Cardiovascular benefits of statin plus ezetimibe combination therapy versus statin monotherapy in acute coronary syndrome: a meta-analysis of randomized controlled trials.

BACKGROUND: The efficacy of adding ezetimibe to statin therapy for event reduction in patients with acute coronary syndromes (ACS) remains a topic of ongoing debate. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ezetimibe plus statin versus statin monotherapy in patients with ACS. We searched PubMed, Embase, and Cochrane for eligible trials. The random-effects model was used to calculate the risk ratios with 95% confidence intervals (CIs). Statistical analyses were performed using RStudio version 4.2.3 (RStudio, PBC). RESULTS: Six RCTs comprising 20 574 patients with ACS were included, of whom 10 259 (49.9%) were prescribed ezetimibe plus statin. The patient population had an average age of 63.8 years, and 75.1% were male. Compared with statin monotherapy, ezetimibe plus statin significantly reduced major adverse cardiovascular events (MACE) (risk ratio 0.93; 95% CI 0.90-0.97; P < 0.01) and nonfatal myocardial infarction (risk ratio 0.88; 95% CI 0.81-0.95; P < 0.01). There was no significant difference between groups for revascularization (risk ratio 0.94; 95% CI 0.90-1.00; P = 0.03), all-cause mortality (risk ratio 0.87; 95% CI 0.63-1.21; P = 0.42), or unstable angina (risk ratio 1.05; 95% CI 0.86-1.27; P = 0.64). CONCLUSION: In this meta-analysis of patients with ACS, the combination of ezetimibe plus statin was associated with a reduction in MACE and nonfatal myocardial infarction, compared with statin monotherapy.

Vanilla from Brazilian Atlantic Forest: In vitro and in silico toxicity assessment and high-resolution metabolomic analysis of Vanilla spp. ethanolic extracts.

The natural vanilla market, which generates millions annually, is predominantly dependent on Vanilla planifolia, a species characterized by low genetic variability and susceptibility to pathogens. There is an increasing demand for natural vanilla, prized for its complex, authentic, and superior quality compared to artificial counterparts. Therefore, there is a necessity for innovative production alternatives to ensure a consistent and stable supply of vanilla flavors. In this context, vanilla crop wild relatives (WRs) emerge as promising natural sources of the spice. However, these novel species must undergo toxicity assessments to evaluate potential risks and ensure safety for consumption. This study aimed to assess the non-mutagenic and non-carcinogenic properties of ethanolic extracts from V. bahiana, V. chamissonis, V. cribbiana, and V. planifolia through integrated metabolomic profiling, in vitro toxicity assays, and in silico analyses. The integrated approach of metabolomics, in vitro assays, and in silico analyses has highlighted the need for further safety assessments of Vanilla cribbiana ethanolic extract. While the extracts of V. bahiana, V. chamissonis, and V. planifolia generally demonstrated non-mutagenic properties in the Ames assay, V. cribbiana exhibited mutagenicity at high concentrations (5000 µg/plate) in the TA98 strain without metabolic activation. This finding, coupled with the dose-dependent cytotoxicity observed in WST-1 (Water Soluble Tetrazolium) assays, a colorimetric method that assesses the viability of cells exposed to a test substance, underscores the importance of concentration in the safety evaluation of these extracts. Kaempferol and pyrogallol, identified with higher intensity in V. cribbiana, are potential candidates for in vitro mutagenicity. Although the results are not conclusive, they suggest the safety of these extracts at low concentrations. This study emphasizes the value of an integrated approach in providing a nuanced understanding of the safety profiles of natural products, advocating for cautious use and further research into V. cribbiana mutagenicity.

Cardiovascular Benefits of GLP-1 Receptor Agonists in Patients Living with Obesity or Overweight: A Meta-analysis of Randomized Controlled Trials.

BACKGROUND: GLP-1 receptor agonists (GLP-1 RAs) have emerged as an effective therapeutic class for weight loss. However, the efficacy of these agents in reducing cardiovascular endpoints among patients living with obesity or overweight is unclear. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing GLP-1 RAs versus placebo in patients with obesity or overweight. We searched PubMed, Cochrane, and Embase databases. A random-effects model was used to calculate risk ratios (RRs) and mean differences (MDs), with 95% confidence intervals (CIs). RESULTS: A total of 13 RCTs were included, with 30,512 patients. Compared with placebo, GLP-1 RAs reduced systolic blood pressure (MD - 4.76 mmHg; 95% CI - 6.03, - 3.50; p < 0.001; I2 = 100%) and diastolic blood pressure (MD - 1.41 mmHg; 95% CI - 2.64, - 0.17; p = 0.03; I2 = 100%). GLP-1 RA significantly reduced the occurrence of myocardial infarction (RR 0.72; 95% CI 0.61, 0.85; p < 0.001; I2 = 0%). There were no significant differences between groups in unstable angina (UA; RR 0.84; 95% CI 0.65, 1.07; p = 0.16; I2 = 0%), stroke (RR 0.91; 95% CI 0.74, 1.12; p = 0.38; I2 = 0%), atrial fibrillation (AF; RR 0.49; 95% CI 0.17, 1.43; p = 0.19; I2 = 22%), and deep vein thrombosis (RR 0.30; 95% CI 0.06, 1.40; p = 0.13; I2 = 0%). CONCLUSIONS: In patients living with obesity or overweight, GLP-1 RA reduced systolic and diastolic blood pressure and the occurrence of myocardial infarction, with a neutral effect on the occurrence of UA, stroke, AF, and deep vein thrombosis. REGISTRATION: PROSPERO identifier number CRD42023475226.

A Preterm Rat Model for Pain Studies.

This research delves into the consequences of consistent pinprick stimulation on preterm offspring to ascertain its long-term implications for pain sensitivity. The primary objective of this protocol was to investigate the impact of neonatal pinprick stimuli on the pain threshold in the later stages of life using a preterm rat model. By establishing this model, we aim to advance the research on understanding and managing early postnatal pain associated with prematurity. The findings of this study indicate that while the baseline thresholds to mechanical stimuli remained unaffected, there was a notable increase in mechanical hypersensitivity following complete Freund's adjuvant (CFA) injection in adult rats. Interestingly, compared with male rats, female rats demonstrated heightened inflammatory hypersensitivity. Notably, maternal behavior, the weight of the litters, and the growth trajectory of the offspring remained unchanged by the stimulation. The manifestation of altered nociceptive responses in adulthood after neonatal painful stimuli could be indicative of changes in sensory processing and the functioning of glucocorticoid receptors. However, further research is needed to understand the underlying mechanisms involved and to develop interventions for the consequences of prematurity and neonatal pain in adults.

Social support perceived by elderly people in social vulnerability according to family functionality: a cross-sectional study.

OBJECTIVE: To compare the social support as perceived by elderly persons in a context of social vulnerability according to family functionality. METHOD: A cross-sectional study using a quantitative approach, carried out in São Carlos-SP, with 123 elderly people living in a context of high social vulnerability. The sample was divided into two groups: good family functionality and moderate/severe family dysfunction. Data was collected on sociodemographic characteristics, family functionality (Family APGAR) and social support (Medical Outcomes Study Social Support Scale). The Mann-Whitney, Chi-square and Fisher's exact statistical tests were used. RESULTS: There was a statistically significant difference between social support and family functionality (p < 0.05). The group with good family functionality obtained higher median social support scores: affective 100.00; material 95.00; information 90.00; emotional 90.00; positive social interaction 85.00; when compared to the group with moderate/severe family dysfunction: affective 86.67; material 87.50; information 70.00; emotional 65.00; positive social interaction 65.00. CONCLUSION: Elderly persons living in dysfunctional families have less perceived social support when compared to those living in families with good family functionality.

Effects of repetitive pinprick stimulation on preterm offspring: Alterations in nociceptive responses and inflammatory hypersensitivity in adulthood.

INTRODUCTION: This study investigates the effects of repetitive pinprick stimulation on preterm offspring and its impact on nociceptive responses and inflammatory hypersensitivity in adulthood. OBJECTIVES: The objective is to shed light on the potential long-term consequences of neonatal pain and prematurity on sensory processing. METHODS: Term and preterm rats were subjected to repetitive pinprick (PP) stimulation or control (CC) during the neonatal period. Adult rats received CFA injection to induce inflammatory hypersensitivity, and mechanical hypersensitivity was measured. Gender differences in inflammatory hypersensitivity were also examined. Maternal behavior, litter weight, and offspring growth were monitored to assess any potential influences of the stimulation on these parameters. RESULTS: In preterm rats, the PP stimulation did not affect baseline thresholds to mechanical stimuli, but increased mechanical hypersensitivity after CFA injection in adult rats. Females exhibited greater inflammatory hypersensitivity compared to males. Maternal behavior, litter weight, and offspring growth were not influenced by the stimulation. PP stimulation during the neonatal period led to changes in nociceptive responses in adulthood, potentially altering sensory processing. CONCLUSION: PP stimulation in preterm rats during the neonatal period resulted in changes in nociceptive responses in adulthood, leading to increased inflammatory hypersensitivity. The study emphasizes how early development can significantly impact sensory processing and further highlights the potential long-term consequences of prematurity and neonatal pain on this processing.

Qualidade de vida e apoio social de pessoas idosas cuidadoras e receptoras de cuidado em alta vulnerabilidade social / Quality of life and social support of older adults caregivers and care recipients in high social vulnerability

Resumo Objetivo comparar a qualidade de vida e o apoio social entre pessoas idosas cuidadoras e receptoras de cuidado. Método estudo observacional, transversal e quantitativo, realizado com 112 pessoas idosas cadastradas em cinco Unidades de Saúde da Família em contexto de alta vulnerabilidade social em um município do interior paulista, Brasil. Foram avaliadas variáveis sociodemográficas, de cuidado e de saúde, apoio social pela Escala de Apoio Social do Medical Outcomes Study e qualidade de vida pelo WHOQOL-bref e WHOQOL-old. Para a análise de dados foram utilizados os testes qui-quadrado de Pearson, Mann-Whitney e correlação de Spearman. Resultados houve diferença significativa entre os participantes para apoio material (p=0,004) e domínio físico da escala de qualidade de vida (p=0,002). Pessoas idosas cuidadoras têm menores escores de apoio material e melhor percepção do domínio físico da escala de qualidade de vida quando comparadas às receptoras de cuidado. Ademais, observou-se correlação direta e moderada entre qualidade de vida e apoio social de pessoas idosas cuidadoras (p<0,001), ou seja, quanto maior a pontuação obtida na escala de apoio social, maior também será a pontuação na escala de qualidade de vida. Conclusão pessoas idosas cuidadoras apresentaram menores escores de apoio material e melhor percepção do domínio físico da escala de qualidade de vida em comparação às receptoras de cuidado. Ações relativas à ampliação da quantidade de relacionamentos significativos dos cuidadores pode ser útil para melhorar o apoio social, com consequente melhora dos demais aspectos envolvidos na qualidade de vida.

Abstract Objective to compare quality of life and social support between older adults caregivers and care recipients. Method observational, cross-sectional and quantitative study, carried out with 112 older adults registered in five Family Health Units in a context of high social vulnerability in a city in the interior of São Paulo, Brazil. Sociodemographic, care and health variables, social support by the Medical Outcomes Study Social Support Scale and quality of life by the WHOQOL-bref and WHOQOL-old were evaluated. For data analysis, Pearson's Chi-Square, Mann-Whitney and Spearman's Correlation tests were used. Results There was a significant difference between the participants for material support (p=0.004) and physical domain of the quality of life scale (p=0.002). Older adults caregivers have lower material support scores and better perception of the physical domain of the quality of life scale when compared to care recipients. Furthermore, there was a direct and moderate correlation between quality of life and social support of older adults (p<0.001), that is, the higher the score on the social support scale, the higher the score on the quality of life scale. Conclusion adults caregivers presented lower material support scores and better perception of the physical domain of the quality of life scale compared to care receptors. Actions related to expanding the amount of significant relationships of caregivers can be useful for improving social support, with consequent improvement of the other aspects involved in quality of life.

Social support perceived by elderly people in social vulnerability according to family functionality: a cross-sectional study / Apoyo social percibido por personas mayores en situación de vulnerabilidad social según la funcionalidad familiar: un estudio transversal / Apoio social percebido por pessoas idosas em vulnerabilidade social segundo a funcionalidade familiar: um estudo transversal

ABSTRACT Objective: To compare the social support as perceived by elderly persons in a context of social vulnerability according to family functionality. Method: A cross-sectional study using a quantitative approach, carried out in São Carlos-SP, with 123 elderly people living in a context of high social vulnerability. The sample was divided into two groups: good family functionality and moderate/severe family dysfunction. Data was collected on sociodemographic characteristics, family functionality (Family APGAR) and social support (Medical Outcomes Study Social Support Scale). The Mann-Whitney, Chi-square and Fisher's exact statistical tests were used. Results: There was a statistically significant difference between social support and family functionality (p < 0.05). The group with good family functionality obtained higher median social support scores: affective 100.00; material 95.00; information 90.00; emotional 90.00; positive social interaction 85.00; when compared to the group with moderate/severe family dysfunction: affective 86.67; material 87.50; information 70.00; emotional 65.00; positive social interaction 65.00. Conclusion: Elderly persons living in dysfunctional families have less perceived social support when compared to those living in families with good family functionality.

RESUMEN Objetivo: Comparar el apoyo social percibido por personas mayores en un contexto de vulnerabilidad social según la funcionalidad familiar. Método: Estudio transversal con abordaje cuantitativo, realizado en São Carlos-SP, con 123 personas mayores residentes en contexto de alta vulnerabilidad social. La muestra fue dividida en dos grupos: buena funcionalidad familiar y disfunción familiar moderada/severa. Se recogieron datos sobre características sociodemográficas, funcionalidad familiar (APGAR Familiar) y apoyo social (Escala de Apoyo Social del Medical Outcomes Study). Se utilizaron las pruebas estadísticas de Mann-Whitney, Chi-cuadrado y exacta de Fisher. Resultados: Hubo una diferencia estadísticamente significativa entre el apoyo social y la funcionalidad familiar (p<0,05). El grupo con buena funcionalidad familiar obtuvo puntuaciones medias de apoyo social más altas: afectivo 100,00; material 95,00; información 90,00; emocional 90,00; interacción social positiva 85,00; en comparación con el grupo con disfunción familiar moderada/grave: afectivo 86,67; material 87,50; información 70,00; emocional 65,00; interacción social positiva 65,00. Conclusión: Las personas mayores que viven en familias disfuncionales tienen menos apoyo social percibido, en comparación con los que viven en familias con buena funcionalidad familiar.

RESUMO Objetivo: Comparar o apoio social percebido por pessoas idosas em contexto de vulnerabilidade social segundo a funcionalidade familiar. Método: Estudo transversal de abordagem quantitativa, realizado em São Carlos-SP, com 123 idosos inseridos em contexto de alta vulnerabilidade social. A amostra foi dividida em dois grupos: boa funcionalidade familiar e disfunção familiar moderada/severa. Foram coletados dados de caracterização sociodemográfica, funcionalidade familiar (APGAR de Família) e apoio social (Escala de Apoio Social do Medical Outcomes Study). Foram utilizados os testes estatísticos Mann-Whitney, Qui-quadrado e Exato de Fisher. Resultados: Houve diferença estatisticamente significante entre apoio social e funcionalidade familiar (p < 0,05). O grupo com boa funcionalidade familiar obteve maiores escores medianos de apoio social: afetivo 100,00; material 95,00; informação 90,00; emocional 90,00; interação social positiva 85,00; quando comparado ao grupo com disfunção familiar moderada/severa: afetivo 86,67; material 87,50; informação 70,00; emocional 65,00; interação social positiva 65,00. Conclusão: Pessoas idosas que vivem em famílias disfuncionais têm menos apoio social percebido quando comparadas àquelas que vivem em famílias com boa funcionalidade familiar.

Transtornos de identidade e de comportamento sexual: uma abordagem epidemiológica / Trastornos de identidad y comportamiento sexual: un enfoque epidemiológico / Disorders of identity and sexual behavior: an epidemiological approach

A pesquisa teve como objetivo caracterizar os pacientes acometidos por Transtornos de Identidade e de Comportamento Sexual e identificar sua ocorrência por sexo, bem como a procedência do paciente, diagnóstico e tempo de internação, tipo de alta e internação e fonte financiadora dos serviços prestados. Trata-se de estudo retrospectivo realizado em uma clínica psiquiátrica do Centro Oeste Mineiro. A amostra foi composta por 2715 pacientes, predominante do sexo masculino (1518-55,9%); a faixa etária de 21 a 30 anos (917-33,7%); a procedência para internação dos Centros de Atenção Psicossocial (1123-41,3%), os diagnósticos de "Outros Transtornos de preferência sexual" (2567-94,5%); o tempo de permanência de 1 a 30 dias (1770-65,2%); as altas médicas (1818-66,9%); as primeiras internações (1775-65,3%) e o Sistema Único de Saúde como principal financiador (2.004-73,1%). Evidenciou-se que os transtornos são mais comuns nos homens jovens e percebeu-se o pouco conhecimento dos profissionais de saúde sobre estes transtornos.

El objetivo fue caracterizar pacientes afectados por trastornos de identidad y comportamiento sexual y determinar su incidencia por sexo, así como la procedencia, el diagnóstico y la duración de la estancia, tipo de ingreso y de alta y fuente de financiamiento para los servicios prestados. Es retrospectivo, realizado en una clínica psiquiátrica del Centro Oeste minero, Brasil. La muestra constituida por 2.715 pacientes varones en su mayoría (1518-55,9%), con edades entre 21 y 30 años (917-33,7%). La origen para hospitalización de los Centros de Atención Psicosocial (1123-41,3%), el diagnóstico de "Otros trastornos de la preferencia sexual" (2567-94,5%), el tiempo en el hospital de 30 días (1770-65,2%), alta médica (1818-66,9%), primera hospitalización (1775-65,3%) y el Sistema Único de Salud como pagador (2004-73,1%). Los trastornos son más comunes en hombres jóvenes y se percibió poco conocimiento de los profesionales acerca de estos trastornos.

The research aimed to characterize patients affected by Identity Disorders and Sexual Behavior and identify their occurrence by sex, as well as the patient's origin, diagnosis and length of stay, type of admission and discharge and funding source for services rendered. This is a retrospective study conducted in a psychiatric clinic in the Midwest Miner. The sample consisted of 2715 patients, predominantly male (1518- 55.9%), age range 21-30 years (917-33.7%), the origin of hospitalization for Psychosocial Care Centers (1123 - 41.3%), the diagnosis of "Other Disorders of sexual preference" (2567- 94.5%), the residence time of 1 to 30 days (1770-65.2%), the high medical (1818-66,9%), the first admissions (1775-65.3%) and Health System as the main funder (2004 to 73.1%). It was evident that the disorders are more common in young men and it was realized how little knowledge of health professionals about these disorders.

Um perfil do docente de medicina e sua participação na reestruturação curricular / A profile of medical professors and their role in reorganizing the course curriculum

A dificuldade em obter a adesão dos docentes de Medicina às reformas curriculares e pesquisas cor-relatas tem sido recorrente e explicada pela não profissionalização da função docente; complexidade e diversidade de atividades e cenários que caracterizam o ensino médico; vínculo precário com as instituições e dedicação parcial às escolas; insegurança; corporativismo e resistências a mudanças. Esta pesquisa objetivou descrever o perfil dos docentes e analisar suas expectativas quanto à formação médica e sua participação no planejamento pedagógico, visando estimular a reorientação curricular, promovendo o ensino "no e para" o Sistema Único de Saúde (SUS). Os docentes observam que aspectos organizacionais e gerenciais da universidade impedem o envolvimento pessoal no Projeto Pedagógico. Por outro lado, reconhecem a necessidade de mudanças no ensino e manifestam interesse pela docência no nível superior. É preciso exercitar a reflexão sobre a prática, para que esta possa ser uma referência para a interpelação e transformação das formas tradicionais de conceber o ensino em saúde.

The difficulty in obtaining adherence by medical faculty members to curricular reform and related research has been a recurrent problem in Brazil, due to the non-professionalization of the faculty's role, complexity and diversity of teaching activities and scenarios in medical schools, precarious faculty contracts with teaching institutions, part-time teaching, insecurity, corporatism, and general resistance to change. This study aimed to describe the profile of medical faculty and analyze their expectations towards medical training and their role in planning the curriculum, with a view towards stimulating curricular reorientation, while promoting teaching "in and for" the Unified National Health System (SUS). Professors stated that organization and management issues in the university impede their personal involvement in the Teaching Project. Meanwhile, they acknowledged the need for changes in teaching and expressed interest in university-level teaching. In-depth reflection is needed on teaching practice in medicine in order for it to become a reference for dialogue and change in the traditional approaches to teaching in health.

Possibilidade da utilização de plasma rico em plaquetas (PRP) autólogo para tratamento de feridas cutâneas crônicas / Possibility of use of platelet-rich plasma (PRP) autologous treatment of cutaneous chronic wounds

levantamento bibliográfico na literatura sobre a utilização de plasma rico em plaquetas PRPautólogo para tratamento de feridas cutâneas crônicas. Método: pesquisa realizada em bancos dedados eletrônicos, na literatura e em artigos de diversos autores publicados no meio científico.Realizou-se um estudo de revisão sobre o funcionamento das plaquetas dentro da cascata decoagulação, além das diversas utilizações medicinais do plasma rico em plaqueta para tratamentosvariados. Resultados: pela comparação de protocolos para extração, foi possível refletir sobre ométodo mais adequado à obtenção de PRP autólogo a baixo custo, destinado à utilização no tratamentode ulceração dérmicas crônicas. A adoção deste tipo de procedimento pode acelerar,exponencialmente, a reparação tecidual, minimizando, principalmente, o risco de infecções e o custodo tratamento além de grande importância sobre impacto psíquico, social e econômico do paciente.Considerações finais: considerando a pesquisa realizada, assim como, as diversas utilizações do PRP,suas formas de obtenção e principalmente as formas de obtenção do PRP autólogo, pode-se considerara realização de um estudo mais aprofundado, juntamente com uma equipe multidisciplinar, para aobtenção do PRP autólogo e a utilização sobre feridas crônicas.

Obtained through relatively simple procedures, the platelet-rich plasma (PRP) is used in variousmedical specialties, especially orthopedics and dentistry, and dermatology, aesthetic medicine andplastic surgery, with its benefits reported by several studies, mainly due to the fact that the plateletsrelease chemical mediators known as cytokines or platelet derived growth factor which stimulatesproduction of collagen and other products, thus increasing the capacity of tissue regeneration and skinhealing. Because is autologous PRP gel minimizes the chance of allergic reactions, increases the effectof filling time and reduces the chances of rejection, but, although many likely benefits and potential, isstill underutilized as a royal treatment. Through the comparison of protocols for the extraction, it waspossible to reflect on the most appropriate method of obtaining autologous PRP at low cost for use inthe treatment of chronic dermal ulcers. The adoption of such a procedure can dramatically acceleratetissue repair, especially minimizing the risk of infections and the cost of treatment beyond majorimpact on the psychological, social and economic development of the patient

Hospitalizations for HIV/AIDS: differences between sexes.

BACKGROUND: Women are especially vulnerable to HIV infection because of biological, social, cultural, and economic factors. In Brazil, AIDS was initially seen predominantly in homosexual men, but the epidemic gradually reached a gender balance as increasing numbers of women became infected with HIV. OBJECTIVE: The aim of the present study was to identify the clinical and epidemiologic characteristics of hospitalized patients with HIV/AIDS of both sexes and compare the differences between them. METHODS: This epidemiologic cross-sectional study evaluated gender differences in demographic, social, clinical, and epidemiologic characteristics of patients diagnosed with HIV/AIDS who were admitted for any reason to the Public Hospital of the Medical School of the Federal University of Triângulo Mineiro, Uberaba, Minas Gerais State, Brazil. RESULTS: A total of 363 patients were included in the analysis, with a male/female ratio of 1.1:1.0. Forty-one percent of women were pregnant. Mean age at hospitalization and duration of hospitalization were significantly greater among men (P<0.05). Men and nonpregnant women were admitted because of infection significantly more often than were pregnant women (P<0.05). Significantly more single men who reported homosexual, bisexual, or heterosexual behavior associated with drug use were admitted compared with women (P<0.05). Women admitted for treatment were significantly more likely than men to be employed (P<0.05). Adherence to antiretroviral treatment and T CD4+ lymphocyte count indicated important differences between the sexes, with better parameters observed among nonpregnant and pregnant women compared with men. CONCLUSIONS: In the present study, women with HIV/AIDS who were admitted to the hospital for any reason were in better clinical condition compared with men. This observation may be partially explained by the proportion of pregnant women in the study population. These findings suggest that future studies should examine pregnant women with HIV/AIDS as a separate population group to avoid bias in analysis.

Perfil clínico-epidemiológico de pacientes com HIV/Aids internados em um hospital de ensino do Brasil / Clinical and epidemiologic profile of hospitalized patients with HIV/Aids

Objetivo: Traçar o perfil clínico-epidemiológico de pacientes com HIV/Aids hospitalizados. Métodos: Foram selecionados pacientes com diagnóstico de infecção pelo HIV/Aids, acima dos 14 anos de idade, internados no Hospital Escola da Universidade Federal do Triângulo Mineiro, durante os anos de 2004 e 2005, analisando-se variáveis clínico-epidemiológicas e sociodemográficas. Resultados: Foram selecionados 363 pacientes (52,3% masculinos [p=0,2]), que foram submetidos a 592 internações. No ano de 2004 ocorreram 320 internações e em 2005, 272 (p=0,005). A média de idade foi de 35,1 (± 10,3) anos. A maioria dos pacientes era formada por pessoas solteiras, com baixo nível de escolaridade, relatando ser heterossexuais. As infecções motivaram 417 (70,8%) internações, a maioria (81,8%), oportunista. Contagem de linfócitos T CD4+ < 350 céls./mm³ e carga viral > 5.000 cópias RNA/ml foram encontradas em 65,5% e 45% dos pacientes, respectivamente. Óbitos aconteceram em 13,5% dos pacientes, todos por causas infecciosas, e neoplasias foram observadas em 3,3% dos casos. Na ocasião da internação, cerca de 69% dos pacientes estavam em uso da HAART. Conclusões: As características clínico-epidemiológicas encontradas neste estudo são semelhantes às relatadas em outros centros brasileiros e de outros países em desenvolvimento e, em alguns aspectos, parecidas às de nações desenvolvidas. Apesar da terapia anti-retroviral, as infecções oportunistas continuam sendo as principais causas de internação.

Anxiolytic-like effects of short-term postnatal protein malnutrition in the elevated plus-maze test.

Given that protein malnutrition induces structural, neurochemical and functional changes in the CNS, the present study aimed to investigate the effects of short-term early protein malnutrition on the behavior and reactivity to diazepam (DZ) in the elevated plus-maze test (EPM). Male Wistar rats (n=176) from well-nourished (16%-protein) or malnourished litters (6%-protein) were distributed in five different groups: W (well-nourished), M7 (malnourished for 7 days), M14 (malnourished for 14 days), M21 (malnourished for 21 days) and M28 (malnourished for 28 days) since birthday. EPM results showed that the longer the exposition to the deficient diet, the lower the anxiety of malnourished animals, a result similar to that produced by the treatment with DZ. This anxiolytic-like effect suggested that short-term malnutrition may affect neural and/or neurochemical systems believed to underlie behavioral expression in anxiogenic experimental situations.

Effects of different malnutrition techniques on the behavior of rats tested in the elevated T-maze.

The influence of different malnutrition techniques on the behavior of adult animals was investigated in the elevated T-maze (ETM). Control litters (C) were composed by eight pups constantly kept with their mother and fed by a 16%-protein diet ad libitum; protein malnutrition litters (PM) were fed by a 6%-protein diet; protein-calorie malnutrition litters (PCM) were fed with 50% of the 16%-protein diet ingested by C litters; malnutrition by increase in the size of the litter (LLM-number of pups was twice the number of pups in C litters), and malnutrition by separation (SM-litters spent half of the day with non-lactating females). After weaning, all groups received lab chow diet until the test day (70th day). During the test were recorded the basal, avoidance 1, avoidance 2 and escape latencies. The data showed that PM, PCM, LLM and SM animals showed lower increases in avoidance latencies, when compared to their control groups. However, malnutrition did not affect escape latencies. The nature of these alterations seems to be nutritional, as the extra-nutritional factors (i.e. maternal care) differ a lot among the malnutrition techniques. These results suggest that malnutrition, irrespective of the technique, altered the neural mechanisms believed to control defensive behaviors in the ETM.

Early postnatal protein malnutrition affects learning and memory in the distal but not in the proximal cue version of the Morris water maze.

Learning and memory of early postnatal protein malnourished rats were investigated in the Morris water maze. During the lactation period (21 days) each litter (mother plus six male and two female pups) was provided with 16% (well-nourished) or 6% (malnourished) protein diets. After weaning, rats remained on the same diet until 49 days of age. From day 50 on all animals were fed a commercial lab chow. Experiments started on day 70. In experiment I (proximal cue version) the animals were trained to escape from water to a visible platform (3 cm above the water level) in six trials daily for four consecutive days, completing 24 trials. In experiment II (distal cue version) the animals were trained to escape from water to a submerged platform using the same procedure as in experiment II. After the 24th trial, the platform was removed and the animals were submitted to a 60-s trial (probe trial). Seven and twenty-eight days after training, the retention test was conducted in one 180-s trial. The results showed no impairment of the learning or memory of malnourished animals tested in the proximal cue version but an increased latency and distance traveled to find the submerged platform in the distal cue version of the procedure. In the distal cue version the malnourished animals also showed increased latency to find the platform 7 and 28 days after the test training. No difference due to diet was found in the probe trial test indicating that, once the task is acquired, malnourished rats can manage extra-maze cues as easily as well-nourished rats. It is suggested that the present results can be due to alterations produced by protein malnutrition in the hippocampal formation or also to reflect the higher emotionality of rats following early malnutrition, specially considering the fact that postnatally malnourished animals are more reactive to unpleasant or aversive stimuli as cold water.