Das psicoses associadas a infecções no Brasil: 100 anos da contribuição psicopatológica de Antonio Austregésilo / On psychoses associated with infections in Brazil: 100 years of the psychopathological contribution by Antonio Austregésilo / De las psicosis asociadas a infecciones en Brasil:1 00 años de la contribución psicopatológica de AntonioAustregésilo / Sur les psychoses associées aux infections au Brésil: 100 ans de contribution psychopathologique de Antônio Austregésilo

No presente trabalho, analisa-se a contribuição do neurologista e neuropsiquiatra Antonio Austregésilo (1876--1960) para o estudo psicopatológico e sistematização das chamadas psicoses infecciosas, no Brasil. Baseando-se em Emil Kraepelin e lançando mão de observações clínicas em doenças infecciosas globais e tropicais, Austregésilo revela detalhado conhecimento clínico e intervém no debate sobre etiologia, especificidades de fatores causais e curso da doença, na fronteira entre as doenças físicas infecciosas e os transtornos mentais.

The present article analyzes the contribution of neurologist and neuropsychiatrist Antonio Austregésilo (1876-1960) for the psychopathological study and systematization of so-called infectious psychoses in Brazil. Based on Emil Kraepelin and using clinical observations on global and tropical infectious diseases, Austregésilo built detailed clinical knowledge and took part in the debate on etiology, specificities of causal factors and the course of the disease, which is located on the edge between infectious physical diseases and mental disorders.

Cet article analyse la contribution du neurologue et neuropsychiatre Antonio Austregésilo (1876-1960) à l'étude psychopathologique et à la systématisation des psychoses dites infectieuses au Brésil. Basé sur Emil Kraepelin et en utilisant des observations cliniques sur les maladies infectieuses mondiales et tropicales, Austregésilo construit un savoir clinique détaillé et participe au débat sur l'étiologie, les spécificités des facteurs causals et le cours de la maladie, à la frontière entre les maladies physiques infectieuses et les troubles mentaux.

En el presente trabajo, analizamos la contribución del neurólogo y neuropsiquiatra Antonio Austregésilo (1876-1960) al estudio psicopatológico y a la sistematización de las llamadas psicosis infecciosas en Brasil. Basándose en Emil Kraepelin y utilizando observaciones clínicas sobre enfermedades infecciosas globales y tropicales, Austregésilo revela conocimientos clínicos detallados e interviene en el debate sobre la etiología, las especificidades de los factores causales y el curso de la enfermedad, en la frontera entre las enfermedades físicas infecciosas y los trastornos mentales.

Metabolic syndrome in HIV-infected middle-aged women on antiretroviral therapy: prevalence and associated factors

ABSTRACT Objectives: To determine the prevalence of metabolic syndrome (MetS) and its associated factors in a group of HIV-infected middle-aged women. Methods: Cross-sectional study including 273 HIV-infected climacteric women of 40-60 years of age under care in two HIV outpatient reference centers in Brazil. Metabolic syndrome diagnosis was based on 2006 International Diabetes Federation criteria. Sociodemographic, clinical and behavioral factors were evaluated as well as HIV infection-related parameters. Results: Mean age was 47.7 years; 59.1% of women were premenopausal, 91% were on antiretroviral therapy. Current CD4 count was >500 cells/mm3 in 61.7%, current viral load undetectable in 76.9% of women, and a quarter had previous diagnosis of aids. The prevalence of metabolic syndrome in the subgroup of menopausal women was 46.9%. Univariate analysis showed an association between metabolic syndrome and age ≥50 years (p = 0.002), schooling <8 years (p = 0.003), post-menopause (p < 0.001), body mass index (BMI) >25 kg/m2 (p < 0.001), and FSH ≥40 mIU/mL (p = 0.002). In the multivariate analysis only increased BMI (PR = 1.09; 95% CI: 1.05-1.13; p < 0.001) and FSH levels ≥40 mIU/mL (PR = 1.66; 95% CI: 1.14-2.40; p = 0.008) maintained statistical significance. There was no association between PI use or any other factor related to HIV-infection and MetS in any of the analyses performed. Conclusion: High BMI and FSH levels compatible with menopause were the only factors associated with MetS in these middle aged HIV-infected women. In the context of well-controlled, early treated HIV infection, traditional rather than HIV-related factors were associated with MetS.

Alteracoes endocrinas, infeccao pelo HIV e HAART - Revisao com enfase nos hormonios sexuais / Endocrine disturbances, human immunodeficiency virus infection and HAART - A review focusing sexual hormones

O primeiro impacto da introducao da terapia anti-retroviral combinada de alta potencia (HAART, do ingles highly active antiretroviral therapy) para tratamento da infeccao pelo virus da imunodeficiencia adquirida (HIV) foi a notavel queda na morbidade e mortalidade da infeccao. Entretanto, alteracoes metabolicas antes desconhecidas ou consideradas pouco comuns nestes pacientes comecaram a surgir recentemente e vem sendo atribuidas ao uso prolongado de anti-retrovirais. Muitas destas manifestacoes, como a lipodistrofia, o aumento da resistencia a insulina e a diabetes melitus, se relacionam com o metabolismo glicolipidico. No entanto, outras alteracoes que tambem tangem o sistema hormonal, particularmente o hipogonadismo e a disfuncao sexual vem sendo atribuidas a HAART. Esta breve revisao tem o intuito de situar a questao das alteracoes hormonais apresentadas por individuos infectados pelo HIV e contextualizar o papel das drogas antiretrovirais e do uso terapeutico de medicacoes hormonais nestes pacientes

A Retrospective bacteriological study of mycobacterial infections in patients with acquired immune deficiency syndrome (AIDS)

The main species of mycobacteria isolated in 51 patients with acquired immunodeficiency syndrome (AIDS) admitted to the Clinical Hospital of UNICAMP (Teaching Hospital) in 1996, were studied retrospectively by recording the isolation site and signs of pathogenesis. Of these isolates, 31 (55 percent) were M.tuberculosis and 20 (45 percent) M.avium complex. Strains of M.tuberculosis isolated in 1996, 1997, and 1998, originating from 42 patients who had AIDS, were tested for susceptibillity to isoniazid and rifampicin. Of these, 34 (81 percent) were susceptible to both drugs tested, 4 (10 percent) were resistant to isoniazid and susceptible to rifampicin, 2 (5 percent) were susceptible to isoniazid and resistant to rifampicin, and 2 (5 percent) were resistant to both rifampicin and isoniazid. We conclude that, in Brazil, M.avium complex infections in AIDS are more commun that has been previously suggested; i.e., almost as frequent as M.tuberculosis infections. Approximately 20 percent of M.tuberculosis strains showed resistence to rifampicin and/or isomiazid. Further distribution of information regarding how to treat the disease in AIDS patients is needed.