HCV coinfection in a cohort of HIV pregnant women

Orientador: Helaine Maria Besteti Pires Mayer MilanezDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Objetivo: Avaliar características clínicas, epidemiológicas e transmissão vertical (TV) em gestantes portadoras do vírus HIV, comparando um grupo com coinfecção para hepatite C (HCV) com o grupo sem esta condição. Sujeitos e Métodos: Estudo de coorte retrospectivo de gestantes infectadas pelo HIV e seus recém-nascidos correspondentes, atendidos no CAISM/UNICAMP no período de 2000 a 2015. Foram analisadas as coinfectadas HIV-HCV versus as não-coinfectadas e avaliados efeitos colaterais maternos, intercorrências gestacionais, evolução dos recém-nascidos e transmissão vertical do HIV e do HCV. Análise dos dados: análise descritiva através de distribuição percentual e de médias, teste de X², exato de Fisher, t de Student, Mann-Whitney e MANOVA, razão de risco e intervalo de confiança. Resultados: Foram encontradas 63 coinfectadas com o VHC dentre as 816 gestantes portadoras do HIV (7,7%). A principal via de aquisição da coinfecção foi a sexual (86,8%). Com relação às intercorrências gestacionais, a presença de diabetes e hipertensão gestacional foi de 10,5% e 11,4% nas coinfectadas em comparação com 6% e 7% no outro grupo. Houve 12,9% de parto prematuro nas coinfectadas versus 14,2% nas não coinfectadas. As alterações de enzimas hepáticas foram observadas em mais de 10% das coinfectadas e em menos de 3% das sem coinfecção (P<0,0001). Com relação a terapia antirretroviral, mais de 60% das coinfectadas e mais de 70% das não-coinfectadas usou esquema com inibidores de protease. O peso e a idade gestacional de nascimento não foram significativas nos dois grupos observados. A ocorrência de índice de apgar baixo foi significativo, sendo 7 vezes mais prevalente nas coinfectadas. A taxa de transmissão vertical do HIV foi de 1,8% nas coinfectadas e 2,7% nas sem coinfecção. No grupo de coinfectadas ocorreram dois casos de transmissão vertical do HCV (3,1%). Conclusão: nessa coorte, a presença da coinfecção HCV-HIV não piorou os resultados gestacionais. A coorte de gestantes coinfectadas apresentou maior ocorrência de prematuridade, baixo peso e apgar <7 ao nascimento em comparação às sem infecçãoAbstract: Objective: To evaluate clinical, epidemiological characteristics and vertical transmission (VT) in pregnant women with HIV, comparing a group of co-infection of hepatitis C (HCV) to those without this condition. Subjects and Methods: A retrospective cohort study of HIV infected pregnant women and their corresponding newborns at CAISM / UNICAMP from 2000 to 2015. HIV-HCV co-infected versus non-coinfected and evaluated maternal side effects were analyzed, pregnancy complications, development of newborns and vertical transmission of HIV and HCV. Data analysis: descriptive analysis by percentage distribution and averages, X² test, Fisher exact test, Student's t test, Mann-Whitney and MANOVA, risk ratios and confidence intervals. Results: We found 63 coinfected with HCV among 816 pregnant women with HIV (7.7%). The main route of acquisition of coinfection was sexual (86.8%). With respect to pregnancy complications, presence of diabetes, and Gestational hypertension was 10.5% and 11.4% in coinfected compared to 6% and 7% in the other group. There was 12.9% of premature birth in coinfected versus 14.2% in non-coinfected. The liver enzyme abnormalities were observed in more than 10% of coinfected and less than 3% without coinfection (P <0.0001). With regards antiretroviral therapy, more than 60% of coinfected and more than 70% of the non-used scheme coinfected with protease inhibitors. The weight and gestational age at birth were not significant in the two study groups. The occurrence of low Apgar score index was significant, 7 times more prevalent in coinfected. The rate of vertical transmission of HIV was 1.8% in coinfected and 2.7% in without coinfection. In coinfected group there were two cases of vertical transmission of HCV (3.1%). Conclusion: In this cohort, the presence of HCV-HIV co-infection did not worsen the pregnancy outcomes. The cohort of coinfected pregnant women showed a higher incidence of prematurity, low birth weight and Apgar score <7 at birth compared to no infectionMestradoSaúde Materna e PerinatalMestra em Tocoginecologi

The Brazilian army and the low prevalence of sexually transmitted infections in women of the military garrison of Campinas between 2017 to 2020: a prospective, cross-sectional epidemiological study

ABSTRACT BACKGROUND: Given the characteristics of military missions, intense interpersonal contact, and wide variation in casual relationships, the military has long been recognized as a high-risk population for sexually transmitted infections (STIs). OBJECTIVE: To assess the prevalence of STIs and socioepidemiological profile of women in the military garrison of Campinas. DESIGN AND SETTING: This prospective, cross-sectional epidemiological study, assisted by the Health Fund in the military garrison of Campinas, assessed the prevalence of human immunodeficiency virus (HIV), hepatitis B and C, syphilis, human papillomavirus (HPV), chlamydia, and gonococcus in military women or companions of soldiers with active or previously active sexual life. METHODS: This study included 647 women based on the non-inclusion criteria. They underwent clinical and laboratory tests for diagnosis of STIs. For statistical analysis, patients were divided into groups according to the presence or absence of STIs and into age groups. RESULTS: Most women were military dependents, and the majority were asymptomatic. The prevalence of STIs, in ascending order, was 0.3% for hepatitis B and C, 0.62% for syphilis, 0.62% for gonorrhea, 1.08% for chlamydia, and 2.63% for HPV. There were no cases of HIV infection. CONCLUSIONS: The Brazilian Army has the most women-like dependents in the military, belonging to the hierarchical circle of the squares. Early onset of sexual activity favored STIs approximately twice, and younger women had approximately seven times more chlamydia infections. In the general population studied, the prevalence of STIs was lower than expected than in the armed forces of other nations

A ASCENÇÃO E QUEDA DO IMPÉRIO X

O presente caso narra a trajetória do empresário Eike Batista desde seus tempos de estudante de engenharia, passando por seu primeiro empreendimento na mineração de ouro, ascensão a “maior empreendedor do Brasil” e homem mais rico do Brasil, até o declínio de seu grupo, culminando no pedido de recuperação judicial pessoal e de suas empresas. A partir de sua história é possível observar diversos pontos fulcrais que contribuíram ora para seu crescimento, ora para seu insucesso. Os fatos narrados destinam-se a uma reflexão que instigue estudantes e profissionais das áreas de Ciências Contábeis e Administração a relacionarem tais acontecimentos práticos à Teoria da Agência e à Teoria da Divulgação. Ainda assim, dada a abrangência do caso quanto à trajetória do empreendedor citado e do ciclo de vida de suas empresas, pode ser aplicado sob outras temáticas relacionadas a Finanças e Empreendedorismo

A ASCENÇÃO E QUEDA DO IMPÉRIO X

O presente caso narra a trajetória do empresário Eike Batista desde seus tempos de estudante de engenharia, passando por seu primeiro empreendimento na mineração de ouro, ascensão a “maior empreendedor do Brasil” e homem mais rico do Brasil, até o declínio de seu grupo, culminando no pedido de recuperação judicial pessoal e de suas empresas. A partir de sua história é possível observar diversos pontos fulcrais que contribuíram ora para seu crescimento, ora para seu insucesso. Os fatos narrados destinam-se a uma reflexão que instigue estudantes e profissionais das áreas de Ciências Contábeis e Administração a relacionarem tais acontecimentos práticos à Teoria da Agência e à Teoria da Divulgação. Ainda assim, dada a abrangência do caso quanto à trajetória do empreendedor citado e do ciclo de vida de suas empresas, pode ser aplicado sob outras temáticas relacionadas a Finanças e Empreendedorismo

Cross-talk between red blood cells and plasma influences blood flow and omics phenotypes in severe COVID-19

Coronavirus disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and can affect multiple organs, among which is the circulatory system. Inflammation and mortality risk markers were previously detected in COVID-19 plasma and red blood cells (RBCs) metabolic and proteomic profiles. Additionally, biophysical properties, such as deformability, were found to be changed during the infection. Based on such data, we aim to better characterize RBC functions in COVID-19. We evaluate the flow properties of RBCs in severe COVID-19 patients admitted to the intensive care unit by using microfluidic techniques and automated methods, including artificial neural networks, for an unbiased RBC analysis. We find strong flow and RBC shape impairment in COVID-19 samples and demonstrate that such changes are reversible upon suspension of COVID-19 RBCs in healthy plasma. Vice versa, healthy RBCs resemble COVID-19 RBCs when suspended in COVID-19 plasma. Proteomics and metabolomics analyses allow us to detect the effect of plasma exchanges on both plasma and RBCs and demonstrate a new role of RBCs in maintaining plasma equilibria at the expense of their flow properties. Our findings provide a framework for further investigations of clinical relevance for therapies against COVID-19 and possibly other infectious diseases

Cross-talk between red blood cells and plasma influences blood flow and omics phenotypes in severe COVID-19

Coronavirus disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and can affect multiple organs, among which is the circulatory system. Inflammation and mortality risk markers were previously detected in COVID-19 plasma and red blood cells (RBCs) metabolic and proteomic profiles. Additionally, biophysical properties, such as deformability, were found to be changed during the infection. Based on such data, we aim to better characterize RBC functions in COVID-19. We evaluate the flow properties of RBCs in severe COVID-19 patients admitted to the intensive care unit by using microfluidic techniques and automated methods, including artificial neural networks, for an unbiased RBC analysis. We find strong flow and RBC shape impairment in COVID-19 samples and demonstrate that such changes are reversible upon suspension of COVID-19 RBCs in healthy plasma. Vice versa, healthy RBCs resemble COVID-19 RBCs when suspended in COVID-19 plasma. Proteomics and metabolomics analyses allow us to detect the effect of plasma exchanges on both plasma and RBCs and demonstrate a new role of RBCs in maintaining plasma equilibria at the expense of their flow properties. Our findings provide a framework for further investigations of clinical relevance for therapies against COVID-19 and possibly other infectious diseases

Adverse effects of antiretroviral therapy in pregnant women infected with HIV in Brazil from 2000 to 2015: a cohort study

Abstract Background Antiretroviral therapy (ART) use in pregnancy presents unquestionable benefits in preventing mother-to-child transmission (MTCT) of HIV although it is associated with maternal adverse effects. The aim of this study was to evaluate the adverse effects of antiretroviral therapy in pregnant women infected with HIV. Methods Cohort study of pregnant women infected with HIV followed at the CAISM/UNICAMP Obstetric Clinic from 2000 to 2015. The following maternal adverse effects were observed: anemia, thrombocytopenia, allergy, liver function test abnormalities, dyslipidemia and diabetes. Data collected from patients’ files was added to a specific database. Descriptive analysis was shown in terms of absolute (n) and relative (%) frequencies and mean, median and standard deviation calculations. Chi-square or Fisher exact test (n < 5) and relative risk (RR) with its respective p values were used for categorical variables and Student t-test (parametric data) or Mann-Whitney (non-parametric data) for the quantitative ones. A 95% confidence interval (CI) and a significant level of 0.05 were used. A multivariate Cox Logistic Regression was also done. Data analysis was conducted using SAS version 9.4. Results Data from 793 pregnancies were included. MTCT rate was 2.3%, with 0.8% in the last 5 years. Maternal adverse effects were: dyslipidemia (82%), anemia (56%), liver function test abnormalities (54.5%), including hyperbilirubinemia (11.6%), fasting glycemia alteration (19.2%), thrombocytopenia (14.1%), and allergic reaction (2.7%). The majority of adverse effects deemed related to ART in this study were mild according to DAIDS scale. In the multivariate analysis, co-infections and starting ART during pregnancy were risk factors for maternal anemia, while CD4 count higher than 200 cells/mm3 was protective. Nevirapine, nelfinavir and atazanavir regimens increased the risk for liver function tests abnormalities. Lopinavir use during pregnancy increased the risk for fasting glycemia alteration. Conclusion The evolution of the national guidelines of antiretroviral therapy for pregnant women improved adherence to the treatment and resulted in a significant reduction of MTCT. Despite the high frequency of maternal adverse effects, they are mostly of low severity. Newer ART medications with improved efficacy and significantly more favorable tolerability profiles should reduce the incidence of ART-related adverse effects

New molecular evidence for fragmentation\ua0between two distant populations of the threatened stingless\ua0bee\ua0Melipona subnitida Ducke (Hymenoptera, Apidae, Meliponini)

Volume: 38Start Page: 1End Page:

Role of nitric oxide in hyperpnea-induced bronchoconstriction and airway microvascular permeability in guinea pigs

The present study aimed to evaluate the role of nitric oxide (NO) on hyperpnea-induced bronchoconstriction (HIB) and airway microvascular hyperpermeability (AMP). Sixty-four guinea pigs were anesthetized, tracheotonnized, cannulated, and connected to animal ventilator to obtain pulmonary baseline respiratory system resistance (Rrs). Animals were then submitted to 5 minutes hyperpnea and Rrs was evaluated during 15 minutes after hyperpnea. AMP was evaluated by Evans blue dye (25 mg/kg) extravasation in airway tissues. Constitutive and inductible NO was evaluated by pretreating animals with N(G)-nitro-1-arginine methyl ester (I-NAME) (50 mg/kg), aminoguadinine (AG) (50 mg/kg), and I-arginine (100 mg/kg) and exhaled NO (NOex) was evaluated before and after drug administration and hyperpnea. The results show that I-NAME potentiated (57%) HIB and this effect was totally reversed by I-arginine pretreatment, whereas AG did not have effect on HIB. I-NAME decreased basal AMP (48%), but neither I-NAME nor AG had any effect on hyperpnea-induced AMP. NOex levels were decreased by 50% with I-NAME, effect that was reversed by I-arginine treatment. These results suggest that constitutive but not inducible NO could have a bronchoprotective effect on HIB in guinea pigs. The authors also observed that neither constitutive nor inducible NO seems to have any effect on hyperpnea-induced AMP