Estudo epidemiológico e monitoramento de Lamivudina (3TC) e Zidovudina (AZT) na terapêutica do HIV-1 em pacientes de Belém – PA e suas correlações com as funções hepática, renal e nutricional, Belém, Pará

A estimativa de pessoas infectadas pelo HIV no mundo, no ano de 2006, foi cerca de 39,5 milhões. No Brasil, o Ministério da Saúde indica terapia para pacientes com manifestações clínicas associadas ao HIV-1 e para aqueles com contagem de linfócitos T CD4⁺ abaixo de 200 células/ mm³. Paralelamente aos benefícios da terapia anti-retroviral há o reconhecimento de efeitos adversos, como miopatia, lipodistrofia, pancreatite, hepatotoxicidade e acidose lática. A complexidade dos esquemas terapêuticos torna a adesão à terapia difícil, contribuindo para a falha terapêutica. Neste trabalho foi realizado um estudo epidemiológico, de monitoramento de Lamivudina (3TC) e Zidovudina (AZT) e correlacionado com as funções hepática, renal e nutricional em pacientes portadores de HIV-1, atendidos na CASA DIA, em Belém/PA. O grupo populacional estudado constou de 60 portadores do HIV-1 de ambos os gêneros, com faixa etária de 20 a 61 anos, que faziam uso de AZT e/ou 3TC. Os níveis plasmáticos de aminotransferases, uréia e creatinina foram determinados por fotometria de absorção e, por Cromatografia Líquida de Alta Eficiência, foram determinadas as concentrações plasmáticas de 3TC e AZT. O estado nutricional foi avaliado através do Índice de Massa Corpórea (IMC). As concentrações de 3TC variaram de 1,283 a 355,953 μg/mL, enquanto que as de AZT variaram de 0,008 a 22,544 μg/mL. A concentração de 3TC evidenciou associação com a ocupação (p < 0,05) e com a creatininemia (p < 0,0001), mas não com as aminotrasnferases e uremia (p > 0,05). Não encontramos associação entre a concentração de AZT com as informações demográficas e com a creatininemia (p > 0,05), todavia verificou-se associação com as aminotransferases e uremia (p < 0,0001). O IMC revelou associação com todos os parâmetros estudados: concentrações de 3TC, AZT, aminotransferases, uremia e creatininemia (p < 0,05). Concluímos que as concentrações de 3TC podem afetar os níveis de creatinina e sofrem influência do estado nutricional do paciente, enquanto que as concentrações de AZT podem alterar os níveis de aminotransferases, uréia e também são influenciadas pelo estado nutricional, ratificando os processos farmacocinéticos desses fármacos.

Avaliação cefalométrica das alterações do perfil facial naturais e induzidas pelos aparelhos de Herbst e Bionator no tratamento da má oclusão de classe II, divisão 1ª

The aim of this study was to evaluate the facial profile changes due to natural growth and induced by Herbst appliance and Bionator in the treatment of Class II, division 1 malocclusion. In order to do that, we used a sample of 90 lateral radiographs of 45 individuals in pre-pubertal stage, divided up in two experimental groups and one control. The first group, composed of 15 brazilian individuals, with initial mean age of 9.4 years, was treated with the Herbst appliance for a period of seven months. The second experimental group consisting of 15 brazilian individuals, initial mean age of 9.9 years has gone through bionator therapy for an average period of 21 months. The control group of 15 individuals, who were not treated orthodontically, comes up from the Burlington Growth Centre, University of Toronto, Canada. The intragroup comparison was performed using the Student t test and intergroup comparisons by ANOVA complemented by the Bonferroni test. The results have shown that only the group treated with the Herbst appliance presented significant changes in facial profile with improvement of its convexity and lower lip protrusion.

Assessing the benefits of rosiglitazone in women with polycystic ovary syndrome through its effects on insulin-like growth factor 1, insulin-like growth factor-binding protein-3 and insulin resistance: a pilot study

Federal University of Sao Paulo

Fertility preservation in >1,000 patients: patient's characteristics, spectrum, efficacy and risks of applied preservation techniques

Data on the characteristics of female patients counselled for fertility preservation and the efficacy and risk of the applied procedures are still poor. We therefore analysed the registry of a network of 70 infertility centers which are involved in fertility preservation in Germany, Switzerland and Austria, called FertiPROTEKT ( hhtp://www.fertiprotekt.eu ).

Discordant responses to potent antiretroviral treatment in previously naive HIV-1-infected adults initiating treatment in resource-constrained countries: the antiretroviral therapy in low-income countries (ART-LINC) collaboration

OBJECTIVES: To assess the frequency of and risk factors for discordant responses at 6 months on highly active antiretroviral therapy (HAART) in previously treatment-naive HIV patients from resource-limited countries. METHODS: The Antiretroviral Therapy in Low-Income Countries Collaboration is a network of clinics providing care and treatment to HIV-infected patients in Africa, Latin America, and Asia. Patients who initiated therapy between 1996 and 2004, were aged 16 years or older, and had a baseline CD4 cell count were included in this analysis. Responses were defined based on plasma viral load (PVL) and CD4 cell count at 6 months as complete virologic and immunologic (VR(+)IR(+)), virologic only (VR(+)IR(-)), immunologic only (VR(-)IR(+)), and nonresponse (VR(-)IR(-)). Multinomial logistic regression was used to assess the association between therapy responses and clinical and demographic variables. RESULTS: Of the 3111 patients eligible for analysis, 1914 had available information at 6 months of therapy: 1074 (56.1%) were VR(+)IR(+), 364 (19.0%) were VR(+)IR(-), 283 (14.8%) were (VR(-)IR(+)), and 193 (10.1%) were VR(-)IR(-). OF THE 3111 patients eligible for analysis, 1914 had available information at 6 months of therapy: 1074 (56.1%) were VRIR, 364 (19.0%) were VRIR, 283 (14.8%) were (VRIR), and 193 (10.1%) were VRIR. Compared with complete responders, virologic-only responders were older, had a higher baseline CD4 cell count, had a lower baseline PVL, and were more likely to have received a nonstandard HAART regimen; immunologic-only responders were younger, had a lower baseline CD4 cell count, had a higher baseline PVL, and were more likely to have received a protease inhibitor-based regimen. CONCLUSIONS: The frequency of and risk factors for discordant responses were comparable to those observed in developed countries. Longer follow-up is needed to assess the long-term impact of discordant responses on mortality in these resource-limited settings.

Ecto-nucleoside triphosphate diphosphohydrolase 1 (E-NTPDase1/CD39) regulates neutrophil chemotaxis by hydrolyzing released ATP to adenosine

Polymorphonuclear neutrophils release ATP in response to stimulation by chemoattractants, such as the peptide N-formyl-methionyl-leucyl-phenylalanine. Released ATP and the hydrolytic product adenosine regulate chemotaxis of neutrophils by sequentially activating purinergic nucleotide and adenosine receptors, respectively. Here we show that that ecto-nucleoside triphosphate diphosphohydrolase 1 (E-NTPDase1, CD39) is a critical enzyme for hydrolysis of released ATP by neutrophils and for cell migration in response to multiple agonists (N-formyl-methionyl-leucyl-phenylalanine, interleukin-8, and C5a). Upon stimulation of human neutrophils or differentiated HL-60 cells in a chemotactic gradient, E-NTPDase1 tightly associates with the leading edge of polarized cells during chemotaxis. Inhibition of E-NTPDase1 reduces the migration speed of neutrophils but not their ability to detect the orientation of the gradient field. Studies of neutrophils from E-NTPDase1 knock-out mice reveal similar impairments of chemotaxis in vitro and in vivo. Thus, E-NTPDase1 plays an important role in regulating neutrophil chemotaxis by facilitating the hydrolysis of extracellular ATP.

Loss of β1-integrin-deficient cells during the development of endoderm-derived epithelia

Beta1-integrins (beta1) represent cell surface receptors which mediate cell-matrix and cell-cell interactions. Fässler and Meyer described chimeric mice containing transgenic cells that express the LacZ gene instead of the beta1 gene. They observed beta1-negative cells in all germ layers at embryonic day E 8.5. Later in development, using a glucose phosphate isomerase assay of homogenized tissue samples, high levels of transgenic cells were found in skeletal muscle and gut, low levels in lung, heart, and kidney and none in the liver and spleen (Fässler and Meyer 1995). In order to study which cell types require beta1 during development of the primitive gut including its derivatives, chimeric fetuses containing 15 to 25% transgenic cells were obtained at days E 14.5 and E 15.5. They were LacZ (beta-galactosidase) stained "en bloc" and cross-sectioned head to tail. In esophagus, trachea, lung, stomach, hindgut, and the future urinary bladder, we observed various mesoderm-derived beta1-negative cells (e.g. fibroblasts, chondrocytes, endothelial cells, and smooth muscle cells) but no beta1-negative epithelial cells. Since the epithelia of lung, esophagus, trachea, stomach, hindgut, and urinary bladder are derived from the endodermal gut tube, we hypothesize that beta1 is essential for the development and/or survival of the epithelia of the fore- and hindgut and its derivatives.

Ms.Ff.F.Stoltze 3. 283 - Brief von Ernst Schalck an Friedrich Stoltze

Frankfurter Latern