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Trends Psychol ; 25(4): 1829-1836, out.-dez. 2017. tab
Article in English | LILACS-Express | LILACS | ID: biblio-904532


Abstract Objective: To analyze the memory performance of participants aged 60 years and older with and without depressive symptoms. Methods: 199 participants were assessed using the Beck Depressio. In ventory (BDI) with a cut-off point of 20 for depression. Of these, 22 met the criteria for depression group; the remaining participants were allocated to the non-depression group. The Rey Auditory-Verbal Learning Test (RAVLT) was used to assess verbal learning, figures I and II of the Visual Reproduction subtest of the Wechsler Memory Scale Revised (WMS-R) was used to evaluate immediate and delayed visual memory, and the Logical Memory subtests I and II of WMS-R were used to test verbal memory. Results: The average scores for verbal learning in the depression group were significantly lower than those in the non-depression group (p = .001). There were no group differences on visual and logical memory I and II scales. Conclusion: Depressive symptoms affect information retention and verbal learning in the elderly. However, they had no effect on visual and logical memory processing in this sample. The results suggest that, in addition to age-related cognitive decline, depression impairs memory performance considerably.

Resumo Objetivo: analisar o desempenho de memória de participantes com 60 anos ou mais de idade, apresentando ou não sintomas de depressão. Métodos: 199 participantes foram examinados através d. In ventário de Depressão de Beck (BDI) com ponto de corte em 20 pontos para depressão. 22 participantes atingiram o critério para inclusão no grupo de depressão e o restante foi alocado no grupo sem depressão. Os testes utilizados foram: Rey Auditory-Verbal Learning Test (RAVLT) para avaliar aprendizagem verbal, teste de reprodução de figuras I e II da Escala Wechsler Revisada (WMS-R) para memória visual imediata e duradoura e teste de memória lógica I e II da WMS-R para memória verbal. Resultados: os escores médios para aprendizagem verbal no grupo com depressão foram significativamente mais baixos do que no grupo sem depressão (p= 0,001). Não ocorreram diferenças significativas entre os grupos nas escalas para memória visual ou lógica I e II. Conclusões: sintomas de depressão afetam a retenção de informação e a aprendizagem verbal em idosos. Entretanto, não parecem afetar o processamento das memórias visual e lógica. Os resultados sugerem que, além do declínio cognitivo devido ao envelhecimento, a presença de depressão afeta e empobrece o desempenho de memória.

Resumen Objectivo: Analizar el rendimiento de la memoria de participantes con mas de 60 anos con sintomas de depresion. Metodos: 199 participantes fueron examinados a traves de. In ventario de Depresion de Beck (BDI), tomando en consideracion acima de 20 puntos para la depresion. 22 participantes alcanzaron el criterio de inclusion en el grupo de depresion y lo restante fue colocado en el grupo sin depresion. Las pruebas utilizadas fueron: Rey Auditory-Verbal Learning Test para evaluar el aprendizaje verbal; Prueba de Reproduccion de Figuras I y II de Wechsler Memory Scale (WMS-R) para memoria inmediata y duradera, memoria visual y logica de ensayo I y II de la WMS-R para memoria verbal. Resultados: La aprendizaje verbal en el grupo con depresion fue abajo que en el grupo sin depresion (p = .001). No hubo diferencias significativas entre los grupos en las escalas para memoria I y II visual y logica. Conclusiones: La depresion afecta la retencion de informacion y aprendizaje verbal en los ancianos pero no parece afectar el procesamiento de los recuerdos visuales y logicos. Los resultados sugieren que, ademas de deterioro cognitivo debido al envejecimiento, afecta a la presencia de depresion y el rendimiento de la memoria se vuelve pobre.

Mem. Inst. Oswaldo Cruz ; 112(4): 269-274, Apr. 2017. tab
Article in English | LILACS | ID: biblio-841782


BACKGROUND The time of progression towards AIDS can vary greatly among seropositive patients, and may be associated with host genetic variation. The NR1I2 (PXR) gene, a ligand-activated transcription factor, regulates the transcription immune pathway genes and can therefore be targets of viral replication mechanisms influencing time of progression to AIDS. OBJECTIVE To verify the association of single nucleotide polymorphisms (SNPs) rs3814057, rs6785049, rs7643645, and rs2461817 in the NR1I2 (PXR) gene with progression to AIDS in HIV-1 infected patients. METHODS Blood samples were obtained from 96 HIV-1 positive individuals following informed consent. DNA was isolated and genotyped through real time polymerase chain reaction (PCR) for the presence of SNPs in the NR1I2. Questionnaires on socio-demographic features and behaviors were answered and time of progression to AIDS was estimated based on medical chart analysis. FINDINGS Patients with the GG genotype for rs7643645 were shown to be related with a more rapid disease progression when compared to GA and AA genotypes. This result was maintained by the Multivariate Cox Regression considering sex, ethnicity, and presence of HLA-B*57, HLA-B*27, and CCR5del32 polymorphisms. MAIN CONCLUSIONS Recent studies reported the expression of the nuclear receptors in T-Lymphocytes, suggesting their possible role in the immune response. In addition, nuclear receptors have been shown to inhibit the HIV replication, although no such mechanism has been thoroughly elucidated to date. This is the first time an association between NR1I2 polymorphism and time of progression to AIDS is reported and supports an apparent relationship between the gene in the immune response and identifies another genetic factor influencing AIDS progression.

Humans , Male , Female , Adult , Acquired Immunodeficiency Syndrome/genetics , Acquired Immunodeficiency Syndrome/pathology , Disease Progression , Polymorphism, Genetic , Genotype
Rev. Soc. Bras. Med. Trop ; 50(2): 251-255, Mar.-Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-1041404


Abstract INTRODUCTION: This study evaluated leprosy rates in Rio Grande do Sul, an area with a historically low prevalence. However, recent studies are lacking. METHODS: Data extracted from a National Database were analyzed for clinical features and compared to 1980s data. Tendency was assessed via stationarity analysis. RESULTS: Between 1990 and 2011, 4,770 cases were reported (0.21/10,000 inhabitants; 95% CI = 0.19-0.24). Detection was slightly higher among males, 1.9% cases were among children and most multibacillary (74.7%) at diagnosis. CONCLUSIONS: Leprosy is controlled in RS, but most cases are multibacillary. Early identification is important to avoid disabilities due to late diagnosis.

Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Leprosy/epidemiology , Brazil/epidemiology , Incidence , Prevalence
Arq. bras. cardiol ; 103(1): 33-40, 07/2014. tab
Article in English | LILACS | ID: lil-718101


Background: Dyslipidemia is the primary risk factor for cardiovascular disease, and statins have been effective in controlling lipid levels. Sex differences in the pharmacokinetics and pharmacodynamics of statins contribute to interindividual variations in drug efficacy and toxicity. Objective: To evaluate the presence of sexual dimorphism in the efficacy and safety of simvastatin/atorvastatin treatment. Methods: Lipid levels of 495 patients (331 women and 164 men) were measured at baseline and after 6 ± 3 months of simvastatin/atorvastatin treatment to assess the efficacy and safety profiles of both drugs. Results: Women had higher baseline levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) compared with men (p < 0.0001). After treatment, women exhibited a greater decrease in plasma TC and LDL-C levels compared with men. After adjustment for covariates, baseline levels of TC and LDL-C influenced more than 30% of the efficacy of lipid-lowering therapy (p < 0.001), regardless of sex. Myalgia [with or without changes in creatine phosphokinase (CPK) levels] occurred more frequently in women (25.9%; p = 0.002), whereas an increase in CPK and/or abnormal liver function was more frequent in in men (17.9%; p = 0.017). Conclusions: Our results show that baseline TC and LDL-C levels are the main predictors of simvastatin/atorvastatin therapy efficacy, regardless of sex. In addition, they suggest the presence of sexual dimorphism in the safety of simvastatin/atorvastatin. The effect of sex differences on receptors, transporter proteins, and gene expression pathways needs to be better evaluated and characterized to confirm these observations. .

Fundamento: A dislipidemia é o principal fator de risco para doenças cardiovasculares e as estatinas são efetivas no controle do perfil lipídico. Diferenças sexuais na farmacocinética e farmacodinâmica contribuem para a variação interindividual na eficácia e toxicidade de fármacos. Objetivo: Avaliar a existência de dimorfismo sexual na eficácia e segurança do tratamento com sinvastatina/atorvastatina. Métodos: 495 sujeitos (331 mulheres e 164 homens) tiveram seus níveis lipídicos mensurados antes e após 6±3 meses de tratamento com sinvastatina/atorvastatina para avaliação dos perfis de eficácia e segurança. Resultados: As mulheres apresentaram maiores níveis basais de colesterol total, LDL-C e HDL-C quando comparadas aos homens (p < 0,0001). Após o tratamento, mulheres tiveram uma maior redução dos níveis de colesterol total e de LDL-C que homens. Após ajuste para covariáveis, foi observado que os níveis basais de colesterol total e de LDL-C são responsáveis por cerca de 30% da eficácia (p < 0,001), independentemente do sexo. Mialgia (com ou sem alteração de creatina fosfoquinase - CPK) ocorreu mais frequentemente em mulheres (25,9%) (p = 0,002), enquanto o aumento isolado de CPK e alterações de função hepática foram mais frequentemente observados em homens (17,9%) (p = 0,017). Conclusões: Nossos resultados demonstram que os níveis basais de colesterol total e LDL-C são os maiores preditores da eficácia do tratamento, independente do sexo. Adicionalmente, sugerimos que existe dimorfismo sexual na segurança do tratamento com sinvastatina/atorvastatina. O efeito das diferenças sexuais em receptores, proteínas transportadoras e rotas de expressão gênica devem ser avaliados ...

Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anticholesteremic Agents/pharmacology , Heptanoic Acids/pharmacology , Hypercholesterolemia/drug therapy , Hypolipidemic Agents/pharmacology , Pyrroles/pharmacology , Sex Factors , Simvastatin/pharmacology , Anticholesteremic Agents/adverse effects , Brazil , Cholesterol/blood , Creatine Kinase/drug effects , Heptanoic Acids/adverse effects , Hypercholesterolemia/blood , Hypolipidemic Agents/adverse effects , Lipoproteins, HDL/blood , Lipoproteins, LDL/blood , Myalgia/etiology , Prospective Studies , Pyrroles/adverse effects , Simvastatin/adverse effects
Mem. Inst. Oswaldo Cruz ; 109(3): 345-351, 06/2014. tab
Article in English | LILACS | ID: lil-711738


Certain host single nucleotide polymorphisms (SNPs) affect the likelihood of a sustained virological response (SVR) to treatment in subjects infected with hepatitis C virus (HCV). SNPs in the promoters of interleukin (IL)-10 (-1082 A/G, rs1800896), myxovirus resistance protein 1 (-123 C/A, rs17000900 and -88 G/T, rs2071430) and tumour necrosis factor (TNF) (-308 G/A, rs1800629 and -238 G/A, rs361525) genes and the outcome of PEGylated α-interferon plus ribavirin therapy were investigated. This analysis was performed in 114 Brazilian, HCV genotype 1-infected patients who had a SVR and in 85 non-responders and 64 relapsers. A significantly increased risk of having a null virological response was observed in patients carrying at least one A allele at positions -308 [odds ratios (OR) = 2.58, 95% confidence intervals (CI) = 1.44-4.63, p = 0.001] or -238 (OR = 7.33, 95% CI = 3.59-14.93, p < 0.001) in the TNF promoter. The risk of relapsing was also elevated (-308: OR = 2.87, 95% CI = 1.51-5.44, p = 0.001; -238: OR = 4.20, 95% CI = 1.93-9.10, p < 0.001). Multiple logistic regression of TNF diplotypes showed that patients with at least two copies of the A allele had an even higher risk of having a null virological response (OR = 16.43, 95% CI = 5.70-47.34, p < 0.001) or relapsing (OR = 6.71, 95% CI = 2.18-20.66, p = 0.001). No statistically significant association was found between the other SNPs under study and anti-HCV therapy response.

Female , Humans , Male , Middle Aged , Antiviral Agents/administration & dosage , Hepacivirus/drug effects , Hepatitis C, Chronic/drug therapy , Interferon-alpha/administration & dosage , Promoter Regions, Genetic , Ribavirin/administration & dosage , Tumor Necrosis Factor-alpha/genetics , Drug Therapy, Combination , Genotype , Hepatitis C, Chronic/genetics , /genetics , Myxovirus Resistance Proteins/genetics , Polymorphism, Single Nucleotide , Treatment Failure , Viral Load
An. bras. dermatol ; 89(1): 26-36, Jan-Feb/2014. tab, graf
Article in English | LILACS | ID: lil-703556


Incontinentia pigmenti is a rare genodermatosis in which the skin involvement occurs in all patients. Additionally, other ectodermal tissues may be affected, such as the central nervous system, eyes, hair, nails and teeth. The disease has a X-linked dominant inheritance pattern and is usually lethal to male fetuses. The dermatological findings occur in four successive phases, following the lines of Blaschko: First phase - vesicles on an erythematous base; second phase - verrucous hyperkeratotic lesions; third phase - hyperchromic spots and fourth phase - hypochromic atrophic lesions.

Humans , Male , Skin/pathology , Incontinentia Pigmenti/pathology , Tooth Abnormalities/etiology , Tooth Abnormalities/pathology , Cataract/etiology , Cataract/pathology , Incontinentia Pigmenti/complications , Central Nervous System Diseases/pathology , Alopecia/etiology , Alopecia/pathology , Mutation
Arq. bras. endocrinol. metab ; 57(7): 513-519, out. 2013. tab
Article in English | LILACS | ID: lil-690588


OBJECTIVE: The aim of the present study was investigate the association between six genetic variants in the nuclear receptor genes PPARA, RXRA, NR1I2 and NR1I3 and the lipid-lowering efficacy and safety of statin therapy. SUBJECTS AND METHODS: The study was carried out on 240 Brazilian hypercholesterolemic patients on simvastatin and atorvastatin therapy. The polymorphisms were analyzed by PCR-based methods. RESULTS: The NR1I3 rs2307424 genotype distribution was different between subjects with and without adverse drug reactions. Among subjects in the ADR group, no T/T homozygotes were observed for this polymorphism, while in the non-ADR group the frequency of this genotype was 19.4% (P = 0.007, after multiple testing corrections P = 0.042). CONCLUSION: The polymorphisms investigated in PPARA (rs1800206), RXRA (rs11381416), and NR1I2 (rs1523130) did not influence the lipid-lowering efficacy and safety of statin. Our results show the possible influence of NR1I3 genetic variant on the safety of statin.

OBJETIVO: O objetivo deste estudo foi investigar a associação de seis variantes genéticas nos genes de receptores nucleares PPARA, RXRA, NR1I2 e NR1I3 na eficácia hipolipemiante e na segurança da terapia com estatinas. SUJEITOS E MÉTODOS: O estudo foi realizado com 240 pacientes hipercolesterolêmicos em terapia com sinvastina e atorvastatina. Os polimorfismos foram analisados por meio de métodos baseados em PCR. RESULTADOS: A distribuição da frequência genotípica do polimorfismo NR1I3 rs2307424 foi diferente entre os pacientes com e sem efeito adverso à medicação; entre os sujeitos do grupo com efeitos adversos, nenhum homozigoto T/T foi observado, enquanto no grupo de indivíduos sem efeitos adversos a frequência desse genótipo foi 19,4% (P = 0,007, após correção para múltiplos testes P = 0,042). CONCLUSÃO: Os polimorfismos investigados nos genes PPARA (rs1800206), RXRA (rs11381416) e NR1I2 (rs1523130) não foram associados com eficácia hipolipemiante e segurança da terapia com estatinas. Nossos resultados mostram uma possível influência de variantes do gene NR1I3 (rs2307424) no desenvolvimento de efeitos adversos à terapia com estatinas.

Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anticholesteremic Agents/therapeutic use , Dyslipidemias/drug therapy , Polymorphism, Genetic , PPAR alpha/genetics , Receptors, Cytoplasmic and Nuclear/genetics , Receptors, Steroid/genetics , Retinoid X Receptor alpha/genetics , Alleles , Anticholesteremic Agents/adverse effects , Dyslipidemias/genetics , Genotype , Heptanoic Acids/adverse effects , Heptanoic Acids/therapeutic use , Lipids/blood , Polymerase Chain Reaction , Pyrroles/adverse effects , Pyrroles/therapeutic use , Risk Factors , Simvastatin/adverse effects , Simvastatin/therapeutic use , Treatment Outcome
Mem. Inst. Oswaldo Cruz ; 108(1): 48-53, Feb. 2013. graf, tab
Article in English | LILACS | ID: lil-666043


A single-nucleotide polymorphism (SNP) upstream of interleukin (IL)28B was recently identified as an important predictor of the outcome of chronic hepatitis C patients treated with pegylated interferon plus ribavirin (PEG-IFN/RBV). The aim of this study was to investigate the association between the IL28B gene polymorphism (rs12979860) and virological response in chronic hepatitis C patients. Brazilian patients (n = 263) who were infected with hepatitis C virus (HCV) genotype 1 and were receiving PEG-IFN/RBV were genotyped. Early virological response (EVR) (12 weeks), end-of-treatment response (EOTR) (48 weeks), sustained virological response (SVR) (72 weeks) and relapse were evaluated using conventional and quantitative polymerase chain reaction (PCR) assays. The frequency of the C allele in the population was 39%. Overall, 43% of patients experienced SVR. The IL28B CC genotype was significantly associated with higher treatment response rates and a lower relapse rate compared to the other genotypes [84% vs. 58% EVR, 92% vs. 63% EOTR, 76% vs. 38% SVR and 17% vs. 40% relapse rate in CC vs. other genotypes (CT and TT), respectively]. Thus, the IL28B genotype appears to be a strong predictor of SVR following PEG-IFN/RBV therapy in treatment-naïve Brazilian patients infected with HCV genotype 1. This study, together with similar research examining other SNPs, should help to define adequate protocols for the treatment of patients infected with HCV genotype 1, especially those with a poor prognosis.

Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antiviral Agents/administration & dosage , Hepatitis C, Chronic/drug therapy , Interferon-alpha/administration & dosage , Interleukins/genetics , Polyethylene Glycols/administration & dosage , Polymorphism, Single Nucleotide/genetics , Ribavirin/administration & dosage , Alleles , Cohort Studies , Drug Therapy, Combination , Genotype , Hepatitis C, Chronic/genetics , Hepatitis C, Chronic/virology , Polymerase Chain Reaction , Prospective Studies , Recombinant Proteins/administration & dosage , Treatment Outcome
Arq. bras. cardiol ; 95(4): 430-435, out. 2010. tab
Article in Portuguese | LILACS | ID: lil-568973


FUNDAMENTO: Baixos níveis de HDL-c são importantes preditores de doença coronariana, a primeira causa de morte no mundo todo. Muitos fatores afetam os níveis de HDL-c, tais como os polimorfismos de genes que codificam proteínas-chave para a via de transporte reverso de colesterol. OBJETIVO: Investigar a influência de sete polimorfismos dos genes CETP, APOA1, ABCA1 e SCARB1 genes nos níveis de HDL-c em uma população da região sul do Brasil. MÉTODOS: Os polimorfismos foram investigados em uma amostra de 500 indivíduos de descendência europeia, mas os níveis de HDL-c de somente 360 indivíduos foram ajustados para cofatores usando regressão linear múltipla no estudo de associação. A amostra foi dividida em tercis de acordo com os níveis ajustados de HDL-c e frequências de alelos e haplótipos foram comparadas entre o 1º e o 3º tercis dos níveis ajustados de HDL-c. RESULTADOS: Quando as combinações dos alelos de risco foram testadas, a frequência de combinações alélicas em três genes (haplótipo 1 do gene APOA1, variante 2S do gene SCARB1, e alelo B1 do gene CETP) foi significantemente mais alta no tercil inferior dos níveis ajustados de HDL-c (28,3 por cento) do que no tercil superior (14,9 por cento; p=0,008), o que indica que a presença dessas variantes aumentou 2,26 vezes a chance de ter níveis de HDL-C < 39,8 mg/dl. CONCLUSÃO: Espera-se que esses marcadores, quando estudados separadamente, tenham uma pequena influência na característica que está sendo analisada, mas uma influência maior foi detectada quando os marcadores foram estudados em combinação. Em uma população da região sul do Brasil, nossos dados mostraram uma influência significante das combinações das variantes dos genes APOA1, SCARB1 e CETP nos níveis de HDL-c.

BACKGROUND: Low HDL-C levels are important predictors of coronary disease, the first cause of death worldwide. Many factors affect HDL-C levels, such as polymorphisms of genes encoding for key proteins of the reverse cholesterol transport pathway. OBJECTIVE: To investigate the influence of seven polymorphisms of the CETP, APOA1, ABCA1 and SCARB1 genes on HDL-C levels in a southern Brazilian population. METHODS: The polymorphisms were investigated in a sample of 500 individuals of European descent, but HDL-C levels from only 360 individuals were adjusted for cofactors using multiple linear regressions in the association study. The sample was divided in tertiles according to adjusted HDL-C levels, and allele and haplotype frequencies were compared between the 1st and 3rd tertiles of adjusted HDL-C levels. RESULTS: When combinations of risk alleles were tested, the frequency of allele combinations in three genes (haplotype 1 of APOA1 gene, variant 2S of SCARB1 gene, and allele B1 of CETP gene) was significantly higher in the lower tertile of adjusted HDL-C (28.3 percent) than in the upper tertile (14.9 percent; p=0.008), which indicated that the presence of these variants increased 2.26 times the chances of having HDL-C levels below 39.8 mg/dl. CONCLUSION: These markers, when studied separately, are expected to have a small influence on the characteristic under analysis, but greater influence was detected when the markers were studied in combination. In a population of southern Brazilians, our data showed a significant influence of variant combinations of APOA1, SCARB1 and CETP genes on HDL-c levels.

FUNDAMENTO: Bajos niveles de HDL-c son importantes predictores de enfermedad coronaria, la primera causa de muerte en todo el mundo. Muchos factores afectan los niveles de HDL-c, tales como los polimorfismos de genes que codifican proteínas-clave para la vía de transporte reverso de colesterol. OBJETIVO: Investigar la influencia de siete polimorfismos de los genes CETP, APOA1, ABCA1 y SCARB1 genes en los niveles de HDL-c en una población de la región sur del Brasil. MÉTODOS: Los polimorfismos fueron investigados en una muestra de 500 individuos de descendencia europea, pero los niveles de HDL-c de solamente 360 individuos fueron ajustados para cofactores usando regresión lineal múltiple en el estudio de asociación. La muestra fue dividida en terciles de acuerdo con los niveles ajustados de HDL-c y frecuencias de alelos y haplotipos fueron comparadas entre el 1º y el 3º terciles de los niveles ajustados de HDL-c. RESULTADOS: Cuando las combinaciones de los alelos de riesgo fueron probadas, la frecuencia de combinaciones alélicas en tres genes (haplotipo 1 del gen APOA1, variante 2S del gen SCARB1, y alelo B1 del gen CETP) fue significativamente más alta en el tercil inferior de los niveles ajustados de HDL-c (28,3 por ciento) que en el tercil superior (14,9 por ciento; p=0,008), lo que indica que la presencia de esas variantes aumentó 2,26 veces la posibilidad de tener niveles de HDL-C < 39,8 mg/dl. CONCLUSIÓN: Se espera que esos marcadores, cuando sean estudiados separadamente, tengan una pequeña influencia en la característica que está siendo analizada, pero una influencia mayor fue detectada cuando los marcadores fueron estudiados en combinación. En una población de la región sur del Brasil, nuestros datos mostraron una influencia significativa de las combinaciones de las variantes de los genes APOA1, SCARB1 y CETP en los niveles de HDL-c.

Humans , Alleles , Cholesterol, HDL/blood , Cholesterol, HDL/genetics , Coronary Disease/genetics , Haplotypes , Polymorphism, Genetic/genetics , Biomarkers/blood , Brazil/ethnology , Coronary Disease/ethnology , Linear Models , Risk Factors
Sci. med ; 20(3)jul. 2010. tab
Article in Portuguese | LILACS | ID: lil-583394


Objetivos: o estudo teve como propósito estimar a prevalência da infecção pelo Vírus da Imunodeficiência Humana (HIV) nos pacientes em tratamento para tuberculose, no Centro de Saúde Modelo de Porto Alegre, RS.Métodos: foi realizada uma investigação transversal cuja população constituiu-se na totalidade dos pacientes em tratamento para tuberculose no Centro de Saúde Modelo de Porto Alegre, RS, entre 2004 e 2007. Para análise estatística foram utilizados o teste qui-quadrado e análise multivariada pelo método forward likelihood ratio. Resultados: no período em estudo foram diagnosticados 1537 casos de tuberculose, sendo que 449 apresentaram sorologia positiva para o HIV, o que representou uma taxa de coinfecção de 29,2%. Nesse grupo houve predominância do sexo masculino (73,9%) e da faixa etária de 30 a 39 anos (40,8%). No diagnóstico dos coinfectados com HIV/tuberculose a forma clínica prevalente foi a extrapulmonar (49%). Na baciloscopia, a forma negativa prevaleceu (29,8%) e a radiologia sugestiva (74,9%) também predominou nesse grupo. O esquema medicamentoso rifampicina, isoniazida e pirazinamida foi o tipo de tratamento mais usado (87,5%) e a alta por cura nos pacientes com sorologia positiva para o HIV em tratamento para tuberculose foi de 43,7%.Conclusões: os resultados ressaltam a importância da realização do teste sorológico para HIV quando se diagnostica a tuberculose.

Aims: The study aimed to estimate the prevalence of Human Immunodeficiency Virus (HIV) infection in patients undergoing treatment for tuberculosis, at the Model Health Center in Porto Alegre, RS.Methods: This was a cross-sectional study in which the studied population consisted of all patients undergoing treatment for tuberculosis in the Model Health Center in Porto Alegre, RS, from 2004 to 2007. Statistical analysis was made by the chi-square test and by multivariate analysis by the forward likelihood ratio method. Results: In the studied period, 1537 patients were diagnosed with tuberculosis, of whom 449 presented positive serology for HIV, resulting in a rate of coinfection of 29.2%. This group was predominantly male (73.9%), aging 30 to 39 years (40.8%). In cases of HIV/tuberculosis coinfection, the most prevalent clinical form was the extra pulmonary (49%). In bacilloscopy, the negative form prevailed (29.8%), and suggestive radiology (74.9%) also predominated in this group. The therapeutic schedule rifampin, isoniazid and pyrazinamide was the most used (87.5%), and the discharge by cure of treated tuberculosis of patients with positive serology for HIV was 43.7%.Conclusion: The results have emphasized the importance of the serological test for HIV when tuberculosis is diagnosed.

Humans , Male , Female , AIDS-Related Opportunistic Infections , Comorbidity , Cross-Sectional Studies , HIV Infections , Tuberculosis, Pulmonary/epidemiology
Rev. saúde pública ; 43(2): 283-290, abr. 2009. ilus, tab
Article in English | LILACS | ID: lil-507818


OBJECTIVE: To evaluate metabolic changes associated with highly active antiretroviral therapy (HAART) in HIV-positive patients, and to identify risk factors associated. METHODS: Retrospective study that included 110 HIV-positive patients who where on HAART in the city of Porto Alegre (Southern Brazil) between January 2003 and March 2004. Data on demographic variables, cigarette smoking, diabetes mellitus, cholesterol and triglyceride levels, stage of HIV infection, antiretroviral therapy and HCV coinfection were collected...

OBJETIVO: Avaliar as alterações metabólicas associadas à terapia anti-retroviral potente em pacientes HIV-positivos e identificar fatores de risco associados. MÉTODOS: Estudo retrospectivo com 110 pacientes HIV-positivos que estavam sob terapia anti-retroviral potente (HAART) na cidade de Porto Alegre (RS), entre janeiro de 2003 e março de 2004. Os dados coletados incluem variáveis demográficas, tabagismo, diabetes mellitus, níveis de colesterol e triglicerídeos, estágio da infecção viral, terapia anti-retroviral e co-infecção com hepatite C...

OBJETIVO: Evaluar las alteraciones metabólicas asociadas a la terapia anti-retroviral potente en pacientes HIV-positivos e identificar factores de riesgo asociados. MÉTODOS: Estudio retrospectivo con 110 pacientes HIV-positivos que estaban en terapia anti-retroviral potente (HAART) en la ciudad de Porto Alegre (Sur de Brasil), entre enero de 2003 y marzo de 2004. Los datos colectados incluyen variables demográficas, tabaquismo, diabetes mellitas, niveles de colesterol y triglicéridos, fase de la infección viral, terapia anti-retroviral y co-infección con hepatitis C...

Adult , Female , Humans , Male , Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active/adverse effects , Dyslipidemias/chemically induced , Glucose/analysis , HIV Infections/blood , Hepatitis C/complications , Cohort Studies , Cholesterol/blood , Dyslipidemias/blood , HIV Infections/complications , HIV Infections/drug therapy , Hepatitis C/blood , Protease Inhibitors/therapeutic use , Retrospective Studies , Risk Factors , RNA, Viral , Triglycerides/blood
Arq. bras. endocrinol. metab ; 51(4): 520-525, jun. 2007.
Article in Portuguese | LILACS | ID: lil-457087


A aterosclerose é resultado da associação de uma deposição de lipídios na parede arterial e um processo inflamatório de baixo grau. Essa inflamação pode ser detectada através da dosagem de marcadores séricos, que indicam o grau de aterosclerose, e estão associados a um maior risco de desenvolvimento de doenças cardiovasculares, independentemente dos níveis lipídicos. Entre estes marcadores destaca-se a Proteína C reativa ultra-sensível. As estatinas reduzem a inflamação associada à aterosclerose, o que é verificado por uma redução dos valores de proteína C reativa. Parte desse efeito está associada à diminuição de proteínas isopreniladas, porém as estatinas possuem efeitos diretos no sistema imune. Variações genéticas individuais estão associadas a variações no efeito hipolipemiante das estatinas, porém pouco se sabe sobre as variantes que interferem com as ações antiinflamatórias desses medicamentos. Além dos genes envolvidos no metabolismo do colesterol, genes que influenciam a farmacocinética e a farmacodinâmica das estatinas são possíveis responsáveis pela variação do efeito antiinflamatório observado.

Atherosclerosis is a result from the association of lipid deposition in the arterial wall and inflammatory process. This inflammatory process may be detected by clinical markers of systemic inflammation, such as ultrasensible C-reactive protein, which is associated with cardiovascular risk, independently of lipid levels. Statins reduce the inflammation associated to atherosclerosis, which may be verified by a reduction of the C-reactive protein levels. It seems that statins alter immune function by modulating post-translational protein prenylation. Individual genetic variations are associated with modulation of statins lipid-lowering effect; however, few studies have related the effect of the genetic variants with anti-inflammatory effect of statins. In addition to the genes involved in the cholesterol metabolism, genetic factors affecting statins pharmacodynamics and/or pharmacokinetics are potentially responsible for lipid and anti-inflammatory effects.

Humans , Anti-Inflammatory Agents/therapeutic use , Arteriosclerosis/drug therapy , C-Reactive Protein/analysis , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Anti-Inflammatory Agents/pharmacology , Arteriosclerosis/genetics , Biomarkers/blood , Cholesterol/blood , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology , Pharmacogenetics , Risk Factors
Medicina (Ribeiräo Preto) ; 39(4): 543-553, out.-dez. 2006. tab, graf
Article in Portuguese | LILACS | ID: lil-457829


RESUMO: Embora o tratamento farmacoterapêutico para redução dos níveis de colesterol tenha sido um dos grandes avanços no tratamento de doenças cardiovasculares e aterosclerose, os benefícios são ainda limitados devido a variabilidade interindividual na resposta a esses medicamentos. Entre os fatores importantes para a avaliação da variabilidade interindividual pode-se citar a severidade da doença, adesão ao tratamento, condições fisiológicas, condições biológicas e o perfil genético do paciente. Neste contexto, três grandes grupos de genes podem ser analisados: a) Genes que codificam proteínas envolvidas na metabolização e/ou transporte dos fármacos, influenciando a farmacocinética dos compostos. b) Genes que codificam proteínas envolvidas no mecanismo de ação e/ou nas rotas metabólicas em que o fármaco age (farmacodinâmica). c) Genes que codificam proteínas envolvidas no desenvolvimento direto da doença ou de fenótipos intermediários. Nessa revisão discutimos os estudos farmacogenéticos dos principais fármacos hipolipemiantes e a expectativa em relação a fármacogenética de auxiliarem nossa capacidade de predição em relação à eficácia do tratamento e a possibilidade de redução dos efeitos adversos a esses medicamentos. Na medida que novos estudos forem efetuados e que a grande parte da variabilidade genética envolvidas nas diferenças interindividuais na ação de fármacos for elucidada, o grande desafio será a aplicação desses conhecimentos na prática médica.

Humans , Cardiovascular Diseases , Genetic Variation , Pharmacogenetics