The magnitude of syphilis: from prevalence to vertical transmission

Introduction: In 2013, the World Health Organization (WHO) reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS) was 22/1,000 in live births (LB) in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State

Association between physical activity levels and polypharmacy in hypertensive patients

Background: exercise reduces medication usage in hypertensive people. However, different domains of physical activity (PA) have not been studied in order to analyze their relationship with the use of multiple medications, known as polypharmacy. Purpose: To examine the association between PA in different domains (leisure-time, locomotion and occupational) and polypharmacy in hypertensive patients. Methods: This is a cross-sectional study carried out with 190 hypertensive patients. Polypharmacy was defined as simultaneous use of three or more drugs. The PA domains were the independent variables: Locomotion PA (LPA), Leisure Time PA (LTPA) and Occupational PA (OPA). The multiple logistic regression was performed to analyze the associations. The Mann Whitney test determined whether medications usage differ according to each domain of PA. Results: The total number of drugs used ranged from 0 to 7, which represents an average of 2.35 (±1.6) drugs per person. Scores of LTPA (OR: 3.25; CI95%:1.61-6.54) and LPA (OR: 2.15; CI95%:1.09-4.25) were inversely associated with polypharmacy in hypertensive patients, in the multiple logistic regression analysis (controlled by BMI, chronic diseases, smoking, alcohol consumption and skin color). Conclusions: lower PA in leisure time and locomotion were associated with polypharmacy in hypertensive peopleIntrodução: o exercício reduz o uso de medicamentos em indivíduos hipertensos. Contudo, diferentes domínios de atividade física (AF) não têm sido estudados no intuito de analisar suas relações com o uso de múltiplos medicamentos, conhecido como polifarmácia. Objetivo: analisar a associação entre AF em diferentes domínios (tempo livre, locomoção e ocupação) e polifarmácia em indivíduos hipertensos. Métodos: trata-se de um estudo transversal realizado com 190 hipertensos. Polifarmácia foi definida como o uso simultâneo de três ou mais drogas. As variáveis independentes foram os domínios de AF: Locomoção (AFL); Tempo Livre (AFTL) e Ocupacional (AFO). A regressão logística múltipla foi empregada para analisar as associações. O teste de Mann Whitney foi empregado para comparar se a média de medicamentos usados diferia entre domínios de AF. Resultados: o número total de drogas usadas variou de 0 a 7, com média de 2.35 (±1.6) por pessoa. Escores de AFTL (OR: 3.25; IC95%: 1.61-6.54) e AFL (OR: 2.15; IC95%: 1.09-4.25) foram inversamente associadas à polifarmácia em hipertensos (controlado por IMC, número de doenças crônicas, fumo, consumo de álcool e cor da pele). Conclusão: menor AF no tempo livre e de locomoção foi associada à polifarmácia em indivíduos hipertenso

Factors associated with leisure-time physical activity among patients undergoing hemodialysis

Background End-stage renal disease patients are characterized by low levels of physical activity, especially during leisure time. However, the recognition of variables associated with patterns of physical activity in this population has been little explored. Thus, the objective was to assess factors associated with levels of physical activity during leisure time among patients on haemodialysis. Methods Ninety-eight patients (51.6 ± 15.7 years, 57 M/41 F) from two dialysis centres in São Paulo, Brazil participated in this cross-sectional study. Participants were divided into those who never exercised during leisure-time (inactive) and those who exercised at least once a week (active). The independent factors assessed were: socio-demographic data, comorbidities, personal barriers to exercise and physical activity records from childhood to adulthood (tracking of physical activity). Results Only 27 % of patients were engaged in PA during their leisure time at least once a week. Patients who engaged in regular physical activity during adulthood before the initiation of the hemodialysis treatment (adjusted OR: 7.24 95 % IC: 1.99; 26.50), those who developed the renal disease through diseases other than diabetes or hypertension (adjusted OR: 4.82; 95 % IC: 1.48; 15.68), and those who had no cardiovascular diseases (adjusted OR: 11.33; 95 % IC: 1.23; 103.8) where more likely to be active during their leisure-time. Conclusion Comorbidities such as cardiovascular disease, hypertension and diabetes mellitus as well as the level of physical activity prior to end-stage renal disease could predict leisure-time physical activity among patients receiving hemodialysis therapy

Production of high-quality coarse recycled aggregates through a two-stage jigging process

Peer ReviewedObjectius de Desenvolupament Sostenible::9 - Indústria, Innovació i InfraestructuraObjectius de Desenvolupament Sostenible::9 - Indústria, Innovació i Infraestructura::9.4 - Per a 2030, modernitzar les infraestructures i reconvertir les indústries perquè siguin sostenibles, usant els recursos amb més eficàcia i promovent l’adopció de tecnologies i processos industrials nets i racionals ambiental­ment, i aconseguint que tots els països adoptin mesures d’acord amb les capacitats respectivesObjectius de Desenvolupament Sostenible::12 - Producció i Consum ResponsablesObjectius de Desenvolupament Sostenible::12 - Producció i Consum Responsables::12.5 - Per a 2030, disminuir de manera substancial la generació de residus mitjançant polítiques de prevenció, reducció, reciclatge i reutilitzacióPostprint (published version

Characterization of Demolished Concretes with Three Different Strengths for Recycling as Coarse Aggregate

This paper presents a physical characterization for the recycling into new concretes of three comminuted concretes: C16/20 (“ordinary concrete”), C50/60 (“high strength concrete”), and C70/85 (“very high strength concrete”). The top size of the crushed concretes was 19.1 mm and the size range was 4.75 to 19.1 mm. The characterization was carried out with coarse aggregate liberation, to be prepared and concentrated in a gravity concentration process. The density distribution of the coarse aggregate, cement paste, and sand was carried out in different size ranges (4.75/19.1 mm; 4.75/8.0 mm; 8.0/12.5 mm; and 12.5/19.1 mm) for the three concretes studied. The form factor of the samples, as well as the porosity determination of particles in different density ranges, are presented. The obtained results indicate that the coarse aggregate liberation was more intensive for the low resistance concrete (C16/20), but a reasonable coarse aggregate recovery is possible for all concretes

Cesarean section and risk of obesity in childhood, adolescence, and early adulthood: evidence from 3 Brazilian birth cohorts123

Background: The number of cesarean sections (CSs) is increasing in many countries, and there are concerns about their short- and long-term effects. A recent Brazilian study showed a 58% higher prevalence of obesity in young adults born by CS than in young adults born vaginally. Because CS-born individuals do not make contact at birth with maternal vaginal and intestinal bacteria, the authors proposed that this could lead to long-term changes in the gut microbiota that could contribute to obesity

Nutritional status of pre-school children from low income families

<p>Abstract</p> <p>Background</p> <p>We evaluated growth and nutritional status of preschool children between 2 and 6 years old from low income families from 14 daycare centers.</p> <p>Methods</p> <p>Cross-sectional study with 1544 children from daycare centers of Santo Andre, Brazil. Body weight (W), height (H) and body mass index (BMI) were classified according to the 2000 National Center for Health Statistics (CDC/NCHS). Cutoff points for nutritional disorders: -2 z scores and 2.5 and 10 percentiles for malnutrition risk, 85 to 95 percentile for overweight and above BMI 95 percentile for obesity. Stepwise Forward Regression method was used including age, gender, birth weight, breastfeeding duration, age of mother at birth and period of time they attended the daycare center.</p> <p>Results</p> <p>Children presented mean z scores of H, W and BMI above the median of the CDC/NCHS reference. Girls were taller and heavier than boys, while we observed similar BMI between both genders. The z scores tended to rise with age. A Pearson Coefficient of Correlation of 0.89 for W, 0.93 for H and 0.95 for BMI was documented indicating positive association of age with weight, height and BMI. The frequency of children below -2 z scores was lower than expected: 1.5% for W, 1.75% for H and 0% for BMI, which suggests that there were no malnourished children. The other extremity of the distribution evidenced prevalence of overweight and obesity of 16.8% and 10.8%, respectively.</p> <p>Conclusion</p> <p>Low income preschool children are in an advanced stage of nutritional transition with a high prevalence of overweight.</p