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1.
Arq. bras. cardiol ; 93(4): 367-373, out. 2009. ilus, tab
Article in English, Portuguese | LILACS | ID: lil-531205

ABSTRACT

FUNDAMENTO: Considerando o alto número de pacientes infectados por HIV em uso de antirretrovirais, evoluindo com alteração da função endotelial e aterotrombose, levando ao alto custo médico social, é importante identificar mecanismos fisiopatológicos envolvidos com a função endotelial em portadores de HIV, para que, precocemente, possamos intervir e evitar a progressão da doença. OBJETIVO: Avaliar a função endotelial pela vasodilatação endotélio dependente e independente em pacientes HIV positivo e em grupo controle. MÉTODOS: O estudo avaliou 27 pacientes HIV positivo e 16 do grupo controle. A avaliação da função endotelial foi realizada por meio da vasodilatação da artéria braquial endotélio dependente (hiperemia reativa) e independente (nitroglicerina SL). RESULTADOS: Pacientes HIV positivo em uso de inibidor de protease (IP) apresentaram vasodilatação endotélio independente significativamente menor que os subgrupos HIV negativo (p = 0,020) e HIV positivo sem uso de IP (p = 0,034). A variação do diâmetro da artéria braquial durante hiperemia reativa não apresentou significância estatística em qualquer subgrupo. A análise de regressão linear múltipla mostrou que apenas o IP estava associado ao delta relativo da reatividade braquial pelo vasodilatador, nos pacientes HIV positivo, aos 60 e 90 segundos. CONCLUSÃO: Os pacientes HIV positivo em uso de IP apresentam disfunção endotélio independente quando comparados a pacientes HIV positivo que não fazem uso de IP e a um grupo controle.


BACKGROUND: A great number of HIV-infected patients using antiretroviral drugs develop endothelial dysfunction and atherothrombosis, which lead to a high medical and social burden. Thus, it is important to identify pathophysiological mechanisms involved with the endothelial function in these patients, so that early intervention can be made to avoid disease progression. OBJECTIVE: To evaluate endothelial function using endothelium-dependent and independent vasodilation in HIV-positive patients and in a control group. METHODS: A total of 27 HIV-positive patients and 16 controls were evaluated. Endothelium-dependent (reactive hyperemia) and independent (SL nitroglycerine) vasodilation of the brachial artery was used to evaluate the endothelial function. RESULTS: HIV-positive patients receiving protease inhibitors (PI) showed significantly lower endothelium-independent vasodilation than the HIV-negative (p=0.020) and HIV-positive without PI (p=0.034) subgroups. The change in brachial artery diameter during active hyperemia was not statistically significant in any subgroup. Multiple linear regression analysis showed that only PI was associated with the relative delta of brachial reactivity to vasodilator in HIV-positive patients at 60s and 90s. CONCLUSION: HIV-positive patients receiving PI presented endothelium-independent dysfunction when compared to HIV-positive patients not receiving PI and to the control group.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Brachial Artery/physiopathology , Endothelium, Vascular/drug effects , HIV Infections/drug therapy , HIV Infections/physiopathology , HIV Protease Inhibitors/therapeutic use , Brachial Artery/drug effects , Brachial Artery , Case-Control Studies , Endothelium, Vascular/physiopathology , Hyperemia/physiopathology , Nitroglycerin , Vasodilator Agents , Young Adult
2.
Rev. Soc. Bras. Med. Trop ; 36(2): 299-302, mar.-abr. 2003. graf
Article in English | LILACS | ID: lil-340908

ABSTRACT

Human parvovirus B19 replicates in erythrocyte precursors. Usually, there are no apparent hematological manifestations. However, in individuals with high erythrocyte turnover, as in patients with sickle-cell disease and in the fetus, the infection may lead to severe transient aplasia and hydrops fetalis, respectively. In AIDS patients, persistent infection may result in chronic anemia. By contrast, in HIV-positive patients without AIDS the infection evolves as a mild exanthematous disease. Two clinical descriptions exemplify these forms of presentation. In the first, an AIDS patient presented with bone marrow failure that responded to immunoglobulin. In the second, an HIV-positive patient without AIDS had a morbilliform rash, and needed no treatment. Knowing that an AIDS patient has chronic B19 anemia lessens concern about drug anemia; protects the patient from invasive diagnostic maneuvers; and prevents the patient from disseminating the infection. In AIDS patients with pure red cell aplasia, a search for parvovirus B19 DNA in the serum or in the bone marrow is warranted


Subject(s)
Adult , Humans , Male , Acquired Immunodeficiency Syndrome/complications , Erythema Infectiosum/diagnosis , Chronic Disease , Erythema Infectiosum/complications , Immunocompromised Host
3.
Radiol. bras ; 29(3): 167-71, maio-jun. 1996. ilus
Article in Portuguese | LILACS | ID: lil-180042

ABSTRACT

Caso de linfoma cerebral em paciente com a síndrome da imunodeficiência adquirida. Tratava-se de um homem de 43 anos de idade, cujos primeiros sintomas foram febre persistente e crises convulsivas. Os exames do crânio (tomografia computadorizada e ressonância magnética) evidenciaram lesäo única no lobo occipital, com halo de edema e impregnaçäo em anel pelo meio de contraste, semelhante à lesäo por toxoplasmose. O diagnóstico histopatológico foi de linfoma näo-Hodgkin. O paciente foi tratado com ressecçäo do tumor e radioterapia e evoluiu para o óbito cerca de um ano após o diagnóstico


Subject(s)
Humans , Male , Adult , Lymphoma, Non-Hodgkin/radiotherapy , Lymphoma, AIDS-Related
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