: a possibilidade de reconhecimento, do bebê por sua mãe, teve a corporeidade como aliada, na conjunção dos corpos da mãe e do bebê, o que favoreceu o estabelecimento de uma comunicação com sintonia de ritmos, por meio da entoação de música cantada, que levou à constituição do bebê enquanto pessoa integrada.

PURPOSE: to analyze the occurrence of vocal symptoms and the relationship among their presence, as well as their probable cause, according to a population sample. Moreover, it is to analyze the probable correlations between the cited causes and symptoms. METHODS: 190 frequenters (18 45-year-old) of a Mall in São Paulo took part in the study. A questionnaire was used containing six closed questions of the yes / no type not referring to the aspects of health (including smoking), perception and probable cause of vocal symptoms. Data analysis was carried through by using chi-square test. RESULTS: the most referred four related symptoms were hoarseness (34.2 percent), ardor in the throat (24.7 percent), dry throat (21.6 percent) and dry cough (21.6 percent); and the most cited causes: high respiratory disease (46.4 percent), stress (14.2 percent) and intense voice use (11.1 percent). It was possible to evidence that in the opinion of the participants, the hoarseness is associated with the intense voice use (p< 0.001) and with high respiratory affections (p> 0.001); vocal fatigue, to stress (p< 0.001); ardor in the throat, to high respiratory affections (p< 0.001); and sore throat, to smoking (p=0.021) and use of drugs (p=0.002). CONCLUSION: the data indicate, therefore, that the studied population perceives that both external factors (stress), as well as habits (smoking and use of drugs) interfere in vocal production, as well as those related to health and voice (high respiratory affections and intense voice use).