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au:Araújo, Paulo Sérgio Ramos de

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O Efeito da Atorvastatina + Aspirina na Função Endotelial Difere com a Idade em Pacientes com HIV: Um Estudo de Caso-Controle
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Santos Junior, Gerson Gomes dos

; Araújo, Paulo Sérgio Ramos

; Leite, Kaliene Maria Estevão

; Godoi, Emmanuelle Tenório

; Vasconcelos, Adriana Ferraz

; Lacerda, Heloisa Ramos

Arquivos Brasileiros de Cardiologia

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aug 2021, Volume 117 N. 2 Pages 365 - 375

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento Pacientes com HIV têm maior probabilidade de apresentar doenças cardiovasculares quando comparados à população em geral. Objetivo Este foi um estudo de caso-controle que teve como objetivo avaliar quais fatores estavam associados a uma redução na espessura médio-intimal da carótida (IMT) da carótida e ao aumento na dilatação mediada por fluxo (DMF) da artéria braquial em pacientes com HIV que receberam atorvastatina + aspirina por um período de 6 meses. Métodos Foi realizada uma análise secundária de um ensaio clínico, que incluiu pessoas vivendo com HIV e baixo risco cardiovascular. Um total de 38 pacientes alocados para o braço de intervenção e tratados por 6 meses com uma combinação de atorvastatina + aspirina foram incluídos. Todos os participantes foram submetidos a ultrassonografia da carótida e da artéria braquial, tanto no início quanto no final do estudo. Os casos que responderam com aumento >10% da dilatação braquial (DMF) e redução da espessura médio-intimal da carótida (IMT) foram considerados casos, e aqueles que não responderam foram considerados controles. Avaliamos os fatores associados às respostas positivas obtidas através da IMT e DMF. Resultados A redução do IMT não se associou significativamente a nenhum dos fatores de risco avaliados: idade (p = 0,211), sexo (p = 0,260), tabagismo (p = 0,131) ou tempo de diagnóstico do HIV (p = 0,836). Um aumento na DMF foi significativamente associado com a idade entre aqueles na faixa etária de 40-59 anos, p = 0,015 (OR = 4,37; IC 95%: 1,07-17,79). Conclusões Os indivíduos mais velhos foram mais propensos a apresentar um aumento na DMF após 6 meses de tratamento com atorvastatina + aspirina.

Abstract Background Patients with HIV are more likely to present with cardiovascular disease when compared to the general population. Objective This was a case-control study that aimed to assess which factors were associated with a reduction in the carotid intima-media thickness (IMT) and an increase in the brachial artery flow-mediated dilation (FMD) in HIV patients who received atorvastatin + aspirin during a period of 6 months. Methods A secondary analysis of a clinical trial was conducted, which included people living with HIV infection and low cardiovascular risk. A total of 38 patients allocated to the intervention arm and treated for 6 months with a combination of atorvastatin + aspirin were included. All participants underwent a carotid and brachial artery ultrasound, both at the beginning and the end of the study. Cases that responded with an increase of >10% of the brachial dilatation (FMD) and reduction of the carotid intima-media thickness (IMT) were considered cases, and those who did not respond were considered controls. We assessed the factors associated with the positive responses obtained through IMT and FMD. Results A reduction in the IMT was not significantly associated with any of the evaluated risk factors: age (p=0.211), gender (p=0.260), smoking (p=0.131) or time since HIV diagnosis (p=0.836). An increase in the FMD was significantly associated with age amongst those in the 40-59 age group, p = 0.015 (OR = 4.37; 95% CI: 1.07-17.79). Conclusions Older individuals were more likely to present with an increased FMD after 6 months of treatment with atorvastatin + aspirin.

https://doi.org/10.36660/abc.20190844 184 downloads

Treatment of mycobacteriosis in a patient with compatible symptoms after a cesarean delivery
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Maia, Carina Scanoni

; Araújo, Paulo Sérgio Ramos de

; Schindler, Haiana Charifker

; Soares, Jardel Pereira

; Cruz, Ana Sofia

; Queiroz Júnior, José Reginaldo Alves de

; Tenorio, Fernanda das Chagas Angelo Mendes

; Medeiros, Juliana Pinto de

; Tenorio, Bruno Mendes

; Maciel, Gyl Everson de Souza

; Amorim, Rosa Valéria da Silva

; Hinrichsen, Sylvia Lemos

Revista do Instituto de Medicina Tropical de São Paulo

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2021, Volume 63 elocation e37

Abstract: En | Text: En | PDF: En

ABSTRACT This study aims to report the diagnostic course and treatment of a fast-growing mycobacteria infection after cesarean delivery. We report the case of a 37-year-old woman admitted to the Infectious Diseases’ Clinic of the Hospital das Clinicas da Universidade Federal de Pernambuco, Pernambuco State, Brazil, four months after a cesarean section, presenting with healing difficulties and located pain outside the surgical site. The first diagnosis was a probable rejection of the sutures that were not absorbed, but based on the clinical signs, reported history, complementary laboratory tests and no response to treatment with the conventional antibiotic therapy (cephalosporins/quinolones) prescribed, the ultimate diagnosis was a mycobacteriosis caused by Micobacterium fortuitum. Since fast-growing mycobacteria do not easily penetrate host tissues, they is mainly related to post-trauma or post-surgical procedures. It is extremely important to call attention to these occurrences in the gynecological-obsthetric field. Treatment for mycobacteriosis is often complicated because of the side effects of antibiotics, especially the ototoxicity of amikacin.

https://doi.org/10.1590/s1678-9946202163037 329 downloads

Registro Multicêntrico de Takotsubo (REMUTA) – Aspectos Clínicos, Desfechos Intra-Hospitalares e Mortalidade a Longo Prazo
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Almeida Junior, Gustavo Luiz Gouvêa de

; Mansur Filho, João

; Albuquerque, Denilson Campos de

; Xavier, Sergio Salles

; Pontes, Álvaro

; Gouvêa, Elias Pimentel

; Martins, Alexandre Bahia Barreiras

; Nunes, Nágela S. V.

; Carestiato, Lilian Vieira

; Petriz, João Luiz Fernandes

; Santos, Armando Márcio Gonçalves

; Bandeira, Bruno Santana

; Abufaiad, Bárbara Elaine de Jesus

; Pacheco, Luciana da Camara

; Oliveira, Maurício Sales de

; Ribeiro Filho, Paulo Eduardo Campana

; Sampaio, Pedro Paulo Nogueres

; Duque, Gustavo Salgado

; Camillis, Luiz Felipe

; Marques, André Casarsa

; Lourenço Jr, Francisco Carlos

; Palazzo, José Ricardo

; Costa, Cláudio Ramos da

; Silva, Bibiana Almeida da

; Zukowski, Cleverson Neves

; Garcia, Romulo Ribeiro

; Zonis, Fernanda de Carvalho

; Paula, Suzana Andressa Morais de

; Ferrari, Carolina Gravano Ferraz

; Rangel, Bruno Soares da Silva

; Ferreira, Roberto Muniz

; Mendes, Bárbara Ferreira da Silva

; Castro, Isabela Ribeiro Carvalho de

; Souza, Leonardo Giglio Gonçalves de

; Araújo, Luiz Henrique dos Santos

; Giani, Alexandre

Arquivos Brasileiros de Cardiologia

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aug 2020, Volume 115 N. 2 Pages 207 - 216

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento A síndrome de takotsubo (takotsubo) é uma forma de cardiomiopatia adquirida. Dados nacionais sobre essa condição são escassos. O Registro REMUTA é o primeiro a incluir dados multicêntricos dessa condição no nosso país. Objetivo Descrever as características clínicas, prognóstico, tratamento intra-hospitalar e mortalidade hospitalar e em 1 ano de seguimento. Métodos Estudo observacional, retrospectivo, tipo registro. Incluídos pacientes internados com diagnóstico de takotsubo ou que desenvolveram esta condição durante internação por outra causa. Os desfechos avaliados incluíram fator desencadeador, análise dos exames, uso de medicações, complicações e óbito intra-hospitalar e em 1 ano de seguimento. O nível de significância adotado foi de 5%. Resultados Foram incluídos 169 pacientes, em 12 centros no Estado do Rio de Janeiro. A idade média foi de 70,9 ± 14,1 anos e 90,5% eram do sexo feminino; 63% dos casos foram de takotsubo primário e 37% secundário. Troponina I foi positiva em 92,5% dos pacientes e a mediana de BNP foi de 395 (176,5; 1725). Supradesnivelamento do segmento ST esteve presente em 28% dos pacientes. A fração de ejeção do ventrículo esquerdo teve mediana de 40 (35; 48)%. Observamos taxa de 25,7% de ventilação mecânica invasiva e 17,4% de choque. Suporte circulatório mecânico foi utilizado em 7,7%. A mortalidade intra-hospitalar foi de 10,6% e a mortalidade ao final de 1 ano foi de 16,5%. Takotsubo secundário e choque cardiogênico foram preditores independentes de mortalidade. Conclusão Os resultados do REMUTA mostram que takotsubo não se trata de patologia benigna como se pensava, especialmente no grupo de takotsubo secundário que acarreta elevada taxa de complicações e de mortalidade. (Arq Bras Cardiol. 2020; 115(2):207-216)

Abstract Background Takotsubo syndrome (TTS) is an acquired form of cardiomyopathy. National Brazilian data on this condition are scarce. The Takotsubo Multicenter Registry (REMUTA) is the first to include multicenter data on this condition in Brazil. Objective To describe the clinical characteristics, prognosis, in-hospital treatment, in-hospital mortality, and mortality during 1 year of follow-up. Methods This is an observational, retrospective registry study including patients admitted to the hospital with diagnosis of TTS and patients admitted for other reasons who developed this condition. Evaluated outcomes included triggering factor, analysis of exams, use of medications, complications, in-hospital mortality, and mortality during 1 year of follow-up. A significance level of 5% was adopted. Results The registry included 169 patients from 12 centers in the state of Rio de Janeiro, Brazil. Mean age was 70.9 ± 14.1 years, and 90.5% of patients were female; 63% of cases were primary TTS, and 37% were secondary. Troponin I was positive in 92.5% of patients, and median BNP was 395 (176.5; 1725). ST-segment elevation was present in 28% of patients. Median left ventricular ejection fraction was 40 (35; 48)%. We observed invasive mechanical ventilation in 25.7% of cases and shock in 17.4%. Mechanical circulatory support was used in 7.7%. In-hospital mortality was 10.6%, and mortality at 1 year of follow-up was 16.5%. Secondary TTS and cardiogenic shock were independent predictors of mortality. Conclusion The results of the REMUTA show that TTS is not a benign pathology, as was once thought, especially regarding the secondary TTS group, which has a high rate of complications and mortality. (Arq Bras Cardiol. 2020; 115(2):207-216)

https://doi.org/10.36660/abc.20190166 1217 downloads

Inflammatory Biomarkers and Carotid Thickness in HIV Infected Patients under Antiretroviral Therapy, Undetectable HIV-1 Viral Load, and Low Cardiovascular Risk
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Leite, Kaliene Maria Estevão

; Santos Júnior, Gerson Gomes

; Godoi, Emmanuelle T. A. M

; Vasconcelos, Adriana Ferraz

; Lorena, Virgínia Maria Barros

; Araújo, Paulo Sérgio Ramos

; Lima, Kledoaldo Oliveira

; Lacerda, Heloisa Ramos

Arquivos Brasileiros de Cardiologia

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jan 2020, Volume 114 N. 1 Pages 90 - 97

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: As pessoas que vivem com HIV têm um risco aumentado de doença cardiovascular e espessamento da carótida, devido à inflamação causada pelo vírus, à terapia antirretroviral e a outros fatores de risco. No entanto, poucos estudos observaram a ocorrência de doenças cardiovasculares e espessamento carotídeo na população soropositiva com baixo risco cardiovascular e carga viral indetectável. Objetivos: Avaliar a associação entre níveis de marcadores inflamatórios e espessura da carótida em pessoas vivendo com HIV, sob terapia antirretroviral e com baixo risco cardiovascular. Métodos: Para determinar o baixo risco cardiovascular em ambos os grupos (indivíduos infectados e não-infectados pelo HIV), foi utilizado o Escore de Risco de Framingham. Os marcadores inflamatórios (IFN-γ, TNF-α, IL-1β, IL-6, sVCAM-1 e sICAM-1) foram avaliados por citometria de fluxo. A espessura da carótida (mm) foi mensurada por meio de ultrassom com Doppler. O nível de significância foi de p < 0,05. Resultados: Em pessoas vivendo com HIV, a idade e o tabagismo foram associados a alterações da espessura da carótida. No grupo não-HIV, idade e níveis mais altos de colesterol total e LDL foram associados ao aumento da espessura da carótida. Utilizando a análise multivariada, observou-se associação significativa entre os níveis de TNF-α e IL-1β e maior chance de desenvolvimento de aterosclerose no grupo com HIV. Conclusão: Ambos os grupos têm risco semelhante de desenvolver doença cardiovascular, portanto, nosso estudo demonstra que indivíduos HIV-positivos com carga viral indetectável em terapia antirretroviral sem inibidores de protease e com baixo risco cardiovascular não apresentam diferenças na espessura da carótida em relação aos indivíduos não-infectados.

Abstract Background: People living with HIV are at increased risk of cardiovascular disease and carotid thickness, due to the inflammation caused by the virus, the antiretroviral therapy, and other risk factors. However, few studies have observed the occurrence of cardiovascular diseases and carotid thickness in HIV-positive population at low cardiovascular risk and with undetectable viral load. Objectives: To evaluate the association between levels of inflammatory markers and carotid thickness in people living with HIV, under antiretroviral therapy and at low cardiovascular risk. Methods: To determine low cardiovascular risk in both groups (HIV infected and non-infected individuals), the Framingham Risk Score was used. Inflammatory markers (IFN-γ, TNF-α, IL-1β, IL-6, sVCAM-1, and sICAM-1) were assessed using flow cytometry. Carotid thickness (mm) was measured using Doppler ultrasound. Level of significance was p < 0.05. Results: In People living with HIV, age and smoking status were associated with carotid thickness alterations. In the non-HIV group, age, higher total cholesterol, and LDL levels were associated with increased carotid thickness. Using the multivariate analysis, a significant association between TNF-α and IL- 1( levels, and a higher chance of atherosclerosis development in HIV group were observed. Conclusions: Both groups have a similar risk for developing cardiovascular disease, therefore our study demonstrates that HIV-positive individuals with undetectable viral load in antiretroviral therapy without protease inhibitors and with low cardiovascular risk do not present differences in carotid thickness in relation to uninfected individuals.

https://doi.org/10.5935/abc.20190230 688 downloads

Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology - 2019
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Précoma, Dalton Bertolim

; Oliveira, Gláucia Maria Moraes de

; Simão, Antonio Felipe

; Dutra, Oscar Pereira

; Coelho, Otávio Rizzi

; Izar, Maria Cristina de Oliveira

; Póvoa, Rui Manuel dos Santos

; Giuliano, Isabela de Carlos Back

; Alencar Filho, Aristóteles Comte de

; Machado, Carlos Alberto

; Scherr, Carlos

; Fonseca, Francisco Antonio Helfenstein

; Santos Filho, Raul Dias dos

; Carvalho, Tales de

; Avezum Jr., Álvaro

; Esporcatte, Roberto

; Nascimento, Bruno Ramos

; Brasil, David de Pádua

; Soares, Gabriel Porto

; Villela, Paolo Blanco

; Ferreira, Roberto Muniz

; Martins, Wolney de Andrade

; Sposito, Andrei C.

; Halpern, Bruno

; Saraiva, José Francisco Kerr

; Carvalho, Luiz Sergio Fernandes

; Tambascia, Marcos Antônio

; Coelho-Filho, Otávio Rizzi

; Bertolami, Adriana

; Correa Filho, Harry

; Xavier, Hermes Toros

; Faria-Neto, José Rocha

; Bertolami, Marcelo Chiara

; Giraldez, Viviane Zorzanelli Rocha

; Brandão, Andrea Araújo

; Feitosa, Audes Diógenes de Magalhães

; Amodeo, Celso

; Souza, Dilma do Socorro Moraes de

; Barbosa, Eduardo Costa Duarte

; Malachias, Marcus Vinícius Bolívar

; Souza, Weimar Kunz Sebba Barroso de

; Costa, Fernando Augusto Alves da

; Rivera, Ivan Romero

; Pellanda, Lucia Campos

; Silva, Maria Alayde Mendonça da

; Achutti, Aloyzio Cechella

; Langowiski, André Ribeiro

; Lantieri, Carla Janice Baister

; Scholz, Jaqueline Ribeiro

; Ismael, Silvia Maria Cury

; Ayoub, José Carlos Aidar

; Scala, Luiz César Nazário

; Neves, Mario Fritsch

; Jardim, Paulo Cesar Brandão Veiga

; Fuchs, Sandra Cristina Pereira Costa

; Jardim, Thiago de Souza Veiga

; Moriguchi, Emilio Hideyuki

; Schneider, Jamil Cherem

; Assad, Marcelo Heitor Vieira

; Kaiser, Sergio Emanuel

; Lottenberg, Ana Maria

; Magnoni, Carlos Daniel

; Miname, Marcio Hiroshi

; Lara, Roberta Soares

; Herdy, Artur Haddad

; Araújo, Cláudio Gil Soares de

; Milani, Mauricio

; Silva, Miguel Morita Fernandes da

; Stein, Ricardo

; Lucchese, Fernando Antonio

; Nobre, Fernando

; Griz, Hermilo Borba

; Magalhães, Lucélia Batista Neves Cunha

; Borba, Mario Henrique Elesbão de

; Pontes, Mauro Ricardo Nunes

; Mourilhe-Rocha, Ricardo

Arquivos Brasileiros de Cardiologia

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oct 2019, Volume 113 N. 4 Pages 787 - 891

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20190204 40841 downloads

Prevalence and risk factors of syphilis and human immunodeficiency virus co-infection at a university hospital in Brazil
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Santos, Alex Maurício Garcia

; Souza Júnior, Valter Romão de

; Melo, Fábio Lopes de

; Aquino, Ana Emília Costa de Araújo

; Ramos, Maria Olivia Aureliano

; Araújo, Lucas Marinho

; Lira, Celso Rodrigues de

; sobral, Patrícia Maria

; Figueiroa, François

; Melo, Heloisa Ramos Lacerda de

; Araújo, Paulo Sérgio Ramos de

Revista da Sociedade Brasileira de Medicina Tropical

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dec 2018, Volume 51 N. 6 Pages 813 - 818

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION The incidence of syphilis has increased since the 1970s. METHODS This was a descriptive and analytical cross-sectional study with a non-probabilistic sample. RESULTS: Of 973 patients with human immunodeficiency virus, 179 (18.4%) tested positive for both human immunodeficiency virus and syphilis, 84.8% were men, 50.9% were aged between 36 and 50 years, 47.8% with syphilis were diagnosed with human immunodeficiency virus for 10-20 years, and 40.3% received antiretroviral therapy for 10-20 years. CONCLUSIONS The prevalence of syphilis in patients with human immunodeficiency virus is higher than expected, making it urgent to adopt efficient public health measures.

https://doi.org/10.1590/0037-8682-0097-2018 1682 downloads

Coccidioidomycosis: first cases reported in Pernambuco, Brazil
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Araújo, Paulo Sergio Ramos de

; Souza Junior, Valter Romão de

; Padilha, Carlos Eduardo

; Oliveira, Marta Iglis de

; Arraes, Luciana Cardoso

; Vieira, Roberto

; Antunes, Ana

; Lima Neto, Reginaldo Goncalves de

; Marsden, Armando

Revista do Instituto de Medicina Tropical de São Paulo

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2018, Volume 60 elocation e75

Abstract: En | Text: En | PDF: En

ABSTRACT Coccidioidomycosis is a fungal infection caused by Coccidioides immitis or Coccidioides posadasii. These fungi are known to thrive in desert climate. Fungi produce infectious arthroconidia in soil, they are aerosolized in the air and when inhaled by humans, usually cause infections such as pneumonia. The first cases of coccidioidomycosis in Brazil were reported in 1978. Since then, there have been other reports mainly from desert regions of Northeastern Brazil. The present report describes three cases of coccidioidomycosis on male farmers from Serra Talhada county, Pernambuco State, who developed pneumonia and were subsequently diagnosed with pulmonary coccidioidomycosis. These three farmers were successfully treated with oral fluconazole. They reported having hunted armadillos in a rural and arid area of Pernambuco State. Armadillos are known to be carriers of Coccidioides. This is the first report of infection caused by Coccidioides in Pernambuco State, Brazil.

https://doi.org/10.1590/s1678-9946201860075 1089 downloads

Detection of multidrug-resistant Pseudomonas aeruginosa harboring bla GES-1 and bla GES-11 in Recife, Brazil
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Silva Júnior, Valdemir Vicente da

; Ferreira, Laura Durão

; Alves, Lílian Rodrigues

; Cabral, Adriane Borges

; Jácome, Paula Regina Luna de Araújo

; Araújo, Paulo Sérgio Ramos de

; Lopes, Ana Catarina de Souza

; Maciel, Maria Amélia Vieira

Revista da Sociedade Brasileira de Medicina Tropical

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dec 2017, Volume 50 N. 6 Pages 764 - 768

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Pseudomonas aeruginosa, an important pathogen globally, presents several resistance mechanisms. This study aimed to investigate the presence of bla GES in clinical isolates of Pseudomonas aeruginosa obtained from various clinical specimens from patients admitted to three different hospitals in Recife, Brazil. The Guiana extended spectrum beta-lactamase (GES) enzymes are responsible for conferring broad spectrum resistance to beta-lactam drugs, including the carbapenems. METHODS: A total of 100 carbapenem-resistant P. aeruginosa isolates underwent polymerase chain reaction (PCR) testing to identify bla GES, bla KPC, bla SPM-1, bla IMP, and bla VIM. Additionally, PCR products positive for bla GES were sequenced. The clonal profiles of these same isolates were then determined by means of enterobacterial repetitive intergenic consensus (ERIC)-PCR analysis. RESULTS: PCR analysis revealed that four isolates harbored bla GES; DNA sequencing showed that two harbored bla GES-1 and two bla GES-11. Beta-lactamase genes bla SPM-1, bla IMP, bla VIM, and bla KPC were investigated; none of these genes was detected. Automated susceptibility testing methods (Vitek®2, bioMérieux) showed that the bla GES-1-positive isolates were only susceptible to polymyxin B. The patterns obtained with ERIC-PCR methods showed clonal relationship between the two isolates that harbored bla GES-11, whereas different clonal profiles were found in the isolates harboring bla GES-1. CONCLUSIONS: We detected the presence of bacterial isolates positive for two different variants of the enzyme GES in three different hospitals from Recife, Brazil. These enzymes have a great capacity for dissemination among Gram-negative bacteria and confer broad-spectrum resistance to beta-lactam antibiotics and to the carbapenems.

https://doi.org/10.1590/0037-8682-0532-2016 1887 downloads

Buschke-Lowenstein tumor in a woman living with HIV/AIDS
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Araújo, Paulo Sérgio Ramos de

; Padilha, Carlos Eduardo Guimarães

; Soares, Melina Ferraz

Revista da Sociedade Brasileira de Medicina Tropical

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aug 2017, Volume 50 N. 4 Pages 577 - 577

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0396-2016 1782 downloads

10.

Clinical and laboratory characteristics, staging, and outcomes of individuals with AIDS-associated Kaposi's sarcoma at an university hospital
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Lima, Catarina Tenório de

; Araújo, Paulo Sérgio Ramos de

; Teixeira, Heberton Medeiros de

; Santos, Josemir Belo dos

; Silveira, Vera Magalhães da

Anais Brasileiros de Dermatologia

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mar 2017, Volume 92 N. 2 Pages 172 - 176

Abstract: En | Text: En | PDF: En

Abstract: Background: Kaposi's sarcoma continues to be the most common human immunodeficiency virus - associated neoplasm with considerable morbidity and mortality. Objective: To describe the clinical and laboratory characteristics, initial staging, and outcomes of aids patients with Kaposi's sarcoma at an university hospital of Recife, Pernambuco. Methods: This is a descriptive study with analytic character, retrospective, of a case series between 2004 and 2014. Results: Of the 22 patients included in the study, 20 were aged <40 years (72.7%). The majority had CD4+ T lymphocyte counts of <200 cells/mm3 (77.3%) and human immunodeficiency virus loads of <100,000 copies/mL (78.9%). Lesions were most commonly observed on the skin (90%), and internal organs were affected in 11 of the 22 patients. Only 7 (31.8%) of the 22 patients were undergoing antiretroviral therapy (ART) at the time of Kaposis sarcoma diagnosis, and the initial disease staging classification was high risk (Aids Clinical Trials Group Oncology Committee) in 19 of the 22 patients (86.4%). Regarding Kaposi's sarcoma treatment, 17 of 22 patients (77.3%) underwent systemic chemotherapy + ART and 5 were treated exclusively with ART. Eight of the 22 patients died (36.5%); of these, 87.5% had died within one year of Kaposi's sarcoma diagnosis. Limitation of the study: Without a control group, this study cannot be used to generate hypotheses. Conclusions: Despite the association between aids and late Kaposi's sarcoma diagnosis in the study population, including an unfavorable risk at the time of staging, a lower mortality rate was observed relative to other studies; this might be related to access to a specialized health service.

https://doi.org/10.1590/abd1806-4841.20175377 1250 downloads

11.

Características clínico-epidemiológicas de la estrongiloidiasis en pacientes portadores de co-morbilidades
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Regueira Fernandes, Amanda

; Romero, Sebastián

; Alcântara de Souza Melo, Paula Fernanda

; Ramos Araújo, Paulo Sérgio

; Bottasso, Oscar

; Rocha, Abraham

; Brandão, Eduardo

Revista chilena de infectología

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feb 2017, Volume 34 N. 1 Pages 47 - 53

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

The strongyloidiasis is a parasitic disease that poses as a serious public health problem, mainly in tropical and subtropical countries. Over the years, some conditions, such as advances in corticosteroid treatment and immunosuppressive diseases, have improved not only the increase in cases of strongyloidiasis, but also the emergence of severe forms of the disease and / or deaths. For these reasons, the objective of this study is to make a critical analysis of the occurrence of strongyloidiasis in patients with comorbidities, describing clinical and epidemiological characteristics associated with these diseases that can highlight the importance of monitoring this parasitosis in most susceptible groups.

La estrongiloidiasis es una parasitosis que representa un grave problema de salud pública, principalmente en países ubicados en regiones tropicales y subtropicales. A lo largo de los años, algunas condiciones, como por ejemplo, avances en el tratamiento con corticosteroides y enfermedades que evolucionan con inmunosupresión, han favorecido no solamente al aumento de casos de estrongiloidiasis, sino también al surgimiento de formas graves de la enfermedad y/u decesos. Por lo expuesto, el objetivo del presente estudio fue realizar un análisis crítico de la ocurrencia de la estrongiloidiasis en portadores de co-morbilidades, describiendo las características clínico-epidemiológicas de esa asociación que puedan resaltar la importancia de vigilar esta parasitosis en grupos considerados más susceptibles.

4724 downloads

12.

Infection by multidrug-resistant Elizabethkingia meningoseptica: case reports
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Lima, Jailton Lobo da Costa

; Albuquerque, Giwellington Silva

; Alves, Lílian Rodrigues

; Torres, Kaliny Benicio

; Mello, Luciana Rezende Bandeira de

; Cavalcanti, Polliana Guabiraba e Silva

; Araújo, Paulo Sérgio Ramos

; Maciel, Maria Amélia Vieira

Jornal Brasileiro de Patologia e Medicina Laboratorial

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dec 2014, Volume 50 N. 6 Pages 434 - 436

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Reportamos dois casos de sepse em pacientes criticamente debilitados em dois hospitais com nível de complexidade terciária em Recife-PE, Brasil. O primeiro caso, paciente de 87 anos com leucemia mieloide crônica e sepse; o segundo, paciente com 93 anos de idade com câncer de próstata apresentava choque séptico causado por Elizabethkingia meningoseptica multirresistente.

We report two cases of sepsis in critically ill patients in two tertiary care hospitals in Recife-PE, Brazil. The first case is an 87-year-old patient with chronic myeloid leukemia and sepsis; and the second case is a 93-year-old patient with prostate cancer and septic shock caused by multidrug-resistant (MDR) Elizabethkingia meningoseptica.

https://doi.org/10.5935/1676-2444.20140053 4786 downloads

13.

CASE STUDY OF A PATIENT WITH HIV-AIDS AND VISCERAL LEISHMANIASIS CO-INFECTION IN MULTIPLE EPISODES
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Silva, Elis Dionísio da

; Andrade, Luiz Dias de

; Araújo, Paulo Sérgio Ramos de

; Silveira, Vera Magalhães

; Padilha, Carlos Eduardo

; Silva, Maria Almerice Lopes da

; Medeiros, Zulma Maria de

Revista do Instituto de Medicina Tropical de São Paulo

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dec 2013, Volume 55 N. 6 Pages 425 - 428

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMORelato de caso de paciente masculino de 45 anos, agricultor, residente na zona da mata do Estado de Pernambuco, diagnosticado com HIV em 1999 e em uso de ARV. Em 2005 foi registrada a primeira ocorrência de LV através do diagnóstico parasitológico a partir do aspirado da medula óssea. À admissão no hospital apresentava-se com febre, hepatoesplenomegalia, perda de peso e diarréia. Desde então houve a ocorrência de mais sete episódios de LV, tendo ocorrido em media, um evento a cada ano (2005-2012 exceto em 2008). O paciente apresentou, em 2011, um quadro cutâneo disseminado, sendo realizada biopsia de pele que evidenciou formas amastigotas de Leishmania no exame histopatológico. Em 2005, o tratamento foi realizado com antimoniato de N-metil-glucamina e anfotericina B desoxicolato, mas desde 2006, devido à toxicidade, o medicamento de escolha foi a anfotericina B lipossomal. Como recomendado pelo Ministério da Saúde, esse relato reforça a necessidade de que os casos de HIV residentes em área endêmica de LV deverão ter inserido em seu protocolo de acompanhamento essa parasitose, principalmente após o primeiro episódio.

SUMMARYReport of a 45-year-old male farmer, a resident in the forest zone of Pernambuco, who was diagnosed with human immunodeficiency virus (HIV) in 1999 and treated using antiretroviral (ARV) drugs. In 2005, the first episode of visceral leishmaniasis (VL), as assessed by parasitological diagnosis of bone marrow aspirate, was recorded. When admitted to the hospital, the patient presented fever, hepatosplenomegaly, weight loss, and diarrhea. Since then, six additional episodes of VL occurred, with a frequency rate of one per year (2005-2012, except in 2008). In 2011, the patient presented a disseminated skin lesion caused by the amastigotes of Leishmania, as identified by histopathological assessment of skin biopsy samples. In 2005, he was treated with N-methyl-glucamine-antimony and amphotericin B deoxycholate. However, since 2006 because of a reported toxicity, the drug of choice was liposomal amphotericin B. As recommended by the Ministry of Health, this report emphasizes the need for HIV patients living in VL endemic areas to include this parasitosis in their follow-up protocol, particularly after the first infection of VL.

https://doi.org/10.1590/S0036-46652013000600010 15833 downloads Cited 1 time in SciELO

14.

Lipid profile of lamb meat from different genotypes submitted to diets with different energy levels
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Costa, Roberto Germano

; Batista, Ana Sancha Malveira

; Azevedo, Paulo Sérgio de

; Queiroga, Rita de Cássia Ramos do Egypto

; Madruga, Marta Suely

; Araújo Filho, José Teodorico de

Revista Brasileira de Zootecnia

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mar 2009, Volume 38 N. 3 Pages 532 - 538

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Para avaliar a influência do genótipo e de dietas com diferentes níveis energéticos sobre o perfil lipídico da carne ovina, foram utilizados 54 cordeiros (18 animais de cada genótipo: Morada Nova, Santa Inês e mestiço ½Dorper + ½Santa Inês) distribuídos em delineamento experimental inteiramente ao acaso, em esquema fatorial 3 × 2 (três genótipos e duas dietas). Os animais foram mantidos com duas dietas (com 2,5 Mcal EM/kg MS ou 3,0 Mcal EM/kg MS) recebendo alimentação e água à vontade até atingirem o peso vivo médio de 30 kg, quando foram abatidos. Determinaram-se os lipídios totais, o colesterol, os fosfolipídios e o perfil de ácidos graxos do músculo Longissimus. A dieta e os genótipos não influenciaram os teores de lipídios totais, colesterol e fosfolipídios. A dieta com maior valor energético apresentou valores mais elevados para concentração dos ácidos C12:0, C14:0, C18:0, C19:0, C22:0 e dos ácidos graxos monoinsaturados (AGM) em comparação àquela com menor valor energético. As maiores concentrações do ácido C15:0 e de ácidos graxos poliinsaturados (AGP) foram obtidas com a dieta de menor valor energético. O genótipo e a dieta influenciaram a concentração dos AGM, que foi maior nos mestiços ½Dorper + ½Santa Inês mantidos com a dieta com 2,5 Mcal EM/kg MS. O genótipo influenciou a concentração dos ácidos graxos saturados (AGS), uma vez que os mestiços ½Dorper + ½Santa Inês apresentaram a menor média, comportamento semelhante ao observado para as concentrações dos AGP. Os ácidos graxos desejáveis (AGD), o índice de aterogenicidade e as relações AGP:AGS, AGM:AGS, (C18:0 + C18:1):C16:0 foram influenciados pelo genótipo e pela dieta. O genótipo ½Dorper + ½Santa Inês e a dieta com 2,5 Mcal EM/kg MS possibilitaram os melhores resultados.

To assess the influence of genotype and diets with different energy levels on the lipid profile of sheep meat, 54 lambs were used (18 animals from each genotype: Morada Nova, Santa Inez and ½Dorper + ½Santa Inez crossbred), distributed in a completely randomized experimental design in a 3 × 2 factorial arragement (three genotypes and two diets). The animals were submitted to two diets, 2.5 Mcal ME/kg DM and 3.0 Mcal ME/kg DM, receiving feed and water to reach the desired average live weight of 30 kg, when they were slaughtered. Total lipids, cholesterol, phospholipids and fatty acids profile of the Longissimus muscle were assessed. Diet and genotype did not influence the total lipids, cholesterol and phospholipids contents. The diet with the highest energy value presented higher values for the concentration of C12:0, C14:0, C18:0, C19:0, C22:0 acids and monounsaturated fatty acids (MUFA) in relation to that with the lowest energy value. However, for the concentrations of C15:0 acid and polyunsaturated fatty acids (PUFA), the highest values were recorded for diet with the lowest energy value. Genotype and diet influenced significantly the MUFA concentration, in which ½Dorper + ½Santa Inez crossbred genotype and diet with 2.5 Mcal ME/kg DM showed the highest values. Genotype influenced the saturated fatty acids (SFA) concentration, with ½Dorper + ½Santa Inez crossbred obtaining the lowest mean, behavior similar to that observed for PUFA concentrations. Desirable fatty acids (DFA), atherogenicity index as well as PUFA:SFA, MUFA:SFA, (C18:0 + C18:1):C16:0 ratios were influenced by diet and genotype. ½Dorper + ½Santa Inez crossbred and diet with 2.5 Mcal ME/kg DM obtained the best results.

3210 downloads Cited 8 times in SciELO

15.

Antiretroviral treatment for HIV infection/AIDS and the risk of developing hyperglycemia and hyperlipidemia
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Araújo, Paulo Sérgio Ramos de

; Ximenes, Ricardo Arraes de Alencar

; Lopes, Carlos Frederico Costa

; Duarte, João Yure

; Silva, Mecleine Mendes da

; Carneiro, Edmilda Marques

Revista do Instituto de Medicina Tropical de São Paulo

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apr 2007, Volume 49 N. 2 Pages 73 - 78

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Um estudo epidemiológico transversal, com caráter analítico, foi realizado para descrever características sócio-demográficas bem como verificar a associação entre o tipo de tratamento antiretroviral empregado e hiperglicemia e hiperlipidemia, com especial atenção aos pacientes em uso de inibidores da protease do HIV. As informações foram obtidas a partir de um questionário e da coleta de sangue e urina para a execução dos exames laboratoriais. Foram entrevistados 418 pacientes, sendo que 46 indivíduos foram excluídos do estudo. A amostra foi então composta por 372 pacientes soropositivos para o HIV atendidos no ambulatório do Hospital Correia Picanço da Secretaria Estadual de Saúde, no período de agosto a novembro de 2000. O teste do Qui-quadrado foi usado para testar as associações e a regressão logística múltipla para ajustar pelos potenciais fatores de confusão. Observou-se uma maior frequência de pacientes com níveis elevados de glicose entre aqueles que faziam uso de terapia antiretroviral sem inibidores da protease, mas o pequeno número de indivíduos limitou as comparações. Verificou-se uma associação entre o colesterol total e o uso de inibidores da protease (p = 0,047) mesmo após o ajuste por idade. Verificou-se também uma associação entre os níveis de triglicerídeos e o uso de inibidores da protease que permaneceu estatisticamente significante mesmo após o ajuste por idade, sexo e níveis de creatinina (p < 0,001). Os níveis de glicose, de TSH, a presença de proteinúria e a pratica de exercícios físicos não estiveram associados com os níveis de colesterol ou com os níveis de triglicerídeos, não se caracterizando como fatores de confusão das associações descritas.

A cross-sectional study with internal comparison groups was conducted to describe sociodemographic characteristics, as well as verify the association between the type of antiretroviral treatment used and hyperglycemia and hyperlipidemia, with special attention to the use of HIV protease inhibitors. The data was obtained through an interview questionnaire, as well as blood and urine samples that were collected for the laboratory exams. A total of 418 patients were interviewed. 46 of these, however, met the exclusion criteria. The sample was therefore composed by 372 HIV positive patients, attended at the laboratory of the Correia Picanço State Hospital for the collection of blood, to estimate the HIV viral load and/or TCD4 cell counts from August to November 2000. The association between the variables was tested using the chi-square test and the p-value. A multiple logistic regression analysis was carried out to adjust for potential confounding factors. A greater frequency of patients with high glucose levels was observed among those making use of antiretroviral therapy without protease inhibitors, but the number of patients limited the comparisons. An association was verified between the total serum cholesterol level and the use of HIV protease inhibitors (p = 0.047) even after controlling for age. An association was also observed between the triglyceride levels and the use of HIV protease inhibitors, which remained after adjustment for age, sex and creatinine levels (p < 0.001). The levels of glucose and TSH, the presence of proteinuria and the practice of physical activity were not associated either with the levels of cholesterol or with the levels of tryglicerides thus they were not confounders of the associations described.

3609 downloads Cited 1 time in SciELO

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