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1.
J Community Health ; 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38409627

RESUMO

Our study assessed the characteristics of people living with HIV (PLWH) detected via opportunistic screening in Valencia (Spain) to determine diagnoses potentially missed under a more restrictive, indicator-condition diagnostic strategy. We conducted a retrospective analysis of electronic health records of 97 PLWH diagnosed between April 2019 and August 2022. The main outcomes reported were patient CD4+ T cell count, known HIV risk factors at diagnosis, and missed opportunities for diagnosis, defined as the failure of a previously untested patient to undergo HIV testing despite attending previous visits to healthcare facilities prior to diagnosis. Successful linkage to care was achieved for 95.9% of diagnosed patients. Half of the PLWH were diagnosed late, while 47.8% did not meet the criteria for indicator-condition-driven HIV diagnosis at the time of their diagnosis. Additionally, 52.2% did not receive HIV testing despite an average of 5.1 ± 6.0 healthcare visits in the 12 months prior to diagnosis. Spaniards had more missed opportunities for diagnosis than foreigners (64% vs. 40%, p = 0.02). Depending solely on an indicator-condition-driven HIV diagnosis approach could result in 47.8% of cases being missed. Including "migrants" as a testing criterion could lower missed diagnoses to 25.3% but might create inequities in prevention access. In conclusion, our findings provide valuable insights to enhance HIV testing, early diagnosis, and linkage to care. While it is crucial to uphold the indicator-condition-driven HIV diagnosis as baseline practice, improving screening strategies will decrease late diagnoses and missed opportunities, thereby effectively contributing to end the epidemic.

2.
Int J Mol Sci ; 25(13)2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-39000607

RESUMO

Natural killer (NK) cells play a crucial role in innate immunity, particularly in combating infections and tumors. However, in hematological cancers, NK cells often exhibit impaired functions. Therefore, it is very important to activate its endosomal Toll-like receptors (TLRs) as a potential strategy to restore its antitumor activity. We stimulated NK cells from the peripheral blood mononuclear cells from children with acute lymphoblastic leukemia and NK cells isolated, and the NK cells were stimulated with specific TLR ligands (Poly I:C, Imiquimod, R848, and ODN2006) and we evaluated changes in IFN-γ, CD107a, NKG2D, NKp44 expression, Granzyme B secretion, cytokine/chemokine release, and cytotoxic activity. Results revealed that Poly I:C and Imiquimod enhanced the activation of both immunoregulatory and cytotoxic NK cells, increasing IFN-γ, CD107a, NKG2D, and NKp44 expression. R848 activated immunoregulatory NK cells, while ODN2006 boosted CD107a, NKp44, NKG2D, and IFN-γ secretion in cytotoxic NK cells. R848 also increased the secretion of seven cytokines/chemokines. Importantly, R848 and ODN 2006 significantly improved cytotoxicity against leukemic cells. Overall, TLR stimulation enhances NK cell activation, suggesting TLR8 (R848) and TLR9 (ODN 2006) ligands as promising candidates for antitumor immunotherapy.


Assuntos
Imiquimode , Células Matadoras Naturais , Ativação Linfocitária , Poli I-C , Leucemia-Linfoma Linfoblástico de Células Precursoras , Receptores Toll-Like , Humanos , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/efeitos dos fármacos , Células Matadoras Naturais/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Poli I-C/farmacologia , Ativação Linfocitária/efeitos dos fármacos , Ativação Linfocitária/imunologia , Imiquimode/farmacologia , Receptores Toll-Like/metabolismo , Receptores Toll-Like/agonistas , Criança , Oligodesoxirribonucleotídeos/farmacologia , Citocinas/metabolismo , Feminino , Interferon gama/metabolismo , Masculino , Imidazóis/farmacologia , Citotoxicidade Imunológica/efeitos dos fármacos , Pré-Escolar , Agonistas do Receptor Semelhante a Toll
3.
Inorg Chem ; 60(4): 2178-2187, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33502194

RESUMO

The specific recognition of AT-rich DNA sequences opens up the door to promising diagnostic and/or therapeutic strategies against gene-related diseases. Here, we demonstrate that amphiphilic PtII complexes of the type [Pt(dmba)(N∧N)]NO3 (dmba = N,N-dimethylbenzylamine-κN, κC; N∧N = dpq (3), dppz (4), and dppn (5)) recognize AT-rich oligonucleotides over other types of DNA, RNA, and model proteins. The crystal structure of 4 shows the presence of significant π-stacking interactions and a distorted coordination sphere of the d8 PtII atom. Complex 5, containing the largest π-conjugated ligand, forms supramolecular assemblies at high concentrations under aqueous environment. However, its aggregation can be promoted in the presence of DNA at concentrations as low as 10 µM in a process that "turns on" its excimer emission around 600 nm. Viscometry, gel electrophoresis, and theoretical calculations demonstrate that 5 binds to minor groove when self-assembled, while the monomers of 3 and 4 intercalate into the DNA. The complexes also inhibit cancer cell growth with low-micromolar IC50 values in 2D tissue culture and suppress tumor growth in 3D tumor spheroids with a multicellular resistance (MCR) index comparable to that of cisplatin.


Assuntos
Complexos de Coordenação/química , DNA/química , Compostos Organoplatínicos/química , Células A549 , Cristalografia por Raios X , Ensaio de Desvio de Mobilidade Eletroforética , Humanos , Substâncias Intercalantes/química , Ligantes , Estrutura Molecular , Análise Espectral/métodos , Estereoisomerismo
4.
Inorg Chem ; 59(14): 10275-10284, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32628466

RESUMO

In the process of synthesis of a new drug, as important as the drug itself is the formulation used, because the same compound can present a very different efficacy depending on how it is administered. In this work, we demonstrate how the antitumor capacity of a new octahedral organoruthenium complex, [Ru(ppy-CHO)(phen)2][PF6] is affected by its encapsulation in different types of mesoporous silica nanoparticles. The interactions between the Ru complex and the silica matrix and how these interactions are affected at two different pHs (7.4 and 5.4, mimicking physiological and endolysosomal acidic conditions, respectively) have been studied. The encapsulation has also been shown to affect the induction of apoptosis and necrosis and progression of the cell cycle compared to the free drug. The encapsulation of the Ru complex in nanoparticles functionalized with amino groups produced very high anticancer activity in cancer cells in vitro, especially against U87 glioblastoma cells, favoring cellular internalization and significantly increasing the anticancer capacity of the initial non-encapsulated Ru complex.


Assuntos
Antineoplásicos/farmacologia , Complexos de Coordenação/farmacologia , Portadores de Fármacos/química , Nanopartículas/química , Dióxido de Silício/química , Antineoplásicos/química , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Complexos de Coordenação/química , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Rutênio/química
5.
J Clin Monit Comput ; 34(5): 1095-1104, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31559523

RESUMO

The objective assessment of the radiculopathy secondary to lumbar disc herniation is essential to optimize treatment. The quantitative sensory test (QST) is a useful tool to evaluate somatosensory nerves. The aim of our study is quantifying by QST the alterations of patients treated by epidural injections (EI) or surgical lumbar decompression (LD). A prospective, cohort study has done in Hospital Universitario Rio Hortega, Valladolid, Spain, between January 2014 and December 2016.The study includes 74 patients (40 men) who underwent EI (50) or LD (24) with lumbar disc herniation and treated by EI or LD. Participants underwent a brief battery of QST at baseline and after 1, 3 and 6 months of follow-up. QST threshold were measured in three series of five warm and cold stimuli (cold detection threshold, warm detection threshold, cold pain threshold, heat pain threshold) bilateral. Additionally, pain assessment (Visual Analogue Scale) and neurological examination was performed. Thermal thresholds were analysed and compared. In the EI group, warm detection threshold (WDT) measurements were significantly lower after 3 and 6 months of follow-up (40.44 ± 3.42°C vs. 38.30 ± 3.73°C and 37.48 ± 4.58°C respectively, p = 0.031 and p = 0.043). LD group showed lower WDT measurements at 1, 3 and 6 months of follow up (40.20 ± 2.97°C vs., 37.98 ± 2.04°C, 37.43 ± 3.80°C and 36.55 ± 2.77°C respectively, p = 0.049, p = 0.032 and p = 0.024) and lower heat pain threshold (HPT) levels after 3 and 6 months of follow-up (48.75 ± 1.37°C vs. 43.26 ± 0.60°C and 42.06 ± 1.37°C respectively, p = 0.037 and p = 0.021). QST explorations were compared between both groups. At 1-month follow-up only the WDT parameter was different, higher in EI group (40.98 ± 4.04°C vs. 37.98 ± 2.04°C, p = 0.043). There were no differences in any parameter measured by QST after 3 and 6-months follow-up between both groups. Epidural injection should be considered the first-step of treatment.


Assuntos
Radiculopatia , Estudos de Coortes , Discotomia , Humanos , Injeções Epidurais , Vértebras Lombares/cirurgia , Masculino , Estudos Prospectivos , Radiculopatia/tratamento farmacológico , Radiculopatia/etiologia
6.
Inorg Chem ; 58(19): 12954-12963, 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31550148

RESUMO

The luminescent chalcone gold(I) conjugates [Au(PPh3)(AN3E)]PF6(1) and [Au(SIMes)(AN3E)]PF6 (2) (AN3E = (E)-3-(9-anthracenyl)-1-(4-pyridyl)propenone; SIMes = N,N'-dimesitylimidazolidin-2-ylidene; Mes = 2,4,6-trimethylphenyl)) were prepared and characterized; complex 1 was also characterized by X-ray crystallography. In MTT assays against a panel of three human colon, a melanoma and a breast cancer cell lines both complexes were antiproliferative with low micromolar IC50 values. It is noteworthy that HCT116p53-/- colon carcinoma cells lacking functional p53 (a vital tumor suppressor) were more susceptible to them than the wildtype parent cell line. In flow cytometry analyses, the gold conjugates induced a significant arrest in G2/M phase primarily. Complexes 1 and 2 quickly increased the production of reactive oxygen species (ROS) and induced mitochondrial membrane potential depolarization, higher ROS values being obtained after coadministration with enzymatic inhibitors. The free chalcone AN3E and its gold(I) complex conjugates located in the cell mitochondria according to confocal microscopy. In addition, complexes 1 and 2 showed in vivo antivascular effects on the chorioallantoic membrane (CAM) of fertilized specific-pathogen-free (SPF) chicken eggs.


Assuntos
Inibidores da Angiogênese/farmacologia , Antracenos/farmacologia , Antineoplásicos/farmacologia , Chalcona/farmacologia , Neoplasias do Colo/tratamento farmacológico , Compostos Organoáuricos/farmacologia , Inibidores da Angiogênese/química , Animais , Antracenos/química , Antineoplásicos/química , Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Chalcona/análogos & derivados , Galinhas , Cristalografia por Raios X , Células HCT116 , Humanos , Modelos Moleculares , Compostos Organoáuricos/química
7.
Sensors (Basel) ; 19(16)2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31430940

RESUMO

BACKGROUND: Several studies have examined the differences between the different small-sided game (SSG) formats. However, only one study has analysed how the different variables that define SSGs can modify the goalkeeper's behavior. The aim of the present study was to analyze how the modification of the pitch size in SSGs affects the physical demands of the goalkeepers. METHODS: Three professional male football goalkeepers participated in this study. Three different SSG were analysed (62 m × 44 m for a large pitch; 50 m × 35 m for a medium pitch and 32 m × 23 m for a small pitch). Positional data of each goalkeeper was gathered using an 18.18 Hz global positioning system. The data gathered was used to compute players' spatial exploration index, standard ellipse area, prediction ellipse area The distance covered, distance covered in different intensities and accelerations/decelerations were used to assess the players' physical performance. RESULTS AND CONCLUSIONS: There were differences between small and large SSGs in relation to the distances covered at different intensities and pitch exploration. Intensities were lower when the pitch size was larger. Besides that, the pitch exploration variables increased along with the increment of the pitch size.

8.
Biol Sport ; 36(2): 155-161, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31223193

RESUMO

This study examined the temporal effects of technical fouls on the performance of the fouling and opposing teams in elite basketball games. A sample of 80 technical fouls was collected from 65 international games. The fouls were charged either to players on court or to the bench players/coaching staff. Performance measures considered were the points scored (during 1, 3, and 5 ball possessions), fouls received, violations, and turnovers during 5 ball possessions before and after a technical foul was called. Data were also obtained on several contextual variables. The results showed that the opposing team scored slightly more points compared to the fouling team during 1 ball possession before and after a foul was charged to the coach/bench personnel (F=5.934; p=0.019; ES=0.11). The results also showed that both types of technical fouls are generally positive for the opposing team (mid-term effects) and for the fouling team only during the short-term performance (points scored after 1 ball possession). Furthermore, significant differences between teams were found when comparing the fouls received, with the opposing team receiving more fouls after both types of technical fouls (F=5.364; p<0.001; ES=0.50 and F=26.350; p<0.001; ES=0.35). However, the gender and contextual variables had no significant effect on any of the performance measures. The results highlight the positive short-term (1 ball possession) and the adverse mid-term (5 ball possessions) strategic effect of technical fouls for the fouling team, and call for coaches and practitioners to design specific training scenarios that involve tactics and strategies to avoid a negative performance immediately after the technical foul.

9.
Hepatology ; 66(2): 344-356, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28109003

RESUMO

We assessed non-liver-related non-acquired immunodeficiency syndrome (AIDS)-related (NLR-NAR) events and mortality in a cohort of human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients treated with interferon (IFN) and ribavirin (RBV), between 2000 and 2008. The censoring date was May 31, 2014. Cox regression analysis was performed to assess the adjusted hazard rate (HR) of overall death in responders and nonresponders. Fine and Gray regression analysis was conducted to determine the adjusted subhazard rate (sHR) of NLR deaths and NLR-NAR events considering death as the competing risk. The NLR-NAR events analyzed included diabetes mellitus, chronic renal failure, cardiovascular events, NLR-NAR cancer, bone events, and non-AIDS-related infections. The variables for adjustment were age, sex, past AIDS, HIV transmission category, nadir CD4+ T-cell count, antiretroviral therapy, HIV RNA, liver fibrosis, HCV genotype, and exposure to specific anti-HIV drugs. Of the 1,625 patients included, 592 (36%) had a sustained viral response (SVR). After a median 5-year follow-up, SVR was found to be associated with a significant decrease in the hazard of diabetes mellitus (sHR, 0.57; 95% confidence interval [CI], 0.35-0.93; P = 0.024) and decline in the hazard of chronic renal failure close to the threshold of significance (sHR, 0.43; 95% CI, 0.17-1.09; P = 0.075). CONCLUSION: Our data suggest that eradication of HCV in coinfected patients is associated not only with a reduction in the frequency of death, HIV progression, and liver-related events, but also with a reduced hazard of diabetes mellitus and possibly of chronic renal failure. These findings argue for the prescription of HCV therapy in coinfected patients regardless of fibrosis stage. (Hepatology 2017;66:344-356).


Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Coinfecção/tratamento farmacológico , Hepatite C Crônica/epidemiologia , Interferon-alfa/uso terapêutico , Ribavirina/uso terapêutico , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adulto , Estudos de Coortes , Coinfecção/fisiopatologia , Comorbidade , Bases de Dados Factuais , Quimioterapia Combinada , Feminino , Seguimentos , HIV/efeitos dos fármacos , HIV/isolamento & purificação , Hepacivirus/efeitos dos fármacos , Hepacivirus/isolamento & purificação , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/tratamento farmacológico , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Estudos Retrospectivos , Medição de Risco , Espanha/epidemiologia , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento
11.
Exp Cell Res ; 352(1): 9-19, 2017 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28132881

RESUMO

Enveloped viruses induce cell-cell fusion when infected cells expressing viral envelope proteins interact with target cells, or through the contact of cell-free viral particles with adjoining target cells. CD4+ T lymphocytes and cells from the monocyte-macrophage lineage express receptors for HIV envelope protein. We have previously reported that lymphoid Jurkat T cells expressing the HIV-1 envelope protein (Env) can fuse with THP-1 monocytic cells, forming heterokaryons with a predominantly myeloid phenotype. This study shows that the expression of monocytic markers in heterokaryons is stable, whereas the expression of lymphoid markers is mostly lost. Like THP-1 cells, heterokaryons exhibited FcγR-dependent phagocytic activity and showed an enhanced expression of the activation marker ICAM-1 upon stimulation with PMA. In addition, heterokaryons showed morphological changes compatible with maturation, and high expression of the differentiation marker CD11b in the absence of differentiation-inducing agents. No morphological change nor increase in CD11b expression were observed when an HIV-fusion inhibitor blocked fusion, or when THP-1 cells were cocultured with Jurkat cells expressing a non-fusogenic Env protein, showing that differentiation was not induced merely by cell-cell interaction but required cell-cell fusion. Inhibition of TLR2/TLR4 signaling by a TIRAP inhibitor greatly reduced the expression of CD11b in heterokaryons. Thus, lymphocyte-monocyte heterokaryons induced by HIV-1 Env are stable and functional, and fusion prompts a phenotype characteristic of activated monocytes via intracellular TLR2/TLR4 signaling.


Assuntos
Linfócitos T CD4-Positivos/citologia , Fusão Celular , Macrófagos/citologia , Monócitos/citologia , Produtos do Gene env do Vírus da Imunodeficiência Humana/metabolismo , Biomarcadores/metabolismo , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/metabolismo , Carcinógenos/farmacologia , Células Cultivadas , Humanos , Imunofenotipagem , Molécula 1 de Adesão Intercelular/metabolismo , Células Jurkat , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Monócitos/efeitos dos fármacos , Monócitos/metabolismo , Fenótipo , Acetato de Tetradecanoilforbol/farmacologia
12.
Mediators Inflamm ; 2017: 9247574, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28607536

RESUMO

Galectins are a group of evolutionarily conserved proteins with the ability to bind ß-galactosides through characteristic carbohydrate-recognition domains (CRD). Galectin-3 is structurally unique among all galectins as it contains a C-terminal CRD linked to an N-terminal protein-binding domain, being the only chimeric galectin. Galectin-3 participates in many functions, both intra- and extracellularly. Among them, a prominent role for Galectin-3 in inflammation has been recognized. Galectin-3 has also been shown to directly bind to pathogens and to have various effects on the functions of the cells of the innate immune system. Thanks to these two properties, Galectin-3 participates in several ways in the innate immune response against invading pathogens. Galectin-3 has been proposed to function not only as a pattern-recognition receptor (PRR) but also as a danger-associated molecular pattern (DAMP). In this review, we analyze the various roles that have been assigned to Galectin-3, both as a PRR and as a DAMP, in the context of immune responses against pathogenic microorganisms.


Assuntos
Galectina 3/metabolismo , Imunidade Inata/fisiologia , Alarminas/genética , Alarminas/metabolismo , Animais , Galectina 3/genética , Humanos , Imunidade Inata/genética , Receptores de Reconhecimento de Padrão/genética , Receptores de Reconhecimento de Padrão/metabolismo
13.
BMC Neurol ; 16(1): 251, 2016 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-27919222

RESUMO

BACKGROUND: This 52-week study evaluated the long-term safety and tolerability of capsaicin 8% w/w (179 mg) patch repeat treatment plus standard of care (SOC) versus SOC alone in painful diabetic peripheral neuropathy (PDPN). METHODS: Phase 3, multinational, open-label, randomised, controlled, 52-week safety study, conducted in Europe. Patients were randomised to capsaicin 8% patch repeat treatment (30 or 60 min; 1-7 treatments with ≥ 8-week intervals) to painful areas of the feet plus SOC, or SOC alone. The primary objective was the safety of capsaicin 8% patch repeat treatment (30 min and 60 min applications) plus SOC versus SOC alone over 52 weeks, assessed by changes in Norfolk Quality of Life-Diabetic Neuropathy (QOL-DN) total score from baseline to end of study (EOS). Secondary safety endpoints included Utah Early Neuropathy Scale (UENS) assessments and standardised testing of sensory perception and reflex function. RESULTS: Overall, 468 patients were randomised (30 min plus SOC, n = 156; 60 min plus SOC, n = 157; SOC alone, n = 155). By EoS, mean changes in Norfolk QOL-DN total score from baseline [estimated mean difference versus SOC alone; 90% CI for difference] were: 30 min plus SOC, -27.6% [-20.9; -31.7, -10.1]; 60 min plus SOC, -32.8% [-26.1; -36.8, -15.4]; SOC alone, -6.7%. Mean changes [difference versus SOC alone] in UENS total score by EoS versus baseline were: 30 min plus SOC, -2.1 [-0.9; -1.8, 0.1]; 60 min plus SOC, -3.0 [-1.7; -2.7, -0.8]; SOC alone, -1.2. No detrimental deterioration was observed in any of the Norfolk or UENS subscales by EoS with capsaicin. Also, no worsening in sensory perception testing of sharp, warm, cold and vibration stimuli was found with capsaicin by EoS. Capsaicin treatment was well tolerated and the most frequent treatment-emergent adverse events were application site pain (30 min, 28.2%; 60 min, 29.3%), burning sensation (30 min, 9.0%; 60 min, 9.6%) and application site erythema (30 min, 7.7%; 60 min, 8.9%). CONCLUSION: In patients with PDPN, capsaicin 8% patch repeat treatment plus SOC over 52 weeks was well tolerated with no negative functional or neurological effects compared with SOC alone. TRIAL REGISTRATION: ClinicalTrials.gov registration: NCT01478607 . Date of registration November 21, 2011; retrospectively registered.


Assuntos
Capsaicina/efeitos adversos , Neuropatias Diabéticas/tratamento farmacológico , Neuralgia/tratamento farmacológico , Avaliação de Resultados em Cuidados de Saúde , Fármacos do Sistema Sensorial/efeitos adversos , Padrão de Cuidado , Administração Cutânea , Adulto , Idoso , Capsaicina/administração & dosagem , Neuropatias Diabéticas/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuralgia/etiologia , Fármacos do Sistema Sensorial/administração & dosagem
14.
Enferm Infecc Microbiol Clin ; 34(2): 122-31, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26474709

RESUMO

Post-exposure prophylaxis (PEP) can be a secondary measure to prevent infection by human immunodeficiency virus (HIV) when primary prevention has failed. PEP is advised for people with sporadic and exceptional risk exposure to HIV. This consensus document about occupational and non-occupational PEP recommendations aims to be a technical document for healthcare professionals. Its main objective is to facilitate the appropriate use of PEP. To this end, some recommendations have been established to assess the risk of transmission in different types of exposure, situations where PEP should be recommended, special circumstances to take into account, antiretroviral (ARV) guidelines including start and end of the treatment, early monitoring of tolerance and adherence to the treatment, subsequent monitoring of people exposed, independently of having received PEP or not, and need of psychological support. This document is intended for all professionals who work in clinical practice in the field of HIV infection.


Assuntos
Infecções por HIV/tratamento farmacológico , Hepatite B/tratamento farmacológico , Hepatite C/tratamento farmacológico , Profilaxia Pós-Exposição , Adulto , Fármacos Anti-HIV/uso terapêutico , Antivirais/uso terapêutico , Criança , Consenso , Humanos , Exposição Ocupacional/prevenção & controle , Guias de Prática Clínica como Assunto
16.
Clin Infect Dis ; 60(6): 950-8, 2015 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-25422386

RESUMO

BACKGROUND: We compared the prognostic value of liver biopsy (LB) and FIB-4 index in patients with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection. METHODS: We studied patients from the Grupo de Estudio del SIDA 3603 study cohort, in whom fibrosis was evaluated at baseline using both LB (Metavir score) and FIB-4 index. We assessed overall death (OD) and liver-related events (LREs), defined as decompensation or hepatocellular carcinoma, whichever occurred first. We used receiver operating characteristic (ROC) curves to determine the ability of LB and FIB-4 to predict outcomes. We also assessed the association between advanced fibrosis-LB (F3 or greater) or FIB-4 (≥3.25)-and outcomes using multivariate Cox regression analysis. RESULTS: The study sample comprised 903 patients (328 with sustained virologic response [SVR]). Baseline fibrosis by LB was as follows: F0, n = 71; F1, n = 242; F2, n = 236; F3, n = 236; F4, n = 118. Fibrosis by FIB-4 was as follows: ≤1, n = 148; >1 to <3.25, n = 597; ≥3.25, n = 158. After a median follow-up of 62 months, there were 46 deaths and 71 LREs. The area under the ROC curves for OD/LREs was 0.648 and 0.742 for LB and FIB-4, respectively (P = .006). Similar results were found for patients without SVR and for OD and LREs separately. The adjusted hazard ratios of OD or LRE were 1.740 (95% confidence interval [CI], 1.119-2.7.06; P = .014) for advanced fibrosis assessed by LB and 3.896 (95% CI, 2.463-6.160; P < .001) assessed by FIB-4. CONCLUSIONS: FIB-4 outperformed LB as a predictor of OD and LRE. These findings are of relevance for clinical practice and research and call into question the role of LB as a gold standard for assessing prognosis in HIV/HCV coinfection.


Assuntos
Coinfecção , Infecções por HIV/complicações , Hepatite C Crônica/complicações , Cirrose Hepática/diagnóstico , Fígado/patologia , Adulto , Biópsia , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Estudos de Coortes , Feminino , Seguimentos , Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/terapia , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Prognóstico , Curva ROC
17.
Enferm Infecc Microbiol Clin ; 33(1): 40.e1-40.e16, 2015 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-25176009

RESUMO

OBJECTIVE: This consensus document is an update of metabolic disorders and cardiovascular risk (CVR) guidelines for HIV-infected patients. METHODS: This document has been approved by an expert panel of GEAM, SPNS and GESIDA after reviewing the results of efficacy and safety of clinical trials, cohort and pharmacokinetic studies published in biomedical journals (PubMed and Embase) or presented in medical scientific meetings. Recommendation strength and the evidence in which they are supported are based on the GRADE system. RESULTS: A healthy lifestyle is recommended, no smoking and at least 30min of aerobic exercise daily. In diabetic patients the same treatment as non-HIV infected patients is recommended. HIV patients with dyslipidemia should be considered as high CVR, thus its therapeutic objective is an LDL less than 100mg/dL. The antihypertensive of ACE inhibitors and ARAII families are better tolerated and have a lower risk of interactions. In HIV-patients with diabetes or metabolic syndrome and elevated transaminases with no defined etiology, the recommended is to rule out a hepatic steatosis Recommendations for action in hormone alterations are also updated. CONCLUSIONS: These new guidelines update previous recommendations regarding all those metabolic disorders involved in CVR. Hormone changes and their management and the impact of metabolic disorders on the liver are also included.


Assuntos
Doenças Cardiovasculares/epidemiologia , Infecções por HIV/epidemiologia , Doenças Metabólicas/epidemiologia , Fármacos Anti-HIV/efeitos adversos , Doenças Cardiovasculares/prevenção & controle , Comorbidade , Exercício Físico , Promoção da Saúde , Estilo de Vida Saudável , Humanos , Transtornos do Metabolismo dos Lipídeos/induzido quimicamente , Transtornos do Metabolismo dos Lipídeos/epidemiologia , Doenças Metabólicas/induzido quimicamente , Doenças Metabólicas/terapia , Fatores de Risco , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Abandono do Hábito de Fumar
18.
Enferm Infecc Microbiol Clin ; 33(1): 41-7, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25096166

RESUMO

The importance of the metabolic disorders and their impact on patients with HIV infection requires an individualized study and continuous updating. HIV patients have the same cardiovascular risk factors as the general population. The HIV infection per se increases the cardiovascular risk, and metabolic disorders caused by some antiretroviral drugs are added risk factors. For this reason, the choice of drugs with a good metabolic profile is essential. The most common metabolic disorders of HIV infected-patients (insulin resistance, diabetes, hyperlipidemia or osteopenia), as well as other factors of cardiovascular risk, such as hypertension, should also be dealt with according to guidelines similar to the general population, as well as insisting on steps to healthier lifestyles. The aim of this document is to provide a query tool for all professionals who treat HIV-patients and who may present or display any metabolic disorders listed in this document.


Assuntos
Doenças Cardiovasculares/epidemiologia , Infecções por HIV/epidemiologia , Doenças Metabólicas/epidemiologia , Fármacos Anti-HIV/efeitos adversos , Doenças Cardiovasculares/prevenção & controle , Comorbidade , Exercício Físico , Promoção da Saúde , Estilo de Vida Saudável , Humanos , Transtornos do Metabolismo dos Lipídeos/induzido quimicamente , Transtornos do Metabolismo dos Lipídeos/epidemiologia , Doenças Metabólicas/induzido quimicamente , Doenças Metabólicas/terapia , Fatores de Risco , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Abandono do Hábito de Fumar
19.
Holist Nurs Pract ; 29(5): 313-22, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26263291

RESUMO

This study investigated the association between physical functioning and activities of daily living (ADL) of elderly people, taking into account the role of cognitive, psychological, and social factors. We administered physical, cognitive, psychological, and social instruments to investigate the level of basic and instrumental activities of daily living (BADL and IADL). The analysis showed that physical functioning was the only individual factor that was significantly linked with the level of BADL and IADL. This study underlines that physical functioning is the main individual characteristic directly associated with the level of BADL and IADL in old age.


Assuntos
Atividades Cotidianas , Serviços de Saúde para Idosos , Autonomia Pessoal , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Enfermagem Holística , Humanos , Masculino , Modelos Psicológicos , Fatores de Risco
20.
PLoS One ; 19(1): e0296764, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38277377

RESUMO

PURPOSE: We endeavored to identify objective salivary biomarkers for pain, a subjective sensation with a biological basis, using molecules already described related to pain. The study aimed to analyze inter-individual differences and intersession variability in salivary potential ocular pain biomarkers on healthy subjects, in samples obtained under the influence of controlled environmental conditions. METHODS: Thirty-four healthy subjects, 20 male, 14 female, median age 35.44 years (range 30-40) were exposed for 30 minutes under standard environmental conditions (T: 22°C, 50% relative humidity) in the Controlled Environmental Research Laboratory (CE-Lab, Vision R&D, Valladolid Spain) in two separate visits (V1, V2) at least 24 hours apart. Saliva was collected after the exposure in each of the visits, and cortisol, α-amylase (sAA), secretory IgA (sIgA), testosterone, and soluble fraction of TNFα receptor II (sTNFαRII) were analyzed by ELISA. Repeatability of inter-subject inter-session measurements was assayed by intraclass correlation coefficient (ICC). RESULTS: There were no significant inter-session differences in testosterone (p = 0.2497), sTNFαRII (p = 0.6451) and sIgA (p = 0.9689) salivary levels. The reproducibility for salivary cortisol, sAA, testosterone, sTNFαRII and sIgA were 0.98 ng/ml, 20.58 U/ml, 21.07 µg/ml, 24.68 pg/ml and 0.19 pg/ml, respectively. Salivary cortisol, sAA, testosterone, sTNFαRII and sIgA yielded the following ICCs: 0.506, 0.569, 0.824, 0.870 and 0.4295, respectively; all these ICCs (except that for cortisol and sIgA) were found to be improved compared to those found previously by our group in a previous study in salivary samples obtained from healthy subjects under non-controlled environmental conditions; Cortisol´s ICC didn´t improve and was in both cases at the limit of acceptability. CONCLUSION: Environmental factors such as temperature and relative humidity affect the reproducibility of measurement of some salivary molecules which have been proposed as potential pain biomarkers. The exposure of subjects to standard controlled environmental conditions before salivary sample obtention would improve the reproducibility of these molecule measures' as potential biomarkers of chronic ocular pain.


Assuntos
Dor Crônica , Hidrocortisona , Humanos , Masculino , Feminino , Adulto , Hidrocortisona/análise , Reprodutibilidade dos Testes , Imunoglobulina A Secretora/análise , Biomarcadores/análise , Dor Ocular , Testosterona , Saliva/química
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