Asymptomatic HIV-Infected Patients Present Blood Parameters Changed, According to Use of Therapy and the CD4+ T Cells Count

Abstract In HIV-patients, the imbalance in immunological, hematological and biochemical factors can contribute to the progression to AIDS and non-AIDS comorbidities, even during combined antiretroviral therapy (cART). In this cross-sectional study, we aimed to analyze some of these parameters in 138 different asymptomatic HIV-infected patients, doing multiple comparisons between the groups, which are dichotomized in the presence / absence of cART and type of immune response (immunological responders [iR,>500cells/mL] or non-responders [iNR,<500cells/ mL]). Were analyzed cytokines and other routine laboratory parameters. Our results showed high creatine phosphokinase and low IL-10 levels in cART-patients. They also presented metabolic alterations, including elevations in total cholesterol and triglycerides, particularly in those iNR. In ART-iR an increased alanine aminotransferase was observed. Those NAÏVE-iNR presented high LDL-cholesterol, C-reactive protein and lactate dehydrogenase values. The long-term non-progressors (LTNP) showed the best laboratory results. In conclusion, many blood parameters were changed in HIV-patients, especially in those under cART. To identify LTNP individuals could be important to discussions their early therapeutic onset.

Restricción del crecimiento intrauterino: perspectiva endocrinológica. Actualización de octubre de 2016 de la publicación de Archivos Argentinos de Pediatría 2007; 105(1): 71-73 / Intrauterine growth restriction: endocrinological perspective. Update of the 2007 version (Arch Argent Pediatr 2007; 105(1): 71-73)

La mayoría de los niños nacidos con bajo peso o restricción del crecimiento intrauterino desarrollan un crecimiento compensador que les permite alcanzar una talla final acorde a su talla objetivo genética. Sin embargo, en alrededor de un 15% de los niños, este crecimiento es insuficiente.Tanto en los niños que presentan un adecuado crecimiento compensador y, por lo tanto, talla normal como en los niños que persisten bajos en la infancia, es necesario tener en cuenta que, si la pubertad se inicia en forma temprana, el pronóstico de talla final podría verse comprometido. Una intervención oportuna y adecuada podría mejorar la talla final.También es importante el control del peso corporal, ya que su excesiva ganancia en la infancia se asocia a complicaciones metabólicas en la adolescencia y la vida adulta.

Most children born with low weight or intrauterine growth restriction develop catch-up growth that allows them to reach a final height according to their genetic target height. However, in about 15% of children this growth is insufficient.In both, children who have adequate compensatory growth and therefore normal height and children who remain low in childhood, it is necessary to take into account that if puberty starts early, the final height could be compromised. Timely and appropriate intervention could improve it.Control of body weight is also important, as an excessive gain in childhood is associated with metabolic complications in adolescence and adult life

Could Helicobacter pylori Infection Impair Glucose Tolerance in Obese Non-diabetic Subjects?.

Helicobacter pylori (HP) is a common gastrointestinal infectious agent with half of the world’s population being infected. In addition to its well-demonstrated role in gastroduodenal diseases, it may have a potential role in several extra-intestinal pathologies including metabolic, hematological, cardiovascular, neurological, autoimmune and skin diseases. There is a controversy about the prevalence of HP in obese patients and its association with metabolic alterations in those patients. This study aimed to detect the relation of HP infection to insulin resistance, glycated hemoglobin and lipid profile in obese subjects. Subjects and Methods: This study was performed on 125 obese non diabetic subjects with BMI ≥30 kg/m2 and age ranged from 22 to 52 years. They were 90 females and 35 males. They were divided according to seropositivity of Helicobacter pylori IgG antibody into HP positive & HP negative groups. HP positive group comprised 83 subjects (60 females and 23 males) and were further subdivided into CagA+ve (13 subjects) and CagA-ve (70 subjects). HP negative group included 42 subjects (30 females and 12 males). Blood glucose, lipid profile, HbA1C, insulin, H. pylori IgG and Cag A IgG antibodies were assayed. Both HOMA-IR and HOMA-B were calculated from fasting blood glucose and fasting insulin levels. Results: A statistical significant increase in HOMA-IR, cholesterol, triglycerides, HDL-C and HbA1c was observed in HP positive group compared to HP negative group. There was a significant positive correlation between seropositivity to HP and both of HOMA-IR & elevated HbA1c. Among HP +ve subjects, both HOMA-IR and HbA1c were significantly elevated in anti-Cag A IgG positive than anti-Cag A IgG negative obese subjects. Multivariate logistic regression analysis showed that HP positive subjects were 7.189 & 19.2 times more susceptible to insulin resistance and increased HbA1c respectively than HP negative subjects. Also anti-Cag A IgG +ve persons were more susceptible to insulin resistance by 8.8 times more than negative subjects. Conclusions: H. pylori infection is associated with dyslipidemia, IR and elevated HbA1c in obese subjects. Whether these metabolic alterations are due to HP infection or just an association needs further studies to determine the effect of HP eradications on these metabolic alterations.

Deficiencia de la actividad de biotinidasa en la población de recién nacidos del Hospital Materno Infantil Ramón Sardá / Deficiency biotinidase activity in the newborn population of Maternity Hospital Ramón Sardá

La deficiencia de biotinidasa es una enfermedad autosómica recesiva del metabolismo provocado por la ausencia o deficiencia de esta enzima. Clínicamente se caracteriza por síntomas neurológicos: convulsiones, ataxia, pérdida de la audición, atrofia óptica retardo del desarrollo, alopecia, problemas dermatológicos y alteraciones metabólicas (acidemia orgánica cuya descompensación puede llevar al coma o a la muerte). La importancia de tener un método cuantitativo en suero o plasma es importante para confirmar esta patología. Objetivo: Obtener valores de referencia de actividad de biotinidasa en la población de recién nacidos (RN) en una maternidad pública aplicando un método colorimétrico para la cuantificación de la enzima en suero. Material y métodos: Se obtuvieron muestras de pesquisa neonatal y sueros de una población de 238 RN. La actividad de la biotinidasa fue determinada utilizando un método colorimétrico (a partir de una modificación del kit Umtest Biotinidasa de Tecnosuma). Los valores de referencia obtenidos en nuestra población fueron compatibles con los hallados en la bibliografía. La población patológica testigo presentó valores concordantes con su clasificación diagnóstica.

Biotinidase’s Deficiency is an autosomal recessive disorder of metabolism caused by the absence or deficiency of the enzyme. The clinical setting characterizes for neurological (convulsions, ataxia, auditive loss, optic atrophy, development delay), alopecia, skin rash and metabolic alterations (organic acidemia whose decompensation can produce coma or death). The availability of a quantitative technique in blood serum is vital to confirm this pathology. Objective: To obtain reference values for a population of newborns at Public Maternity applying a colorimetric quantitative method in serum blood. Material and methods: Dried blood samples and sera were obtained from a population of 238 newborns. The activity of Biotinidase was measured by using a colorimetric method (from a modification of the Umtest Bionitidase kit of Tecnosuma). We obtained reference values in the analysed population, which are compatible with the bibliographic values used until now. The control pathological population had results according to its diagnostic classification.

Alterações lipídicas em pacientes com câncer colorretal em fase pós-operatória: ensaio clínico randomizado e duplo-cego com fungos Agaricus sylvaticus / Lipidic alterations in patients with colorectal cancer in post-surgery phase: a randomized and double-blind clinical trial with Agaricus sylvaticus fungus

INTRODUÇÃO: Alterações no metabolismo lipídico são comuns em pacientes com câncer. Fungos medicinais podem exibir atividade hipolipidêmica. OBJETIVO: Avaliar os efeitos da suplementação dietética com fungos Agaricus sylvaticus no perfil lipídico de pacientes com câncer colorretal em fase pós-operatória. MÉTODOS: Ensaio clínico randomizado, duplo-cego, placebo-controlado, realizado no Hospital de Base do Distrito Federal por seis meses. Amostra constituída por 56 pacientes, estádios I, II e III, separados em dois grupos: placebo e suplementado com Agaricus sylvaticus (30mg/kg/dia). Resultados analisados pelos programas Microsoft Excel 2003 e SPSS 14.0 com p = 0.05. RESULTADOS: O grupo Agaricus sylvaticus apresentou níveis séricos iniciais de colesterol total de 207.36±52.67mg/dL, lipoproteína de baixa densidade de 120.79±44.02mg/dL e triglicérides de 181.64±187.52mg/dL. Após seis meses de suplementação, observou-se redução para 191.11±39.72mg/dL (p = 0.01), 103.08±39.20mg/dL (p = 0.0001) e 168.04±146.91mg/dL (p = 0.18), respectivamente. No grupo placebo, observou-se aumento não-significativo de colesterol total (p = 0.08) e aumento significativo de lipoproteína de baixa densidade (p = 0.01) e triglicérides (p = 0.0001). Não foram observadas, em ambos os grupos, alterações significantes nos níveis de lipoproteína de alta densidade e lipoproteína de muito baixa densidade. CONCLUSÃO: Os resultados sugerem que a suplementação dietética com Agaricus sylvaticus pode melhorar significativamente o perfil lipídico de pacientes com câncer colorretal em fase pós-operatória.

INTRODUCTION: Alterations in the lipidic metabolism are common in patients with cancer. Medicinal fungus may show hypolipidemic activity. OBJECTIVE: To evaluate the effects of dietary supplementation with Agaricus sylvaticus fungus in lipidic profile of patients with colorectal cancer in post-surgery phase. MEHTODS: Randomized, double-blind, placebo-controlled clinical trial carried out at the Federal District Base Hospital, for six months. Samples of 56 enrolled patients, stadiums phase I, II and III, divided in two groups: placebo group and group supplemented with Agaricus sylvaticus (30mg/kg/day). Results were analyzed with Microsoft Excel 2003 and SPSS 14.0 programs, with p = 0.05. RESULTS: The Agaricus sylvaticus group had initial total cholesterol levels of 207.36±52.67mg/dL, low-density lipoprotein of 120.79±44.02mg/dL and triglycerides of 181.64±187.52mg/dL. After six months of supplementation it was observed a reduction 191.11±39.72mg/dL (p = 0.01), 103.08±39.20mg/dL (p = 0.0001) and 168.04±146.91mg/dL (p = 0.18), respectively. In the placebo group it was observed not-significant increase of total cholesterol levels (p = 0.08) and significant increase of low-density lipoprotein (p = 0.01) and triglycerides (p = 0.0001). No significant statistically alterations were observed in the levels of high-density lipoprotein and very-low-density lipoprotein in both groups. CONCLUSION: Results suggest that the dietary supplementation with Agaricus sylvaticus may significantly improve the lipidic profile of colorectal cancer patients in post-surgery phase.

Qualidade de vida de pacientes com câncer colorretal em uso de suplementação dietética com fungos Agaricus sylvaticus após seis meses de segmento: ensaio clínico aleatorizado e placebo-controlado / Quality of life of patients with colorectal cancer on dietary supplementation with Agaricus sylvaticus fungus: after six months of segment: randomized and placebo-controlled clinical trial

INTRODUÇÃO: O câncer gastrointestinal compromete a qualidade de vida devido às alterações fisiológicas, metabólicas e psicológicas. Fungos medicinais podem melhorar a qualidade de vida de pacientes com câncer. OBJETIVO: Avaliar os efeitos da suplementação dietética com fungos Agaricus sylvaticus na qualidade de vida de pacientes com câncer colorretal em fase pós-operatória. METODOLOGIA: Ensaio clínico randomizado, duplo-cego, placebo-controlado, realizado no Hospital de Base do Distrito Federal. Amostra constituída por 56 pacientes (24 homens e 32 mulheres), estádios I, II e III, separados em grupos placebo e Agaricus sylvaticus (30mg/kg/dia), e acompanhados por um período de seis meses. Para avaliar os indicadores da qualidade de vida foram utilizados um formulário-padrão e uma anamnese dirigida-padrão. Os resultados foram analisados de forma qualitativa e descritiva, utilizando os programas Microsoft Excel 2003 e Epi Info 2004. RESULTADOS: Após seis meses de tratamento, observou-se, no grupo Agaricus sylvaticus, aumento da adesão à prática de atividade física, melhora da disposição e do humor, redução das queixas de dores e das alterações do sono como insônia e noites mal dormidas comparado com o grupo placebo. CONCLUSÃO: Os resultados sugerem que a suplementação dietética com Agaricus sylvaticus pode melhorar a qualidade de vida de pacientes no pós-operatório de câncer colorretal.

INTRODUCTION: Gastrointestinal cancer jeopardizes the quality of life through physiological, metabolic and psychological alterations. Medicinal fungus may boost the quality of life of patients with cancer. OBJECTIVE: To evaluate the effects of the dietary supplementation with Agaricus sylvaticus fungus in relation to the quality of life in patients with colorectal cancer during post-surgery phase. METHODOLOGY: Randomized, double-blind, placebo-controlled clinical trial carried out at the Federal District Hospital - Brazil, for six months. Samples of 56 enrolled patients (24 men and 32 women), stadiums phase I, II and III, separated as placebo and Agaricus sylvaticus (30mg/kg/day) supplemented groups: In order to evaluate indicators for quality of life, it was used form-standard and direct anamnese-standard. The method of analysis for results was qualitative and descriptive, using the Microsoft Excel 2003 and Epi Info 2004 programs. RESULTS: After six months of treatment, it was observed an increase of adhesion to physical activity; improved disposition and good mood, reduction of complaints, pains, and alterations of sleep such as insomnia and bad nights of sleep when Agaricus sylvaticus and placebo groups were compared. CONCLUSION: The results suggest that the dietary supplementation with Agaricus sylvaticus may improve the quality of life of patients with colorectal adenocarcinoma in post-surgery phase.

Alteraciones musculares periféricas en la enfermedad de Chagas

La enfermedad de Chagas sigue siendo un problema en Venezuela y en varios países de Latinoamérica. Este trabajo presenta datos sobre las alteraciones que esta enfermedad produce en los músculos esqueléticos periféricos, lo cual puede contribuir a la incapacidad funcional que presentan muchos de los pacientes. Fueron estudiados 19 pacientes con enfermedad avanzada, a quienes se les hizo evaluación cardiorrespiratoria, ecocardiograma, prueba de ejercicio y biopsia del músculo cuádriceps. El 42% presentó incapacidad funcional moderada a severa, medida por el consumo máximo de oxígeno, que estuvo relacionada con cambios morfológicos y metabólicos en las fibras musculares. Se hallaron alteraciones en la microvasculatura muscular compatibles con daño autoinmune. En conclusión, los pacientes con enfermedad de Chagas sufren alteraciones en la musculatura periférica que puede contribuir a la incapacidad funcional y al grado de afectación por esta enfermedad. La determinación de la capacidad funcional debería agregarse a la evaluación de la enfermedad

Chagas disease is still a problem in Venezuela and other Latin American countries, in spite of efforts to control the disease. Peripheral muscle alterations that contribute to decreased functional capacity in moderate to advanced Chagas’ disease patients are analyzed in the present work. Nineteen Chagas’ disease patients were studied, including cardio-respiratory evaluation, echocardiogram, exercise test and quadriceps muscle biopsy. The results showed 42% patients with moderate to severe decrease of maximal oxygen consumption. Muscle biopsies presented morphologic and metabolic alterations, some related to functional capacity. Capillary vessel damage in muscle was similar to that found in autoimmune diseases. In conclusion, Chagas’ disease patients showed peripheral muscle alterations related to decreased functional capacity. The functional capacity changes may contribute to the severity of the disease and should be added to the evaluation of the patients