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An explosive epidemic of DENV-3 in 2002 was the most severe dengue epidemic reported in Brazil since dengue viruses were introduced.

RESUMOObjetivo: Determinar a prevalência de diabetes mellitus (DM) e fatores de risco em adultos, em Campos dos Goytacazes. Métodos: Estudo transversal, de base populacional, com amostragem por conglomerados, estratificada pelo nível sócio-econômico. Foram realizadas duas visitas a 1039 indivíduos, com aplicação de questionário, avaliação da pressão arterial, medidas antropométricas e coleta de amostra de sangue em jejum para análise da glicose, triglicerídeos, colesterol, HDLc e LDL-c. Resultados: A prevalência ajustada pela idade foi de 6,0%. Homens (6,3%) e mulheres (5,7%) tiveram resultados semelhantes, assim como brancos (5,9%) e não brancos (6,3%). A prevalência de DM foi maior em pessoas com história familiar da doença (p<0,001). A prevalência de DM aumentou de 2,1% na faixa de 18-29 anos para 18,3% nos pacientes acima de 70 anos de idade (p<0,001). O DM foi mais prevalente entre os pacientes portadores de hipertensão arterial, dislipidemia e excesso de peso (p<0,001 Objective: To determine the prevalence of diabetes mellitus (DM) and risk factors in adults of Campos dos Goytacazes, RJ. Methods: A crosssectional study of a populational basis was performed, with sample conglomerates stratified by social and economical levels. Two visits were performed to 1039 individuals, with application of a questionnaire, evaluation of the arterial blood pressure, anthropometric measurements and collection of fasting blood for glucose, triglycerides, cholesterol, HDL-c and LDL-c. Results: The age-adjusted prevalence was 6.0%. Men (6.3%) and women (5.7%) had similar results, as well white (5.9%) and non-white (6.3%). The prevalence of DM was higher in people with family history of the disease (p<0.001). The prevalence of DM increased from 2.1% in people with 18-29 years to 18.3% in those with more than 70 years of age (p<0.001). DM was more prevalent among patients with arterial hypertension, dyslipidemia and weight excess (p<0.001). Conclusions: The results are similar to prevalence numbers in other regions of Brazil. Thus, we realize the great importance of DM on public health context as a chronic and non-transmissible disease. (Arq Bras Endocrinol Metab 2003;47/1:69-74)

BackgroundDengue displays a broad spectrum of clinical manifestations that may vary from asymptomatic to severe and even fatal features. Plasma leakage/hemorrhages can be caused by a cytokine storm induced by monocytes and dendritic cells during dengue virus (DENV) replication. Plasmacytoid dendritic cells (pDCs) are innate immune cells and in response to virus exposure secrete IFN-α and express membrane TRAIL (mTRAIL). We aimed to characterize pDC activation in dengue patients and their function under DENV-2 stimulation in vitro.Methods & FindingsFlow cytometry analysis (FCA) revealed that pDCs of mild dengue patients exhibit significantly higher frequencies of mTRAIL compared to severe cases or healthy controls. Plasma levels of IFN-α and soluble TRAIL are increased in mild compared to severe dengue patients, positively correlating with pDC activation. FCA experiments showed that in vitro exposure to DENV-2 induced mTRAIL expression on pDC. Furthermore, three dimension microscopy highlighted that TRAIL was relocalized from intracellular compartment to plasma membrane. Chloroquine treatment inhibited DENV-2-induced mTRAIL relocalization and IFN-α production by pDC. Endosomal viral degradation blockade by chloroquine allowed viral antigens detection inside pDCs. All those data are in favor of endocytosis pathway activation by DENV-2 in pDC. Coculture of pDC/DENV-2-infected monocytes revealed a dramatic decrease of antigen detection by FCA. This viral antigens reduction in monocytes was also observed after exogenous IFN-α treatment. Thus, pDC effect on viral load reduction was mainly dependent on IFN-α productionConclusionsThis investigation characterizes, during DENV-2 infection, activation of pDCs in vivo and their antiviral role in vitro. Thus, we propose TRAIL-expressing pDCs may have an important role in the outcome of disease.

The objective of this study was to evaluate the impact of dengue virus infection on liver function by measuring aminotransferase in blood samples from patients serologically diagnosed by according to two MAC-ELISA protocols. Degrees of liver damage were classified according to aminotransferase levels: grade A -normal enzyme levels; grade B -increased levels of at least one of the enzymes; grade C -increased, with at least one of the enzymes being at levels higher than three times the upper reference values; grade D -acute hepatitis, with aminotransferase levels at least ten times their normal values. Of the 169 serologically confirmed cases of dengue at the dengue referral center in Campos dos Goytacazes in the state of Rio de Janeiro, Brazil, 65.1% had abnormal aminotransferase levels: 81 cases being classified as grade B, 25 as grade C and 3 as grade D. A further 34.9% of cases had normal enzyme levels and were classified as grade A. Liver damage is a common complication of dengue infection and aminotransferase levels are a valuable marker for monitoring these cases.

RESUMOObjetivos: Determinar a prevalência de obesidade e sua associação com hipertensão arterial sistêmica (HAS), dislipidemias (DL), diabetes mellitus (DM) e outros fatores de risco cardiovascular. Casuística e Méto-dos: Estudo de delineamento transversal de 1039 adultos ≥18anos da região urbana, amostragem aleatória em estágios múltiplos e conglomerados. Os dados foram obtidos no domicílio, através de questionário, avaliação clínica e coleta de sangue para análise laboratorial. Resultados: A prevalência de obesidade (IMC ≥30kg/m 2 ) foi de 17,8% (IC 95% 15,5-20,1), enquanto que a obesidade abdominal (CA >102cm e >88cm para homens e mulheres, respectivamente) esteve presente em 35,1% (IC 95% 32,2-38) dos entrevistados. A obesidade foi mais freqüente entre as mulheres -20,2% do que entre os homens -15,2% (p= 0,01) e apresentou associação positiva com a idade (p= 0,05), sedentarismo (p= 0,02), HAS (p< 0,001) e DL (p= 0,005). Nos pacientes com e sem excesso de gordura abdominal as freqüências de HAS, DM e DL foram respectivamente de: 57,7% / 32,0% (p< 0,001), 11,8% / 6,4% (p= 0,03) e 32,2% / 24,1% (p= 0,005). Conclusões: A obesidade foi mais freqüente entre as mulheres e aumentou com o avançar da idade. Os indivíduos com obesidade e/ou excesso de gordura abdominal apresentaram maior prevalência de HAS, DM e DL em relação aos pacientes eutrófi-cos. Cross-sectional study of 1039 adults ≥18 years from an urban region, randomly selected in conglomerates and in a multiple stage process. Data were obtained in the household through a questionnaire, clinical evaluation and blood sampling for laboratory analysis. Results: The overall prevalence of obesity (BMI ≥30kg/m 2 ) was 17.8% (CI 95% 15.5-20.1), while abdominal obesity (AC >102cm and >88cm for men and women, respectively) was present in 35.1% (CI 95% 32.2-38) of the interviewees. Overall obesity was more common among women (20.2%) than men (15.2%) (p= 0.01), with a positive association with age (p= 0.05), sedentarism (p= 0.02), SAH (p< 0.001) and DL (p= 0.005). Among the patients with and without excess abdominal fat, the SAH, DM and DL rates were respectively of: 57.7% / 32.0% (p< 0.001), 11.8% / 6.4% (p= 0.03) and 32.2% / 24.1% (p= 0.005). Conclusions: Overall obesity was more common among women and it increased with age. Individuals with obesity and/or excess abdominal fat presented a greater prevalence of SAH, DM and DL, as compared to healthy individuals.

In Brazil, an epidemic of Zika virus (ZIKV) infections was declared in 2015 that coincided with alarming reports of microcephaly in newborns associated with mother infection. Although the virus has placental tropism, changes in the tissue morphology and immunity of infected patients have not yet been elucidated. Here, we investigated the histopathological and ultrastructural changes along with the immunological profile and the BDNF expression in rare placental material. Tissues were obtained in the 2015–2016 Brazilian epidemic, of ten ZIKV-infected patients during pregnancy, five resulting in cases of fetal microcephaly and five non-microcephaly, compared to five non-infected control placentae. Viral antigens were only detected in samples from the ZIKV infected patients. Infected placentae presented histopathological severe damage, while the ultrastructural evaluation showed abnormal organelles, such as clusters of virus-like particles consistent with the ZIKV dimensions. Increased infiltration of CD68 + and TCD8 + cells, expression of MMPs, cytokines (IFN-γ and TNF-α) and other immunological mediators (RANTES/CCL5 and VEGFR-2) confirmed excessive inflammation and vascular permeability dysfunction. An evaluation of BDNF showed a decrease that could modulate neuronal damage in the developing fetus. The placental changes caused by ZIKV are not pathognomonic, however, the data provide evidence that this infection leads to severe placental injury.

OBJECTIVE: To determine the prevalence of dyslipidemias in adults in the city of Campos dos Goytacazes, in the Brazilian state of Rio de Janeiro, and to identify its relation to risk factors. METHODS: Cross-sectional, population-based, observational study with sampling through conglomerates and stratified according to socioeconomic levels, sex, and age, with 1,039 individuals. Risk factors, familial history, blood pressure, anthropometric measurements, glucose, triglycerides and cholesterol were determined. RESULTS: The following prevalences were observed: of dyslipidemias 24.2%; of hypercholesterolemia, 4.2%; of elevated LDL-C, 3.5%; of low HDL-C, 18.3%; and of hypertriglyceridemia, 17.1%. The following mean levels were observed: cholesterol, 187.6± 33.7 mg/dL; LDL-C, 108.7±26.8 mg/dL; HDL-C, 48.5±7.7 mg/dL; and triglycerides, 150.1±109.8 mg/dL. The following variables showed a positive correlation with dyslipidemia: increased age (P<0.001), male sex (P<0.001), low familial income (P<0.001), familial history (P<0.01), overweight/obesity (P<0.001), waist measure (P<0.001), high blood pressure (P<0.001), and diabetes mellitus (P<0.001). The following variables had no influence on dyslipidemias: ethnicity, educational level, smoking habits, and sedentary lifestyle. CONCLUSION: The frequency of lipid changes in the population studied was high, suggesting that measures for the early diagnosis should be taken, in association with implementation of programs for primary and secondary prevention of atherosclerosis