ACALASIA NA DOENÇA DE CHAGAS É DIFERENTE DE ACALASIA IDIOPÁTICA? EXPERIÊNCIA DO HOSPITAL DE CLÍNICAS DE PORTO ALEGRE

Objetive: The objective of this study is to evaluate the differences between achalasia in Chagas’ disease and idiopathic achalasia in patients admitted to the Hospital de Clínicas de Porto Alegre, by analyzing epidemiologic, clinic, radiologic and manometric findings.Methods: Patients referred to the Hospital de Clinicas de Porto Alegre between November 1996 and December 2001 with suspicion of achalasia, later confirmed by esophageal manometry, were included in the study. In addition to manometric and radiologic findings, patients were assessed for age, sex, symptomsand symptomatic period.Results: Among 51 patients, nine (18%) presented positive serology for Chagas’ disease and 42 (82%) presented negative serology. The latter were considered carriers of idiopathic achalasia. The mean age of patients with achalasia in Chagas’ disease was 62 ± 15 years, while the mean age in the idiopathic group was 43 ± 18 years (P < 0.02). The symptomatic period for patients with achalasia in Chagas’ disease was 74 ± 47 months, and in the idiopathic group, 49 ± 35 months (P < 0.05). Dysphagia, regurgitation, thoracic pain and weight loss, values at the lower esophageal sphincter (basal pressure, post-deglutitive relaxation pressure/duration and total length) and at the esophageal body (amplitude and duration of the post-deglutitive waves) were similar in both groups.Conclusions: The only statistically significant differences found between the two groups were age and length of the symptomatic period, significantly greater in patients with achalasia in Chagas’ disease. These data suggest a greater resistance to the symptoms in older patients.Objetivo: O presente trabalho tem como objetivo avaliar as diferenças entre a acalasia chagásica e a idiopática em pacientes do Hospital de Clínicas de Porto Alegre, através da análise de achados epidemiológicos, clínicos, radiológicos e manométricos.Métodos: Foram estudados pacientes encaminhados ao Hospital de Clínicas de Porto Alegre, entre novembro de 1996 e dezembro de 2001, com suspeita de acalasia, posteriormente, confirmada por manometria esofágica. Além das características manométricas e radiológicas, os pacientes foram avaliados quanto a idade, sexo, sintomas e tempo de evolução.Resultados: Entre 51 pacientes, nove (18%) tiveram sorologia positiva para doença de Chagas e 42 (82%) sorologia negativa. Indivíduos com sorologia negativa foram considerados portadores de acalasia idiopática. Pacientes com acalasia chagásica tinham média de idade de 62 ± 15 anos e os com idiopática 43 ± 18 anos (P < 0,02). O período de evolução dos sintomas em pacientes com acalasia chagásica foi de 74 ± 47 meses e nos idiopáticos 49 ± 35 meses (P < 0,05). Disfagia, regurgitação, dor torácica e emagrecimento, valores do esfíncter esofágico inferior (pressão basal, pressão e duração de relaxamento pós-deglutição e comprimento total) e do corpo esofágico (amplitude e duração das ondas pós-deglutição) foram similares em ambos os grupos.Conclusões: As únicas diferenças estatisticamente significativas encontradas entre os dois grupos foram a média de idade e o período de evolução dos sintomas, maiores nos pacientes chagásicos. Esses dados permitem especular sobre uma maior tolerância aos sintomas nos pacientes com idade mais avançada

High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort

Background: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.World Health OrganizationRevisión por pare

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

Prevalence of obesity in adolescents from Bragança Paulista and its relation to parental obesity

This study was aimed to determine the prevalence of obesity among adolescents who attend State Schools in the city of Bragança Paulista (SP), and its relationship with parental nutritional status. This was a cross-sectional study involving 1,334 adolescents (796 [59.7%] female), ranging in age from 11 to 18 years, regularly registered in the 5th through the 12th grade. The following variables were studied: sex, age, current weight and height (in the adolescents and parents) and educational level (in the adolescents). The nutritional status was evaluated by the body mass index [BMI - weight (kg)/height (m²)], and determined according to the cut-offs previously recommended. A low prevalence of overweight and obesity was found among adolescents (7.3 and 3.5%, respectively) and a high prevalence of obesity among adolescents whose parents (father and mother) were obese (26.09%), as compared to parents with normal weight (9.29%). Obesity appears not to be an issue of Public Health in this particular population but there is a relationship between adolescents obesity with theirs parents nutritional status.O objetivo do trabalho foi determinar a prevalência da obesidade entre adolescentes da Rede Estadual de Ensino da cidade de Bragança Paulista, SP, e relacioná-la com o estado nutricional dos pais. Foi realizado um estudo transversal com 1.334 adolescentes, na faixa de 11 a 18 anos, matriculados da 5ª série ao 3ª colegial, sendo 796 (59,7%) do sexo feminino. As variáveis estudadas nos adolescentes foram: sexo, idade, escolaridade, peso atual e estatura, e nos pais: sexo, idade, peso atual e estatura. O diagnóstico nutricional foi feito pelo índice de massa corpórea [IMC - peso (kg)/altura (m²)]. A avaliação do estado nutricional foi realizada com as medidas anteriores, de acordo com indicadores antropométricos recomendados para adolescentes. Encontrou-se baixa prevalência de sobrepeso e obesidade entre os adolescentes (7,3 e 3,5%, respectivamente), e maior prevalência de sobrepeso e obesidade em adolescentes que possuem pai e mãe obesos (26,09%), quando comparados aos pais com peso normal (9,29%). Concluiu-se que a obesidade não é um problema de Saúde Pública nesta população e que existe relação da obesidade dos adolescentes com o estado nutricional de seus pais.66366