Accidental Father-to-Son HIV-1 Transmission During the Seroconversion Period

A 4-year-old child born to an HIV-1 seronegative mother was diagnosed with HIV-1, the main risk factor being transmission from the child's father who was seroconverting at the time of the child's birth. In the context of a forensic investigation, we aimed to identify the source of infection of the child and date of the transmission event. Samples were collected from the father and child at two time points about 4 years after the child's birth. Partial segments of three HIV-1 genes (gag, pol, and env) were sequenced and maximum likelihood (ML) and Bayesian methods were used to determine direction and estimate date of transmission. Neutralizing antibodies were determined using a single cycle assay. Bayesian trees displayed a paraphyletic-monophyletic topology in all three genomic regions, with the father's host label at the root, which is consistent with father-to-son transmission. ML trees found similar topologies in gag and pol and a monophyletic-monophyletic topology in env. Analysis of the time of the most recent common ancestor of each HIV-1 gene population indicated that the child was infected shortly after the father. Consistent with the infection history, both father and son developed broad and potent HIV-specific neutralizing antibody responses. In conclusion, the direction of transmission implicated the father as the source of transmission. Transmission occurred during the seroconversion period when the father was unaware of the infection and was likely accidental. This case shows how genetic, phylogenetic, and serological data can contribute for the forensic investigation of HIV transmission.info:eu-repo/semantics/publishedVersio

Portuguese Adaptation of Students Engagement in Schools International Scale (SESIS)

The importance of student’s engagement has been recently pointed out in research. However, there has been a lack of engagement assessment instrument, pertaining psychometric qualities. Objective: This paper presents the Portuguese adaptation of the “Student’s Engagement in School International Scale” (SESIS), drawn up from a12 countries international study (Lam et al., 2012; Lam et al., in press). Method: Psychometric properties of this scale were examined with data from 685 students from different grades (6th, 7th, 9th and 10th), from both sexes, and different regions of the country. Results: Factorial analysis of the results, with varimax rotation, lead to three different factors which explain 50.88% of the variance. The scale integrates the original 33 items, and cognitive, affective and behavioural dimensions. For the external validity study, the relationship between student’s engagement in school results and other school variables — academic performance, self-concept — was considered, and significant relations were observed, as expected. Conclusion: The data presented highlights the qualities of SESIS, as well as its usefulness for research purposes. Suggestion: It is suggested the investigation of the extension of SESIS’s three-dimensionality, in future studiesKeywords: Innovation, technology, research projects, etc. [Arial 10-point, justified alignment]

Inhibition of HIV cell-to-cell fusion by antiretroviral drugs and neutralizing antibodies

Poster presented at the 7th iMed.ULisboa Postgraduate Students Meeting. Lisbon, 15 July 2015"Inhibition of HIV cell entry by antiretroviral drugs and neutralizing antibodies (NAbs) is typically measured in assays where cell-free virions enter reporter cell lines. However, direct Env-mediated cell-to-cell transmission is a major mechanism of HIV infection that also needs to be targeted. In this work we aimed to determine the ability of anti-HIV compounds in clinical or research use to inhibit HIV mediated cell-to-cell fusion (syncytia formation)."Fundação para a Ciência e a Tecnologia - Portugal ; European Unio

Ecologia do desenvolvimento profissional das crianças: uma revisão da literatura

Previous efforts to elaborate an organizing framework for the study of children’s career development identified its main dimensions and processes. However, the existing literature on children’s ecological subsystems is scarce. This article presents a literature review of the context of children’s career development. Based on Bronfenbrenner’s theory, 36 eligible articles covered the following subjects: the Microsystems family and school; the mesosystems family-school/peer-school relations and antecedents of transitions; the exosystems parents’ work situation, social class, curriculum and teachers’ professional development; the macrosystems ethnicity and culture; and the chronosystems passage of time over the life-course and across generations. An ecological perspective can be included in an organizing framework of children’s careers and support further research and intervention. Empirical and practical implications are discussed.Esforços prévios para organizar um modelo organizador do estudo do desenvolvimento profissional das crianças têm identificado as suas principais dimensões e processos. Contudo, a literatura existente sobre os subsistemas ecológicos das crianças é escassa. Este artigo apresenta uma revisão da literatura sobre os contextos de desenvolvimento profissional das crianças. De acordo com a teoria de Bronfenbrenner, 36 artigos elegidos abordam: os microssistemas família e escola; os mesossistemas família-escola/pares-escola e antecedentes de transições; os exossistemas situação profissional parental, classe social, currículo e desenvolvimento profissional de professores; os macrossistemas etnia e cultura; e os cronossistemas passagem do tempo no ciclo vital e entre gerações. Uma perspetiva ecológica pode ser incluída em um modelo organizador do desenvolvimento profissional das crianças e apoiar ivestigações e intervenção futuras. Discutem-se implicações empíricas e práticas.(undefined)info:eu-repo/semantics/publishedVersio

Hematopoietic stem cell transplantation in chronic lymphoid leukemia: a proposal by the Brazilian Consensus on Bone Marrow Transplantation of the Brazilian Society of Bone Marrow Transplantation, Rio de Janeiro 2009

Portadores de leucemia linfoide crônica (LLC) apresentam curso clínico indolente e prolongado que devem ser diferenciados daqueles que têm doença de evolução agressiva e fatal. Pacientes mais jovens e com critérios de alto risco podem se beneficiar com tratamento mais agressivo como o transplante de células-tronco hemopoéticas (TCTH). O transplante autólogo apresenta casos com remissão citogenética e molecular, baixa taxa de mortalidade, mas não demonstram platô nas curvas de sobrevivência e alta taxa de recaídas. Os transplantes alogênicos com regime mieloablativos têm altos índices de toxicidade e mortalidade, mas evidenciam o efeito enxerto versus leucemia, que aumenta a possibilidade de cura destes indivíduos. Assim, a opção dos transplantes alogênicos está dirigida para os transplantes com regime de condicionamento não mieloablativo, que pode ser aplicado inclusive a pacientes mais idosos ou portadores de comorbidades, e manter o potencial efeito GVL. A identificação dos pacientes que podem ser beneficiados por esses procedimentos, caracterizar e apontar os novos marcadores prognósticos permanece objeto de muitos estudos clínicos e foi o objetivo do grupo responsável em discutir as diretrizes do TCTH no consenso da Sociedade Brasileira de Transplante de Medula Óssea - SBTMO. Assim, consideramos que o TCTH para a leucemia linfoide crônica (LLC) deve seguir, para sua indicação, os critérios do European Group for Blood and Marrow Transplantation (EBMT) e, quando houver disponibilidade de um doador aparentado, a opção deve ser do TCTH alogênico com regime não mieloablativo. O TCTH alogênico não aparentado e o autólogo devem ser considerados como opção secundária de indisponibilidade de doador, situações especiais e ensaios clínicos.Patients with chronic lymphocytic leukemia usually have an indolent and prolonged clinical course and need to be differentiated from those who have an aggressive and fatal disease. Younger patients with high-risk criteria may benefit with a more aggressive treatment that includes hematopoietic stem cell transplantation (HSCT). Autologous transplantation, despite of the encouraging results with cases of molecular and/or cytogenetic remission and low mortality rates, does not present a plateau in survival curves and has a high relapse rate. Allogeneic transplantations using myeloablative regimens, have high toxicity and mortality rates, but also demonstrate the graft-versus-leukemia effect that increases the possibility of cure of these individuals. So the option of allogeneic transplants for patients with CLL is directed to conditioning using non-myeloablative regimens, which can also be applied to older patients or those with comorbidities, and maintain a potential graft-versus-leukemia effect. The identification of patients who may benefit from these procedures and the characterization of new prognostic markers remain the subjects of many clinical studies and were the objective of the group responsible for discussing guidelines for CLL of the consensus on HSCT SBTMO. Thus we believe that HSCT for CLL should follow the criteria of the EBMT. When a sibling donor is available the best option is allogeneic HSCT with a myeloablative regimen. The strategy of unrelated allogeneic or autologous HSCT must be considered as a second option when no donor is available, for special situations and clinical trials

Effectiveness of a Multifactorial Cardiovascular Risk Reduction Clinic for Diabetes Patients with Depression

Introduction Depression may attenuate the effects of diabetes interventions. Our ongoing Cardiovascular Risk Reduction Clinic simultaneously addresses hyperglycemia, hypertension, smoking, and hyperlipidemia. We examined the relationship between depression diagnosis and responsiveness to the Cardiovascular Risk Reduction Clinic. Methods We studied Cardiovascular Risk Reduction Clinic participants with diabetes who had a depression diagnosis and those with no mental health diagnosis. Our outcome measure was change in 20-year cardiovascular mortality risk according to the United Kingdom Prospective Diabetes Study (UKPDS) score. Results Of 231 participants, 36 (15.6%) had a depression diagnosis. Participants with a depression diagnosis had a higher baseline UKPDS score (56.8 [SD 21.3]) than participants with no mental health diagnosis (49.5 [SD 18.7], P =.04). After Cardiovascular Risk Reduction Clinic participation, mean UKPDS scores did not differ significantly (37.8 [SD 15.9] for no mental health diagnosis and 39.4 [SD 18.6] for depression diagnosis). Mean UKPDS score reduction was 11.6 [SD 15.6] for no mental health diagnosis compared with 18.4 [SD 15.9] for depression diagnosis (P =.03). Multivariable linear regression that controlled for baseline creatinine, number of Cardiovascular Risk Reduction Clinic visits, sex, and history of congestive heart failure showed significantly greater improvement in UKPDS score among participants with a depression diagnosis (ß = 6.0, P =.04) and those with more Cardiovascular Risk Reduction Clinic visits (ß = 2.1, P \u3c.001). Conclusion The Cardiovascular Risk Reduction Clinic program reduced cardiovascular disease risk among patients with diabetes and a diagnosis of depression. Further work should examine how depressive symptom burden and treatment modify the effect of this collaborative multifactorial program and should attempt to determine the durability of the effect

Antagonism of BST-2/Tetherin is a conserved function of the Env glycoprotein of primary HIV-2 isolates

Although HIV-2 does not encode a vpu gene, the ability to antagonize bone marrow stromal antigen 2 (BST-2) is conserved in some HIV-2 isolates, where it is controlled by the Env glycoprotein. We previously reported that a single-amino-acid difference between the laboratory-adapted ROD10 and ROD14 Envs controlled the enhancement of virus release (referred to here as Vpu-like) activity. Here, we investigated how conserved the Vpu-like activity is in primary HIV-2 isolates. We found that half of the 34 tested primary HIV-2 Env isolates obtained from 7 different patients enhanced virus release. Interestingly, most HIV-2 patients harbored a mixed population of viruses containing or lacking Vpu-like activity. Vpu-like activity and Envelope functionality varied significantly among Env isolates; however, there was no direct correlation between these two functions, suggesting they evolved independently. In comparing the Env sequences from one HIV-2 patient, we found that similar to the ROD10/ROD14 Envs, a single-amino-acid change (T568I) in the ectodomain of the TM subunit was sufficient to confer Vpu-like activity to an inactive Env variant. Surprisingly, however, absence of Vpu-like activity was not correlated with absence of BST-2 interaction. Taken together, our data suggest that maintaining the ability to antagonize BST-2 is of functional relevance not only to HIV-1 but also to HIV-2 as well. Our data show that as with Vpu, binding of HIV-2 Env to BST-2 is important but not sufficient for antagonism. Finally, as observed previously, the Vpu-like activity in HIV-2 Env can be controlled by single-residue changes in the TM subunit.info:eu-repo/semantics/publishedVersio

Medicines review in the elderly

Poster presented at the Pharmaceutical Care Network Europe (PCNE) Working Symposium: Medication review, Drug-related problems, Standards and Guidelines, 2014, Sliema (Malta)Egas Moniz - Cooperativa de Ensino Superior CRL; Ordem dos Farmacêuticos