ABSTRACT
OBJETIVO: Descrever as impressões, experiências, conhecimentos, crenças e a receptividade de usuários de drogas injetáveis para participar das estratégias de testagem rápida para HIV. MÉTODOS: Estudo qualitativo exploratório foi conduzido entre usuários de drogas injetáveis, de dezembro de 2003 a fevereiro de 2004, em cinco cidades brasileiras, localizadas em quatro regiões do País. Um roteiro de entrevista semi-estruturado contendo questões fechadas e abertas foi usado para avaliar percepções desses usuários sobre procedimentos e formas alternativas de acesso e testagem. Foram realizadas 106 entrevistas, aproximadamente 26 por região. RESULTADOS: Características da população estudada, opiniões sobre o teste rápido e preferências por usar amostras de sangue ou saliva foram apresentadas junto com as vantagens e desvantagens associadas a cada opção. Os resultados mostraram a viabilidade do uso de testes rápidos entre usuários de drogas injetáveis e o interesse deles quanto à utilização destes métodos, especialmente se puderem ser equacionadas questões relacionadas à confidencialidade e confiabilidade dos testes. CONCLUSÕES: Os resultados indicam que os testes rápidos para HIV seriam bem recebidos por essa população. Esses testes podem ser considerados uma ferramenta valiosa, ao permitir que mais usuários de drogas injetáveis conheçam sua sorologia para o HIV e possam ser referidos para tratamento, como subsidiar a melhoria das estratégias de testagem entre usuários de drogas injetáveis.
OBJECTIVE: To describe perceptions, experiences, knowledge, beliefs and the willingness of injecting drug users to be HIV tested by using rapid tests. METHODS: A qualitative exploratory study was carried out among injecting drug users from December 2003 to February 2004 in five Brazilian cities, located in four regions of Brazil. A semi-structured interview guide containing both closed and open-ended questions was used to address perceptions about non-conventional testing procedures, and non-traditional ways to provide testing access to injecting drug users. A total of 106 interviews, about 26 per region, were conducted. RESULTS: Characteristics of the population studied, common thoughts about HIV rapid testing, preference for using blood or saliva specimens, and other testing preferences, were presented together with reported advantages and disadvantages of each option. The study findings showed that the use of rapid tests among these users is feasible and that they are willing to be tested using rapid HIV tests, especially if some issues related to privacy and reliability of the test could be addressed. CONCLUSIONS: The study findings showed that rapid tests may be well accepted for this population. These tests can be considered a valuable tool, allowing a more injecting drug users to learn their HIV status and possibly be referred to treatment and should support more effective testing strategies for them.
Subject(s)
Substance Abuse, Intravenous , AIDS Serodiagnosis , Acquired Immunodeficiency Syndrome/diagnosis , Diagnostic Techniques and Procedures , Disaster Vulnerability , Brazil , Qualitative ResearchABSTRACT
Interactions between immunocompetent cells require the participation of T cell antigen receptor (TCR) and the integrin lymphocyte function-associated molecule-1 (LFA-1, CD11a/CD18). These interactions are mediated by interlinking cytokines, which are important in determining the type of immune response. In the present study, we have shown that in American cutaneous leishmaniasis (ACL) lesions, most infiltrating T cells expressed the alpha beta TCR including those selectively migrating to the epidermis. In contrast, gamma delta T cells were abundant in localized (LCL) and scarce in muco-cutaneous (MCL) and diffuse (DCL) cutaneous leishmaniasis, suggesting a role in effective granulomas. There were differences in the expression of LFA-1 alpha and beta subunits, with most cells expressing LFA-1 beta. The ratio LFA-1 beta/LFA-1 alpha was higher in LCL (11.8:1) than in MCL (3.3:1) and DCL (2.4:1). Similar results were observed in Leishmania mexicana-infected C57BL/6 mice. DCL lesions showed a higher proportion of LFA-1 alpha+ cells than MCL and LCL lesions. A reverse-transcriptase polymerase chain reaction (RT-PCR) analysis of the cytokine profiles showed that most T cells present in the MCL and DCL lesions secrete a mixture of Type 1 and Type 2 cytokine patterns, but in DCL granulomas predominate the Type 2 cytokines. In LCL the cytokine patterns show a preponderance of INF gamma over IL-4, and low levels of IL-5 and IL-10, suggesting a Type 1 cytokine profile
Subject(s)
Animals , Female , Humans , Mice , Leishmaniasis, Cutaneous/immunology , Lymphokines/biosynthesis , Skin/immunology , T-Lymphocyte Subsets/immunology , Antibodies, Monoclonal , Cell Adhesion Molecules/biosynthesis , Granuloma/immunology , Leishmaniasis, Diffuse Cutaneous/immunology , Leishmaniasis, Mucocutaneous/immunology , Lymphocyte Function-Associated Antigen-1/biosynthesis , Lymphokines/immunology , Mice, Inbred C57BL , Polymerase Chain Reaction , Receptors, Antigen, T-Cell/biosynthesis , RNA-Directed DNA Polymerase , T-Lymphocytes/immunologyABSTRACT
Fueron tratados 21 pacientes portadores de carcinoma indiferenciado de pulmon con un esquema de poliquimioterapia intermitente, de fundamentos citociniticos, en series moduladas incluyendo Citosina Arabinosido 60 MG/M2 S/C C/12 horas dias 1,2 y 3, Ifosfamida 1,5 gr/m2 i/v dias 4,5 y 6 Lomustine 50 mg/m2 v/o dias 4 y 5, con o sin radioterapia pre o post-quimioterapia, resultando evaluable 17 casos, obteniendose un 40% de remisiones objetivas entre RC t RP un 80% de no progresividad tumoral durante por lo menos 3 meses, con un 75% de mejorias subjetivas de una duracion promedio de 4 meses, y un aumento de la sobrevida en relacion con el tratamiento radiante solo, con una media de 6,4 meses.Dicho esquema fue generalmente mal tolerada tanto clinica como hematologicamente, destacandose especialmente su utilidad como terapia inicial inductiva y la ausencia del desarrollo de metastasis encefalicas en el curso del tratamiento, relacionandose este hecho con el efecto quimioprofilactico del CCNU sobre el S.N.C