Transitions of cardio-metabolic risk factors in the Americas between 1980 and 2014

Describing the prevalence and trends of cardiometabolic risk factors that are associated with non-communicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

A century of trends in adult human height

Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3-19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8-144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries

Tuberculose em doentes com Sida. Tratamento completo sob observação directa## Projecto de investigação subsidiado pela Comissão Nacional de Luta Contra a SIDA

RESUMO: A co-infecção VIH-tuberculose tem um enorme impacto em termos de saúde pública. A deficiente adesão ao tratamento antibacilar, particularmente em toxicodependentes infectados por VIH, contribui para a elevada morbilidade e mortalidade registadas e, bem assim, para o recrudescimento da multirresistência da bacilo da tuberculose e para a sua disseminação na comunidade.Tendo em conta resultados obtidos em doentes observados entre 1986 e 1997, os autores iniciaram um projecto de investigação cujo objectivo principal era o de melhorar a adesão à terapêutica da tuberculose em toxicodependentes infectados por VIH. Esse projecto, que teve a duração de dois anos, previa que todos os doentes tomassem, sob observação directa, a terapêutica antibacilar conjuntamente com metadona.Apresentam-se os resultados desse trabalho, salientando-se que a comparação estatística de diferentes parâmetros observados nos doentes de 1986-97 e nos doentes envolvidos neste projecto, apontam para a prossecução desta metodologia e para a sua generalização.REV PORT PNEUMOL 2001; VII (3): SUMMARY: HIV and tuberculosis co-infection has an enormous impact on public health. Inadequate patient compliance for tuberculosis therapy, especially in intravenous drug-abusers (IVDA), has contributed to increased mortality and morbidity rates, as well as a renewed activity of multi-resistant tuberculosis and its dissemination in the community.Taken into consideration results obtained between 1986 and 1997, the authors´ main objective was to initiate a program whose main purpose was to improve patient compliance in HIV-positive IVDA undergoing treatment for tuberculosis. This two-year program stipulated a daily directly observed tuberculosis treatment in conjunction with methadone.Through various observed parameters, we present the results obtained in this study, and hope to point out that the comparison of the results registered in the patients treated between 1986-97 and those of the present study, suggest a continuation of these methodologies and their general usage.REV PORT PNEUMOL 2001; VII (3)

Cryptococcosis: a review of the brazilian experience for the disease Criptococose: revisão sobre a experiência brasileira sobre a doença

Cryptococcosis is a systemic mycosis caused by Cryptococcus neoformans. The disease occurs in patients with cellular immunodeficiency. The incidence of cryptococcosis arises with aids, and mycosis is one of the opportunistic infections that defines AIDS. After the HAART era the occurrence of cryptococcosis decreased all over the world, but it still continues to be a prevalent disease in Brazil. Thus, we consider this paper to be very important as a result of our reviewing of Brazilian literature regarding some relevant aspects of that disease.<br>Criptococose é micose sistêmica causada por Cryptococcus neoformans. A doença ocorre em pacientes com deficiência da imunidade celular. Com o aparecimento da doença AIDS, a incidência de criptococose aumentou, e a micose é uma das infecções oportunistas que definem um caso de AIDS. Após a era HAART, criptococose parece estar diminuindo no mundo todo, mas continua sendo uma doença prevalente no Brasil. Este artigo visa a análise da contribuição dos autores brasileiros sobre vários aspectos da doença

Genome-wide association analyses of physical activity and sedentary behavior provide insights into underlying mechanisms and roles in disease prevention.

Although physical activity and sedentary behavior are moderately heritable, little is known about the mechanisms that influence these traits. Combining data for up to 703,901 individuals from 51 studies in a multi-ancestry meta-analysis of genome-wide association studies yields 99 loci that associate with self-reported moderate-to-vigorous intensity physical activity during leisure time (MVPA), leisure screen time (LST) and/or sedentary behavior at work. Loci associated with LST are enriched for genes whose expression in skeletal muscle is altered by resistance training. A missense variant in ACTN3 makes the alpha-actinin-3 filaments more flexible, resulting in lower maximal force in isolated type II &lt;sub&gt;A&lt;/sub&gt; muscle fibers, and possibly protection from exercise-induced muscle damage. Finally, Mendelian randomization analyses show that beneficial effects of lower LST and higher MVPA on several risk factors and diseases are mediated or confounded by body mass index (BMI). Our results provide insights into physical activity mechanisms and its role in disease prevention

Genome-wide association analyses of physical activity and sedentary behavior provide insights into underlying mechanisms and roles in disease prevention.

Although physical activity and sedentary behavior are moderately heritable, little is known about the mechanisms that influence these traits. Combining data for up to 703,901 individuals from 51 studies in a multi-ancestry meta-analysis of genome-wide association studies yields 99 loci that associate with self-reported moderate-to-vigorous intensity physical activity during leisure time (MVPA), leisure screen time (LST) and/or sedentary behavior at work. Loci associated with LST are enriched for genes whose expression in skeletal muscle is altered by resistance training. A missense variant in ACTN3 makes the alpha-actinin-3 filaments more flexible, resulting in lower maximal force in isolated type IIA muscle fibers, and possibly protection from exercise-induced muscle damage. Finally, Mendelian randomization analyses show that beneficial effects of lower LST and higher MVPA on several risk factors and diseases are mediated or confounded by body mass index (BMI). Our results provide insights into physical activity mechanisms and its role in disease prevention