Prevalence of arterial hypertension and risk factors among people with acquired immunodeficiency syndrome

Objectives: to verify the prevalence of arterial hypertension and its risk factors among people with acquired immunodeficiency syndrome under antiretroviral therapy. Method: crosssectional study with 208 patients. Data collection was conducted through interviews using a form containing data on sociodemographic, clinical and epidemiological aspects, hypertension risk factors, blood pressure, weight, height, body mass index and abdominal circumference. Mean, standard deviation, odds ratio and confidence interval were calculated, t-test and Chisquare test were used, considering P < 0.05 as statistically significant. Hypertension associated variables were selected for logistic regression. Results: patients were male (70.7%), selfreported as mixed-race (68.2%), had schooling between 9 and 12 years of study (46.6%), had no children (47.6%), were single (44.2%), in the sexual exposure category (72.1%) and heterosexual (60.6%). The prevalence of people with acquired immunodeficiency syndrome and arterial hypertension was 17.3%. Logistic regression confirmed the influence of age greater than 45 years, family history of hypertension, being overweight and antiretroviral therapy for more than 36 months for hypertension to occur. Conclusion: the prevalence of hypertension was 17.3%. Patients with acquired immunodeficiency syndrome and hypertension were older than 45 years, had family history of hypertension, were overweight and under antiretroviral therapy for more than 36 months.Objetivos: verificar la prevalencia de hipertensión arterial y sus factores de riesgo entre personas con síndrome de inmunodeficiencia adquirida en terapia antirretroviral. Método: estudio transversal, con muestra de 208 pacientes. La recolección de datos se realizó a través de entrevistas con formulario de datos sociodemográficos, clínicos, epidemiológicos, factores de riesgo para la hipertensión arterial, verificación de la presión arterial, peso, altura, índice de masa corporal y la circunferencia abdominal. Se calcularon la media, la desviación estándar, la razón de probabilidades (odds ratio)y el intervalo de confianza, y se utilizaron la prueba t y la prueba del chi-cuadrado, considerándose estadísticamente significante P <0,05. Las variables asociadas a la hipertensión fueron seleccionadas para la regresión logística. Resultados: se destacaron pacientes del género masculino (70,7%), color parda (68,2%), escolaridad entre nueve y 12 años de estudio (46,6%), sin hijos (47,6% ), solteros (44,2%), categoría de exposición sexual (72,1%) y heterosexuales (60,6%). La prevalencia de personas con síndrome de inmunodeficiencia adquirida e hipertensión fue del 17,3%. La regresión logística confirmó que hay influencia de la edad mayor de 45 años, del historial familiar de hipertensión, del sobrepeso y de la terapia antirretroviral por más de 36 meses para ocurrir la enfermedad. Conclusión: la prevalencia de hipertensión fue del 17,3%. Los pacientes con el síndrome de inmunodeficiencia adquirida y hipertensión tenían más de 45 años, historial familiar de hipertensión, sobrepeso y terapia antirretroviral por más de 36 meses.Objetivos: verificar a prevalência de hipertensão arterial e seus fatores de risco entre pessoas com síndrome da imunodeficiência adquirida em terapia antirretroviral. Método: estudo transversal, com amostra de 208 pacientes. Coleta de dados realizada por meio de entrevista, com formulário envolvendo dados sociodemográficos, clínicos, epidemiológicos, fatores de risco para hipertensão, verificação da pressão arterial, peso, altura, índice de massa corporal e circunferência abdominal. Foram calculadas média, desvio padrão, odds ratio e intervalo de confiança e utilizados teste t e teste do qui-quadrado, considerando-se estatisticamente significante P < 0,05. Variáveis associadas à hipertensão foram selecionadas para regressão logística. Resultados: destacaramse pacientes do sexo masculino (70,7%), cor parda (68,2%), escolaridade entre nove e 12 anos de estudo (46,6%), sem filhos (47,6%), solteiros (44,2%), categoria de exposição sexual (72,1%) e heterossexuais (60,6%). A prevalência de pessoas com síndrome da imunodeficiência adquirida e hipertensão foi de 17,3%. Regressão logística confirmou influência da idade maior que 45 anos, história familiar de hipertensão, sobrepeso e terapia antirretroviral acima de 36 meses para ocorrer hipertensão. Conclusão: a prevalência de hipertensão foi de 17,3%. Pacientes com síndrome da imunodeficiência adquirida e hipertensão tinham mais de 45 anos, história familiar de hipertensão, sobrepeso e terapia antirretroviral por mais de 36 meses

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Prevalence of arterial hypertension and risk factors among people with acquired immunodeficiency syndrome

ABSTRACT Objectives: to verify the prevalence of arterial hypertension and its risk factors among people with acquired immunodeficiency syndrome under antiretroviral therapy. Method: cross-sectional study with 208 patients. Data collection was conducted through interviews using a form containing data on sociodemographic, clinical and epidemiological aspects, hypertension risk factors, blood pressure, weight, height, body mass index and abdominal circumference. Mean, standard deviation, odds ratio and confidence interval were calculated, t-test and Chi-square test were used, considering P < 0.05 as statistically significant. Hypertension associated variables were selected for logistic regression. Results: patients were male (70.7%), self-reported as mixed-race (68.2%), had schooling between 9 and 12 years of study (46.6%), had no children (47.6%), were single (44.2%), in the sexual exposure category (72.1%) and heterosexual (60.6%). The prevalence of people with acquired immunodeficiency syndrome and arterial hypertension was 17.3%. Logistic regression confirmed the influence of age greater than 45 years, family history of hypertension, being overweight and antiretroviral therapy for more than 36 months for hypertension to occur. Conclusion: the prevalence of hypertension was 17.3%. Patients with acquired immunodeficiency syndrome and hypertension were older than 45 years, had family history of hypertension, were overweight and under antiretroviral therapy for more than 36 months

Prática insulinoterápica realizada por pessoas com diabetes na Atenção Primária em Saúde

Objetivo Analisar a insulinoterapia realizada por pessoas com diabetes na Atenção Primária em Saúde. Método Estudo transversal, descritivo e quantitativo. A coleta de dados foi realizada por meio de entrevista, utilizando-se formulário com variáveis sociodemográficas, clínicas e etapas da insulinoterapia. Foram calculadas frequências absoluta e relativa, razão de prevalência e foi usado o teste de qui-quadrado, sendo significante o p &lt; 0,05. Resultados A amostra foi composta de 150 pacientes. A maioria era do sexo feminino (66,7%), faixa etária de 50-85 anos (79,3%) e havia analfabetos (16,7%). Destacou-se o diabetes tipo 2 (62,0%) com complicações (42,7%), em uso de hipoglicemiantes orais e insulina. Seringas/agulhas (83,1%), lancetas (85,5%), fitas reagentes (91,0%) e frascos de insulina (93,8%) foram armazenados incorretamente pela maioria. No preparo, aplicação e transporte predominou a forma correta. Resíduos foram descartados incorretamente. Na análise geral das etapas da insulinoterapia, a maioria a realizava de forma inadequada (93,3%). Variáveis sociodemográficas e clínicas não influenciaram na prática insulinoterápica, mas na análise intragrupo houve diferença significante para realização incorreta em alguns grupos. Conclusão A insulinoterapia foi realizada de forma inadequada na maioria dos casos.Objetivo Analizar la insulinoterapia realizada por personas con diabetes en la Atención Primaria en Salud. Método Estudio transversal, descriptivo y cuantitativo. La recolección de los datos fue realizada por medio de la entrevista, utilizando formulario con variables sociodemográficas, clínicas y etapas de la insulinoterapia. Fueran calculadas frecuencias absoluta y relativa, razón de prevalencia y fue utilizado la prueba de qui-cuadrado, siendo significante el p &lt; 0,05. Resultados La amuestra fue composta de 150 pacientes. La mayoría era del sexo femenino (66,7%), rango de edad de 50-85 años (79,3%) y hubo analfabetos (16,7%). Destacó se la diabetes tipo 2 (62,0%) con complicaciones (42,7%), en el uso de hipoglicemiantes orales y insulina. Seringas/agujas (83,1%), lancetas (85,5%), tiras reactivas (91,0%) y frascos de insulina (93,8%) fueran almacenados incorrectamente por la mayoría. En el preparo, aplicación y transporte predominó la forma correcta. Residuos fueran descartados incorrectamente. En el análisis general de las etapas de la insulinoterapia, la mayoría realizaba de forma inadecuada (93,3%). Variables sociodemográficas y clínicas non influenciaran en la práctica de la terapia de insulina, pero en el análisis intragrupo hubo diferencia significante para realización incorrecta en algunos grupos. Conclusión La insulinoterapia fue realizada de forma inadecuada en la mayoría de los casos.Objective To analyze insulin therapy performed by people with diabetes in Primary Healthcare. Method A cross-sectional, descriptive and quantitative study. Data collection was carried out through an interview using a form with sociodemographic, clinical and insulin therapy variables. Absolute and relative frequencies as well as prevalence ratio were calculated and the chi-squared test was used, with p&lt;0.05 being significant. Results The sample consisted of 150 patients. Most were female (66.7%), aged 50-85 years (79.3%) and some were illiterate (16.7%). Type 2 diabetes (62.0%) with complications (42.7%), and using oral hypoglycemic agents and insulin stood out. Syringes/needles (83.1%), lancets (85.5%), reagent strips (91.0%) and insulin vials (93.8%) were stored incorrectly by the majority. The correct form predominated in preparation, application and transport. Waste was disposed of incorrectly. In the general analysis most performed the insulin therapy stages inappropriately (93.3%). Sociodemographic and clinical variables did not influence insulin therapy, but there was a significant difference in the intra-group analysis for incorrect performance in some groups. Conclusion Insulin therapy was inappropriately performed in most cases

Systemic Arterial Hypertension in people living with HIV/AIDS: integrative review

ABSTRACT Objective: To analyze scientific productions about the relationship between HIV and Systemic Arterial Hypertension (SAH) in people living with HIV/AIDS (PLWHA). Method: Integrative literature review in six databases, held in March 2016. “AIDS” and “hypertension” were the keywords used in Portuguese, English and Spanish languages. We found 248 articles and selected 17. The categories formulated were “prevalence of SAH in PLWHA,” “risk factors for SAH in PLWHA” and “adverse events of antiretroviral therapy (ART) that contribute to HAS.” Results: There is no consensus whether HIV and ART influence the SAH development, but there are several risk factors for SAH among PLWHA. It was observed that protease inhibitors medicines influence SAH the most. Conclusion: Guidelines for SAH prevention must be performed in all individuals, however, in PLWHA, they must focus on characteristic risk factors of this population

Mortalidad, supervivencia y factores pronósticos de las personas con SIDA en la unidad de cuidados intensivos

Objective: To analyze mortality, survival and prognostic factors of patients with AIDS in Intensive Care Unit (ICU). Method: Retrospective cohort study with a sample of 202 patients with AIDS in ICU, whose sociodemographic, epidemiological, and clinical characteristics were obtained from medical records and assessed. Results: Patients were mostly male (73.8%) and drug users (59.4%), with no regular health follow-up (61.4%) and no adherence to antiretrovirals (40.6%), presenting low CD4+ T lymphocyte count (94.0%) and high viral load (44.6%). The main causes of hospitalization were sepsis and respiratory and renal insufficiency. The mean duration of hospitalization was 11.9 days (p = 0.0001), with a 41.6% survival; 58.5% died in the ICU. Sepsis upon admission (p &lt; 0.001), pressure injury (p = 0.038), sexual exposure (p = 0.002), high viral load (p = 0.00001) and prolonged hospitalization (p &lt; 0.001) increased the risk of death. Conclusion: Most patients had no regular health follow-up, were drug users and presented low CD4+ T lymphocyte count and high viral load. The high mortality indicated that antiretroviral adherence is essential to reduce viral resistance, opportunistic diseases, and mortality.Objetivo: Analisar a mortalidade, sobrevida e fatores prognósticos de pacientes com aids em Unidade de Terapia Intensiva (UTI). Método: Estudo de coorte retrospectivo, com amostra de 202 pessoas com aids em UTI, cujas características sociodemográficas, epidemiológicas e clínicas foram obtidas em prontuários e avaliadas. Resultados: A maioria dos pacientes era do sexo masculino (73,8%) e usuária de drogas (59,4%), sem acompanhamento regular de saúde (61,4%), não aderente aos antirretrovirais (40,6%), com baixa contagem de linfócitos T CD4+ (94,0%) e carga viral elevada (44,6%). As principais causas de internação foram sepse e insuficiência respiratória e renal. O tempo médio de internação foi de 11,9 dias (p = 0,0001), com sobrevida de 41,6%; 58,5% foram a óbito na UTI. Sepse na admissão (p &lt; 0,001), lesão por pressão (p = 0,038), exposição sexual (p = 0,002), carga viral elevada (p = 0,00001) e hospitalização prolongada (p &lt; 0,001) aumentaram o risco de morte. Conclusão: A maioria dos pacientes não tinha acompanhamento regular de saúde, era usuária de drogas e apresentava baixa contagem de linfócitos T CD4+ e alta carga viral. A mortalidade foi elevada, indicando que a adesão antirretroviral é essencial para reduzir a resistência viral, doenças oportunistas e mortalidade.Objetivo: Analizar la mortalidad, la supervivencia y los factores pronósticos de los pacientes con SIDA en la Unidad de Cuidados Intensivos (UCI). Método: Estudio de cohorte retrospectivo con una muestra de 202 personas con SIDA en la UCI, cuyas características sociodemográficas, epidemiológicas y clínicas fueron obtenidas de las historias clínicas y evaluadas. Resultados: La mayoría de los pacientes eran del sexo masculino (73,8%) y consumidores de drogas (59,4%), sin seguimiento sanitario regular (61,4%), no adherentes a los antirretrovirales (40,6%), con bajo recuento de linfocitos T CD4+ (94,0%) y carga viral elevada (44,6%). Las principales causas de hospitalización fueron la sepsis y la insuficiencia respiratoria y renal. La duración media de la hospitalización fue de 11,9 días (p = 0,0001), con una supervivencia del 41,6%; el 58,5% falleció en la UCI. La sepsis al ingreso (p &lt; 0,001), las lesiones por presión (p = 0,038), la exposición sexual (p = 0,002), la carga viral elevada (p = 0,00001) y la hospitalización prolongada (p &lt; 0,001) aumentaron el riesgo de muerte. Conclusión: La mayoría de los pacientes no tenían un seguimiento sanitario regular, eran consumidores de drogas y tenían recuentos bajos de linfocitos T CD4+ y una carga viral elevada. La mortalidad fue elevada, lo que indica que la adherencia a los antirretrovirales es esencial para reducir la resistencia viral, las enfermedades oportunistas y la mortalidad

Systemic Arterial Hypertension in people living with HIV/AIDS: integrative review

<div><p>ABSTRACT Objective: To analyze scientific productions about the relationship between HIV and Systemic Arterial Hypertension (SAH) in people living with HIV/AIDS (PLWHA). Method: Integrative literature review in six databases, held in March 2016. “AIDS” and “hypertension” were the keywords used in Portuguese, English and Spanish languages. We found 248 articles and selected 17. The categories formulated were “prevalence of SAH in PLWHA,” “risk factors for SAH in PLWHA” and “adverse events of antiretroviral therapy (ART) that contribute to HAS.” Results: There is no consensus whether HIV and ART influence the SAH development, but there are several risk factors for SAH among PLWHA. It was observed that protease inhibitors medicines influence SAH the most. Conclusion: Guidelines for SAH prevention must be performed in all individuals, however, in PLWHA, they must focus on characteristic risk factors of this population.</p></div

Intervenções associadas à entrevista motivacional para adesão antirretroviral por pessoas com HIV

Resumo Objetivo Analisar as produções científicas acerca da eficácia de intervenções utilizando a entrevista motivacional para adesão à terapia antirretroviral por pessoas com o vírus da imunodeficiência humana. Métodos Revisão sistemática realizada em quatro bases de dados, o MEDLINE, CINAHL, IBECS, LILACS, e em uma biblioteca eletrônica, a SciELO, sem restrição de idioma, data e tamanho amostral. O levantamento de artigos foi realizado em setembro de 2021, utilizando-se os descritores Motivational Interviewing, HIV, Acquired Immunodeficiency Syndrome e Antiretroviral Therapy, Highly Active. Foram incluídos artigos do tipo ensaio clínico randomizado, com amostra de pessoas com vírus da imunodeficiência humana maiores de 18 anos, e excluídas pesquisas envolvendo crianças, adolescentes e gestantes. Dez artigos foram selecionados e analisados quanto ao rigor e características de cada estudo. Resultados A entrevista motivacional foi aplicada presencialmente e associada à chamada telefônica, visita domiciliar, fitas de áudio, encartes informativos, aconselhamento, teorias cognitivas-comportamentais e cognitivas-sociais. Os estudos incluídos nesta revisão evidenciaram que as intervenções utilizando a entrevista motivacional aumentaram a adesão aos antirretrovirais por pessoas com vírus da imunodeficiência humana. Conclusão O estudo contribuiu para identificar os dados existentes sobre a eficácia de intervenções com a entrevista motivacional, com foco na adesão à terapia antirretroviral por pessoas com vírus da imunodeficiência humana, tornando visíveis os pontos que precisam ser aprofundados e mostrando a importância desta estratégia, que pode ser utilizada pelos enfermeiros e demais profissionais de saúde, visando o bem-estar dos pacientes. International Prospective Register Systematic Reviews: CRD4201912372