Influência do tempo de uso de Antirretrovirais na resistência insulínica entre pessoas vivendo com HIV com síndrome lipodistrófica

Objetivo: O presente estudo avaliou a influência do tempo de uso de antirretrovirais na resistência insulínica (HOMA-IR) entre pacientes vivendo com HIV, com síndrome lipodistrófica. Métodos: Foram avaliados 36 indivíduos de ambos os sexos, com idade entre 22 e 60 anos, divididos em três grupos: 1) Soropositivo para HIV em uso de TARV com síndrome de lipodistrofia (VIH + LIPO +); 2) Soropositivo para HIV em uso de TARV sem síndrome de lipodistrofia (VIH + LIPO-); 3) Soronegativo para HIV (Controle). Os dados foram coletados na Unidade Especial de Tratamento para Doenças Infecciosas (UETDI), no Ambulatório de Dislipidemia (ADIS) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HC-FMRP). Para a análise bioquímica foram utilizados kits de laboratório, quando os mesmos não estavam disponíveis nos prontuário eletrônico. Resultados: Foram observados maiores valores de HOMA-IR para o grupo GRUPO 1: HIV+LIPO+ (1,61 ± 1,17), comparado aos grupos GRUPO 2: HIV+LIPO- (0,79 ± 0,87) e GRUPO 3: Controle (0,46 ± 0,72), sendo que o HOMA-IR apresentou correlação positiva com o tempo de uso dos antirretrovirais (r=0,41). Conclusão: O tempo de infecção por HIV e o uso de antirretrovirais influenciam o metabolismo glicídico, com modificações nos níveis séricos de insulina e consequentemente resistência à insulina e maior risco para desenvolver diabetes e enfermidades relacionadas ao metabolismo de carboidratos.Objective: The present study evaluated the influence of the duration of antiretroviral therapy on insulin resistance among people living with HIV with lipodystrophic syndrome. Methods: The study assessed 36 subjects of both sexes between 22 and 60 years old split into three groups: 1) HIV-positive using antiretroviral with lipodystrophy syndrome (HIV+LIPO+); 2) HIV-positive using antiretroviral therapy with no lipodystrophy syndrome (HIV+LIPO-); and 3) HIV-negative and healthy (Control). The data were collected at the Special Unit for the Treatment of Infectious Diseases (Unidade Especial de Tratamento para Doenças Infecciosas - UETDI) of the Dyslipidemia Outpatient Clinic (Ambulatório de Dislipidemia - ADIS) of the General Hospital of the Medical School of Ribeirão Preto (HC-FMRP). The biochemical assessment used laboratory kits when the results were not available in the volunteer's records. Results: Higher HOMA-IR values were observed for the group 1: HIV+LIPO+ (1,61 ± 1,17 ) compared to group 2: HIV+LIPO- (0,79 ± 0,87) and group 3: Control (0,46 ± 0,72 ) and such values were positively correlated with the time of antiretroviral medication use (r=0,41). Conclusions: The time of infection by HIV and the use of antiretrovirals impact the glucose metabolism with changes in serum insulin levels and consequent insulin resistance and increased risk for the development of diabetes and diseases related to carbohydrate metabolism

Complicações vasculares pós covid-19 / Vascular complications after covid-19

A pandemia causada pela Covid-19 trouxe ao planeta os mais inúmeros impactos, em especial na área da saúde. De forma mais específica, as complicações e impactos vasculares que são consequências da doença se revelam a cada dia, e justifica-se a escolha do tema pela necessidade de maiores estudos sobre as complicações vasculares causadas pelo vírus. O estudo possui por objetivo geral estudar as complicações vasculares pós doença retratadas na literatura. A metodologia adotada no estudo foi a bibliográfica, através de um estudo exploratório e descritivo sobre o tema e assuntos relacionados. Foram abordados os principais pontos acerca do tema em si das complicações vasculares pós Covid-19, bem como de assuntos ao tema relacionados, como a pandemia trazida pela Covid-19. Para melhor discussão, os resultados foram agrupados em categorias e discutido os achados com a literatura pertinente. Conclui-se que as complicações vasculares pós Covid-19 se revelam em números cada vez mais crescentes, indicando que medidas devam sem tomadas no sentido de prevenir tais complicações

Defining microbial biomarkers for risk of preterm labor

Preterm birth remains the main contributor to early childhood mortality. The vaginal environment, including microbiota com-position, might contribute to the risk of preterm delivery. Alterations in the vaginal microbial community structure mightrepresent a risk factor for preterm birth. Here, we aimed to (a) investigate the association between preterm birth and the vaginalmicrobial community and (b) identify microbial biomarkers for risk of preterm birth. Microbial DNA was isolated from vaginalswabs in a cohort of 69 women enrolled at hospital admission for their delivery. Microbiota was analyzed by high-throughput 16SrRNA sequencing. While no differences in microbial diversity measures appeared associated with the spontaneous preterm andfull-term outcomes, the microbial composition was distinct for these groups. Differential abundance analysis showedLactobacillusspecies to be associated with full-term birth whereas an unknownPrevotellaspecies was more abundant in thespontaneous preterm group. Although we studied a very miscegenated population from Brazil, our findings were similar toevidence pointed by other studies in different countries. The role ofLactobacillusspecies as a protector in the vaginalmicrobiome is demonstrated to be also a protector of spontaneous preterm outcome whereas the presence of pathogenic species,such as Prevotellaspp., is endorsed as a factor of risk for spontaneous preterm delivery

Simultaneous bilateral femoral neck fracture in a patient with renal osteodystrophy

AbstractWe present a unique case of displaced simultaneous bilateral fractures, Garden 3 type, in a 49year woman treated with non-cemented total hip arthroplasty. The patient showed a Harris hip score of 86 on the right hip and a 81 on the left side on the fourth postoperative year, besides a bilateral Trendelenburg gait, more pronounced on the right side. She needed a cane to walk, and felt pain in the left thigh. The X-ray showed a shortening of 0.9cm and a left femoral varus. The other arthroplasty components showed good osseointegration and position.We found that the use of the uncemented total hip arthroplasty to treat a simultaneous bilateral fracture in renal osteodystrophy patients has satisfactory results at a four year follow-up.According to the OCEBM Levels of Evidence Working Group, this study is graded as a Level of Evidence IV

Influence of thickness and translucency of lithium disilicate ceramic on degree of conversion of resinous materials

In this study was assessed the degree of conversion (DC) of amine-free resin cements light cured through lithium disilicate-reinforced ceramics at different thicknesses and translucency. Specimens were divided into 21 groups (n = 5) according to luting agent used: Variolink Esthetic LC (Light shade), RelyX Ultimate (A1 shade), and Filtek Z350 XT Flow (A1 shade); the ceramic translucency: low (LT) and high (HT); and the ceramic thickness: no ceramic (control), 0.5 mm, 1 mm, and 2 mm. A Teflon mold with (5 x 5 x 0.5 mm) was used to standardize the cement and over it the ceramic block from each group was placed. Set was cured using a polywave LED light (1200 mW/cm2 - Bluephase G2) for 40 s. FTIR spectra of uncured and cured materials was obtained and DC calculated from the height of the peaks 1610 and 1640 cm-1. Data were submitted to ANOVA followed by Tukey?s test (? = 0.05). There was a significant difference for luting agents (p< 0.0001) and translucency (p = 0.025), but not for thickness (p = 0.73). Dual amine-free RelyX Ultimate showed the lowest DC values and higher translucency promoted higher DC. Dual amine-free cement showed the lowest monomer conversion and higher translucency ceramics promoted a higher DC

Comparison of the nutritional status in children aged 5 to 10 years old on the Conditional Cash Transfer Programme in the States of Acre and Rio Grande do Sul, Brazil

Introduction: In recent years, there has been a reduction in cases of malnutrition in Brazil but this has been accompanied with an increase in the overweight and obesity rates. These changes, together with others, such as changes in eating patterns and lifestyle, characterise the process of nutritional transition. Objective: We aimed to compare the prevalence of nutritional status of beneficiary children of the Bolsa Família Program (PBF) in the states of Acre and Rio Grande do Sul, Brazil, and to analyse the changes in the anthropometric profile of these children during 5 years. Methods: This is an ecological study using secondary data from the Food and Nutrition Surveillance System (SISVAN) and Bolsa Família Department of SUS (DATASUS), which assessed the nutritional status of children over 5 years and under 10 years benefiting from the PBF in the years 2011 to 2015 in the states of Acre and Rio Grande do Sul. The sample consisted of 94,865 children from Acre and 342,462 children from Rio Grande do Sul. The Body Mass Index was used to classify the nutritional status. Results: The mean prevalence of eutrophic children aged 5 to 10 years in Acre was 70.42% and was 61.28% in Rio Grande do Sul. Overweight was 13.06% in Acre and 19.48% in Rio Grande do Sul. Obesity was 5.08% in Acre and 9.36% in Rio Grande do Sul. Severe obesity was 4.02% in Acre and 6.92% in Rio Grande do Sul. Conclusion: Overweight and obesity in children benefiting from the PBF has been growing in the last 5 years, notably in the state of Rio Grande do Sul. This is possibly due to the fact that the nutritional transition is at a more advanced stage here than in Acre State. 

Influence of additives in the transesterification of crude coconut oil catalyzed by Burkholderia cepacia lipase immobilized onto agro-industrial waste fibers / Influência de aditivos na transesterificação de óleo de coco bruto catalisado por lipase de Burkholderia cepacia imobilizada em fibras de resíduo agroindustrial

In this study was verified the influence of different additives in the transesterification reaction of the crude coconut oil catalyzed with lipase from Burkholderia cepacia  immobilized by physical adsorption onto palm fiber originated from agroindustrial wastes. Reactions was performed under the conditions: molar ratio 1:7 (oil:alcohol), 10 % biocatalyst immobilized for 96 h at 40 °C in the presence in different concentrations of additives (water, tert-butanol, molecular sieve and protic ionic liquids). The results showed that the use of all the additives in this study did not increase conversion to ethyl esters. The maximum conversion in the absence of the additives was 72 %, in the presence of water 45 ± 2 %, molecular sieve 53 ± 2 % and tert -butanol 59 ± 2 %, respectively, all in the lowest concentrations. For ionic liquids, those with higher alkyl chains had the highest conversions, but lower than in their absence