Prevalência de síndrome metabólica (SM) em usuários de antipsicóticos

-OBJETIVOS: São descritos diversos transtornos metabólicos, associados ao uso de antipsicóticos, sugerindo interface com o quadro de síndrome metabólica (SM). O objetivo do presente estudo é determinar a freqüência dos componentes da SM, em indivíduos com diagnóstico prévio de esquizofrenia, usuários de medicação antipsicótica, verificando possível relação entre uso o dessas drogas e a SM. MATERIAL E MÉTODOS: Foram estudados 64 indivíduos sendo 28 usuários de antipsicóticos típicos (grupo 1), 17 usuários de antipsicóticos atípicos (grupo 2) e 19 como grupo controle (grupo 3). Cada indivíduo foi submetido à avaliação clínica, avaliação do nível de atividade física e às dosagens de glicose, colesterol total e HDL, triglicérides, insulina e leptina. RESULTADOS: As médias dos parâmetros clínicos foram: idade, 37±10 anos, 35±7 anos e 37±10 anos; circunferência abdominal, 97±15cm, 93±12cm e 86±14cm (p<0,05); IMC 26,3±3,7kg/m2 , 25,1±4,0kg/m2, 24,5±4,9kg/m2; PAS 119±21mmHg; 112±15mmHg e 120±19mmHg e PAD 79±14mmHg; 70±9mmHg e 77±14mmHg, nos grupos 1, 2 e 3, respectivamente. Foram considerados sedentários 90,6% dos indivíduos do grupo 1, 59,2% do grupo 2 e 49,7%, do grupo 3. As médias dos exames laboratoriais foram colesterol total: 185± 31mg/dl, 170±42mg/dl e 169±25mg/dl; colesterol HDL:42±12mg/dl, 43±15mg/dl, 51±13mg/dl (p<0,05), triglicérides: 161±105mg/dl, 119±60mg/dl e 114±84mg/dl, glicose: 90±15mg/dl, 86±10mg/dl e 89±16mg/dl, HOMA-index: 1,5± 1,1, 1,5±1,0, 1,2 ±0,8 e leptina 2,5±1,7mg/dl, 2,3± 1,5mg/dl, 3,3± 2,1mg/dl (NS), nos grupos 1, 2 e 3, respectivamente. A prevalência de SM foi 33%, 20% e 25%, nos grupos 1, 2 e 3, respectivamente. DISCUSSÃO: Na maioria dos parâmetros, não se encontrou diferença significativa entre os grupos, todavia observou-se perfil metabólico mais desfavorável, no grupo 1. Diferença significativa nos níveis de HDL colesterol e na circunferência abdominal bem como maior prevalência de SM em usuários de antipsicóticos típicos sugerem possível relação desses transtornos metabólicos e o uso desse tipo de droga. Todavia, existe a possibilidade de que o sedentarismo e o ganho de peso que estão ligados à doença psiquiátrica de base e não o tipo de tratamento em si possam ser a causa do transtorno metabólico. CONCLUSÃO: Os achados sugerem que usuários de antipsicóticos apresentam maior prevalência de SM. A ampliação do número de indivíduos avaliados poderá esclarecer a possível relação entre o tipo de medicação anti-psicótica e a SM

Prevalence of asymptomatic urethritis by Chlamydia trachomatis and Neisseria gonorrhoeae and associated risk factors among males living with HIV-1

Objectives The increase in HIV transmissibility in non-ulcerative sexually transmitted infection is already well-established. It is estimated that symptomatic carriers of N. gonorrhoeae and C. trachomatis have a relative risk of 4.8-fold and 3.6-fold, respectively, for the sexual acquisition of HIV. This type of evaluation for asymptomatic urethritis is necessary to reinforce strategies to combat HIV transmission. This study aims to assess the prevalence of patients with asymptomatic urethritis among men diagnosed with HIV-1 and determine the risk factors associated with this infection. Methods We enrolled a total of 115 male patients aged 18 years or older who have been diagnosed with HIV infection and have no symptoms of urethritis or other sexually transmitted infections and who have been evaluated between May and August 2015 in a follow-up visit at the Immunology Outpatient Clinic of a Brazilian University Hospital. Results Four asymptomatic patients were positive for C. trachomatis and were considered asymptomatic carriers of urethritis. Prevalence was 3.47%. Patients who were positive for C. trachomatis urethritis had a lower mean age (p = 0.015). Conclusion The presence of asymptomatic sexually transmitted infection is a challenge in clinical practice. We recommend that, in outpatient practice, the habit of inquiring on previous sexual behavior to obtain more information about risks and associations with asymptomatic sexually transmitted infection, a routine physical examination and complementary tests to detect STI pathogens should be performed to discard these conditions. The development of rapid tests for this purpose should also be encouraged

Chlamydia trachomatis asymptomatic urethritis recurrence among males living with HIV-1

A prevalence of 3.47% of asymptomatic Chlamydia trachomatis urethritis has been previously reported among males living with HIV infection in Brazil. This study aims to assess the recurrence of C. trachomatis urethritis three years later in the same cohort of patients and analyze associated risk factors. A total of 115 male patients diagnosed with HIV infection, with no symptoms of urethritis and observed since May of 2015 in followup visits were enrolled. They had urine samplers tested by PCR for C. trachomatis and N. gonorrhoeae between February and March 2018. Results: Three of the four patients who had asymptomatic C. trachomatis urethritis three years before were recurrently positive for C. trachomatis urethritis. Two new patients were diagnosed as positives, accounting for a total asymptomatic C. trachomatis urethritis prevalence of 4.34%. The prevalence during the whole study was 5.21%. The relative risk for a new urethritis episode among those previously diagnosed with urethritis is RR=41.62 (95% CI: 9.42-183.84), p &lt; 0.01. Patients who presented asymptomatic urethritis anytime and who were recurrently positive for C. trachomatis had a lower mean age (p&lt;0.01). Married individuals were protected regarding asymptomatic urethritis [p&lt;0.01, OR = 0.04 (0.005-0.4)] and had lower risk to develop recurrence [p&lt;0.01, RR = 0.86 (0.74-0.99)]. Illicit drugs users had risk associated to asymptomatic urethritis [p=0.02, OR= 5.9 (1.03-34)] and higher risk to develop recurrence [p&lt;0.01, RR=1.1 (1-1.22)]. Conclusion: The recurrence of asymptomatic C. trachomatis urethritis after treatment among males living with HIV infection in Brazil can be considered high and should not be neglected

Análise genética de características produtivas e reprodutivas em populações multirraciais de bovinos leiteiros

The objective of this work was to determine whether the random regression model using linear splines (RRMLS) is suitable to estimate the genetic parameters for productive and reproductive traits of a multiple-breed dairy cattle population, as well as to investigate the effect of the genetic group of the progeny on the genetic merit of the sire. The multiple-trait model (MTM) and the RRMLS with one knot fitted for every genetic group were used to obtain the genetic parameters. Records of 1/2 Holstein + 1/2 Gyr (1/2HG), 5/8 Holstein + 3/8 Gyr (5/8HG), and 3/4 Holstein + 1/4 Gyr (3/4HG) crossbreed dams were considered. The RRMLS showed better fitting. The additive and residual variances estimated by the MTM and the RRMLS were similar. Heritability varied from 0.20 to 0.33 for age at first calving, from 0.09 to 0.22 for first lactation length, and from 0.15 to 0.35 for first lactation 305-day milk yield, according to the genetic composition of the dams. The RRMLS is suitable to estimate the genetic parameters for productive and reproductive traits of multiple-breed dairy cattle populations. The genetic merit of the sires is affected by the genetic group of the progeny by which they are evaluated.O objetivo deste trabalho foi verificar se o modelo de regressão aleatória com polinômios lineares do tipo spline (MRAPLS) é adequado para estimar os parâmetros genéticos de características produtivas e reprodutivas em uma população multirracial de bovinos leiteiros, bem como investigar o efeito do grupo genético da progênie sobre o mérito genético do touro. Foram utilizados o modelo multicaracterístico (Mult) e o MRAPLS com nós ajustados aos grupos genéticos, para obtenção dos parâmetros genéticos. Foram considerados os registros de vacas 1/2 Holandesa + 1/2 Gir (1/2HG), 5/8 Holandesa + 3/8 Gir (5/8HG) e 3/4 Holandesa + 1/4 Gir (3/4HG). O MRAPLS apresentou os melhores ajustes. As variâncias aditivas e residuais estimadas por Mult e MRAPLS foram semelhantes. As herdabilidades variaram de 0,20 a 0,33 para idade ao primeiro parto, de 0,09 a 0,22 para duração da primeira lactação e de 0,15 a 0,35 para produção de leite em até 305 dias na primeira lactação, de acordo com a composição genética das vacas. O MRAPLS é adequado para estimar parâmetros genéticos de características produtivas e reprodutivas em populações multirraciais de bovinos leiteiros. O mérito genético do touro é influenciado pelo grupo genético da progênie por meio do qual ele é avaliado

Panoramic snapshot of serum soluble mediator interplay in pregnant women with convalescent COVID-19: an exploratory study

IntroductionSARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators.MethodsA sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array.ResultsIn the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and &lt;5 in HC) observed at the 3rd pregnancy trimester.Discussion and conclusionFrom an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women