ABSTRACT Objective The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul. Methods Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question. Results The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Conclusion To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.

ABSTRACT Polymyxin antibiotics are disfavored owing to their potential clinical toxicity, especially nephrotoxicity. However, the dry antibiotic development pipeline, together with the increasing global prevalence of infections caused by multidrug-resistant (MDR) gram-negative bacteria, have renewed clinical interest in these polypeptide antibiotics. This review highlights the current information regarding the mechanisms of resistance to polymyxins and their molecular epidemiology. Knowledge of the resistance mechanisms and epidemiology of these pathogens is critical for the development of novel antibacterial agents and rapid treatment choices.

ABSTRACT Pseudomonas aeruginosa is one of the most common bacterium with a broad spectrum of human-associated infections. It is intrinsically resistant to many antimicrobial drugs, making carbapenems crucial in clinical management. The emergence and dissemination of carbapenemases among P. aeruginosa clinical isolates is a serious public health concern as it limits the options for the treatment of bacterial infections. Here, we described the molecular and epidemiological characteristics of 28 carbapenem-resistant P. aeruginosa strains isolated from patients hospitalized in an intensive care unit (ICU). The antimicrobial susceptibility of carbapenem-resistant P. aeruginosa strains was determined by broth microdilution. The presence of resistance genes was evaluated by PCR and DNA sequencing. Additionally, alterations in genes encoding P. aeruginosa outer membrane proteins were analyzed by PCR as well as SDS-PAGE. Clinical characteristics of the patients and the economic impact of hospitalization on the public health system were evaluated. PCR amplification showed that the blaKPC-2 and blaTEM genes were identified in three isolates (11%) and blaSHV gene in two isolates (7%). Outer membrane profiles obtained by SDS–PAGE indicated that the OprD porin was either absent or was produced at very low levels. A PCR assay using oprD-specific primers failed to show the presence of mutations in this gene. P. aeruginosa strains were isolated from 28 patients, among whom 43% (12/28) had sepsis, 31% (9/28) had respiratory failure, and 31% (9/28) had systemic arterial hypertension. A high mortality rate (39%) was observed in these patients, with an average duration of hospitalization of 34.6 days and a median cost of 3.275 dollars per patient. The production of carbapenemase was not the main mechanism of resistance in these strains. All carbapenem-resistant P. aeruginosa were isolated from patients hospitalized in the ICU. Besides the high mortality rate, many patients remained hospitalized for several days, resulting in a high cost of hospitalization for the public health system. Therefore, the evolution of this resistance and its dissemination should be actively monitored among critically ill patients to improve their health conditions.

Resumo Objetivo Identificar características clínicas, microscópicas e bioquímicas que diferenciam a vaginose citolítica (VC) da candidíase vulvovaginal (CVV). Métodos O presente estudo de corte transversal analisou o conteúdo vaginal de 24 mulheres não grávidas, com idades entre 18 e 42 anos, atendidas no ambulatório de Infecções Genitais do Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas (CAISM-UNICAMP). Elas foram diagnosticadas com (CV = 8, CVV = 8) ou sem vulvovaginite ou disbiose vaginal (controles = 8). Os dados sociodemográficos, clínicos e ginecológicos foram obtidos em uma entrevista detalhada do paciente. Amostras do conteúdo vaginal foram coletadas para análise do pH vaginal, coloração de Gram e cultura específica de fungos. Os testes exatos de Kruskal-Wallis e Fisher foram utilizados para comparar as diferenças entre os grupos. A razão de chances foi utilizada para comparar as variáveis categóricas. O nível de significância considerado foi de p < 0,05. Resultados As mulheres com VC e CVV apresentaram corrimento vaginal irregular (p = 0,002) e hiperemia vaginal (p = 0,001), em comparação aos controles. O processo inflamatório foi mais intenso no grupo CVV (p = 0,001). No grupo VC, houve significância estatística para a quantidade de lactobacilos (p = 0,006), lise do epitélio vaginal (p = 0,001) e pH vaginal (p = 0,0002). Conclusão Os diagnósticos de VC e CVV raramente diferem nas características clínicas, mas apresentam achados laboratoriais diferentes. O presente estudo destaca a importância de conduzir uma investigação precisa por meio de testes laboratoriais, em vez de critérios apenas clínicos, a fim de evitar erros de diagnóstico.

Abstract Objective To identify clinical, microscopic, and biochemical characteristics that differentiate cytolytic vaginosis (CV) from vulvovaginal candidiasis (VVC). Methods The present cross-sectional study analyzed the vaginal contents of 24 non-pregnant women aged 18 to 42 years who were attended at the Genital Infections Clinic at Centro de Atenção Integral à Saúde da Mulher da Universidade Estadual de Campinas (CAISM-UNICAMP). They were diagnosed either with (CV = 8, VVC = 8) or without vulvovaginitis or vaginal dysbiosis (controls). The socio-demographic, clinical, and gynecological data were obtained from a detailed patient interview. Samples of the vaginal contents were collected for analysis of vaginal pH, gram stain, and specific fungal culture. The Kruskal-Wallis and Fisher exact tests were used to compare the differences between the groups. Odds ratios were used to compare the categorical variables. The significance level was considered at p < 0.05. Results Both women with CV and VVC had a lumpy vaginal discharge (p = 0,002) and vaginal hyperemia (p = 0.001), compared with controls. The inflammatory process was more intense in the VVC group (p = 0.001). In the CV group, there was statistical significance for the lactobacillus amount (p = 0.006), vaginal epithelium lysis (p = 0.001), and vaginal pH (p = 0.0002). Conclusion Cytolytic vaginosis and VVC diagnoses rarely differ on clinical characteristics but have different laboratorial findings. The present study highlights the importance of conducting an accurate investigation through laboratory tests rather than clinical criteria to avoid misdiagnosis.

O presente estudo identificou a prevalência e os fatores associados à prática de ginástica laboral por trabalhadores da indústria no Estado do Rio Grande do Sul, Brasil. Realizou-se análise secundária dos dados de um estudo de delineamento transversal, com amostra probabilística de 2.265 trabalhadores, de ambos os sexos. O instrumento de pesquisa foi o questionário autoadministrado "Estilo de vida e hábitos de lazer dos trabalhadores das indústrias brasileiras", previamente validado. A variável dependente foi a prática de ginástica laboral, definida pela resposta positiva à questão: "Você participa do programa de ginástica na empresa (ginástica laboral)?". Foram coletadas informações demográficas, socioeconômicas, comportamentais e relacionadas à saúde, como potenciais fatores associados. Na análise de dados, empregou-se o teste Qui-quadrado de Pearson e o modelo de regressão de Poisson com variância robusta, nas análises bruta e ajustada, respectivamente. A prática de ginástica laboral foi referida por 40,3% dos respondentes (IC95%: 38,2; 42,3), sendo mais prevalente nos trabalhadores do sexo feminino, com maiores níveis de escolaridade, naqueles mais ativos no lazer e que relatavam menores intensidades de esforço no trabalho. Não se observou associação da variável dependente com idade, estado civil, renda familiar bruta, tabagismo, autopercepção de saúde e autopercepção do nível de estresse. Programas de ginástica laboral devem desenvolver estratégias de promoção da saúde que priorizem subgrupos de trabalhadores menos envolvidos, em especial, indivíduos do sexo masculino e com menor escolaridade. Desse modo, será possível reduzir as disparidades, beneficiando trabalhadores, independentemente de suas características sociodemográficas, a melhores condições saúde e bem-estar no ambiente das indústrias.

We evaluated the prevalence and factors associated with participation on stretching programs in the workplace among industrial workers in the State of Rio Grande do Sul, Brazil. A cross-sectional study was developed with a probabilistic sample of 2.265 workers of both sexes. We used the questionnaire "Lifestyle and Leisure Habits of Industry Workers", previously validated and used in studies with adults. The participation on stretching programs in the workplace was the outcome defined by the positive response to the question: "Have you been enjoying the stretching program at your company?". Other variables included demographic, socioeconomic, health-related behaviors, work-related behaviors, and personal perception indicators. For the analysis of the data we used the statistical program Stata, version 9.0 (Stata Corporation, College Station, USA), including procedures for descriptive statistics, CI95%, mean and standard deviation, and analytical statistics, with unadjusted and adjusted analysis. The prevalence of the participation on stretching programs was 40.3% (CI95%: 38.2, 42.3), associated with being women, higher educational levels, practice of leisure-time physical activity, and lower intensities of physical demands on the job. Being women and higher levels of education were the factors most strongly associated with the occurrence of such behavior. No significant differences were found considering age, marital status, family income, smoking, perceived health status and perceived level of stress. Thus, the exercise breaks on stretching programs should follow strategies for health promotion, with focus on male workers, those with less education, physically inactive during leisure time, and those that engage in strenuous activities at work, so that better working conditions, health and wellness are reached.p.

A depressão é considerada o problema de saúde mental mais comum na população idosa. Estudos têm demonstrado que a prática regular de atividades físicas pode reduzir os sintomas depressivos em idosos, proporcionando efeitos clínicos imediatos. Neste contexto, o objetivo deste estudo foi verificar a associação entre a presença de sintomas depressivos e o Índice de Aptidão Funcional Geral (IAFG) em idosos praticantes de exercícios físicos. Aplicou-se a Escala de Depressão Geriátrica de Yesavage (GDS-15) para verificar a presença de sintomas depressivos e a bateria de testes físicos da AAHPERD (American Alliance for Health, Physical Education, Recreation and Dance), para obter o IAFG. Utilizaram-se a estatística descritiva e a correlação de Pearson, com nível de 95% de confiança. A população foi composta por 146 idosos, participantes do Programa Floripa Ativa - Fase B, sendo a amostra constituída de 77 idosos com média de 67,9 (DP 5,7) anos de idade. Dentre os avaliados, 13 apresentaram sintomas de depressão e 33 se enquadraram com IAFG regular. Encontrou-se uma correlação negativa (r= -0,307) e significante (p=0,007) entre o IAFG e a GDS. Esse fato demonstra uma relação inversamente proporcional, ou seja, idosos com melhor IAFG apresentaram menor incidência de sintomas depressivos. Considerando que o valor do IAFG é obtido por meio de testes físicos, sugere-se que, para o grupo estudado, a prática de exercícios físicos pode ter contribuído para atenuar os sintomas depressivos.

Depression is considered the most common mental health disorder in older adults. Studies have shown that physical activity can reduce depressive symptoms in this population with immediate clinical effects. The objective of this study was to analyze the association between symptoms of depression and General Functional Fitness Index (GFFI) in elderly physical exercise practitioners. The Geriatric Depression Scale of Yesavage (GDS-15) was used to evaluate the presence of depressive symptoms, and the AAHPERD (American Alliance for Health, Physical Education, Recreation and Dance) fitness test battery for assessment of GFFI. We used descriptive statistics and Pearson correlation with 95% confidence intervals. The population consisted of 146 elderly participants of the Floripa Ativa Program - Phase B, with the sample consisting of 77 older adults with a mean age of 67.9 (SD 5.7) years. Among them, 13 exhibited symptoms of depression and 33 were fit, with the GFFI within normal range. We found a negative (r = -0.307) and significant (p = 0.007) correlation between GDS and GFFI. This inversely proportional relationship demonstrates that subjects with a better GFFI had a lower incidence of depressive symptoms. As the GFFI value is obtained through physical tests, it can be suggested that physical exercise supported the reduction of depressive symptoms in the study group.

Este estudo tem por objetivo verificar a correlação entre o tempo de reação e o estado cognitivo de idosas praticantes de atividades físicas. Foram avaliadas 77 idosas (68,6 ± 3,9 anos), participantes de um programa estruturado de atividade física. Os testes de Tempo de Reação Simples e Tempo de Reação de Escolha foram avaliados por meio de um software e para avaliação cognitiva utilizou-se o Mini-Exame do Estado Mental. Os dados foram analisados no Pacote Estatístico SPSS, versão 16.0, com nível de significância de p< 0,05 e diante da não normalidade dos dados, empregou-se a correlação de Spearman. Os resultados observados nos testes representaram um desempenho satisfatório na pontuação do Mini-Exame do Estado Mental, enquanto que para o tempo de reação os resultados foram insatisfatórios. A correlação entre as variáveis tempo de reação simples e o estado cognitivo foi considerada significativa e fraca, pois se esperava que com bons resultados no estado cognitivo e também pela prática de atividades físicas as idosas apresentassem um tempo de reação menor. Diante das informações observadas e considerando as evidências de que o exercício físico auxilia na eficiência do processamento de informações pelo sistema nervoso central, sugere-se que seja incentivada, além da prática regular de atividades físicas, intervenções motoras e cognitivas que estimulem a plasticidade do sistema nervoso central contribuindo para a melhora da funcionalidade da população idosa.

The objective of this study was to investigate the correlation between reaction time and cognitive state of elderly women that are engaged in physical activities. We evaluated 77 elderly women (68.6 ± 3.9 years) that were participating in a structured program of physical activity. The Simple Reaction Time and Choice Reaction Time tests were evaluated by software tool and to the cognitive estimation; we used the Mini-Mental State Examination. The results were analyzed with the SPSS package, version 16.0, with a significance level of p <0.05 and before the non-normality of the data, Spearman correlation was chosen. The results observed in the tests represented a satisfactory score on the Mini-Mental State Examination, while for the reaction time the results were unsatisfactory. The correlation between the simple reaction time and cognitive state were considered significant and weak, it was hoped that with good results in cognitive state and by participating in physical activity, the women could show a shorter reaction time. Based on the information observed and considering the evidence that physical exercise helps in the efficiency of information processing by the central nervous system, it suggests, besides the practice of regular physical activity, motor and cognitive interventions that stimulate the plasticity of nervous system central should be promoted, with the purpose of contributing to the improved functionality of the elderly population.