RESUMO
OBJECTIVE: This trial's objective was to investigate the effect of an exercise program with and without cognitive-behavioral therapy (CBT), compared by a control group, on weight, functional capacity, and cardiometabolic profile of morbidly obese individuals while waiting for bariatric surgery. MATERIALS AND METHODS: This randomized controlled trial investigated the effect of a 4-month low-intensity exercise program (two weekly sessions of 25 min each) on 66 morbidly obese individuals awaiting bariatric surgery. Participants were randomly divided into three groups: EXER, exercise program; EXER + CBT, exercise program plus support group sessions for lifestyle modification, with a CBT; and CONTROL, routine treatment. They were compared on weight, functional capacity, and cardiometabolic profile. RESULTS: The weight change (Kg) was -7.4 (-9.6 to 5,1); -4,2 (-6,8 to -1.6) and 2.9 (0.4 to 5.3) and the BMI change (kg/m2) was -2.7 (-3.6 to -1.8); -1.4 (-2.4 to -0.4) and 1.1 (0.1 to 2.1) for groups EXER, EXER + CBT, and CONTROL, respectively. Changes were significant when compared to the control group (p < 0.001), but there were no differences between the two intervention arms (p = 0.2). Functional capacity and cardiometabolic parameters significantly improved in the intervention arms and worsened in the control group. The adherence to the exercise program in both groups was above 78 %. CONCLUSION: A 4-month, twice-weekly supervised program of low-intensity physical activity that encourages individuals to adopt a more active lifestyle can positively interfere with weight loss and improvement in functional capacity and cardiometabolic parameters of morbidly obese individuals with and without the aid of support group sessions.
Assuntos
Cirurgia Bariátrica , Terapia Cognitivo-Comportamental/métodos , Terapia por Exercício/métodos , Obesidade Mórbida/reabilitação , Psicoterapia de Grupo/métodos , Adulto , Antropometria/métodos , Pressão Sanguínea/fisiologia , Terapia Combinada , Teste de Esforço/métodos , Tolerância ao Exercício/fisiologia , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/fisiopatologia , Obesidade Mórbida/cirurgia , Cooperação do Paciente , Listas de Espera , Redução de Peso/fisiologiaRESUMO
BACKGROUND: Hepatitis E virus (HEV) infection represents an important cause of acute viral hepatitis. Selective waste collection is a widespread activity carried out by the urban poor, and recyclable waste pickers have a lifestyle that makes this group highly vulnerable to unfavorable socio-economic and environmental factors. To date, the epidemiology of HEV infection in this population remains unknown. OBJECTIVES: To assess the seroprevalence of hepatitis E-specific antibodies in a population of recyclable waste pickers in Brazil. STUDY DESIGN: Between April 2010 and May 2011, a cross-sectional study was conducted among recyclable waste pickers from all 15 recycling cooperatives in Goiânia City, Central Brazil. The participants were tested for serological markers indicative of HEV infection. RESULTS: Of 432 individuals asked to participate in the survey, 431 (99.8%) agreed to participate. Twenty-four of 431 participants were anti-HEV IgG positive by ELISA. Of these, 22 were confirmed positive by immunoblot, resulting in an anti-HEV IgG prevalence of 5.1% (95% CI: 3.4-7.6). In addition, four individuals were anti-HEV IgM positive by ELISA. Of these, three (0.7%; 95% CI: 0.4-2.4) were confirmed anti-HEV IgM positive by immunoblot, but were HEV RNA negative. One was concurrently positive for anti-HEV IgG. Only age>40 years was independently associated with the presence of anti-HEV. CONCLUSIONS: These findings demonstrated that the prevalence of HEV antibodies among recyclable waste pickers in Central Brazil is relatively low and increased with age.
Assuntos
Anticorpos Anti-Hepatite/sangue , Hepatite E/epidemiologia , Adulto , Brasil/epidemiologia , Feminino , Hepatite E/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais , Pobreza , Estudos Soroepidemiológicos , Instalações de Eliminação de Resíduos , Adulto JovemRESUMO
BACKGROUND: Hepatitis B virus (HBV) and tuberculosis (TB) represent major public health problems. There is currently little data on HBV infection among TB patients with and without human immunodeficiency virus (HIV). OBJECTIVES: To assess HBV prevalence among TB patients with and without HIV. STUDY DESIGN: From April 2008 to March 2010, a cross-sectional study was conduct among TB patients attended at a reference hospital in Goiânia City, Brazil. The participants were tested for serological markers of HBV infection and HIV antibodies. HBV DNA was detected in HBsAg-positive samples, and also in HBsAg-negative/anti-HBc-positive samples to look for HBV occult infection. RESULTS: Of 425 patients, 402 (94.6%) agreed to participate in the study. The overall prevalence of HBV (HBsAg and/or anti-HBc positive) and HIV infections were 25.6% (103/402) and 27.6% (111/402), respectively. A higher HBV infection rate was found among HIV-infected patients (36.9%; 41/111) compared to patients infected with TB only (20.0%; 57/285). A multivariate analysis of risk factors showed that age ≥ 50 years (p=0.03), non-injecting (p<0.01) and injecting (p<0.01) drugs use were associated with HBV infection. Among the HBsAg-positive samples (n=13), HBV DNA was detected in 10 (76.9%) samples. Of the 90 anti-HBc-positive samples, 13 were HBV DNA positive (with very low levels) resulting in an occult HBV infection rate of 14.4%. PCR-RFLP was successfully performed in 20 HBV DNA-positive samples: 15 were genotype A and 5 were genotype D. CONCLUSIONS: HBV infection was common, particularly among this with HIV infection.
Assuntos
Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Hepatite B/complicações , Hepatite B/epidemiologia , Tuberculose/complicações , Tuberculose/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , DNA Viral/sangue , Feminino , HIV-1/imunologia , Hepatite B/virologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/classificação , Vírus da Hepatite B/genética , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Prevalência , Fatores de Risco , Tuberculose/microbiologia , Adulto JovemRESUMO
SETTING: Goiânia City, Goiás State, Brazil. OBJECTIVES: To determine the prevalence of hepatitis C virus (HCV) infection, risk factors, HCV genotype/ subtype, HCV viral load and human immunodeficiency virus (HIV) status in patients with tuberculosis (TB) in Central Brazil. DESIGN: A cross-sectional study was carried out with 402 patients who were under tuberculosis (TB) treatment in the reference hospital for infectious diseases in Goiânia, Goiás, Central Brazil. RESULTS: The prevalence rates of HCV and HIV were respectively 7.5% and 27.6%. Two thirds of the HCV-infected patients (20/30) were HIV-positive. Age, injecting drug use (IDU) and HIV status were factors independently associated with HCV infection. HCV RNA was detected in 23 serum samples; HCV RNA levels were measured in 22/23 samples. HCV RNA level was slightly higher in HCV-HIV co-infected patients than in HCV monoinfected patients. Genotypes 1 (n = 17) and 3 (n = 6) were determined by LiPA. Using phylogenetic tree analysis of the NS5B region, subtypes 1a (n = 12), 1b (n = 2) and 3a (n = 6) were identified. CONCLUSION: These data indicate that patients with TB may benefit from integrated HIV and HCV screening, which may have an important impact upon TB management and treatment.
Assuntos
Coinfecção , Hepatite C/epidemiologia , Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Estudos Transversais , Feminino , Genótipo , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Soropositividade para HIV , HIV-1/imunologia , Hepacivirus/genética , Hepacivirus/imunologia , Hepatite C/diagnóstico , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/análise , Medição de Risco , Fatores de Risco , Tuberculose/diagnóstico , Tuberculose/terapia , Adulto JovemRESUMO
Data collected during an oceanographic cruise along the southeastern Brazilian coast from Cape Frio (22 degrees 58' S) and Paraná (27 degrees 50' S) in March 1982 showed that the marine insect Halobates micans occurred along the Southeastern Brazilian Bight, but in lower abundance in low-temperature areas due to the intrusion and upwelling of South Atlantic Central Water, and in low-salinity areas in Coastal Water. Insect capture was higher at night and in the oligotrophic Tropical Water. The number of nymphs and adult females was higher, probably because of an active breeding season during the austral summer. Adult sex ratio was 1.3:1.0 (F:M). Floating gas vesicles of benthic Sargassum spp. and petroleum lumps were used by females for egg-laying.
Assuntos
Heterópteros/fisiologia , Animais , Brasil , Feminino , Heterópteros/anatomia & histologia , Heterópteros/classificação , Masculino , Densidade Demográfica , Dinâmica Populacional , Estações do Ano , Água do MarRESUMO
Data collected during an oceanographic cruise along the southeastern Brazilian coast from Cape Frio (22° 58' S) and Paraná (27° 50' S) in March 1982 showed that the marine insect Halobates micans occurred along the Southeastern Brazilian Bight, but in lower abundance in low-temperature areas due to the intrusion and upwelling of South Atlantic Central Water, and in low-salinity areas in Coastal Water. Insect capture was higher at night and in the oligotrophic Tropical Water. The number of nymphs and adult females was higher, probably because of an active breeding season during the austral summer. Adult sex ratio was 1.3:1.0 (F:M). Floating gas vesicles of benthic Sargassum spp. and petroleum lumps were used by females for egg-laying.
Dados coletados em um cruzeiro oceanográfico ao longo da costa sudeste do Brasil, entre o cabo Frio (22° 58' S) e o Paraná (27° 50' S), em março de 1982, mostram que o inseto marinho Halobates micans ocorreu no embaiamento sudeste do Brasil, em baixa abundância em locais de baixas temperaturas superficiais, devido à penetração e ressurgência da Água Central do Atlântico Sul, e em locais com salinidade mais baixa devido à presença da Água Costeira. A captura do inseto foi maior durante a noite e na Água Tropical oligotrófica. O número de ninfas e fêmeas adultas foi mais alto, provavelmente por um ativo período reprodutivo no verão austral. As proporções sexuais dos adultos foram 1,3:1,0 (F:M). Vesículas flutuantes de Sargassum spp. e grumos de petróleo (pixe) foram usados pelas fêmeas para oviposição.
Assuntos
Animais , Feminino , Masculino , Heterópteros/fisiologia , Brasil , Heterópteros/anatomia & histologia , Heterópteros/classificação , Densidade Demográfica , Dinâmica Populacional , Estações do Ano , Água do MarRESUMO
We have evaluated the cellular and humoral immune response to primary respiratory syncytial virus (RSV) infection in young infants. Serum specimens from 65 patients <=12 months of age (39 males and 26 females, 28 cases <3 months and 37 cases > or = 3 months; median 3 3.9 months) were tested for anti-RSV IgG and IgG subclass antibodies by EIA. Flow cytometry was used to characterize cell surface markers expressed on peripheral blood mononuclear cells (PBMC) from 29 RSV-infected children. There was a low rate of seroconversion in children <3 months of age, whose acute-phase PBMC were mostly T lymphocytes (63.0 +/- 9.0%). In contrast, a higher rate of seroconversion was observed in children >3 months of age, with predominance of B lymphocytes (71.0 +/- 17.7%). Stimulation of PBMC with RSV (2 x 10(5) TCID50) for 48 h did not induce a detectable increase in intracellular cytokines and only a few showed a detectable increase in RSV-specific secreted cytokines. These data suggest that age is an important factor affecting the infants' ability to develop an immune response to RSV.
Assuntos
Linfócitos B/imunologia , Citocinas/imunologia , Infecções por Vírus Respiratório Sincicial/imunologia , Vírus Sincicial Respiratório Humano/imunologia , Linfócitos T/imunologia , Fatores Etários , Anticorpos Antivirais/imunologia , Antígenos de Superfície/imunologia , Biomarcadores , Brasil , Feminino , Citometria de Fluxo , Humanos , Imunidade Celular , Técnicas Imunoenzimáticas , Imunoglobulina G/imunologia , Lactente , Recém-Nascido , MasculinoRESUMO
We have evaluated the cellular and humoral immune response to primary respiratory syncytial virus (RSV) infection in young infants. Serum specimens from 65 patients <=12 months of age (39 males and 26 females, 28 cases <3 months and 37 cases > or = 3 months; median 3 ± 3.9 months) were tested for anti-RSV IgG and IgG subclass antibodies by EIA. Flow cytometry was used to characterize cell surface markers expressed on peripheral blood mononuclear cells (PBMC) from 29 RSV-infected children. There was a low rate of seroconversion in children <3 months of age, whose acute-phase PBMC were mostly T lymphocytes (63.0 ± 9.0 percent). In contrast, a higher rate of seroconversion was observed in children >3 months of age, with predominance of B lymphocytes (71.0 ± 17.7 percent). Stimulation of PBMC with RSV (2 x 10(5) TCID50) for 48 h did not induce a detectable increase in intracellular cytokines and only a few showed a detectable increase in RSV-specific secreted cytokines. These data suggest that age is an important factor affecting the infants' ability to develop an immune response to RSV
Assuntos
Humanos , Masculino , Feminino , Lactente , Recém-Nascido , Linfócitos B , Citocinas , Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Linfócitos T , Fatores Etários , Anticorpos Antivirais , Antígenos de Superfície , Biomarcadores , Brasil , Citometria de Fluxo , Técnicas ImunoenzimáticasRESUMO
Hepatitis B vaccine is the most effective strategy for preventing the transmission of hepatitis B virus (HBV) in haemodialysis centers. Nevertheless, lower vaccine responses have been reported in haemodialysis patients as compared with healthy subjects. This study examines the response to Euvax-B in Brazilian haemodialysis patients and staff. A total of 102 eligible patients (n = 42) and staff members (n = 60) consented to be studied. Patients were immunized intramuscularly with four doses of 40 microg of Euvax-B vaccine at 0, 1, 2 and 6 months. In staff members, the vaccine was administered in three doses of 20 microg at 0, 1, and 6 months. Post-vaccine samples were taken from all subjects I month after each dose. The vaccine response was determined by measuring antibody to the hepatitis B surface antigen (anti-HBs) levels using ELISA. Subjects with anti-HBs titres equal to or higher than 10 UI/L were considered immune protected. Of the haemodialysis patients who received four doses of hepatitis B vaccine, 89.5% responded to Euvax-B vaccine. The geometric mean of anti-HBs titres was 322.8 IU/L (95% CI: 317.7-328). Among staff members, 93.3% reached anti-HBs protective titres after the third vaccine dose. The geometric mean of anti-HBs titres was 2,209 IU/L (Cl: 2,198-2,219). Age, male gender and body mass index were not associated with vaccine response in either group. This study showed a good immunogenicity response to Euvax-B in haemodialysis patients and staff.
Assuntos
Vacinas contra Hepatite B/administração & dosagem , Vacinas contra Hepatite B/imunologia , Diálise Renal , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Terapia Combinada , Relação Dose-Resposta Imunológica , Feminino , Hepatite B/prevenção & controle , Hepatite B/transmissão , Anticorpos Anti-Hepatite B/administração & dosagem , Anticorpos Anti-Hepatite B/imunologia , Humanos , Imunogenética , Masculino , Pessoa de Meia-Idade , Diálise Renal/enfermagem , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/imunologiaRESUMO
An hemodialysis population in Central Brazil was screened by polymerase chain reaction (PCR) and serological methods to assess the prevalence of hepatitis C virus (HCV) infection and to investigate associated risk factors. All hemodialysis patients (n=428) were interviewed in eight dialysis units in Goiânia city. Blood samples were collected and serum samples screened for anti-HCV antibodies by an enzyme-linked immunosorbent assay (ELISA). Positive samples were retested for confirmation with a line immunoassay (LIA). All samples were also tested for HCV RNA by the PCR. An overall prevalence of 46.7% (CI 95%: 42-51.5) was found, ranging from 20.7% (CI 95%: 8.8-38.1) to 90.4% (CI 95%: 79.9-96.4) depending on the dialysis unit. Of the 428 patients, 185 were found to be seropositive by ELISA, and 167 were confirmed positive by LIA, resulting in an anti-HCV prevalence of 39%. A total of 131 patients were HCV RNA-positive. HCV viremia was present in 63.5% of the anti-HCV-positive patients and in 10.3% of the anti-HCV-negative patients. Univariate analysis of risk factors showed that the number of previous blood transfusions, transfusion of blood before mandatory screening for anti-HCV, length of time on hemodialysis, and treatment in multiple units were associated with HCV positivity. However, multivariate analysis revealed that blood transfusion before screening for anti-HCV and length of time on hemodialysis were significantly associated with HCV infection in this population. These data suggest that nosocomial transmission may play a role in the spread of HCV in the dialysis units studied. In addition to anti-HCV screening, HCV RNA detection is necessary for the diagnosis of HCV infection in hemodialysis patients.