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1.
ACS Appl Mater Interfaces ; 16(20): 26439-26449, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38739688

RESUMO

In response to the ongoing quest for new, highly sensitive upconverting luminescent thermometers, this article introduces, for the first time, upconverting luminescent thermometers based on thermally induced structured phase transitions. As demonstrated, the transition from the low-temperature monoclinic to the high-temperature tetragonal structures of LiYO2:Yb3+,Er3+ induces multifaceted modification in the spectroscopic properties of the examined material, influencing the spectral positions of luminescence bands, energy gap values between thermally coupled energy levels, and the red-to-green emission intensities ratio. Moreover, as illustrated, both the color of the emitted light and the phase transition temperature (from 265 K, for LiYO2:Er3+, 1%Yb3+, to 180 K, for 10%Yb3+), and consequently, the thermometric parameters of the luminescent thermometer can be modulated by the concentration of Yb3+ sensitizer ions. Establishing a correlation between the phase transition temperature and the mismatch of ion radii between the host material and dopant ions allows for smooth adjustment of the thermometric performance of such a thermometer following specific application requirements. Three different thermometric approaches were investigated using thermally coupled levels (SR = 1.8%/K at 180 K for 1%Yb3+), green to red emission intensities ratio (SR = 1.5%/K at 305 K for 2%Yb3+), and single band ratiometric approach (SR = 2.5%/K at 240 K for 10%Yb3+). The thermally induced structural phase transition in LiYO2:Er3+,Yb3+ has enabled the development of multiple upconverting luminescent thermometers. This innovative approach opens avenues for advancing the field of luminescence thermometry, offering enhanced relative thermal sensitivity and adaptability for various applications.

2.
Med Oral Patol Oral Cir Bucal ; 28(4): e310-e316, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-36641744

RESUMO

BACKGROUND: Since the beginning of the COVID-19 pandemic, the number of medical appointments and the offer and use of oral health services have decreased sharply with the lockdown period. Restriction to regular dental care can increase the risk of oral diseases, capable of affecting general health and oral health-related quality of life, particularly among medically compromised patients. This study aimed to assess health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) of patients with non-alcoholic liver disease (NAFLD) before and during the COVID-19 pandemic. MATERIAL AND METHODS: Prospective cohort of 58 patients with NAFLD followed up from March 2020 (before the pandemic) to December 2021 (during the pandemic). RAND 36-Item Health Survey and Oral Health Impact Profile 14 (OHIP-14) questionnaires were used to assess HRQoL and OHRQoL, respectively, in the two points of time. RESULTS: The scores of all scales HRQoL and of the question about health change in the last year decreased substantially with the advent of the pandemic. Large (>0.50) effect sizes were estimated for the scales Role functioning/physical, Pain, General health, and Energy/fatigue. Patients who had COVID-19 presented better HRQoL and OHIP-14 mean scores than those who did not have the disease. The OHIP-14 total score increased 3.6 points with the advent of the pandemic, representing a large effect size (0.62). Patients presented high probability (84.3%) of increasing OHIP14 score during the pandemic. CONCLUSIONS: The HRQoL and the OHRQoL scores of NAFLD patients decreased substantially with the advent of the pandemic. However, these decreases were not associated with the COVID-19 disease by itself, but probably to other factors related to the deep social changes brought by the social isolation measures to combat the pandemic.


Assuntos
COVID-19 , Hepatopatia Gordurosa não Alcoólica , Humanos , Qualidade de Vida , Saúde Bucal , Hepatopatia Gordurosa não Alcoólica/complicações , Pandemias , Estudos Prospectivos , Controle de Doenças Transmissíveis , Inquéritos e Questionários
5.
Nanoscale ; 10(14): 6602-6610, 2018 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-29578227

RESUMO

The rapid evolution in luminescence thermometry in the last few years gradually shifted the research from the fabrication of more sensitive nanoarchitectures towards the use of the technique as a tool for thermal bioimaging and for the unveiling of properties of the thermometers themselves and of their local surroundings, for example to evaluate heat transport at unprecedented small scales. In this work, we demonstrated that KLu(WO4)2:Ho3+,Tm3+ nanoparticles are able to combine controllable heat release and upconversion thermometry permitting to estimate its thermal resistance (in air), a key parameter to model the heat transfer at the nanoscale.

6.
Data Brief ; 15: 389-396, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29214199

RESUMO

In the dataset presented in this article, 168 rice samples comprising sixteen rice varieties (including Indica and Japonica sub species) from a Portuguese Rice Breeding Program obtained from three different sites along four seasons, and 11 standard rice varieties from International Rice Research Institute were characterised. The amylose concentration was evaluated based on iodine method, and the near infrared (NIR) spectra were determined. To assess the advantage of Near infrared spectroscopy, different rice varieties and specific algorithms based on Matlab software such as Standard Normal Variate (SNV), Multiple Scatter Calibration (MSC) and Savitzky-Golay filter were used for NIR spectra pre-processing.

7.
J Food Sci Technol ; 54(7): 2104-2114, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28720968

RESUMO

Algarroba flour is used to supplement lysine-limiting systems such as wheat flour due to its amino acidic composition. The effects of adding up to 30% of this flour to wheat flour (W-A30) on dough characteristics and breadmaking performance were studied. Dough rheology was tested by farinograph, oscillatory rheometry and texture profile analyses. Molecular mobility was evaluated by nuclear magnetic resonance, and thermal properties were analyzed by differential scanning calorimetry and viscoamylograph studies. Besides, different bread quality parameters were evaluated. Incorporation of algarroba flour resulted into increase in water absorption, development time and degree of softening, and decrease in stability of wheat flour, leading to softer, less adhesive and elastic dough, although at intermediate replacement levels cohesiveness improved. At the molecular level, a reduction of water activity and limited proton motion were observed in W-A30 samples, suggesting that protons were highly bound to the dough matrix. Dough samples with algarroba flour showed lower G' and G″ values than the control, although with the formation of a more elastic structure for W-A30. In addition, algarroba flour produced a protective effect on starch granule disruption and interfered with amylose-amylose association during cooling. The specific volume of breads decreased with the increase in algarroba level, W-A30 reaching the highest decrease (15%). Bread crumbs with algarroba flour exhibited higher values of hardness and resilience. The use of algarroba flour resulted in lower quality when compared to the control. However, algarroba flour at 20% level can be added to wheat flour to obtain bakery products of similar technological quality and with improved nutritional components.

8.
Ultrasound Obstet Gynecol ; 50(6): 717-722, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27644020

RESUMO

OBJECTIVE: To describe the pattern and progression of central nervous system (CNS) lesions in microcephalic fetuses with suspected Zika virus (ZIKV) infection. METHODS: In this prospective study in Salvador, Brazil, we analyzed fetuses diagnosed with microcephaly and suspected ZIKV infection after a routine primary care ultrasound scan between July 2015 and February 2016 raised suspicion of fetal microcephaly. The pregnancies were followed with serial ultrasound scans until delivery at one of the three main referral centers for fetal abnormalities in Salvador, Brazil. Microcephaly was diagnosed when the head circumference was two or more SDs below the mean for gestational age and its relationship with ZIKV infection was defined according to the World Health Organization's criteria. All women were interviewed, to assess potential factors associated with fetal microcephaly. Serology test results for toxoplasmosis, cytomegalovirus, rubella, syphilis and human immunodeficiency virus (HIV) were recorded, as were previous routine ultrasound results. Signs/symptoms of infection during the pregnancy were noted. RESULTS: Of 60 cases of suspected ZIKV-related fetal microcephaly seen during the study period, eight were excluded due to serological evidence of other congenital infections or major ultrasound chromosomal markers. In the remaining 52 fetuses, microcephaly was diagnosed between 19 and 40 (median, 27.7; interquartile range, 23.4-32.0) weeks of gestation. The main ultrasound findings were: ventriculomegaly (65.4% of cases), cerebral calcifications (44.2%) and posterior fossa abnormalities (32.7%). 9.6% presented with arthrogryposis as an associated finding. Microcephaly was an isolated finding in four cases (7.7%). While ventriculomegaly was progressive in 41.2% of cases with this finding, the velocity of head circumference increase decreased progressively in almost all cases. Exanthematic disease was present in the majority (86.5%) of the women, 67.3% presenting in the first trimester of pregnancy. Additional lesions were detected after birth in 71.4% of the 35 cases with neonatal follow-up. CONCLUSIONS: The majority of cases of congenital ZIKV syndrome have other ultrasonographic findings in addition to microcephaly. ZIKV-related CNS anomalies present mainly as progressive CNS lesions and slowing rate of growth of the fetal head, and this seems to be evident only in the late second trimester, even when maternal infection occurs in the first trimester. Other ultrasound findings, such as ventriculomegaly, brain calcifications and posterior fossa destruction lesions, are also common in this congenital syndrome. Posterior fossa destruction lesions and arthrogryposis are an uncommon finding in other congenital infections, perhaps suggesting a novel severe congenital syndrome associated with fetal ZIKV. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Anormalidades Múltiplas/virologia , Feto/anormalidades , Microcefalia/virologia , Malformações do Sistema Nervoso/virologia , Complicações Infecciosas na Gravidez/virologia , Infecção por Zika virus/complicações , Zika virus/patogenicidade , Anormalidades Múltiplas/diagnóstico por imagem , Adulto , Brasil , Feminino , Feto/diagnóstico por imagem , Seguimentos , Idade Gestacional , Humanos , Recém-Nascido , Microcefalia/diagnóstico por imagem , Microcefalia/etiologia , Malformações do Sistema Nervoso/diagnóstico por imagem , Malformações do Sistema Nervoso/etiologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia Pré-Natal , Infecção por Zika virus/congênito , Infecção por Zika virus/diagnóstico por imagem
9.
Braz. j. med. biol. res ; 48(11): 965-972, Nov. 2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-762902

RESUMO

This study reviewed the use of the Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviors (SWAN) rating scale in diagnostic and evolutive approaches to attention deficit hyperactivity disorder (ADHD) and in correlational studies of the disorder. A review of articles published in indexed journals from electronic databases was conducted and 61 articles on the SWAN scale were analyzed. From these, 27 were selected to a) examine use of SWAN in research on attention disorders and b) verify evidence of its usefulness in the areas of genetics, neuropsychology, diagnostics, psychiatric comorbidities, neuroimaging, pharmacotherapy, and to examine its statistical reliability and validity in studies of diverse populations. This review of articles indicated a growing use of the SWAN scale for diagnostic purposes, for therapy, and in research on areas other than ADHD, especially when compared with other reliable scales. Use of the scale in ADHD diagnosis requires further statistical testing to define its psychometric properties.


Assuntos
Humanos , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Escala de Avaliação Comportamental/normas , Avaliação de Sintomas/métodos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Escala de Avaliação Comportamental/estatística & dados numéricos , Comorbidade , Reprodutibilidade dos Testes , Inquéritos e Questionários , Estudos de Validação como Assunto
10.
Braz J Med Biol Res ; 48(11): 965-72, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26313140

RESUMO

This study reviewed the use of the Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviors (SWAN) rating scale in diagnostic and evolutive approaches to attention deficit hyperactivity disorder (ADHD) and in correlational studies of the disorder. A review of articles published in indexed journals from electronic databases was conducted and 61 articles on the SWAN scale were analyzed. From these, 27 were selected to a) examine use of SWAN in research on attention disorders and b) verify evidence of its usefulness in the areas of genetics, neuropsychology, diagnostics, psychiatric comorbidities, neuroimaging, pharmacotherapy, and to examine its statistical reliability and validity in studies of diverse populations. This review of articles indicated a growing use of the SWAN scale for diagnostic purposes, for therapy, and in research on areas other than ADHD, especially when compared with other reliable scales. Use of the scale in ADHD diagnosis requires further statistical testing to define its psychometric properties.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Escala de Avaliação Comportamental/normas , Avaliação de Sintomas/métodos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Escala de Avaliação Comportamental/estatística & dados numéricos , Comorbidade , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , Estudos de Validação como Assunto
11.
Transpl Infect Dis ; 17(2): 308-13, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25726707

RESUMO

BACKGROUND: The incidence of bloodstream infection (BSI) varies according to the transplanted organ. Mortality can be as high as 24%, with a significant impact on graft survival. Transplantation is a risk factor for multidrug-resistant (MDR) organisms, but comparison with a non-transplanted population in a single large cohort has not been described. METHODS: This is a prospective nationwide study (16 centers) reporting data on 2364 monomicrobial nosocomial BSIs, comparing 83 episodes in solid organ transplant patients with 2447 BSIs occurring in the general hospital population. RESULTS: The prevalence of groups of infecting organisms (gram-positive, gram-negative, and fungi) was similar between transplant patients and the general population and a similar crude mortality rate was observed (34.9% in transplant vs. 43.3% in non-transplant patients). Staphylococcus aureus was the single most frequently isolated organism in both groups, and Acinetobacter species was more frequently isolated in the general population. Regarding MDR organisms, Klebsiella species, and Enterobacter species resistant to cefepime, as well as Acinetobacter species resistant to meropenem, were significantly more frequent in transplant patients. CONCLUSION: Antimicrobial resistance is higher, particularly among gram-negative bacteria in the transplant population, although the overall mortality rate between transplant and non-transplant patients with nosocomial BSI is similar.


Assuntos
Bacteriemia/epidemiologia , Candidemia/epidemiologia , Infecção Hospitalar/epidemiologia , Transplantados/estatística & dados numéricos , Infecções por Acinetobacter/epidemiologia , Infecções por Acinetobacter/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/microbiologia , Brasil/epidemiologia , Candidemia/microbiologia , Criança , Pré-Escolar , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Fungemia/epidemiologia , Fungemia/microbiologia , Humanos , Lactente , Recém-Nascido , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções por Pseudomonas/epidemiologia , Infecções por Pseudomonas/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Adulto Jovem
12.
Braz J Infect Dis ; 15(1): 6-11, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21412582

RESUMO

OBJECTIVE: To compare the clinical characteristics and outcomes of HIV-1-HTLV-1 coinfected patients, in Bahia, Brazil. METHODS: Retrospective, comparative study. RESULTS: Among a total of 123 consecutive HIV infected patients, 20 men (20.6%) and 6 women (23.1%) had detectable antibodies against HTLV-I/II. The major risk factor associated with coinfection by HTLV was intravenous drug use (57.7% of coinfected patient versus 9.2% of HTLV seronegative patients, p < 0.0001). Coinfected patients had higher absolute lymphocyte counts (1,921 + 762 versus 1,587 + 951, p = 0.03). Both groups of patients had similar means of CD4+ and CD8+ cell counts. However, among patients with AIDS CD4+ cell counts were significantly higher among those coinfected with HTLV-I/II (292 ± 92 cells/mm³, versus 140 ± 177 cells/mm³, p = 0.36). The frequency and type of opportunistic infections were similar for both groups, but strongyloidiasis and encephalopathy were more frequently diagnosed in coinfected patients (p < 0.05). On the other hand, patients coinfected with HTLV-I/II received significantly less antiretroviral therapy than singly infected by HIV-1. CONCLUSION: Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis for HIV patients. Higher CD4 count may lead to underestimation of immunodeficiency, and delay to initiate antiretroviral therapy.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Infecções por HTLV-II/complicações , Estrongiloidíase/etiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Adulto , Terapia Antirretroviral de Alta Atividade , Relação CD4-CD8 , Feminino , Infecções por HTLV-I/complicações , Infecções por HTLV-I/diagnóstico , Infecções por HTLV-I/imunologia , Infecções por HTLV-II/diagnóstico , Infecções por HTLV-II/imunologia , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Estrongiloidíase/diagnóstico , Estrongiloidíase/imunologia
13.
Braz. j. infect. dis ; 15(1): 6-11, Jan.-Feb. 2011. tab
Artigo em Inglês | LILACS | ID: lil-576778

RESUMO

OBJECTIVE: To compare the clinical characteristics and outcomes of HIV-1-HTLV-1 coinfected patients, in Bahia, Brazil. METHODS: Retrospective, comparative study. RESULTS: Among a total of 123 consecutive HIV infected patients, 20 men (20.6 percent) and 6 women (23.1 percent) had detectable antibodies against HTLV-I/II. The major risk factor associated with coinfection by HTLV was intravenous drug use (57.7 percent of coinfected patient versus 9.2 percent of HTLV seronegative patients, p < 0.0001). Coinfected patients had higher absolute lymphocyte counts (1,921 + 762 versus 1,587 + 951, p = 0.03). Both groups of patients had similar means of CD4+ and CD8+ cell counts. However, among patients with AIDS CD4+ cell counts were significantly higher among those coinfected with HTLV-I/II (292 ± 92 cells/mm³, versus 140 ± 177cells/mm³, p = 0.36). The frequency and type of opportunistic infections were similar for both groups, but strongyloidiasis and encephalopathy were more frequently diagnosed in coinfected patients (p < 0.05). On the other hand, patients coinfected with HTLV-I/II received significantly less antiretroviral therapy than singly infected by HIV-1. CONCLUSION: Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis for HIV patients. Higher CD4 count may lead to underestimation of immunodeficiency, and delay to initiate antiretroviral therapy.


Assuntos
Adulto , Feminino , Humanos , Masculino , Infecções Oportunistas Relacionadas com a AIDS/complicações , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Infecções por HTLV-II/complicações , Estrongiloidíase/etiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Terapia Antirretroviral de Alta Atividade , Infecções por HTLV-I/complicações , Infecções por HTLV-I/diagnóstico , Infecções por HTLV-I/imunologia , Infecções por HTLV-II/diagnóstico , Infecções por HTLV-II/imunologia , Estudos Retrospectivos , Fatores de Risco , Estrongiloidíase/diagnóstico , Estrongiloidíase/imunologia
14.
Braz. j. infect. dis ; 13(3): 221-225, June 2009. ilus, tab
Artigo em Inglês | LILACS | ID: lil-538524

RESUMO

This study defined the normal variation range for different subsets of T-lymphocyte cells count in two different Brazilian regions. We analysed the T-lymphocytes subpopulations (CD3+, CD4+, CD8+) in blood donors of two Brazilian cities, located in North (Belem, capital state of Para, indian background) and Northeast (Salvador, capital state od Bahia, African background) regions of Brazil. Results were compared according to gender, stress level (sleep time lower than 8 hours/day), smoking, and alcohol intake. Lymphocytes subpopulations were measured by flow cytometry. Five hundred twenty-six blood donors from two Brazilians cities participated in the study: 450 samples from Bahia and 76 samples from Pará. Most (60 percent) were men, 59 percent reported alcohol intake, 12 percent were smokers, and 80 percent slept at least 8 h/day. Donors from Bahia presented with significantly higher counts for all parameters, compared with Para. Women had higher lymphocytes levels, in both states, but only CD4+ cells count was significantly higher than men's values. Smokers had higher CD4+ counts, but sleep time had effect on lymphocytes levels only for Para's donors (higher CD3+ and CD4+ counts). That state had also, a higher proportion of donors reporting sleep time <8 h/day. The values for CD3, CD4 and CD8+ cells count were significantly higher in blood donors from Bahia than among those from Pará. Female gender, alcohol intake, stress level, and smoking were associated with higher lymphocyte counts. The use of a single reference range for normal lymphocytes count is not appropriate for a country with such diversity, like Brazil is.


Assuntos
Feminino , Humanos , Masculino , Consumo de Bebidas Alcoólicas/imunologia , Doadores de Sangue , Fumar/imunologia , Estresse Psicológico/imunologia , Subpopulações de Linfócitos T/citologia , Brasil , Citometria de Fluxo , Contagem de Linfócitos , Valores de Referência
15.
Braz J Infect Dis ; 13(3): 221-5, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20191201

RESUMO

This study defined the normal variation range for different subsets of T-lymphocyte cells count in two different Brazilian regions. We analysed the T-lymphocytes subpopulations (CD3+, CD4+, CD8+) in blood donors of two Brazilian cities, located in North (Belem, capital state of Para, indian background) and Northeast (Salvador, capital state od Bahia, African background) regions of Brazil. Results were compared according to gender, stress level (sleep time lower than 8 hours/day), smoking, and alcohol intake. Lymphocytes subpopulations were measured by flow cytometry. Five hundred twenty-six blood donors from two Brazilians cities participated in the study: 450 samples from Bahia and 76 samples from Pará. Most (60%) were men, 59% reported alcohol intake, 12% were smokers, and 80% slept at least 8 h/day. Donors from Bahia presented with significantly higher counts for all parameters, compared with Para. Women had higher lymphocytes levels, in both states, but only CD4+ cells count was significantly higher than men's values. Smokers had higher CD4+ counts, but sleep time had effect on lymphocytes levels only for Para's donors (higher CD3+ and CD4+ counts). That state had also, a higher proportion of donors reporting sleep time <8 h/day. The values for CD3, CD4 and CD8+ cells count were significantly higher in blood donors from Bahia than among those from Pará. Female gender, alcohol intake, stress level, and smoking were associated with higher lymphocyte counts. The use of a single reference range for normal lymphocytes count is not appropriate for a country with such diversity, like Brazil is.


Assuntos
Consumo de Bebidas Alcoólicas/imunologia , Doadores de Sangue , Fumar/imunologia , Estresse Psicológico/imunologia , Subpopulações de Linfócitos T/citologia , Brasil , Feminino , Citometria de Fluxo , Humanos , Contagem de Linfócitos , Masculino , Valores de Referência
17.
Braz J Infect Dis ; 5(4): 177-82, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11712962

RESUMO

We evaluated samples of peripheral blood mononuclear (PBMC) cells from 46 AIDS patients, before starting therapy with HIV-1 reverse transcriptase inhibitors (RTI), and after 6 months of drug use. PBMC were stored and tested by a Line Probe Assay (LiPA), in order to assess the frequency of RT mutations in this population. Six patients were taking AZT before initial blood collection (1 to 16 weeks of drug use) and 40 patients had no prior therapy. After baseline evaluation, 19 patients received AZT, 23 AZT plus DDI, 3 started AZT only with DDI added after 3 months, and 3 received a combination of AZT plus 3TC. Detection of at least one mutation was found in 33% (15/46) of patients at baseline, and 83% (38/46) had at least 1 mutation after 6 months of therapy. In the majority of cases, samples presented with the wild type and variants of HIV, simultaneously. Patients receiving monotherapy had a higher frequency of mutations (L41 and F214, Y215) than did patients receiving double-drug therapy (19 vs. 10). No specific mutation associated with DDI was identified in 26 patients so treated. Despite the finding of a mean increase in CD4 count and a mild decrease in viral load, patients tended to have an inverse correlation between the CD4 variation and number of mutations detected after 6 months, suggesting potential loss of drug efficacy in the presence of these genotypic changes.


Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral , HIV-1/efeitos dos fármacos , HIV-1/genética , Inibidores da Transcriptase Reversa/farmacologia , Síndrome da Imunodeficiência Adquirida/sangue , Fármacos Anti-HIV/uso terapêutico , Brasil , Contagem de Linfócito CD4 , Humanos , Leucócitos Mononucleares/virologia , Mutação Puntual , Inibidores da Transcriptase Reversa/uso terapêutico , Carga Viral
18.
AIDS ; 15(15): 2053-5, 2001 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-11600839

RESUMO

Co-infection with HTLV-1 reaches 20% among patients infected by HIV-1 in Bahia, Brazil. To evaluate its impact on survival, we conducted a retrospective, case-control study involving 198 patients (63 cases). Co-infection was associated with parenteral exposure (P = 0.0001) and female sex (P = 0.02). Co-infected patients had a shorter mean survival (1849 days) than controls (2430 days, P = 0.001), regardless of sex or baseline CD4 cell count. In Bahia, Brazil, co-infection with HIV-1 and HTLV-1 is associated with a shorter survival time.


Assuntos
Infecções por HIV/complicações , Infecções por HIV/mortalidade , HIV-1 , Infecções por HTLV-I/complicações , Vírus Linfotrópico T Tipo 1 Humano , Adolescente , Adulto , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Estudos Retrospectivos , Análise de Sobrevida
19.
Braz J Infect Dis ; 5(6): 339-44, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12010598

RESUMO

Diarrhea due to intestinal microbial infections is a frequent manifestation among HIV-infected patients. It has been postulated that HIV-infected patients may have special types of intestinal infections, and that immune activation from such parasites may affect the progression of HIV disease. To evaluate these associations, the frequency of infections was examined in HIV-infected patients in Bahia, Brazil. To determine the potential impact of the presence of intestinal parasitic infections on HIV disease progression, a retrospective study approach was used. The medical charts of 365 HIV-infected patients who had been treated at the AIDS Clinic of the Federal University of Bahia Hospital were reviewed, and the prevalence of parasites was compared with 5,243 HIV-negative patients who had attended the hospital during the same period of time. Among HIV-infected subjects, CD(4) count, RNA plasma viral load (VL), and number of eosinophils were compared according to their stool examination results. The overall prevalence of each parasite was similar for HIV-positive and HIV-negative patients. However, the prevalence of S. stercoralis (p<10(-7)) and G. lamblia (p=0.005) was greater for HIV-infected subjects. The mean CD(4) count and viral load of HIV patients in our clinic who had stool examinations was 350 cells +/- 340 and 4.4 +/- 1.4 log RNA viral load, respectively. In this patient group there was no clear association between the level of the absolute CD(4) count or the viral load and a specific parasitic infection. The presence of an intestinal parasitic infection was not associated with faster progression of the HIV disease among HIV-infected patients. We conclude that strongyloidiasis and giardiasis are more frequent in HIV-infected patients in Bahia, Brazil. If this association is due to immune dysregulation, as has been proposed elsewhere, it must occur in patients after only minor shifts in CD(4) count from normal levels, or as a result of immune dysfunction not represented by CD(4) count. These infections do not appear to alter the progression of HIV disease.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Giardíase/epidemiologia , Estrongiloidíase/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Adulto , Animais , Brasil/epidemiologia , Contagem de Linfócito CD4 , Fezes/parasitologia , Feminino , Giardia lamblia/isolamento & purificação , Giardíase/parasitologia , HIV-1/fisiologia , Humanos , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/sangue , Estudos Retrospectivos , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/parasitologia , Carga Viral
20.
J Infect Dis ; 182(5): 1531-5, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11023477

RESUMO

Preliminary preclinical and clinical data suggest that granulocyte-macrophage colony-stimulating factor (GM-CSF) may decrease viral replication. Therefore, 105 individuals with AIDS who were receiving nucleoside analogue therapy were enrolled in a placebo-controlled, double-blind study and were randomized to receive either 125 microgram/m(2) of yeast-derived, GM-CSF (sargramostim) or placebo subcutaneously twice weekly for 6 months. Subjects were evaluated for toxicity and disease progression. A significant decrease in mean virus load (VL) was observed for the GM-CSF treatment group at 6 months (-0.07 log(10) vs. -0.60 log(10); P=.02). More subjects achieved human immunodeficiency virus (HIV)-RNA levels <500 copies/mL at >/=2 evaluations (2% on placebo vs. 11% on GM-CSF; P=.04). Genotypic analysis of 46 subjects demonstrated a lower frequency of zidovudine-resistant mutations among those receiving GM-CSF (80% vs. 50%; P=.04). No difference was observed in the incidence of opportunistic infections (OIs) through 6 months or survival, despite a higher risk for OI among GM-CSF recipients. GM-CSF reduced VL and limited the evolution of zidovudine-resistant genotypes, potentially providing adjunctive therapy in HIV disease.


Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/uso terapêutico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/uso terapêutico , Zidovudina/uso terapêutico , Síndrome da Imunodeficiência Adquirida/imunologia , Síndrome da Imunodeficiência Adquirida/virologia , Adulto , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Método Duplo-Cego , Feminino , Genótipo , Fator Estimulador de Colônias de Granulócitos e Macrófagos/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/sangue
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