The initial months of antiretroviral therapy and its influence on AGEs, HMGB1, and sRAGE levels in asymptomatic HIV-infected individuals

The development of the typical comorbidities of aging which currently affects people living with HIV/AIDS (PLWHA) can be partially ascribed to the persistent immune activation and chronic inflammation characterizing these individuals. The aim of this study was to analyze the effect exerted by combined antiretroviral therapy (cART) administration on plasma levels of HMGB1 (high mobility group box protein-1), AGEs (advanced glycation end products), their soluble receptor sRAGE, cytokines, C-reactive protein (CRP), and some metabolic markers in asymptomatic PLWHA. Analyses were performed longitudinally in 30 PLWHA, before and about 6\u201312 months after cART initiation. We observed that lower levels of AGEs in post-cART group were accompanied by an increase of CRP and triglyceride levels already in the early months of therapy. Because of the current ever-earlier recommendations to start cART and its prolonged use, these and other markers should be investigated in order to monitor and postpone the appearance of non-AIDS comorbidities in PLWHA

Antiretroviral therapy initiation alters the redox system of asymptomatic HIV-Infected individuals

Background. The combination antiretroviral therapy (cART) increases the oxidative stress in HIV-infected people, which in turn favors the onset and aggravation of non-AIDS comorbidities, a common situation affecting these individuals. We aimed to evaluate the influence of cART initiation on oxidative stress parameters. This is a longitudinal study including 30 asymptomatic patients divided according to their CD4+ T cell count (G1: 500 cell/mL) before (M0) and after (M1) cART initiation. We analyzed total antioxidant capacity (TAC), fat-soluble vitamins, malondialdehyde, 8-isoprostane, and DNA damage. Results. Results showed a decrease in TAC, retinol, \u3b1-tocopherol, and some carotenoids, in addition to a significant increase in DNA damage at M1. These changes were more evident in G2 subjects. Moreover, there was a significant 8-isoprostane increase at M1 in individuals belonging to G1. Conclusion. The results indicate that cART interfered in the redox system, mainly by reducing the antioxidant defenses. In addition, patients who had CD4+ T counts higher than 500 cells/mm3 showed more susceptibility to genotoxicity, while patients with less CD4+ T counts displayed more damage triggered by lipoperoxidation. Considering the early beginning of cART, its chronic use, and its capacity to alter the redox status, further long-term studies on larger cohorts are needed to define the best time to initiate therapy and to investigate new strategies to delay the development of non-AIDS diseases

Lessons From The Epidemiological Surveillance Program, During The Influenza A (h1n1) Virus Epidemic, In A Reference University Hospital Of Southeastern Brazil [lições Aprendidas Pelo Programa De Vigilância Epidemiológica, Durante A Epidemia Pelo Vírus Da Influenza A (h1n1), Em Um Hospital Universitário Na Região Sudeste Do Brasil]

Introduction: The case definition of influenza-like illness (ILI) is a powerful epidemiological tool during influenza epidemics. Methods: A prospective cohort study was conducted to evaluate the impact of two definitions used as epidemiological tools, in adults and children, during the influenza A H1N1 epidemic. Patients were included if they had upper respiratory samples tested for influenza by real-time reverse transcriptase polymerase chain reaction during two periods, using the ILI definition (coughing + temperature ≥ 38°C) in period 1, and the definition of severe acute respiratory infection (ARS) (coughing + temperature ≥ 38°C and dyspnoea) in period 2. Results: The study included 366 adults and 147 children, covering 243 cases of ILI and 270 cases of ARS. Laboratory confirmed cases of influenza were higher in adults (50%) than in children (21.6%) (p < 0.0001) and influenza infection was more prevalent in the ILI definition (53%) than ARS (24.4%) (p < 0.0001). Adults reported more chills and myalgia than children (p = 0.0001). Oseltamivir was administered in 58% and 46% of adults and children with influenza A H1N1, respectively. The influenza A H1N1 case fatality rate was 7% in adults and 8.3% in children. The mean time from onset of illness until antiviral administration was 4 days. Conclusions: The modification of ILI to ARS definition resulted in less accuracy in influenza diagnosis and did not improve the appropriate time and use of antiviral medication.444405411Dawood, F.S., Jain, S., Finelli, L., Shaw, M.W., Lindstrom, S., Emergence of a novel swineorigin influenza A (H1N1) virus in humans (2009) N Engl J Med, 360, pp. 2605-2615. , Novel swine-origin influenza A (H1N1) virus investigation team, et alPeiris, J.S., Poon, L.L., Guan, Y., Emergence of a novel swine-origin influenza A virus (S-OIV) H1N1 virus in humans (2009) J Clin Virol, 45, pp. 169-173Antigenic and genetic characteristics of swine-origin 2009 A (H1N1) influenza viruses circulating in humans (2009) Science, 325, pp. 197-201. , WHO Collaborating Center for Influenza, Centers for Disease Control and Prevention, et alSmith, G.J.D., Vijaykrishna, D., Bahl, J., Lycett, S.J., Worobey, M., Pybus, O.G., Origins and evolutionary genomics of the 2009 swine-origin H1N1 influenza A epidemic (2009) Nature, 450, pp. 1122-1126Oliveira, W.K., Penna, G., Kuchenbecker, R., Santos, H., Araujo, W., (2009) Pandemic H1N1 Influenza in Brazil: Analysis of the First 34,506 Notified Cases of Influenza-like Illness with Severe Acute Respiratory Infection (SARI), , http://www.eurosurveillance.org/viewarticle.aspx?articleid=19362/, Surveillance Team for the pandemic influenza A(H1N1) 2009 in the Ministry of Health, et al, Euro Surveill, Available fromBerts, R.F., Flu virus (1995) Principles and Practice of Infectious Diseases, pp. 1546-1567. , In: Mandell GL, Bennett JE, Dolin R, editors, 4th ed. 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Clinical presentation of influenza in hospitalized patients (2006) Infect Control Hosp Epidemiol, 27, pp. 266-270Kelly, H., Birch, C., The causes and diagnosis of influenza-like illness (2004) Aust Family Physician, 33, pp. 305-309Clinical aspects of pandemic 2009 influenza A (H1N1) virus infection (2010) N Engl J Med, 362, pp. 1708-1719. , Writing Committee of the WHO consultation on Clinical Aspects of Pandemic (H1N1) 2009 InfluenzaPresanis, A.M., de Angelis, D., Hagy, A., Reed, C., Riley, S., The severity of pandemic H1N1 influenza in the United States from April to July 2009: A Bayesian analysis (2009) PLoS Med, 6, pp. e1000207. , New York City Swine Flu Investigation TeamDonaldson, L.J., Rutter, P.D., Ellis, B.M., Greaves, F.E., Mytton, O.T., Pebody, R.G., Mortality from pandemic A/H1N1 2009 influenza in England: Public health surveillance study (2009) BMJ, 339, pp. b5213(2010), http://portal.salud.gov.mx/contenidos/noticias/influenza/estadisticas.html/, Secretaria de Salud Mexico. 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Características químicas de um latossolo adubado com uréia e cloreto de potássio em ambiente protegido

A produção de vegetais mais sadios e de boa qualidade e o fornecimento contínuo no mercado são fatores que têm determinado a adoção do sistema de cultivo protegido por um número maior de produtores. Porém, devido ao pouco conhecimento sobre o manejo do solo nessas condições, tem-se aplicado altas doses de fertilizantes, ocasionando problemas de salinidade e desequilíbrio nutricional. O objetivo desse trabalho foi avaliar os efeitos da aplicação da uréia e do cloreto de potássio nas características químicas de um LATOSSOLO VERMELHO Destrófico, principalmente nos índices de acidez e saturação em potássio. O N e o K foram aplicados em cobertura, nas doses equivalentes de 13,3 e 39,9 g m-2 de N e 5,5 e 16,6 g m-2 de K, em esquema fatorial (2x2+1), com tratamento adicional, sem a aplicação dos nutrientes. Cultivou-se pimentão, cultivar Mayata, em condições de ambiente protegido, durante 34 semanas. Após o pegamento das mudas, foi aplicado 1/6 dos nutrientes a cada dez dias. Ao final do ciclo, as formas de N nítrico e N amoniacal representaram melhor as doses do nutriente aplicados ao solo e não houve acidificação. As raízes tiveram significativo crescimento após a aplicação de N, enquanto que o aumento da dose de K, aplicado como KCl, prejudicou o crescimento radicular, provavelmente associado à alta concentração de K no solo e possíveis efeitos salinos, correspondendo a mais de 5,0 mmol c dm-3 e mais que 5,3% de saturação do K no complexo de troca, na camada superficial do solo