HspBP1 and anti-HspBP1 levels in the serum of HIV-infected individuals are associated to the disease progression.

AIMS: The objective of this research was to quantify the levels of circulating HspBP1 and anti-HspBP1 IgG in HIV-infected individuals and to correlate them with CD4 T cell counts and viral load, as well as to determine the kinetics of those proteins during acute phase. METHODS AND RESULTS: Sixty serum samples from HIV-positive outpatients, thirty with high viral load and thirty with low viral load were analysed. The HspBP1 and anti-HspBP1 were quantified by ELISA. To investigate the kinetic of HspBP1 and anti-HspBp1 during the acute phase, these proteins and antibodies were quantified in samples of a commercial seroconverting HIV panel. All dosages were compared with the CD4 and CD8 T cell counts and HIV viral load. The results indicated that HIV positive outpatients presented significant increase in HspBP1 and anti-HspBP1 serum levels, compared with uninfected healthy. HspBP1 and anti-HspBP1 were negatively correlated with CD4 counts and CD4:CD8 ratio. In the acute phase, HspBP1 became significantly elevated 15 days after HIV infection. CONCLUSIONS: These results indicate that the quantification of HspBP1 can be associated to others well-established parameters of the HIV progression. SIGNIFICANCE AND IMPACT OF THE STUDY: The discovery that HspBp1 and anti-HspBp1 are associated with progression of HIV infection is new and corroborates to validate the quantification of these proteins as an additional strategy in the management of the HIV infection.

Gastroesophageal reflux episodes in asthmatic patients and their temporal relation with sleep architecture.

Gastroesophageal reflux (GER) is common in asthma patients and can contribute to sleep disruption. The aim of the present study was to determine the time-related distribution of GER events together with their impact on sleep in asthmatic subjects with GER disease symptoms. The inclusion criteria were: 18-65 years, controlled moderate to severe asthma and GER-compatible clinical evidence. The exclusion criteria were: chronic obstructive lung disease, smoking, infections of the upper airways, use of oral corticosteroids, other co-morbidities, pregnancy, sleep-related disorders, night-time shift work, and the use of substances with impact on sleep. Asthmatic patients with nocturnal symptoms were excluded. All-night polysomnography and esophageal pH monitoring were recorded simultaneously. Of the 147 subjects selected, 31 patients and 31 controls were included. Seventeen patients were classified as DeMeester positive and 14 as DeMeester negative. Both groups displayed similar outcomes when general variables were considered. Sleep stage modification one minute prior to GER was observed in the DeMeester-positive group. Awakening was the most frequent occurrence at GER onset and during the 1-min period preceding 38% of the nocturnal GER. Sleep stage 2 was also prevalent and preceded 36% of GER events. In the DeMeester-negative group, awakening was the most frequent response before and during GER. Modifications in sleep stages, arousals or awakenings were associated with 75% of the total GER events analyzed during the period of one minute before and after the fall of esophageal pH below 4 in the DeMeester-positive group. These data provide evidence that sleep modifications precede the GER events in asthmatic patients.

Gastroesophageal reflux episodes in asthmatic patients and their temporal relation with sleep architecture

Gastroesophageal reflux (GER) is common in asthma patients and can contribute to sleep disruption. The aim of the present study was to determine the time-related distribution of GER events together with their impact on sleep in asthmatic subjects with GER disease symptoms. The inclusion criteria were: 18-65 years, controlled moderate to severe asthma and GER-compatible clinical evidence. The exclusion criteria were: chronic obstructive lung disease, smoking, infections of the upper airways, use of oral corticosteroids, other co-morbidities, pregnancy, sleep-related disorders, night-time shift work, and the use of substances with impact on sleep. Asthmatic patients with nocturnal symptoms were excluded. All-night polysomnography and esophageal pH monitoring were recorded simultaneously. Of the 147 subjects selected, 31 patients and 31 controls were included. Seventeen patients were classified as DeMeester positive and 14 as DeMeester negative. Both groups displayed similar outcomes when general variables were considered. Sleep stage modification one minute prior to GER was observed in the DeMeester-positive group. Awakening was the most frequent occurrence at GER onset and during the 1-min period preceding 38 percent of the nocturnal GER. Sleep stage 2 was also prevalent and preceded 36 percent of GER events. In the DeMeester-negative group, awakening was the most frequent response before and during GER. Modifications in sleep stages, arousals or awakenings were associated with 75 percent of the total GER events analyzed during the period of one minute before and after the fall of esophageal pH below 4 in the DeMeester-positive group. These data provide evidence that sleep modifications precede the GER events in asthmatic patients.

Recorrência da infecção por H. pylori na Unifesp / Recurring H. pylori infection at Unifesp

Informações quanto à recorrência da infecção por H. Pylori (Hp) são restritas. A erradicação da bacteriaresulta na cura da doença ulcerosa péptica (DUP) na ausência de antiinflamatório. a DUP, todavia, recidiva com a reinfecção. Quanto maior a falha na erradicação maior a recorrencia, que envolve reinfecção e recrudescência. Objetivo: Avaliar o índice de recorrência do Hp ao longo do período pós-erradicação e confrontar os resultados do serviço com os observados em outros centros. Casuística e método: estudo retrospectivo longitudinal de pacientes com DUP infectados pelo Hp, atendidos de março de 1993 a agosto de 2003 no Ambulatório de Dispepsia da Disciplina e que receberam integralmente esquema para erradicação da bactéria. Foi feita reavaliação clínica, controle endoscópico com pesquisa de Hp, aos três , seis e 12 meses da erradicação e a partir de então, anualmente, por até oito anos. Para análise dos dados empregou-se o teste do qui-quadrado. Resultados: A 422 pacientes forneceram-se 609 tratamentos. Ao longo de oito anos, houve 633,4 pacientes-ano, o que denota o grande abandono de acompanhamento. A taxa de sucesso em três meses, seis meses e em um ano do tratamento foi de 70,3por cento,61,9por cento e de 54,2por cento, respectivamente. Considerando esquema com a associação do IBP, amoxilina e claritromicina (esquema mais eficaz dentre os utilizados) e somente a erradicação pela primeira vez, a taxa de sucesso foi de 85,3por cento, 81,0por cento, e de 74,3 em três meses, seis meses e em um ano após a erradicação, respectivamente. Conclusões:1) a taxa de sucesso de erradicação do Hp depende do intervalo de tempo em que se define o controle de cura, sendo o de três meses o mais adequado em relação ao de um mês; 2) há melhor resposta terapêutica na primeira tentativa de erradicação com esquema IBP, amoxicilina e claritromicina; 3) a positivação da pesquisa de Hp ocorre principalmente no primeiro ano após a erradicação; 4) quanto menor a falha terapêutica no primeiro ano, menores as taxas de recorrência ao longo dos anos; 5) de forma geral, a recorrência da infecção por Hp é de 9,6por cento ao ano (média ao longo de oito anos); considerando-se a associação IBP, amoxicilina e claritromicina, a média cai para 6,0por cento no mesmo período