Diversity of group A rotavirus genes detected in the Triângulo Mineiro region, Minas Gerais, Brazil

AbstractGroup A rotaviruses are the main causative agent of infantile gastroenteritis. The segmented nature of the viral genome allows reassortment of genome segments, which can generate genetic variants. In this study, we characterized the diversity of the VP7, VP4 (VP8*), VP6, NSP4, and NSP5 genes of the rotaviruses that circulated from 2005 to 2011 in the Triângulo Mineiro (TM) region of Brazil. Samples with genotypes G2 (sublineages IVa-1 and IVa-3), G1 (sublineage I-A), G9 (lineage III), G12 (lineages II and III), G8 (lineage II), G3 (lineage III), P[4] (sublineages IVa and IVb), P[8] (sublineages P[8]-3.6, P[8]-3.3, and P[8]-3.1), I2 (lineage VII), E2 (lineages VI, XII, and X), and H2 (lineage III) were identified. The associations found in the samples were G1, G9, or G12 with P[8]-I1-E1-H1; G2 or G8 with P[4]-I2-E2-H2; G12 with I3-E3-H6; and G3 with P[4]-I2-E3-H3 (previously unreported combination). Reassortment events in G2P[4] strains and an apparent pattern of temporal segregation within the lineages were observed. Five TM samples contained genes that exhibited high nucleotide and amino acid identities with strains of animal origin. The present study includes a period of pre- and post-introduction of rotavirus vaccination in all Brazilian territories, thereby serving as a basis for monitoring changes in the genetic constitution of rotaviruses. The results also contribute to the understanding of the diversity and evolution of rotaviruses in a global context

Temporal trend of inequality in risk factors for chronic non-communicable diseases among Brazilian adults from 2007 to 2016

Noncommunicable chronic diseases are one of the main causes of death in the world and in Brazil. Studies show that the distribution of both deaths and risk factors is unequal among different social levels, with greater burden on the poorest. In Brazil, although some social pol-icies have been implemented focusing on the most vulnerable groups, there is no evidence on the tendency of inequality for the main risk factors. This study aimed to evaluate the trend of social inequality for systemic arterial hypertension (SAH), diabetes mellitus (DM), smoking and obesity, from 2007 to 2016, based on three equity stratifiers: schooling, gender and skin color of the adult population living in Brazilian capitals. Data from 2007 to 2016 were used from the Survey of Risk Factors and Protection for Chronic Diseases by Telephone Survey conducted by the Ministry of Health of Brazil. Inequality was assessed using the slope index of inequality (SII) and the concentration index (CIX). The trend of inequality was estimated by the Prais-Winstern method. Analyzes were performed using STATA / SE® 12.1 software. The risk factors was concentrated in the least educated groups, since the SII and the CIX var-ied between 0 and -20. The inequality decreased for SAH in all analyzes, both by SII (9.8%) and by CIX (41.4%), except for whites and males according to SII, where there was no change. There was an increase in the inequality for DM (21.3%) analyzing the SII, while the CIX showed maintenance of the inequality concentration in the period, with reduction only in females (18.9%). For smoking, there was an increase in inequality according to the CIX (85.2%), except for males where inequality remained constant in the period. According to the SII, smoking inequality increased only among whites (235.7%). There was no change in ine-quality in relation to obesity. We concluded that in Brazil the risk factors for NCDs affect the poor most pronouncedly and that overall, over the last ten years, there has been a reduction in inequality only for SAH, an increase in DM and smoking and an maintenance for obesity. Further studies should explore the possible cause of the observed increased inequality in some of the risk factors analyzed in order to guide social policies and programs targeting the most vulnerable groups.Pesquisa sem auxílio de agências de fomentoDissertação (Mestrado)Doenças crônicas não transmissíveis são uma das principais causas de morte no mundo e no Brasil. Alguns estudos mostram que a distribuição tanto das mortes quanto dos fatores de risco se dá de forma desigual entre os diferentes níveis sociais, com maior carga sobre os mais pobres. No Brasil, embora algumas políticas sociais tenham sido implementadas com foco nos grupos mais vulneráveis, não se tem evidência sobre a tendência da desigualdade para os principais fatores de risco para as DNCT. Este estudo objetivou avaliar a tendência da desigualdade social para hipertensão arterial sistêmica (HAS), diabetes mellitus (DM), tabagismo e obesidade, no período de 2007 a 2016, com base em três estratificadores de equidade: escolaridade, sexo e cor da pele da população adulta residente nas capitais brasileiras. Utilizou-se os dados, entre os anos de 2007 a 2016, do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico realizado pelo Ministério da Saúde do Brasil. A desigualdade foi avaliada por meio do índice angular de inequidade (SII) e do índice de concentração (CIX). A tendência da desigualdade foi estimada pelo método de Prais-Winstern. As análises foram realizadas no software STATA/SE® 12.1. Os fatores de risco concentraram-se nos grupos de menor escolaridade, uma vez que o SII e o CIX, variaram entre 0 e -20. A desigualdade diminuiu para HAS em todas as análises, tanto pelo SII (9,8%), quanto pelo CIX (41,4%), exceto para brancos e para o sexo masculino, em que não houve mudança segundo o SII. Durante o período, houve aumento da desigualdade para DM (21,3%) analisando o SII e manutenção da concentração da desigualdade segundo o CIX, com redução apenas no sexo feminino (18,9%). Para o tabagismo, houve aumento da desigualdade de acordo com o CIX (85,2%), exceto para o sexo masculino em que a desigualdade se manteve constante, e aumento a da desigualdade de acordo com o SII apenas entre os brancos (235,7%). Não houve mudança na desigualdade em relação à obesidade. Concluiu-se que no Brasil os fatores de risco para as DCNT afetam mais pronunciadamente os mais pobres e que ao longo dos últimos dez anos, de um modo geral, houve redução na desigualdade somente para a HAS, aumento para o DM e tabagismo e manutenção para a obesidade. É importante que mais estudos sejam realizados a fim de elucidar a possível causa do aumento da desigualdade em alguns dos fatores de risco analisados para que as políticas e os programas sociais direcionados aos grupos mais vulneráveis possam atingir os resultados almejados

Changes in epidemiology of rotavirus in the Triângulo Mineiro region of Brazil: lack of two consecutive rotavirus seasons

Rotaviruses are the main cause of infantile acute diarrhea, and a monovalent (G1P[8]) vaccine against the virus was introduced into the Brazilian National Immunization Program for all infants in March 2006. The objectives of this study were to determine the rate and genotype distribution of rotavirus causing infantile diarrhea in the Triângulo Mineiro region of Brazil during 2011-2012 and to assess the impact of local vaccination. Fecal specimens were analyzed for detection and characterization of rotavirus using polyacrylamide gel electrophoresis, reverse transcription followed by polymerase chain reaction (PCR), and PCR-genotyping assays. Overall, rotavirus was diagnosed in 1.7% (6/348) of cases. Rotavirus positivity rates decreased 88% [95% confidence intervals (CI)=15.2, 98.3%; P=0.026] in 2011 and 78% (95%CI=30.6, 93.0%; P=0.007) in 2012 when compared with available data for baseline years (2005/2006) in Uberaba. In Uberlândia, reductions of 95.3% (95%CI=66.0, 99.4%; P=0.002) in 2011, and 94.2% (95%CI=56.4, 99.2%; P=0.004) in 2012 were also observed compared with data for 2008. The circulation of rotavirus G2P[4] strains decreased during the period under study, and strains related to the P[8] genotype reemerged in the region. This study showed a marked and sustained reduction of rotavirus-related cases, with a lack of rotavirus in the 2011 and 2012 seasons, suggesting a positive impact of the vaccination program

Analysis of bovine rotavirus strains circulating in diarrheic dairy calves in Uberaba, Minas Gerais, Brazil, during 2008-2009

RESUMO O objetivo deste estudo foi detectar rotavírus em fezes de bezerros com diarreia em Uberaba, MG, e caracterizar os genes VP7 e VP4 por meio da genotipagem e da análise filogenética. Setenta e quatro amostras foram coletadas entre novembro de 2008 e setembro de 2009. A detecção do vírus foi feita por teste de aglutinação e as amostras positivas foram submetidas à transcrição reversa, seguida de reação em cadeia da polimerase (RT-PCR), tipagem por PCR e sequenciamento. A taxa de detecção de rotavírus foi de 6,8% e todas as amostras apresentaram o genótipo G6P[5]. A análise filogenética mostrou que as amostras do genótipo G6 pertencem à linhagem IV e que, para ambos os genes (VP7 e VP4), as amostras deste estudo compõem um sub-cluster à parte daquele das cepas referências e das amostras campo mais similares. O alinhamento das sequências de aminoácidos deduzidas mostrou substituições em regiões antigênicas quando comparadas com as sequências das cepas bovinas UK e NCDV, presentes nas vacinas disponíveis no Brasil. Uma nova sublinhagem genética de G6P[5] foi evidenciada neste estudo. Substituições de aminoácidos nas regiões antigênicas dos rotavírus e a circulação de novas variantes podem representar desafios para as vacinas utilizadas atualmente. O presente estudo contribui para a compreensão da epidemiologia dos rotavírus bovinos no Brasil

Parametry biometryczne płodu: wykresy odniesienia dla nieselektywnej populacji ryzyka z Uberaby w Brazylii

Objective: To establish reference charts for fetal biometric parameters in a non-selected risk population from Uberaba, Southeast of Brazil. Methods: A retrospective cross-sectional study was performed among 5656 non-selected risk singleton pregnant women between 14 and 41 weeks of gestation. The ultrasound exams were performed during routine visits of second and third trimesters. Biparietal diameter (BPD) was measured at the level of the thalami and cavum septi pellucidi. Head circumference (HC) was calculated by the following formula: HC = 1.62*(BPD + occipital frontal diameter, OFD). Abdominal circumference (AC) was measured using the following formula: AC = (anteroposterior diameter + transverse abdominal diameter) × 1.57. Femur diaphysis length (FDL) was obtained in the longest axis of femur without including the distal femoral epiphysis. The estimated fetal weight (EFW) was obtained by the Hadlock formula. Polynomial regressions were performed to obtain the best-fit model for each fetal biometric parameter as the function of gestational age (GA). Results: The mean, standard deviations (SD), minimum and maximum of BPD (cm), HC (cm), AC (cm), FDL (cm) and EFW (g) were 6.9 ± 1.9 (2.3 – 10.5), 24.51 ± 6.61 (9.1 – 36.4), 22.8 ± 7.3 (7.5 – 41.1), 4.9 ± 1.6 (1.2 – 8.1) and 1365 ± 1019 (103 – 4777), respectively. Second-degree polynomial regressions between the evaluated parameters and GA resulted in the following formulas: BPD = –4.044 + 0.540 × GA – 0.0049 × GA² (R² = 0.97); HC= –15.420 + 2.024 GA – 0.0199 × GA² (R² = 0.98); AC = –9.579 + 1.329 × GA – 0.0055 × GA² (R² = 0.97); FDL = –3.778 + 0.416 × GA – 0.0035 × GA² (R² = 0.98) and EFW = 916 – 123 × GA + 4.70 × GA² (R² = 0.96); respectively. Conclusion: Reference charts for the fetal biometric parameters in a non-selected risk population from Uberaba, Southeast of Brazil, were established.Rozmiar płodu oraz trajektorie jego rozwoju są waż- nymi wskaźnikami zdrowia płodu, a najważniejszym standardem jest prenatalne badanie ultrasonograficzne. Zaburzenia rozwoju płodu zazwyczaj identyfikuje się na podstawie rozbieżności pomiędzy faktycznymi a oczekiwanymi miarami biometrycznymi dla określonego wieku ciążowego(1). Rutynowe badanie USG, bez opcji dopplerowskiej, w 3. trymestrze zwiększa stopień wykrywalności zarodków ma- łych jak na wiek ciążowy (small for gestational age, SGA) z 46 do 80% oraz zarodków dużych jak na wiek ciążowy (large for gestational age, LGA) z 36 do 91%, jak udowodniono w badaniach randomizowanych(2). W późnym 3. trymestrze (34.–37. tydzień) USG znacznie zwiększa stopień wykrywalności SGA i LGA (odpowiednio do 75,2% i 63,2%)(3). Krótkoterminowe wyniki płodu SGA i LGA kojarzone są z porażeniem mózgowym, hipoglikemią, hiperbilirubinemią, nadkrwistością lub dystocją(4,5). Wyniki długoterminowe u tych płodów kojarzone są z wysokim ryzykiem ciśnienia tętniczego, cukrzycy i choroby wieńcowej(6). Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/wydawnictwa/volume-17-no-6