ABSTRACT
Abstract Objective: Weight and height growth impairment is one of the most frequent manifestations in HIV-infected children and may be the first sign of disease, being considered a marker of disease progression and an independent risk factor for death. The aim of this review is to evaluate the influence of antiretroviral therapy on the growth pattern of children and adolescents living with HIV/AIDS. Source of data: A non-systematic review was carried out in the PubMed database, with the terms "HIV", "Weight and height growth", "ART" and "children". The most relevant publications were selected. Data Synthesis: Antiretroviral therapy has significantly reduced morbidity and mortality in HIV-infected children and is clearly associated with recovery of weight and height-for-age Z-scores, especially when started early, in the asymptomatic child still without weight-height impairment. Therapeutic strategies involving the GH/IGF-1 axis, especially for children with growth impairment, are still being studied. Conclusions: HIV-infected children show early weight-height impairment; antiretroviral therapy improves the anthropometric profile of these children.
Resumo Objetivo: O acometimento do desenvolvimento pondero-estatural é uma das manifestações mais frequentes nas crianças infectadas pelo HIV e pode ser o primeiro sinal de doença, é considerado um marcador de progressão para doença e um fator de risco independente para morte. O objetivo desta revisão é avaliar a influência da terapia antirretroviral no padrão de crescimento em crianças e adolescentes vivendo com HIV/Aids. Fonte dos dados: Foi feita uma revisão não sistemática na base de dados PubMed, com os termos "HIV", "desenvolvimento pondero estatural", "TARV" e "crianças". Foram selecionadas as publicações mais relevantes. Síntese dos dados: A terapia antirretroviral reduziu substancialmente a morbimortalidade em crianças infectadas pelo HIV e está claramente associada à recuperação do escore-z de peso e de estatura para idade, principalmente quando iniciada precocemente, na criança assintomática e ainda sem comprometimento pondero-estatural. Estratégias terapêuticas que envolvem o eixo GH/IGF-1, principalmente para crianças com comprometimento do crescimento, ainda estão em estudo. Conclusões: As crianças infectadas pelo HIV apresentam comprometimento pondero-estatural precoce e a terapia antirretroviral melhora o perfil antropométrico dessas crianças.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Body Height/drug effects , HIV Infections/drug therapy , Child Development/physiology , Anti-HIV Agents/therapeutic use , Growth and Development/drug effects , Growth Disorders/physiopathology , HIV Infections/physiopathology , Child Development/drug effects , Disease Progression , Anti-HIV Agents/adverse effects , Antiretroviral Therapy, Highly Active , Growth and Development/physiology , Growth Disorders/chemically inducedABSTRACT
Fungos no ambiente podem ser patogênicos ou oportunistas, dependendo da imunidade do hospedeiro. Existem várias espécies de fungos, por exemplo, Cândida albicans, Cryptococcus e Aspergillus. A primeira espécie fúngica pode ser tratada com o antifúngico fluconazol, que é um composto que contém anéis heterocíclicos 1,2,4-triazólicos. Além disso, existem cepas de fungos que são resistentes à terapia com fluconazol, que é o caso das Cândida krusei, Cândida tropicalis; entre outras. A busca por novos tratamentos envolve o desenvolvimento de novas moléculas sintéticas. Neste trabalho, sintetizamos uma biblioteca de compostos oxazolínicos e seus derivados 1,2,3-triazólicos. A atividade microbiológica foi avaliada contra 10 tipos de Cândida, 2 tipos de Cryptococcus e 2 tipos de Aspergillus. Além disso, foram feitos os testes de hemólise, citotoxicidade, combinações de drogas e permeabilidade de membrana. Os resultados sugerem um alto potencial terapêutico dos compostos e os propomos como potenciais novos antifúngicos
ungi in the environment may be pathogenic or opportunistic depending on the immune status of the host. There are several species of fungi, for example, Candida albicans, Cryptococcus and Aspergillus. The first fungal species can be treated with the antifungal fluconazole, which is a compound containing 1,2,4-triazole heterocyclic rings. In addition, there are strains of fungi that are resistant to fluconazole therapy, which is the case of Candida krusei, Candida tropicalis; among others. The search for new treatments involves the development of new synthetic molecules. In this work, we synthesized a library of oxazoline compounds and their 1,2,3-triazole derivatives. Microbiological activity was evaluated against 10 types of Candida, 2 types of Cryptococcus and 2 types of Aspergillus. In addition, hemolysis, cytotoxicity, drug combinations and membrane permeability were performed. The results suggest the high therapeutic potential of the compounds and we propose them as potential new antifungals
Subject(s)
Triazoles/analysis , Pharmaceutical Preparations , Drug Combinations , Fungi/drug effects , Antifungal Agents/pharmacology , Aspergillus/isolation & purification , Biological Products , Candida albicans/isolation & purification , Fluconazole/administration & dosage , Cryptococcus/isolation & purification , Growth and Development/drug effectsABSTRACT
OBJECTIVE: To determine the impact of supplemental zinc, vitamin A, and glutamine alone or in combination on growth, intestinal barrier function, stress and satiety-related hormones among Brazilian shantytown children with low median height-for-age z-scores. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in children aged two months to nine years from the urban shanty compound community of Fortaleza, Brazil. Demographic and anthropometric information was assessed. The random treatment groups available for testing (a total of 120 children) were as follows: (1) glutamine alone, n = 38; (2) glutamine plus vitamin A plus zinc, n = 37; and a placebo (zinc plus vitamin A vehicle) plus glycine (isonitrogenous to glutamine) control treatment, n = 38. Leptin, adiponectin, insulin-like growth factor (IGF-1), and plasma levels of cortisol were measured with immune-enzymatic assays; urinary lactulose/mannitol and serum amino acids were measured with high-performance liquid chromatography. ClinicalTrials.gov: NCT00133406. RESULTS: Glutamine treatment significantly improved weight-for-height z-scores compared to the placebo-glycine control treatment. Either glutamine alone or all nutrients combined prevented disruption of the intestinal barrier function, as measured by the percentage of lactulose urinary excretion and the lactulose:mannitol absorption ratio. Plasma leptin was negatively correlated with plasma glutamine (p = 0.002) and arginine (p = 0.001) levels at baseline. After glutamine treatment, leptin was correlated with weight-for-age (WAZ) and weight-for-height z-scores (WHZ) (p≤0.002) at a 4-month follow-up. In addition, glutamine and all combined nutrients (glutamine, vitamin A, and zinc) improved the intestinal barrier function in these children. CONCLUSION: Taken together, these findings reveal the benefits of glutamine alone or in combination ...