ABSTRACT
HIV infection causes a constant activation of the immune system and contributes to an enhanced systemic pro-inflammatory cytokine milieu, which has been associated with premature aging and frailty. We performed a systematic review and meta-analysis to analyze whether the HIV-1 RNA load, CD4+ T-lymphocyte counts and exposure to HAART in HIV-positive subjects are associated with frailty phenotype. Searches were performed in PubMed, SCOPUS, Lilacs, Web of Science, Google Scholar, and OpenThesis databases. We used the odds ratio as a measure of the association. We used either a fixed or random-effects model to pool the results of individual studies depending on the presence of heterogeneity. Eleven studies were included in the review. Data from 8035 HIV-positive subjects were analyzed; 2413 of the subjects had viral load detectable, 981 had a CD4T-cell count <350â cells/µL, and 1342 had HAART exposure information. We found an association between frailty and CD4T-cell count <350â cells/µL (OR 2.68, CI 95% 1.68-4.26, I2 = 46%), HIV-1 RNA load detectable (OR 1.71, CI 95% 1.38-2.12, I2 = 0%), and protease inhibitor-containing HAART regimen (OR 2.21, CI 95% 1.26-3.89, I2 = 0%). Further studies are necessary to evaluate the effects of other factors on the development of clinical features related to frailty.
Subject(s)
Frailty , HIV Infections , HIV Seropositivity , HIV-1 , Antiretroviral Therapy, Highly Active , CD4 Lymphocyte Count , Humans , Phenotype , RNA/pharmacology , RNA/therapeutic use , RNA, Viral , Viral LoadABSTRACT
Background: There is emerging evidence that frail individuals present a decreased physiological reserve, de-creased ability to maintain homeostasis, and increased vulnerability to stressors. The concept of frailty has be-come increasingly recognized as a valuable measure in oncological surgical patients, including those with headand neck cancer. Preoperative screening for frailty may provide an individualized risk assessment that can be usedby an interdisciplinary team for preoperative counseling and to improve outcomes. The aim of this meta-analysiswas to evaluate the relationship between frailty and the risk of major postoperative complications in frail individu-als submitted to head and neck oncologic surgery.Material and Methods: PubMed, SCOPUS, Web of Science, Google Scholar and OpenThesis were systematicallysearched to identify studies that evaluated the risk of major postoperative complications in frail individuals under-going head and neck oncologic surgery. The search was performed on August 31, 2020, without language or daterestrictions. Two independent investigators screened the searched studies based on each papers title and abstract.Relevant studies were read in full and selected according to the eligibility criteria. Frailty was assessed by modi-fied Frailty Index (mFI-11) and major postoperative complications were measured by the Clavien-Dindo classifica-tion. We performed a categorical and dose-response meta-analysis using a random-effects model to evaluate theassociation between frailty and the risk of major postoperative complications in patients submitted to head andneck oncologic surgery. The results of the meta-analysis were expressed as relative risk (RR) and 95% confidenceinterval (95% CI). The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Results: Four studies (9,947 patients) were included in this systematic...(AU)
Subject(s)
Humans , Male , Female , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/surgery , Postoperative Complications , Risk Factors , Risk Assessment , FrailtyABSTRACT
OBJECTIVE: The aim of this study was to investigate oral and maxillofacial outcomes in children with congenital Zika syndrome (CZS) and the presence of nonnutritive sucking habits, functional habits, and features related to breastfeeding and nutrition of these children. STUDY DESIGN: We conducted a cross-sectional study with 45 children with CZS and 50 healthy controls in Sergipe state, Brazil, from February 2018 to June 2018. Demographic and clinical data, including breastfeeding and feeding data, were obtained for each child. Additionally, oral and maxillofacial evaluation was performed. RESULTS: Low weight (prevalence rate [PR] 8.33; 95% confidence interval [CI] 2.02-34.45), nonexclusive breastfeeding up to 6 months (PR 1.56; 95% CI 1.18-2.08); mouth breathing (PR 3.46; 95% CI 1.83-6.52); difficulty in swallowing (PR 6.00; 95% CI 2.53-14.25); and excessive salivation (PR 4.81; 95% CI 2.18-10.62) were more frequent in children with CZS. Children with CZS were more likely to have abnormal insertion of the upper labial frenulum (PR 7.04; 95% CI 2.23-22.20); ogival palate (PR 3.70; 95% CI 1.63-8.40), dental enamel defects (PR 2.22; 95% CI 1.05-4.69); and delayed dental eruption (PR 8.89; 95% CI 1.16-68.32) compared with healthy children. CONCLUSIONS: Children with CZS had a higher frequency of problems related to breastfeeding, low weight, and oral and maxillofacial abnormalities compared with healthy children.
Subject(s)
Zika Virus Infection , Zika Virus , Brazil , Breast Feeding , Child , Cross-Sectional Studies , Female , Humans , Nutritional StatusABSTRACT
In this information epidemiology (infodemiology) study, we describe the online public interest about the issue of femicide in Brazil and analyze the relationship between search queries and femicide trends from 2004 to 2015. We showed that information-seeking behavior for femicide in the Brazilian states has been strongly influenced by female homicide rates. Educational and policy-related interventions are needed to improve the population's knowledge and attitude toward femicide.
