ABSTRACT
FUNDAMENTO: O uso maciço da Terapia Antirretroviral (TARV) na população com vírus da imunodeficiência adquirida (HIV) coincidiu com um aumento das doenças cardiovasculares, causa importante de morbimortalidade nesse grupo. OBJETIVO: Determinar a frequência de aterosclerose carotídea e avaliar a associação entre os níveis dos biomarcadores e o espessamento da camada médio-intimal carotídea em indivíduos HIV positivos, atendidos em serviços de referência para HIV em Pernambuco. MÉTODOS: Corte transversal com 122 pacientes HIV positivos. Considerou-se aterosclerose carotídea subclínica o aumento da espessura da camada média intimal da carótida comum > 0,8 milímetros ou placas no ultrassom de carótidas. Os biomarcadores inflamatórios analisados foram IL6, IL1-β, TNF-α, PCR-ultrassensível, sVCAM-1 e sICAM-1. RESULTADOS: Dos 122 pacientes analisados, a maioria era de homens (60,7%), com > 40 anos (57,4%), em uso de TARV (81,1%). A prevalência de aterosclerose foi de 42,6% (52 casos). Pacientes com idade acima de 40 anos e Framingham intermediário ou alto apresentaram maior chance de desenvolver aterosclerose na análise univariada. Idade acima de 40 anos (OR = 6,57 IC 2,66 -16,2; p = 0,000), sexo masculino (OR = 2,76 IC 1,12-6,79; p = 0,027) e a condição de síndrome metabólica (OR = 2,27 IC 0,94-5,50; p = 0,070) mostraram-se associados à aterosclerose na análise multivariada. Níveis elevados de citocinas inflamatórias e moléculas de adesão não mostraram associação com a presença de aterosclerose. CONCLUSÃO: Não houve associação entre os biomarcadores inflamatórios, moléculas de adesão e presença de aterosclerose carotídea. Entretanto, evidenciou-se em homens, pessoas com mais de 40 anos, portadores de escore de Framingham intermediário/alto ou síndrome metabólica maior chance de aterosclerose subclínica.
BACKGROUND: The massive use of Highly-Active Antiretroviral Therapy (HAART) in individuals with human immunodeficiency virus (HIV) coincided with an increase in cardiovascular disease, a major cause of morbidity and mortality in this group. OBJECTIVE: To determine the frequency of carotid atherosclerosis and the association between biomarker levels and carotid intimal-medial thickening in HIV-positive individuals treated for HIV at referral centers in Pernambuco. METHODS: This was a cross-sectional study of 122 HIV-positive patients. Subclinical carotid atherosclerosis was considered with the presence of increased intimal-medial thickness of the common carotid artery > 0.8 mm or plaques in the carotid ultrasound. The following inflammatory biomarkers were analyzed: IL6, IL1-β, TNF-α, high-sensitivity CRP, sVCAM-1 and sICAM-1. RESULTS: Of the 122 patients analyzed, most were men (60.7%) aged > 40 years (57.4%) receiving HAART (81.1%). The prevalence of atherosclerosis was 42.6% (52 cases). Patients older than 40 years and intermediate or high Framingham score were more likely to develop atherosclerosis at the univariate analysis. Age older than 40 years (OR = 6.57, 95%CI: 2.66 to 16.2, p = 0.000), male gender (OR = 2.76, 95%CI: 1.12 to 6.79, p = 0.027) and presence of syndrome metabolic (OR = 2.27, 95%CI: 0.94 to 5.50, p = 0.070) were associated with atherosclerosis at the multivariate analysis. Elevated levels of inflammatory cytokines and adhesion molecules were not associated with the presence of atherosclerosis. CONCLUSION: There was no association between inflammatory biomarkers, adhesion molecules and presence of carotid atherosclerosis. However, a higher chance of subclinical atherosclerosis was observed in men, those older than 40 years, with intermediate / high Framingham score or metabolic syndrome.
Subject(s)
Adult , Female , Humans , Male , Carotid Artery Diseases/blood , Coronary Artery Disease/blood , HIV , HIV Infections/blood , Age Factors , Antiretroviral Therapy, Highly Active/adverse effects , Biomarkers/blood , Brazil/epidemiology , Carotid Intima-Media Thickness , Carotid Artery Diseases/epidemiology , Coronary Artery Disease/epidemiology , Epidemiologic Methods , HIV Infections/drug therapy , HIV Infections/physiopathology , Metabolic Syndrome/blood , Risk Factors , Sex DistributionABSTRACT
A través del método de equilibrio batch se comparó la adsorción de las catecolaminas Dopamina (DA), Noradrenalina (NA) y Adrenalina (A), y de los metabolitos ácido dihidroxifenilacético (Dopac) y ácido indolacético (5- HIAA) en las fases sólidas octadecil (C18) hidrofóbica, diol (C Diol) hidrofílica y de intercambio catiónico débil (WCX). En la fase sólida WCX a pH 4,0 se observó un 78% de adsorción de catecolaminas y 68% de adsorción de Dopac. Las isotermas de adsorción de las catecolaminas en la fase WCX son de tipo Langmuir. La adrenalina tiene mayor afinidad que la dopamina por la fase WCX a pH 4,0 y la dopamina mayor afinidad que el Dopac y éste es coadsorbido sobre las catecolaminas adsorbidas en la fase WCX. Un ensayo con solventes orgánicos demostró que el tolueno extrajo selectivamente de una mezcla sintética el Dopac y el 5-HIAA coadsorbido, mientras que en una muestra de tejido cerebral de ratas experimentales fueron extraídos el Dopac y el ácido homovanílico (HVA). Estos resultados sirvieron para proponer un paso adicional de extracción con solventes orgánicos para la separación de metabolitos ácidos durante la extracción en fase sólida (EFS) en el análisis de catecolaminas.
The adsorptions of Dopamine (DA), Noradrenaline (NA), and Adrenaline (A) catecholamines were compared by using the batch equilibrium method, as well as those of the dihydroxyphenylacetic acid (Dopac) and indolacetic acid (5-HIAA) metabolites on the hydrophobic octadecyl (C18), hydrophilic diol (C Diol) and weak cation exchange (WCX) solid phases. On the WCX solid phase at pH 4.0, catecholamines adsorption of 78% and Dopac adsorption of 68% were observed. The adsorption isotherms of catecholamines on the for the WCX phase at pH 4.0 than dopamine, dopamine has greater affinity than Dopac, and this latter is coadsorbed over the adsorbed catecholamines on the WCX phase. A trial with organic solvents demonstrated that toluene selectively extracted Dopac and the coadsorbed 5-HIAA from a synthetic mix, while in a brain tissue specimen from experimental rats, Dopac and homovanilic acid (HVA) were extracted. These results served to propose an additional extraction step with organic solvents throughout the separation of acid metabolites during solid phase extraction (EFS) for the analysis of catecholamines.
Subject(s)
Animals , Rats , 3,4-Dihydroxyphenylacetic Acid/cerebrospinal fluid , Catecholamines/chemistry , Hydroxyindoleacetic Acid/cerebrospinal fluid , Dopamine , Epinephrine/chemistry , Norepinephrine , Solid Phase ExtractionABSTRACT
Avaliou-se a relação colina/N-acetil-aspartato (Co/NAA), obtida pela espectroscopia multivoxel com tempo de eco (TE) curto, na graduação histológica dos astrocitomas encefálicos (graus I, II e III-IV), comparando com o parênquima cerebral normal. Observou-se aumento significativo (p<0,05) das relações médias de Co/NAA nos três grupos de astrocitomas estudados em relação ao tecido normal, havendo tendência de elevação com o aumento da graduação, sem significância estatística, que correspondeu a: 0,53±0,24 no grupo controle, 1,19±0,49 no grau I, 1,58±0,65 no grau II e 5,13±8,12 no grupo de alto grau (graus III-IV). Houve aumento da relação Co/NAA em 4/5 (80 por cento) dos pacientes com grau I, 5/6 (83 por cento) com grau II e 10/20 (50 por cento) com graus III e IV. Concluiu-se que a espectroscopia multivoxel com TE curto pode ser usada na discriminação entre o parênquima normal e o tecido neoplásico. Entretanto, nem todo tecido neoplásico estudado apresentou aumento da relação Co/NAA, principalmente o grupo com maior malignidade.
The choline/N-acetyl-aspartate (Cho/NAA) ratio, obtained by the multivoxel spectroscopy with short echo time (TE), was evaluated, in the histological grading of the brain astrocytomas (grades I, II and III-IV) in comparison with the normal cerebral parenchyma. A significant increase (p<0.05) in the average ratios of Cho/NAA was observed in the three astrocytoma groups studied in relation to normal tissue, having a tendency to increase with the increase in grading, without any statistic significance, which corresponded to: 0.53±0.24 in the control group, 1.19±0.49 in grade I, 1.58±0.65 in grade II and 5.13±8.12 in the high grade group (grades III-IV), with variation in the values encountered. There was an increase in the Cho/NAA ratio in 4/5 (80 percent) in grade I, 5/6 (83 percent) in grade II and 10/20 (50 percent) in grades III and IV. We conclude that multivoxel spectroscopy with short TE can be used in discriminating between normal parenchyma and neoplasm tissue. However, not all neoplasm tissue studied presented an increase in Cho/NAA, especially in the group with higher grade of malignancy.