INFECÇÕES FÚNGICAS EM TRANSPLANTADOS RENAIS: UMA REVISÃO INTEGRATIVA / FUNGAL INFECTION IN RENAL TRANSPLANTATION: A INTEGRATIVE REVIEW

Introdução: A doença renal crônica em estágio avançado apresenta a diálise e o transplante como formas de tratamento substitutivo.O transplante renal é uma das principais formas de tratamento da medicina moderna, promovendo qualidade de vida eaumento da sobrevida dos pacientes. Esses, ao longo de sua vida pós-transplante, necessitam fazer uso de agentes imunossupressores.Assim, o paciente transplantado apresenta risco aumentado para infecções oportunistas, dentre as quais se encontramas infecções por fungos. Objetivo: Verificar a literatura existente acerca das infecções fúngicas que acometem pacientestransplantados renais. Método: Estudo do tipo revisão integrativa da literatura, cujo levantamento ocorreu nas bases de dadosPubMed, LILACS, MEDLINE e SciELO, utilizando-se os descritores infecções fúngicas invasivas, micoses e transplante renal.Foram selecionados artigos originais publicados entre 2006 e 2016, em inglês, espanhol ou português, disponibilizados naíntegra e que abordassem infecções fúngicas em pacientes transplantados renais. Resultados: Conforme critérios estabelecidos,foram encontrados quatorze artigos, dos quais dez eram relatos de caso e quatro eram estudos do tipo coorte. Observouseque os principais fungos citados foram dos gêneros Aspergillus, Rhizopus, Candida e Scedosporium, o principal sítio deinfecção foi o pulmão e os principais medicamentos utilizados no tratamento foram o Voriconazol e a Anfotericina B. Conclusão:Por meio desta revisão verificou-se carência de estudos na literatura nacional, sendo internacional a totalidade dos artigosencontrados. Torna-se relevante, portanto, maior investimento em pesquisas e divulgação dos resultados, a fim de ampliar oconhecimento acerca dessas infecções no país.Palavras-chave: Infecções Oportunistas. Infecções Fúngicas. Transplante Renal.AbstractIntroduction: Advanced chronic kidney disease presents dialysis and transplantation as forms of substitutive treatment. Renaltransplantation is one of the main ways of treating modern medicine, promoting quality of life and increasing patient survival.These, throughout their post-transplant life, need to make use of immunosuppressive agents. Thus, the transplanted patientpresents an increased risk for opportunistic infections, among which are fungal infections. Objective: To verify the existingliterature on the fungal infections that affect renal transplant patients. Method: An integrative review of the literature wascarried out in the PubMed, LILACS, MEDLINE and SciELO databases, using the descriptors invasive fungal infections, mycosesand renal transplantation. We selected original articles published between 2006 and 2016, in English, Spanish or Portuguese,available in full and that deal with fungal infections in renal transplant patients. Results: According to established criteria,fourteen articles were found, of which ten were case reports and four were cohort studies. It was observed that the main fungimentioned were of the genus Aspergillus, Rhizopus, Candida and Scedosporium, the main site of infection was the lung and themain drugs used in the treatment were Voriconazole and Amphotericin B. Conclusion: Through this review, it was verified therewas a lack of studies in the national literature, being international the totality of the articles found. Therefore, greater investmentin research and dissemination of results is relevant, in order to increase knowledge about these infections in the country.Keywords: Opportunistic Infections. Mycoses. Kidney Transplantation

Alterations in postmenopausal plasmatic lipidome.

BACKGROUND:Menopause consists of a physiological process in women between 40 and 50 years of age, and it has substantial consequences for health, ranging from disturbances in lipid and glycidic metabolism to psychological stress and sleep alterations, thereby increasing women's risk of cardiovascular diseases. Here, we attempted to identify potential lipid alterations not identified by the classic methods. METHODS AND RESULTS:We analyzed the serum lipid profile in 40 women in pre- and post-menopause using a lipidomic approach and mass spectrometry. Lipid species presented increased concentrations, with a difference of more than 25% post-menopause and with the ceramides (N.C23:0.Cer, N.C23:0(OH).Cer and N.C24:0(OH).Cer) standing out with a fold change of 1.68, 1.59, and 1.58, respectively. It was also observed that 14 metabolites presented a significant difference in the average concentrations between pre- and post-menopause, especially the ceramide species. Strong and positive correlations were identified between various metabolites and fasting glucose, glycated hemoglobin, total cholesterol, LDL, and triglycerides. Of note were the association ceramide (N.C10:0.Cer) and lysophosphatidylethanolamine (LPE.a.C18:0) between fasting glucose and glycated hemoglobin. CONCLUSION:This study detected lipid alterations, especially in ceramides, post-menopause, as well as correlations with glycidic and lipid markers, which may in the future be useful to investigate diseases associated with menopause