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Sample records for terapia anti retroviral

  1. Manifestações otoneurológicas associadas à terapia anti-retroviral Otoneurological manifestations associated with antiretroviral therapy

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    Andrêza Batista Cheloni Vieira

    2008-02-01

    Full Text Available Ototoxicidade e terapia anti-retroviral parecem estar associadas. O objetivo desse estudo foi avaliar essa possível correlação. Foram avaliados 779 prontuários médicos de pacientes infectados pelo HIV e regularmente acompanhados, sendo 162 tratados com terapia anti-retroviral e 122 não tratados (controle. Pacientes em tratamento eram mais velhos (média 42 anos, com maior tempo de confirmação sorológica (80 meses e com menor carga viral (p=0,00. CD4+ foi semelhante entre os grupos (P=0,60. No grupo tratado, três (1,8% casos de perda auditiva idiopática e dois (1,3% de perda auditiva relacionada a otosclerose foram observadas e ambas iniciadas após terapia anti-retroviral. Nenhuma diferença estatística relacionada à perda auditiva idiopática foi encontrada entre os grupos. Enquanto estudos descritivos consideram possível ototoxidade associada à terapia anti-retroviral, esse possível efeito adverso não foi relacionado à terapia anti-retroviral neste estudo. Contrariamente, otosclerose poderia estar correlacionada à terapia anti-retroviral. Este assunto merece ser estudado.Ototoxicity and antiretroviral therapy seem to be associated. The aim of this study was to evaluate this possible correlation. Evaluations were carried out on 779 medical records from HIV-infected patients who were being regularly followed up, of whom 162 were being treated with antiretroviral therapy and 122 were untreated (controls. The patients undergoing treatment were older (mean: 42 years, had had serological confirmation for longer times (80 months and had smaller viral loads (P = 0.00. CD4+ was similar between the groups (P = 0.60. In the treated group, three cases (1.8% of idiopathic hearing loss and two (1.3% of otosclerosis-related hearing loss were observed, which both started after antiretroviral therapy. No statistical difference relating to idiopathic hearing loss was found between the groups. While descriptive studies consider possible

  2. Abordagem metabólica e nutricional da lipodistrofia em uso da terapia anti-retroviral Metabolic and nutritional approach of lipodystrophy in the use of antiretroviral therapy

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    Claudia Daniele Tavares Dutra

    2008-08-01

    Full Text Available A terapia anti-retroviral altamente ativa, usada contra o Vírus da Imunodeficiência Humana, vem possibilitando a melhora do quadro clínico-laboratorial de portadores da Síndrome da Imunodeficiência Adquirida. Contudo, alterações metabólicas e complicações morfológicas, associadas ao uso da terapia, vêm sendo investigadas. A utilização prolongada desta terapia tem um impacto importante sobre o estado nutricional dos pacientes. Antes da sua utilização, a perda de peso e a desnutrição, conseqüências das infecções oportunistas, eram os maiores problemas nutricionais. Atualmente, o foco principal das discussões têm sido as complicações metabólicas e morfológicas, dentre elas a lipodistrofia, com a dislipidemia, a resistência à insulina, a osteopenia, e a distribuição alterada da gordura corporal, aumentando assim os riscos de doenças cardiovasculares. A nutrição desempenha um papel fundamental no suporte da saúde desses pacientes, integrando as equipes multiprofissionais, promovendo a melhora da adesão à terapia anti-retroviral e do prognóstico da doença. No entanto, para que se tenha mais conhecimento sobre a terapia, as proporções de seus efeitos adversos, e o perfil nutricional desses pacientes, a curto e a longo prazos, é de suma importância que se estude mais sobre este assunto, a fim de permitir perspectivas de um regime terapêutico mais seguro dentro de seus alcances metodológicos, proporcionando uma melhor qualidade de vida aos pacientes.The highly active antiretroviral therapy used against Human Immunodeficiency Virus provides an improvement in laboratory and clinical findings of patients with Acquired Immunodeficiency Syndrome. However, metabolic and morphologic disturbances associated with the therapy are being investigated. The drawn out use of these therapy has an important impact on the nutritional status of the patients. Before the use of this therapy, weight loss and malnutrition caused by

  3. Metabolic changes associated with antiretroviral therapy in HIV-positive patients Alteraciones metabólicas asociadas a la terapia anti-retroviral en pacientes HIV-positivos Alterações metabólicas associadas à terapia anti-retroviral em pacientes HIV-positivos

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    Sabrina Esteves de Matos Almeida

    2009-04-01

    Full Text Available OBJECTIVE: To evaluate metabolic changes associated with highly active antiretroviral therapy (HAART in HIV-positive patients, and to identify risk factors associated. METHODS: Retrospective study that included 110 HIV-positive patients who where on HAART in the city of Porto Alegre (Southern Brazil between January 2003 and March 2004. Data on demographic variables, cigarette smoking, diabetes mellitus, cholesterol and triglyceride levels, stage of HIV infection, antiretroviral therapy and HCV coinfection were collected. General linear models procedure for repeated measures was used to test the interaction between HAART and HCV coinfection or protease inhibitor treatment. RESULTS: Total cholesterol, triglycerides, and glucose levels significantly increased after receiving HAART (pOBJETIVO: Evaluar las alteraciones metabólicas asociadas a la terapia anti-retroviral potente en pacientes HIV-positivos e identificar factores de riesgo asociados. MÉTODOS: Estudio retrospectivo con 110 pacientes HIV-positivos que estaban en terapia anti-retroviral potente (HAART en la ciudad de Porto Alegre (Sur de Brasil, entre enero de 2003 y marzo de 2004. Los datos colectados incluyen variables demográficas, tabaquismo, diabetes mellitas, niveles de colesterol y triglicéridos, fase de la infección viral, terapia anti-retroviral y co-infección con hepatitis C. El análisis multivariado para medidas repetidas (General Linear Model procedure for Repeated Measures fue utilizada para analizar la interacción entre el efecto de uso de HAART y el uso de inhibidores de proteasa o co-infección por hepatitis C. RESULTADOS: Fueron observados aumentos significativos en los niveles de colesterol total, triglicéridos y glucosa posterior al tratamiento con HAART (pOBJETIVO: Avaliar as alterações metabólicas associadas à terapia anti-retroviral potente em pacientes HIV-positivos e identificar fatores de risco associados. MÉTODOS: Estudo retrospectivo com 110

  4. Rinossinusites em crianças infectadas pelo HIV sob terapia anti-retroviral Rhinosinusitis in HIV-infected children undergoing antiretroviral therapy

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    Carlos Diógenes Pinheiro Neto

    2009-02-01

    Full Text Available A associação dos inibidores de protease (IP à terapia anti-retroviral provocou mudanças importantes na morbidade e mortalidade de pacientes infectados pelo HIV. OBJETIVOS: Avaliar o impacto desta associação na prevalência de rinossinusite (RS e na contagem sérica de linfócitos CD4 em crianças infectadas pelo HIV. CASUÍSTICA E MÉTODOS: A forma de estudo foi cross-sectional com 471 crianças infectadas pelo HIV. Em 1996, inibidores de protease foram liberados para terapia anti-retroviral. Desta forma, dois grupos de crianças foram formados: as que não fizeram uso de IP e as que fizeram uso desta droga após 1996. A prevalência de RS e a contagem sérica de linfócitos CD4 foram comparadas entre estes grupos. RESULTADOS: 14,4% das crianças infectadas pelo HIV apresentaram RS. A RS crônica foi mais prevalente que a RS aguda em ambos os grupos. Crianças menores de 6 anos tratadas com a associação de IP apresentaram maior prevalência de RS aguda. A associação de IP esteve associada à maior contagem de linfócitos CD4 séricos com menor prevalência de RS crônica. CONCLUSÕES: A terapia com IP esteve associada ao aumento na contagem de linfócitos CD4. Crianças abaixo dos 6 anos em uso de IP apresentaram menor tendência à cronificação da doença.The association of protease inhibitors (PI to antiretroviral therapy has generated sensible changes in morbidity and mortality of HIV-infected patients. AIM: Aims at evaluating the impact of this association on the prevalence of rhinosinusitis (RS and CD4+ lymphocyte count in HIV-infected children. METHODS: Retrospective cross-sectional study of the medical charts of 471 HIV-infected children. In 1996, protease inhibitors were approved for use as an association drug in antiretroviral therapy. Children were divided into two groups: one which did not receive PI and another which received PI after 1996. The prevalence of RS and CD4+ lymphocyte counts were compared between these groups

  5. Longitudinal comparison between plasma and seminal HIV-1 viral loads during antiretroviral treatment Comparação longitudinal entre cargas virais seminais e plasmáticas do HIV-1 durante terapia anti-retroviral

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    Lauro Ferreira da Silva Pinto Neto

    2003-12-01

    Full Text Available This study was designed to investigate the impact of anti-retroviral therapy on both plasma and seminal HIV-1 viral loads and the correlation between viral loads in these compartments after treatment. Viral load, CD4+ and CD8+ T-cell counts were evaluated in paired plasma and semen samples from 36 antiretroviral therapy-naïve patients at baseline and on days 45, 90, and 180 of treatment. Slopes for blood and seminal viral loads in all treated patients were similar (p = 0.21. Median HIV-1 RNA titers in plasma and semen at baseline were 4.95 log10 and 4.48 log10 copies/ml, respectively. After 180 days of therapy, the median viral load declined to 3.15 log10 copies/ml (plasma and 3.2 log10 copies/ml (semen. At this timepoint 22 patients presented HIV-1 viral load below 400 copies/ml in either plasma or semen, but only 9 had viral loads below 400 copies/ml in both compartments.Este estudo foi desenhado para investigar o impacto do tratamento com anti-retrovirais na evolução das cargas virais plasmáticas e seminais do HIV-1. A carga viral do HIV-1 e a contagem de linfócitos T CD4+ e CD8+ foi determinada em amostras pareadas de sangue e sêmen de 36 pacientes virgem de tratamento nos dias 0, 45, 90 e 180 após o início da terapia. As curvas de declínio das cargas virais plasmática e seminal foram semelhantes (p= 0.21. As medianas da carga viral plasmática e seminal no pré-tratamento (dia 0 foram 4.95 e 4.48 log10 cópias/ml, respectivamente. Seis meses após o início da terapia, a mediana da carga viral plasmática era 3.15 log10 cópias/ml e a seminal 3.2 log10 cópias/ml. Neste mesmo periodo, 22 pacientes apresentavam carga viral abaixo de 400 cópias/ml no plasma e/ou sêmen, enquanto apenas 9 pacientes apresentavam carga viral abaixo do limite de detecção nos dois compartimentos.

  6. Lesões anorretais em pacientes HIV positivos usuários de terapia anti-retroviral de alta efetividade Anorrectal lesions in HIV-positive patients using highly active antiretroviral therapy

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    Manuel Retamozo-Palacios

    2007-06-01

    Full Text Available As lesões anorretais são comuns nos pacientes positivos para o vírus da imunodeficiência humana. A terapia antirretroviral de alta efetividade tem pouca influência na progressão das neoplasias anais. Estudou-se a prevalência das lesões anorretais em 88 pacientes HIV positivos atendidos no serviço de doenças infecto-parasitárias do Hospital Universitário de Brasília, em uso de terapia antirretroviral de alta efetividade. Dados sócio-demográficos foram coletados usando um questionário pré-elaborado e os pacientes foram submetidos a exame proctológico. Cerca de 71% relataram coito anal e 30,7% estavam em uso de inibidor de protease. A prevalência das lesões anorretais foi 36,4%, sendo as mais freqüentes: condiloma acuminado e fissura anal. O condiloma acuminado foi a lesão anorretal mais prevalente e teve associação com o uso de lopinavir/ritonavir. Sugere-se o rastreamento das lesões anorretais causadas pelo papilomavírus humano nos pacientes HIV positivos/AIDS em uso de inibidor de protease.Anorectal lesions are common in patients with human immunodeficiency virus (HIV. Highly active anti-retroviral therapy (HAART has little influence on the progression of anal neoplasms. The prevalence of anorectal lesions in 88 HIV-positive patients attended at the infectious diseases service of the University Hospital of Brasília who were using HAART was studied. Sociodemographic data were collected using a pre-prepared questionnaire and then the patients underwent proctological examination. Around 71% of the patients said they practiced anal intercourse. 30.7% were using a protease inhibitor. The prevalence of anorectal lesions was 36.4%, and condyloma acuminata and anal fissure were the most frequent of these. Condyloma acuminata was the most prevalent anorectal lesion and was strongly associated with the use of lopinavir/ritonavir. Screening for anorectal lesions caused by human papillomavirus in HIV/AIDS patients who use protease

  7. Adesão à terapia antiretroviral para HIV/AIDS Adhesión a la terapia anti-retroviral para el vih/sida Adherence to the antiretroviral therapy for HIV/AIDS

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    Maria Rosa Ceccato Colombrini

    2006-12-01

    Full Text Available A não-adesão à terapêutica antiretroviral altamente eficaz (HAART é considerada, no plano individual, como um dos mais ameaçadores perigos para a efetividade do tratamento da pessoa com HIV/aids e para a disseminação de vírus-resistência, no plano coletivo. Assim, o objetivo deste estudo foi analisar, mediante revisão de literatura, os fatores de risco para não-adesão à HAART, além de agrupá-los e relacioná-los à pessoa em tratamento, à doença, ao tratamento e ao serviço de saúde e suporte social. A literatura aponta para a necessidade da realização de estudos que avaliem aspectos socioculturais, crenças, qualidade do serviço prestado, relações do cliente com a equipe multiprofissional e outros referentes à raça e aos efeitos colaterais dos anti-retrovirais. Estes estudos visam a favorecer o estabelecimento de estratégias que melhorem a adesão dos clientes à HAART, ao mesmo tempo em e que contribuem para a construção e exercício da cidadania.La no adhesión a la terapéutica anti-retroviral altamente eficaz (HAART es considerada, en el plano individual, como uno de los más amenazadores peligros para la efectividad del tratamiento de la persona con VIH/SIDA y para la diseminación del virus-resistencia, en el plano colectivo. Así, el objetivo de este estudio fue analizar, mediante revisión de la literatura, los factores de riesgo para la no adhesión a la HAART, además de agruparlos y relacionarlos a la persona en tratamiento, a la enfermedad, al tratamiento y al servicio de salud y soporte social. La literatura apunta hacia la necesidad de realizar estudios que evalúen aspectos socioculturales, creencias, calidad del servicio prestado, relaciones del cliente con el equipo multi-profesional y otros referentes a la raza y a los efectos colaterales de los anti-retrovirales. Estos estudios visan a favorecer el establecimiento de estrategias que mejoren la adhesión de los clientes a la HAART, al mismo tiempo

  8. Lipodystrophy syndrome associated with antiretroviral therapy in HIV patients: considerations for psychosocial aspects Síndrome de la lipodistrofia asociado con la terapia antiretroviral en pacientes con VIH: consideraciones para los aspectos psicosociales Sindrome da lipodistrofia associada com a terapia anti-retroviral em portadores do HIV: considerações para os aspectos psicossociais

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    Ana Paula Morais Fernandes

    2007-10-01

    son necesarios para entender mejor este complejo síndrome, proveyendo nueva información para ser utilizada en el cuidado de enfermería para pacientes con VIH que están afectados por este problema.Diversos efeitos colaterais têm sido associados à terapia anti-retroviral em portadores da infecção pelo HIV, dentre esses, a síndrome da lipodistrofia apresentando hiperlipidemia e alterações na forma do corpo, com hipertrofia adiposa central e lipoatrofia periférica, relatada pelos pacientes como um visível marcador para a identificação de portadores da infecção pelo HIV. Este estudo consiste em análise da produção científica sobre aspectos psicossociais em portadores da infecção pelo HIV que apresentam lipodistrofia associada à utilização da terapia anti-retroviral. Os resultados mostram que alterações corporais podem ser suficientemente perturbadoras para o bem-estar psicossocial, afetando a qualidade de vida e aumentando o estigma da doença, ocasionando perturbações nas relações sociais. Esta revisão possibilita uma análise preliminar dos aspectos psicossocias da lipodistrofia; entretanto, outros estudos são necessários para o melhor entendimento desta complexa síndrome, trazendo novas informações a serem utilizadas no cuidado de enfermagem a portadores da infecção pelo HIV afetados por este problema.

  9. Adherence to antiretroviral therapy: a qualitative study with physicians from Rio de Janeiro, Brazil Aderência à terapia anti-retroviral: um estudo qualitativo com médicos no Rio de Janeiro, Brasil

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    Monica Malta

    2005-10-01

    Full Text Available Brazil provides free antiretroviral (ARV therapy to some 150,000 individuals living with HIV/ AIDS. ARV regimens require optimal adherence to achieve undetectable viral loads and to avoid viral resistance. Physicians play a key role to foster ARV adherence, but until now little is known about the communication between physicians/ people living with HIV/AIDS in this setting. In-depth interviews were conducted with 40 physicians treating people living with HIV/AIDS at six public reference centers in Rio de Janeiro, Brazil. Interview topics included: experiences in the treatment of people living with HIV/AIDS, relationship and dialogue with patients, barriers/facilitators to adherence, and effectiveness of available services. Barriers to ARV adherence were mainly related to the low quality of patient-provider relationship. Other barriers were related to "chaotic" patients' lifestyles, and inadequate knowledge and/or negative beliefs about HIV/AIDS and ARV effectiveness. It is necessary to improve networking between services, establish agile referral systems, and improve health professionals' integration. These structural changes could contribute to improved adherence, resulting in improved quality of life for people living with HIV/AIDS.O Brasil fornece gratuitamente terapia anti-retroviral (ARV para cerca de 150 mil pessoas vivendo com HIV/ AIDS. A terapia ARV requer aderência ótima, visando alcançar carga viral indetectável e evitar resistência viral. Os médicos desempenham papel central quanto à aderência à ARV, mas há escassa informação sobre a comunicação entre médicos/pessoas vivendo com HIV/ AIDS. Entrevistas em profundidade foram realizadas com 40 médicos assistentes de seis hospitais de referência do Rio de Janeiro, Brasil. Tópicos da entrevista incluíram: experiências relativas ao tratamento de pessoas vivendo com HIV/AIDS, relacionamento/diálogo com pacientes, barreiras/facilitadores para aderência aos servi

  10. Adesão e não-adesão à terapia anti-retroviral: as duas faces de uma mesma vivência Adhesión y no adhesión a la terapia antiretroviral: las dos caras de una misma vivencia Adhesion and non adhesion to anti-retroviral therapy: the two faces of a same experience

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    Ana Lúcia Cardoso Nogueira da Silva

    2009-04-01

    Full Text Available O objetivo do estudo foi compreender, a partir da perspectiva de portadores e familiares, os aspectos que influenciam na adesão à terapêutica anti-retroviral. Trata-se de um estudo descritivo, de natureza qualitativa, desenvolvido no período de junho de 2006 a julho de 2007, junto a 10 indivíduos portadores do HIV/Aids, acompanhados pelo Serviço de Atendimento Especializado em Aids de Campo Mourão - PR e seus familiares. Constituem fatores facilitadores da adesão: adoção de estratégias para lembrar horários e mascarar o gosto do medicamento, ausência de efeitos colaterais, número reduzido de medicamentos a serem ingeridos e capacidade para reconhecê-los, lembrança dos sintomas da doença e o apoio da rede social. A ausência destes fatores pode culminar na não-adesão.El objetivo del estudio fue comprender, a partir de la perspectiva de portadores y familiares, los aspectos que influyen en la adhesión a la terapéutica antiretroviral. Se trata de un estudio descriptivo, de naturaleza cualitativa, desarrollado en el período de junio de 2006 a julio de 2007, junto a 10 individuos portadores del VIH/SIDA, acompañados por el Servicio de Atención Especializado en SIDA de Campo Mourão - PR y sus familiares. Constituyen factores que facilitan la adhesión: adopción de estrategias para recordar horarios y enmascarar el sabor del medicamento, ausencia de efectos colaterales, número reducido de medicamentos a ser ingeridos y capacidad para reconocerlos, recuerdo de los síntomas de la enfermedad y el apoyo de la red social. La ausencia de estos factores puede culminar en la no-adhesión.The objective of the study was to understand, from the perspective of HIV bearers and family, the aspects that influence in the adhesion to the antiretroviral therapy. It is a descriptive study, of qualitative nature, carried out from June 2006 to July 2007, with 10 HIV/Aids positive individuals, attended at the Service of Specialized Care on Aids

  11. Enteropatógenos relacionados à diarréia em pacientes HIV que fazem uso de terapia anti-retroviral Enteropathogens relating to diarrhea in HIV patients on antiretroviral therapy

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    Áurea Regina Telles Pupulin

    2009-10-01

    Full Text Available A etiologia do processo diarréico na AIDS pode ser causada por vírus, bactérias, fungos, protozoários e helmintos, assim como pelo próprio HIV. Este trabalho avaliou enteropatogenos relacionados à diarréia em pacientes HIV que fazem uso de terapia anti-retroviral. Os métodos parasitológicos utilizados foram Faust, Hoffmann e Kinyoun. O isolamento e cultura dos fungos foram realizados conforme metodologia recomendada por NCCLS M27-A standard. A identificação das espécies de leveduras foi realizada através da reação em cadeia da polimerase. O isolamento de bactérias, foi feito em agar Mac Conkey e agar SS, a identificação das espécies através do Enterokit B (Probac do Brasil e métodos bioquímicos. Foram avaliados 49 pacientes, 44,9% apresentaram enteroparasitas, 48,1% Candida sp com 61,5% Candida albicans, 7,6% Candida sp e 30,7% Candida não- albicans. Foram isoladas bactérias de 72% dos pacientes, 49% Escherichia coli, 13% Salmonella parathyphi, Klebsiella sp ou Proteus e 6% Citrobacter freundii ou Yersinia sp. Houve alta prevalência de Candida sp nos pacientes HIV com diarréia e foram isoladas espécies não albicans cuja presença pode ser entendida como cúmplice ou causa da infecção.The etiology of the diarrheic process in AIDS may be caused by viruses, bacteria, fungi, protozoa or helminths, as well as HIV itself. This study evaluated enteropathogens relating to diarrhea in HIV patients who were on antiretroviral therapy. The parasitological methods used were Faust, Hoffmann and Kinyoun. Isolation and culturing of fungi were carried out in accordance with the methodology recommended by the NCCLS M27-A standard. The yeast species were identified using the polymerase chain reaction (PCR. Bacteria were isolated on MacConkey and SS agar and the species were identified using Enterokit B (Probac do Brasil and biochemical methods. Forty-nine patients were evaluated: 44.89% presented enteroparasites and 48.1% presented

  12. THE EVOLUTION OF ANTI-RETROVIRAL THERAPY IN NIGERIA ...

    African Journals Online (AJOL)

    PUBMED search by Akanmu et al from Lagos in 2001 to reports in 2013, it is undeniable that HIV scientists in Nigeria have produced a good number of very informative and relevant results in the area of anti-retroviral therapy research in Nigeria. Key words: Medical History, Anti-retroviral therapy, HAART, Nigeria mother to ...

  13. Fatores de risco para a não adesão ao tratamento com terapia antiretroviral altamente eficaz Factores de riesgo para la no-adherencia al tratamiento con terapia anti-retroviral altamente eficiente Risk factors for non-compliance to treatment with highly effective antiretroviral therapy

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    Maria Rosa Ceccato Colombrini

    2008-09-01

    Full Text Available O estudo objetivou: mensurar a prevalência de não-adesão à terapia anti-retroviral altamente eficaz (HAART em pacientes com AIDS; identificar se alguns fatores relacionados na literatura estavam associados com a não-adesão; estabelecer o valor preditivo dos fatores associados à não-adesão à HAART. Foi realizado um estudo analítico de prevalência (N=60. Foram considerados os três dias anteriores à entrevista e os pacientes classificados como aderentes quando ingeriam 95% ou mais do total de comprimidos prescritos por dia. A adesão foi de 73,3%. A análise de regressão logística multivariada indicou que indivíduos da raça negra apresentaram 6,48 vezes mais risco de não-adesão; aqueles que apresentaram ausência de efeito colateral tiveram um risco 7,6 vezes maior, e a cada comprimido ingerido o risco foi de 1,12. A adesão observada foi maior que a encontrada na literatura. Os fatores sociodemográficos e culturais podem interferir na adesão à HAART.Objetivo del estudio: medir la prevalencia por falta de seguimiento al tratamiento anti-retroviral altamente eficaz (HAART en pacientes con SIDA; identificar si algunos factores relacionados en la bibliografía se encuentran asociados con la falta de seguimiento; establecer el valor preditivo de los factores asociados con la falta de seguimiento al HAART. Para lo cual fue realizado un estudio analitico de prevalencia (N=60, considerándose los tres días anteriores a la entrevista, donde aquellos pacientes con ingesta del 95% o más del total de comprimidos prescritos por día eran clasificados como seguidores del tratamiento. El seguimiento fue de 73,3%. El análisis de regresion logística multi-variable mostró que sujetos de raza negra presentaron 6,48 veces mayor riesgo de no continuar con el tratamiento; aquellos individuos sin efectos colaterales tuvieron un riesgo 7,6 veces mayor, asimismo, cada comprimido ingerido produjo un riesgo de 1,12. El seguimiento observado fue

  14. Impacto da terapia anti-retroviral na magnitude da epidemia do HIV/AIDS no Brasil: diversos cenários Impact of antiretroviral therapy on the magnitude of the HIV/AIDS epidemic in Brazil: various scenarios

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    Maria Tereza S. Barbosa

    2003-04-01

    Full Text Available Neste trabalho, utilizaram-se os algoritmos EM e EMS aplicados ao método do Cálculo Retroativo para estimar a magnitude da epidemia do HIV no Brasil. Fazendo-se suposições a respeito do comportamento dos infectados, em relação à utilização da terapia combinada das drogas anti-retrovirais, construíram-se cinco cenários para a epidemia brasileira. O objetivo foi o de ilustrar os impactos que a utilização da terapia combinada das drogas anti-retrovirais possam estar tendo ou possam vir a ter na incubação do vírus e, por conseguinte, nas avaliações da epidemia realizadas a partir dos casos de Aids notificados.We applied the back-calculation method to estimate the magnitude of the HIV epidemic in Brazil, using the EM and EMS algorithms. Under certain assumptions regarding the behavior of infected patients towards combined antiretroviral therapy, we discuss five different scenarios applied to the Brazilian epidemic. Our objective was to illustrate the impact of combined antiretroviral treatment on the incubation period and thus on estimates of the size of the HIV-infected population, based on reported AIDS cases.

  15. Infecções oportunistas em indivíduos com infecção pelo HIV e relação com uso de terapia antirretroviral = Opportunistic infections in individuals with HIV infection and relationship with the use of anti-retroviral therapy

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    Vinicius Henrique Veraldo Fagundes

    2010-07-01

    non-anti-retroviral therapy. Clinical evaluations were made and medical reports and tests consulted to detect opportunistic infections and a questionnaire was applied to evaluate the use ofantiretroviral drugs. A questionnaire was applied for socioeconomic and clinical evaluation for the diagnosis of opportunistic infection. We evaluated 144 patients, 131 had opportunistic infections before the HAART therapy and 74 even after HAART therapy with an episode ofopportunistic infection in 44 (59.45% patients where 34 (45.95% alleged irregular antiretroviral use and 10 (13.5%, regular use. There were two episodes of opportunistic infections in 26 (35.14% patients, 21 (28.38% with irregular use of antiretrovirals and five (6.76% with regular use and three episodes of opportunistic infections in four patients (5, 41%, three (4.05% with irregular use of therapy and one (1.35% with regular use. As is observed in other regions of Brazil, the incidence of opportunistic infections decreased with the use of HAART therapy. On the other hand, there continue to be new cases of opportunistic infections, suggesting that some people have exhausted all possibilities as to available therapies.

  16. Terapia anti-retroviral: fatores que interferem na adesão de crianças com HIV/AIDS Terapia anti-retroviral: factores que interfieren en la adherencia de niños con VIH/SIDA Antiretroviral therapy: factors interfering in the adherence of children with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Ana Claúdia Feitosa

    2008-09-01

    Full Text Available O objetivo deste estudo foi conhecer os fatores que interferem na adesão à terapêutica medicamentosa em crianças infectadas pelo HIV/AIDS, relatados por 12 cuidadores em um serviço de referência em AIDS, em Fortaleza-CE. Os dados foram obtidos mediante entrevista, e, com eles, foram apurados fatores que dificultaram a adesão terapêutica, evidenciando relatos referentes à apresentação da droga, horário da tomada do medicamento, efeitos colaterais, falta na distribuição de medicamento gratuito, dificuldade de acesso regular ao serviço de saúde e problemas financeiros. Constatou-se a importância de conhecer o contexto social no qual a criança está inserida e as dificuldades no uso dos anti-retrovirais para intervir de forma eficiente e possibilitar uma melhor qualidade de vida às crianças.La finalidad de este estudio fue conocer los factores que interfieren en la adherencia a la terapéutica medicamentosa en niños infectados por el VIH/sida relatados por 12 cuidadores en un servicio de referencia en sida, en Fortaleza-CE, Brasil. Los datos fueron obtenidos mediante entrevista, y, con ellos fueran apurados factores que dificultaron la adherencia terapéutica, evidenciando relatos referentes a la presentación de la droga, horario de la toma del medicamento, efectos colaterales, falta en la distribución de medicamento gratuito, dificultad de acceso regular al servicio de salud y problemas financieros. Se constató la importancia de conocer el contexto social en que el niño está insertado y las dificultades en el uso de los anti-retrovirales para intervenir de forma eficiente y posibilitar una mejor calidad de vida a los niños.This study aimed to get to know the factors that interfere in medication treatment adherence among children infected by HIV/aids, as reported by 12 caregivers in a service reference to aids in Fortaleza/CE, Brazil. Data were collected through interviews, verifying factors that made treatment adherence

  17. Neurological disease in HIV-infected patients in the era of highly active antiretroviral treatment: a Brazilian experience Doença neurológica em pacientes infectados pelo HIV na era da terapia anti-retroviral altamente ativa: uma experiência brasileira

    Directory of Open Access Journals (Sweden)

    Jacqueline Ferreira de Oliveira

    2006-04-01

    Full Text Available To study characteristics of neurological disorders in HIV/AIDS patients and their relationship to highly active antiretroviral treatment, a cross-sectional study was conducted in an infectious disease public hospital in Belo Horizonte, Brazil, between February 1999 and March 2000. Of the 417 patients enrolled, neurological disease was observed in 194 (46.5% and a new AIDS-defining neurological event developed in 23.7% of individuals. Toxoplasmosis (42.3%, cryptococcosis meningitis (12.9% and tuberculosis (10.8% were the most common causes of neurological complications. The majority (79.3% of patients were on highly active antiretroviral treatment and these individuals using HAART showed higher CD4 cell counts (p = 0.014 and presented stable neurological disease (p= 0.0001, although no difference was found with respect to the profile of neurological complications. The neurological diseases continue to be a frequent complication of HIV/AIDS and infections are still its main causes in Brazil, even in the highly active antiretroviral treatment era.Com o objetivo de estudar as doenças neurológicas em pacientes HIV/AIDS e sua relação com a terapia anti-retroviral altamente ativa, foi realizado estudo transversal em hospital público de doenças infecciosas de Belo Horizonte, Brasil, no período de fevereiro de 1999 a março de 2000. Doença neurológica foi observada em 194 (46,5% dos 417 indivíduos incluídos e um novo episódio de doença neurológica definidora de AIDS ocorreu em 23,7% pacientes. Toxoplasmose (42,3%, criptococose (12,9% e tuberculose (10,8% foram as principais causas de complicações neurológicas. A maioria dos pacientes estava em uso de terapia anti-retroviral altamente ativa (79,3% e esses indivíduos apresentaram maiores contagens de linfócitos CD4 (p = 0,014 e maior freqüência de doença neurológica clinicamente estável, embora não tenha havido diferença no perfil etiológico das complicações neurológicas. As

  18. Nurses' perceptions about Botswana patients' anti-retroviral therapy ...

    African Journals Online (AJOL)

    Anti-retroviral drugs(ARVs) are supplied free of charge in Botswana. Lifelong adherence to antiretroviral therapy (ART) is vital to improve the patient's state of well-being ... weerstand bied teen anti-retrovirale behandeling (ARB). Persone met ARB-weerstandbiedende MIV stamme kan dit versprei na ander mense toe, wat ...

  19. Antiplasmodial Activity of 'Highly Active Anti-Retroviral Therapy ...

    African Journals Online (AJOL)

    The anti-plasmodial effect of 'Highly Active Anti Retroviral Therapy (HAART) was investigated. A hundred and twenty healthy Swiss albino mice (20-24 g) were passaged with Chloroquine sensitive P.berghei and randomly assigned into three study groups: prophylactic, suppressive and curative study group. The animals ...

  20. Adherence to anti-retroviral drugs in pregnant and lactating HIV ...

    African Journals Online (AJOL)

    Background: Anti-retroviral drugs reduce morbidity and mortality due to HIV and prevent transmission from mother to child. But compliance on anti-retroviral treatment is an essential element for the success of therapeutic goals. Objective: To assess the level of compliance of anti-retroviral treatment in pregnant and lactating ...

  1. The Evolution of Anti-Retroviral Therapy in Nigeria | Michael ...

    African Journals Online (AJOL)

    Areas of research highlighted are the Monitoring of ART, adherence to ART, and highly active anti-retroviral therapy in Nigeria. From the first report on the PUBMED search by Akanmuet al from Lagos in 2001 to reports in 2013, it is undeniable that HIV scientists in Nigeria have produced a good number of very informative ...

  2. CD4 + CELL RESPONSE TO ANTI-RETROVIRAL THERAPY (ARTs ...

    African Journals Online (AJOL)

    East African Medical Journal Vol. 90 No. 12 (Supplement) December 2013. CD4 + CELL RESPONSE TO ANTI-RETROVIRAL THERAPY (ARTs) IN ROUTINE CLINICAL CARE OVER ONE YEAR. PERIOD IN A COHORT OF HAART NAIVE, HIV POSITIVE KENYAN PATIENTS. C. F. Otieno, MBChB, MMed (Int. Med), ...

  3. Patients' perceptions of a rural decentralised anti-retroviral therapy ...

    African Journals Online (AJOL)

    Patients' perceptions of a rural decentralised anti-retroviral therapy management and its impact on direct out-of-pocket spending. Monique Lines, Fatima Suleman. Abstract. Background: Geographical and financial barriers hamper accessibility to HIV services for rural communities. The government has introduced the nurse ...

  4. Psychological distress and adherence to highly active anti-retroviral ...

    African Journals Online (AJOL)

    Background: Mental health related risk factors for non-adherence to highly active anti-retroviral therapy (HAART) have not been investigated in Uganda and yet adherence is critical to the success of the current scale up in the provision of HAART to HIV positive individuals in rural areas of Uganda. Objective: To determine ...

  5. Infecções oportunistas em indivíduos com infecção pelo HIV e relação com uso de terapia antirretroviral - doi: 10.4025/actascihealthsci.v32i2.4508 Opportunistic infections in individuals with HIV infection and relationship with the use of anti-retroviral therapy - doi: 10.4025/actascihealthsci.v32i2.4508

    Directory of Open Access Journals (Sweden)

    Miguel Spack Junior

    2010-09-01

    of non-anti-retroviral therapy. Clinical evaluations were made and medical reports and tests consulted to detect opportunistic infections and a questionnaire was applied to evaluate the use of antiretroviral drugs. A questionnaire was applied for socioeconomic and clinical evaluation for the diagnosis of opportunistic infection. We evaluated 144 patients, 131 had opportunistic infections before the HAART therapy and 74 even after HAART therapy with an episode of opportunistic infection in 44 (59.45% patients where 34 (45.95% alleged irregular antiretroviral use and 10 (13.5%, regular use. There were two episodes of opportunistic infections in 26 (35.14% patients, 21 (28.38% with irregular use of antiretrovirals and five (6.76% with regular use and three episodes of opportunistic infections in four patients (5, 41%, three (4.05% with irregular use of therapy and one (1.35% with regular use. As is observed in other regions of Brazil, the incidence of opportunistic infections decreased with the use of HAART therapy. On the other hand, there continue to be new cases of opportunistic infections, suggesting that some people have exhausted all possibilities as to available therapies.

  6. Estudo da síndrome da ceratoconjuntivite seca de pacientes soropositivos para o vírus da imunodeficiência adquirida humana tipo 1 e com síndrome da imunodeficiência adquirida, em uso ou não de terapia anti-retroviral combinada (HAART

    Directory of Open Access Journals (Sweden)

    Rodrigues Márcia Lopes

    2004-01-01

    Full Text Available OBJETIVOS: Verificar a presença de olho seco e de alterações no epitélio conjuntival em pacientes com sorologia positiva para o HIV-1 e com AIDS; relacionar as eventuais alterações com as características e com outras condições oculares e sistêmicas dos pacientes; estudar a influência da terapia anti-retroviral combinada na ceratoconjuntivite seca (KCS, nos pacientes com AIDS. MÉTODOS: Foram estudados pacientes com confirmação laboratorial da infecção pelo HIV, divididos em 2 grupos: I. HIV+ (sem diagnóstico clínico e com contagem de CD4+ acima de 200 células/mm³ e II. pacientes com AIDS (contagem de CD4+ abaixo de 200 células e/ou manifestação clínica. Foram estudadas alterações oculares, dados laboratoriais, análise do filme lacrimal e estudo da citologia de impressão conjuntival. Método estatístico: qui-quadrado. RESULTADOS: Incluídos 43 pacientes do grupo I e 77 do grupo II. Após a introdução do HAART houve queda significativa das manifestações oculares internas; entretanto, o mesmo não ocorreu com as externas. Dos pacientes que apresentaram quadro clínico de olho seco, 65,1% eram do sexo masculino. As alterações do teste de Schirmer e tempo de ruptura do filme lacrimal não estiveram relacionados com a gravidade da doença pelo HIV e nem com a contagem de CD4+.Todos os pacientes com alterações na citologia de impressão apresentavam KCS e 88,8% pertenciam ao grupo II. Observou-se aumento da freqüência dessas alterações nos pacientes com tempo de doença superior a 4 anos. CONCLUSÃO: O decréscimo da produção lacrimal não esteve relacionado com a gravidade da infecção pelo HIV e a introdução do HAART não interferiu na freqüência da síndrome de olho seco nos pacientes HIV positivos.

  7. Usuários de drogas injetáveis e terapia anti-retroviral: percepções das equipes de farmácia Injecting drug users and antiretroviral therapy: perceptions of pharmacy teams

    Directory of Open Access Journals (Sweden)

    Chizuru Minami Yokaichiya

    2007-12-01

    Full Text Available OBJETIVO: Compreender as percepções das equipes de farmácia sobre seu papel nos desafios assistenciais e adesão aos anti-retrovirais de usuários de drogas injetáveis vivendo com HIV/Aids. MÉTODOS: Estudo qualitativo por grupos focais e análise temática das falas produzidas com farmacêuticos, técnicos e auxiliares com experiência superior a seis meses na dispensação de medicamentos, de 15 unidades assistenciais de DST/Aids do município de São Paulo, em 2002. RESULTADOS: Formaram-se três grupos, totalizando 29 participantes, provenientes de 12 dos 15 serviços existentes, com 12 universitários e 17 profissionais de nível médio. Os grupos concluíram que a farmácia tem importante papel na dispensação de anti-retrovirais, o que se reflete na adesão ao tratamento, pois por meio de seus procedimentos podem ser construídas relações de confiança. Avaliam, porém, que tal construção não ocorra pela excessiva burocratização de suas atividades. Isso repercute negativamente para todos os pacientes, em especial sobre usuários de drogas injetáveis, concebidos como "pessoas difíceis". Tal concepção essencializa seus comportamentos: seriam confusos, com limites de compreensão e sem possibilidades de adesão ao tratamento. Os profissionais, porém, afirmam que tratam esses pacientes tal como os demais, igualando-os. Não percebem neste proceder, uma invisibilização das necessidades específicas dos usuários de drogas injetáveis no serviço, bem como a possibilidade de gerarem estereótipos estigmatizantes com barreira adicional ao trabalho da adesão. CONCLUSÕES: Embora a farmácia seja indicada como espaço potencialmente favorável para escuta e construção de vínculos com os usuários, os resultados mostram obstáculos objetivos e subjetivos para torná-la propícia para trabalhar a adesão.OBJECTIVE: To understand the perceptions of pharmacy teams about their role in the healthcare assistance challenges and

  8. anti-retroviral therapy related liver injury (arli): a series of 11 cases

    African Journals Online (AJOL)

    2013-12-02

    Dec 2, 2013 ... ANTI-RETROVIRAL THERAPY RELATED LIVER INJURY (ARLI): A SERIES OF 11 CASES. A. E. O. Otedo, MBChB, MMed ... Background: HIV Anti-retroviral therapy (ART) related liver injury (ARLI) is associated with elevated liver .... and the patients were given palliative and supportive care as in-patients; ...

  9. Quimioterapia associada à terapia anti-retroviral de alta eficácia no tratamento dos linfomas não-Hodgkin agressivos relacionados à Síndrome da Imunodeficiência Adquirida Chemotherapy combined with highly active antiretroviral therapy for the treatment of aggressive AIDS related lymphomas

    Directory of Open Access Journals (Sweden)

    Juliana Pereira

    2004-01-01

    Full Text Available Linfoma não-Hodgkin é uma das complicações oncológicas mais freqüentes em portadores da Síndrome da Imunodeficiência Adquirida (AIDS. Em outros países, após a introdução da terapia anti-retroviral de alta atividade (HAART, a queda na incidência dos linfomas agressivos sistêmicos ficou aquém das expectativas, embora a sobrevida destes pacientes tenha triplicado. No Brasil, pouco se conhece a respeito do comportamento clínico e da sobrevida dos pacientes com linfoma e AIDS na era pós-HAART. O objetivo deste estudo foi avaliar retrospectivamente 25 pacientes com linfoma e AIDS, tratados com a associação de quimioterapia e HAART. Em concordância com a literatura, a maior parte dos pacientes era do sexo masculino - 20 (80%, com mediana de idade de 39 anos. Houve predomínio do subtipo histológico Difuso de Grandes Células B - 13 (52%, de pacientes em estádios avançados - 15 (60%, com envolvimento extranodal - 22 (88% e com sintomas B - 18 (72%. O diagnóstico prévio de AIDS observado em 14 (56% foi superior em nossa casuística em relação ao descrito por outros autores. Cinqüenta e dois por cento dos pacientes obtiveram RC, com SLD e SG em três anos de 54% e 42%, respectivamente e mediana de SG de 15 meses. Toxicidade hematológica e infecções foram freqüentes, porém nenhum óbito foi relacionado à sua ocorrência. Concluímos que o tratamento combinado com quimioterapia e HAART é factível em pacientes brasileiros, podendo propiciar uma sobrevida global similar à descrita por alguns grupos internacionais, com um perfil aceitável de toxicidade.Non-Hodgkin lymphoma is one of the most frequent oncological complications in patients with the Acquired Immune-Deficiency Syndrome (AIDS. In other countries, after the introduction of the Highly Active Antiretroviral Therapy (HAART, the drop in the incidence of systemic aggressive lymphomas was below expectations, although the survival of these patients rose. In Brazil

  10. Nurses' perceptions about Botswana patients' anti-retroviral therapy adherence

    Directory of Open Access Journals (Sweden)

    Valerie J. Ehlers

    2009-04-01

    Full Text Available Anti-retroviral drugs (ARVs are supplied free of charge in Botswana. Lifelong adherence to anti-retroviral therapy (ART is vital to improve the patient’s state of well-being and to prevent the development of strains of the human immunodef ciency virus (HIV that are resistant to ART. Persons with ART-resistant strains of HIV can spread these to other people, requiring more expensive ART with more severe side-effects and poorer health outcomes. The purpose of this exploratory, descriptive, qualitative study was to determine nurses’ perspectives on Botswana patients’ anti-retroviral therapy (ART adherence, and to identify factors which could promote or hinder ART adherence. Four ART sites were randomly selected and all 16 nurses providing ART services at these sites participated in semi-structured interviews. These nurses indicated that patients’ ART adherence was inf uenced by service-related and patient-related factors. Service-related factors included the inaccessibility of ART clinics, limited clinic hours, health workers’ inability to communicate in patients’ local languages, long waiting times at clinics and delays in being informed about their CD4 and viral load results. Nurses could not trace defaulters nor contact them by phone, and also had to work night shifts, disrupting nurse-patient relationships. Patient-related factors included patients’ lack of education, inability to understand the significance of CD4 and viral load results, financial hardships, non-disclosure and non-acceptance of their HIV positive status, alcohol abuse, the utilisation of traditional medicines and side effects of ART. The challenges of lifelong ART adherence are multifaceted involving both patient-related and service-related factors. Supplying free ARVs does not ensure high levels of ART adherence.

    Opsomming

    Anti-retrovirale middels (ARMs word gratis verskaf in Botswana. Lewenslange getroue nakoming van ARM voorskrifte is

  11. Modelling of anti-latency treatment in HIV; What is the optimal duration of anti-retroviral-free HIV remission?

    DEFF Research Database (Denmark)

    Cromer, Deborah; Pinkevych, Mykola; Rasmussen, Thomas A

    2017-01-01

    A number of treatment strategies are currently being developed to promote anti-retroviral free HIV cure or remission. While complete elimination of the HIV reservoir would prevent recurrence of infection, it is not clear how different remission lengths would affect viral rebound and transmission......-retroviral-free HIV remission to be targeted. We also investigate the trade-off between increasing the average duration of remission, versus the risk of treatment failure (viral recrudescence) and the need for re-treatment. To minimise drug exposure, we find that the optimal target of anti-latency interventions...... are targeted, there is a real probability of viral transmission occurring in between testing for viral rebound.Importance Current treatment of HIV involves patients taking anti-retroviral therapy to ensure that the level of virus remains at very low, or undetectable levels. Continuous therapy is required...

  12. Reasons for Change of Anti-Retroviral Therapy (ART) Drugs: Local ...

    African Journals Online (AJOL)

    Background: Highly active anti-retroviral therapy (HAART) reduces morbidity and mortality in HIV/AIDS infected patients. HAART is used indefinitely and the regimens are changed over the course of treatment due to resistance, adverse drug reactions or access to drugs. Few studies have been done in resource constrained ...

  13. The effect of interrupted anti-retroviral treatment on the reconstitution ...

    African Journals Online (AJOL)

    Keywords: Interrupted anti-retroviral treatment, memory and naive T cells, HIV patients, active pulmonary tuberculosis. ... viral treatment on the reconstitution of memory and naive T cells during tuberculosis treatment in HIV patients with active pulmonary tuberculosis. Afri Health ..... In this prospective cohort study of the.

  14. Providing anti-retroviral therapy in the context of self-perceived ...

    African Journals Online (AJOL)

    Adherence to anti-retroviral treatment (ART) has been a significant step towards improving quality of life among people living with HIV. However, stigma has been described to influence adherence to ART. A cross-sectional mixed methods study was conducted to explore factors related to stigma and perceived influence of ...

  15. Pregnancy Outcome of HIV-Infected Women on Anti-Retroviral ...

    African Journals Online (AJOL)

    User

    Pregnancy Outcome of HIV-Infected Women on Anti-Retroviral Therapy in a Treatment. Centre in Port Harcourt, .... child transmission are indisputable, monitoring antiretroviral therapy in pregnancy has remained a priority for ... abnormality of the central nervous system, such as neural tube defect with first trimester exposure.

  16. Expansion of HIV-1 screening and anti-retroviral treatment programs ...

    African Journals Online (AJOL)

    Expansion of HIV-1 screening and anti-retroviral treatment programs in a resource-poor setting: results from a faith-based organization in Jos, Plateau State, ... Analysis of 645 patients initiated on ART during the first quarter of the FAFH-PEPFAR ART program revealed that the median CD4+ cell count at baseline was ...

  17. anti-retroviral therapy related liver injury (arli): a series of 11 cases

    African Journals Online (AJOL)

    2013-12-02

    Dec 2, 2013 ... and protease inhibitors, low body mass index, low platelet count and deranged renal functions prior ART initiation are associated with ... Risk factors for liver injury should be evaluated before initiating anti-retroviral therapy .... Event. Number. Haepatomegaly and ascites. 6. Haepatomegaly and gall stones.

  18. CD4 + Cell Response to Anti-Retroviral Therapy (ARTS) In Routine ...

    African Journals Online (AJOL)

    Background: Untreated HIV/AIDS leads to severe immune depletion with opportunistic infections and other co-morbidities. Highly active anti-retroviral therapy (HAART) enhances immunity by sustained HIV- viral suppression, increase in CD4+ cell count and immune restoration. HAART reduces risk of neutropaenia, ...

  19. Early Mortality among HIV-positive Children Initiated Anti-retroviral ...

    African Journals Online (AJOL)

    RAGHAVENDRA

    10.4314/star.v4i. ISSN: 2226-7522(Print) and 2305-. Science, Technology and Arts Research Journ. Sci. Technol. Arts Res. J., April-June 2015, 4. Journal Homepage: http://www.starjournal. positive Children Initiated Anti-retroviral Therapy.

  20. Anti-Retroviral Therapy Related Liver Injury (ARLI): A Series of 11 ...

    African Journals Online (AJOL)

    Objective: To describe anti-retroviral-related liver injury (ARLI) in HIV positive patients, their CD4+ cell counts, biochemical and viral markers and liver ultrasound. Design: Prospective, descriptive, consecutive entry study. Setting: Kisumu District Hospital liver clinic/medical outpatient clinic, Nairobi Rheumatology Clinic and ...

  1. Gaps in the Implementation of Anti-Retroviral Treatment: A Case for ...

    African Journals Online (AJOL)

    Gaps in the Implementation of Anti-Retroviral Treatment: A Case for Addressing Gender and Mental Health Consequences of HIV Positive Individuals. ... Zambia is among the worst affected countries in Sub-Saharan Africa in terms of HIV infection, with a prevalence of 14.3% in the age group of 15-49. Each year about 1.6 ...

  2. anti-retroviral therapy related liver injury (arli): a series of 11 cases

    African Journals Online (AJOL)

    2013-12-02

    Dec 2, 2013 ... for liver enzyme elevation during highly active anti-retroviral therapy in HIV – HCV co –infected patients: results from the Italian EPOKA – MASTER. COHORT. BMC infection diseases 2005; 9: 58 – 67. 3. Podzammecer D., Fumero E. The role of Nevirapine in the treatment of HIV – 1 disease. Expert. Opin.

  3. Anti retroviral drug prophylaxis in prevention of mother-to-child ...

    African Journals Online (AJOL)

    Anti retroviral drug prophylaxis in prevention of mother-to-child transmission of HIV infection in a treatment centre in Jos, Nigeria. ... Of the 135 pregnant mothers' records reviewed, all of them were on triple ARV before delivery with 2 of them on second line regimen. The study revealed that 221 babies were given post ...

  4. The effect of interrupted anti-retroviral treatment on the reconstitution ...

    African Journals Online (AJOL)

    Background: The reconstitution of cellular immune components contributes to clinical outcome of HIV and Mycobacterium tuberculosis (MTB) infection. Interruption of anti-retroviral therapy (ART) could lead to perturbations in reconstitution of T cells in HIV/ tuberculosis (TB) patients. Objectives: To ascertain the effect of ...

  5. Virological failure and drug resistance during first line anti-retroviral treatment in Indonesia

    NARCIS (Netherlands)

    Fibriani, A.; Wisaksana, R.; Indrati, A.; Hartantri, Y.; Vijver, D. van de; Schutten, M.; Alisjahbana, B.; Sudjana, P.; Boucher, C.A.B.; Crevel, R. van; Ven, A. van der

    2013-01-01

    The virological response and development of drug resistance during first-line anti-retroviral treatment (ART) were studied in Indonesia where the majority of patients infected with HIV have a history of injecting drug use, which is often linked with lower treatment adherence and development of

  6. Impact of highly active antiretroviral therapy (HAART on the incidence of opportunistic infections, hospitalizations and mortality among children and adolescents living with HIV/AIDS in Belo Horizonte, Minas Gerais State, Brazil Impacto da terapia anti-retroviral de alta potência (HAART na incidência de infecções oportunistas, hospitalização e mortalidade associadas em crianças e adolescentes vivendo com HIV/AIDS em Belo Horizonte, Minas Gerais, Brasil

    Directory of Open Access Journals (Sweden)

    Talitah M. S. Candiani

    2007-01-01

    Full Text Available The impact of highly active antiretroviral therapy (HAART can be evaluated using indicators, such as rates of opportunistic infections, hospitalizations by cause of infection, and associated death. This study aimed to estimate the impact of HAART on the incidence of these indicators, in children and adolescents with HIV/AIDS. It was a hybrid cohort study; 371 patients were followed from 1989 to 2003. In December 2003, 76% of the patients were still being followed, while 12.1% had died, 9.5% had dropped out, and 2.4% had been transferred. The overall rate of opportunistic infections was 18.32 infections/100 persons-year and 2.63 in the pre- and post-HAART periods, respectively. In the multivariate analysis, the risk of developing an opportunistic infection was 5.4 times greater and 3.3 times greater for hospitalization risk before HAART. Respiratory causes represented 65% of the hospitalizations and they were reduced by 44.6% with therapeutic intervention. The average hospital stay of 15 days was reduced to 9.There was a post-HAART decline in deaths of 38%. This study demonstrates the effectiveness of HAART in significantly reducing opportunistic infections, hospitalizations, and deaths in this Brazilian cohort.O impacto da terapia anti-retroviral de alta potência ativa (HAART pode ser avaliado utilizando-se indicadores, como taxas de incidências de infecções oportunistas, hospitalizações por causas infecciosas e mortalidade associada. O objetivo deste trabalho foi estimar o impacto da HAART na incidência desses indicadores em crianças e adolescentes com HIV/AIDS. Trata-se de uma coorte híbrida, na qual foram acompanhados 371 pacientes no período de 1989-2003. Em dezembro de 2003, 76% dos pacientes permaneciam em acompanhamento, 12,1% faleceram, 9,5% foram perda de seguimento e 2,4% transferidos. A taxa de incidência global de infecções oportunistas foi de 18,32 infecções/100 pessoas-ano e 2,63 nos períodos pré e p

  7. Recent updates for designing CCR5 antagonists as anti-retroviral agents.

    Science.gov (United States)

    Shah, Harshil R; Savjani, Jignasa Ketan

    2018-03-10

    The healthcare system faces various challenges in human immunodeficiency virus (HIV) therapy due to resistance to Anti-Retroviral Therapy (ART) as a consequence of the evolutionary process. Despite the success of antiretroviral drugs like Zidovudine, Zalcitabine, Raltegravir WHO ranks HIV as one of the deadliest diseases with a mortality of one million lives in 2016. Thus, there emerges an urgency of developing a novel anti-retroviral agent that combat resistant HIV strains. The clinical development of ART from a single drug regimen to current triple drug combination is very slow. The progression in the structural biology of the viral envelope prompted the discovery of novel targets, which can be demonstrated a proficient approach for drug design of anti-retroviral agents. The current review enlightens the recent updates in the structural biology of the viral envelope and focuses on CCR5 as a validated target as well as ways to overcome CCR5 resistance. The article also throws light on the SAR studies and most prevalent mutations in the receptor for designing CCR5 antagonists that can combat HIV-1 infection. To conclude, the paper lists diversified scaffolds that are in pipeline by various pharmaceutical companies that could provide an aid for developing novel CCR5 antagonists. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  8. Evaluation of quantitative liver function tests in HIV-positive patients under anti-retroviral therapy

    Directory of Open Access Journals (Sweden)

    Miller M

    2009-09-01

    Full Text Available Abstract Background and aims Quantitative tests of liver function (QTLF which are based on the hepatic metabolism or clearance of test substances have been successfully used to predict prognosis of a variety of different liver diseases. Still sufficient data in HIV-patients under anti-retroviral therapy (ART are lacking. Therefore, the aim of this prospective study was to investigate if and to what extent ART influences a broad panel of quantitative tests of liver function in patients with HIV-infection. Patients and methods Nineteen patients (14 males, 5 females, mean age 40 years with HIV-infection underwent QTLF including lidocaine half-life test (LHT, galactose elimination capacity (GEC, and indocyanine green clearance (IGC. These tests were performed before and 3 to 6 months after initiation of anti-retroviral therapy. Twenty age-matched healthy, medication-and virus-free adults served as controls. Results Lidocaine half-life was significantly lower in HIV-patients without ART. Combining anti-retroviral therapies shifted cytochrome p450 activity back into standard ranges. Galactose elimination capacity as a parameter of cytosolic liver function and indocyanine green clearance as a parameter of liver perfusion were not affected by ART. Conclusions QTLF may be a tool to predict prognosis or hepatic complications in HIV-infected patients with liver disease. Early determination of lidocaine half-life seems to be useful - this should be considered during the treatment of HIV-positive individuals.

  9. Epidemiologic studies of adverse effects of anti-retroviral drugs: how well is statistical power reported.

    Science.gov (United States)

    Halpern, Scott D; Barton, Todd D; Gross, Robert; Hennessy, Sean; Berlin, Jesse A; Strom, Brian L

    2005-03-01

    To determine whether there is a difference in average statistical power between pharmacoepidemiologic studies of anti-retroviral adverse drug effects (ADEs) sponsored by for-profit versus non-profit organizations. We studied all published pharmacoepidemiologic studies of ADEs associated with the 15 anti-retroviral drugs approved through the end of 1999. A priori, the primary outcome was the power of each study to detect a clinically important difference in the risk for an adverse effect among patients exposed to the study drug(s). We could not evaluate this outcome because of the infrequent reporting of power calculations. We instead report the distribution of studies across a 5-tiered measure of adequacy of reporting of statistical power, as well as the sponsorship of these studies. Of 48 studies meeting our inclusion criteria, only 1 (2%) reported either a completed, a priori power calculation or sufficient details for readers to calculate the power to detect a pre-defined, clinically important effect. Thirty-five studies (73%) reported the minimum information required for sophisticated readers to determine the power to detect an event rate of interest to them; 6 additional studies (13%) reported confidence intervals around at least one summary effect measure and 6 (13%) provided no indication of power or uncertainty. Of the 41 studies for which sponsorship was determined, only 3 (7%) were sponsored by for-profit organizations. The poor reporting of statistical power in this sample suggests a need for guidelines to improve the reporting of pharmacoepidemiologic studies of ADEs. Future research is needed to determine whether the observed paucity of industry-sponsored observational studies of anti-retroviral ADEs extends to other clinical areas, and if so, to identify the causes of this phenomenon. Copyright 2004 John Wiley & Sons, Ltd.

  10. Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem

    Directory of Open Access Journals (Sweden)

    Md Dilshad Manzar

    Full Text Available Human immunodeficiency virus (HIV infection, and the anti-retroviral therapy (ART associated complications necessitate that the medical care system keeps evolving for proper management of this group of patients. Electrolyte imbalance and sleep problems are common in patients on ART. Both of these conditions are associated with increased morbidity (such as acute kidney injury, chronic kidney disease, low CD4 count, non-adherence and depression and mortality. Therefore, screening for both sleep problems and electrolytes imbalance may help to decrease the risk of complications in patients on ART.

  11. Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem.

    Science.gov (United States)

    Manzar, Md Dilshad; Sony, Peter; Salahuddin, Mohammed; Kumalo, Abera; Geneto, Mathewos; Pandi-Perumal, Seithikurippu R; Moscovitch, Adam; BaHammam, Ahmed S

    2017-01-01

    Human immunodeficiency virus (HIV) infection, and the anti-retroviral therapy (ART) associated complications necessitate that the medical care system keeps evolving for proper management of this group of patients. Electrolyte imbalance and sleep problems are common in patients on ART. Both of these conditions are associated with increased morbidity (such as acute kidney injury, chronic kidney disease, low CD4 count, non-adherence and depression) and mortality. Therefore, screening for both sleep problems and electrolytes imbalance may help to decrease the risk of complications in patients on ART.

  12. HIV-1 anti-retroviral drug effect on the C. albicans hyphal growth rate by a Bio-Cell Tracer system Efeito da droga anti-retroviral HIV-1 no crescimento de hifas de C. albicans monitoradas pelo sistema "Bio-Cell Tracer"

    Directory of Open Access Journals (Sweden)

    Nadja Rodrigues de Melo

    2006-09-01

    Full Text Available Declining incidence of oropharyngeal candidosis and opportunistic infections over recent years can be attributed to the use of highly active anti-retroviral therapy (HAART. Infection with C. albicans generally involves adherence and colonization of superficial tissues. During this process, budding yeasts are able to transform to hyphae and penetrate into the deep tissue. Using the biocell tracer system, C. albicans hyphal growth was dynamically observed at the cellular level. Ritonavir was effective in the inhibition of hyphal growth with growth rate of 0.8 mum/min. This study showed the in vitro effect of HIV anti-retroviral drug on the growth rate of the C. albicans hyphae.O declínio na incidência de candidose orofaríngea e infecções oportunistas associadas a infecção pelo HIV tem sido atribuído a introdução da terapia antiretroviral combinada (HAART. Infecção por C. albicans envolve aderência e colonização da mucosa superficial. Durante este processo leveduras são capazes de transformar-se na forma de hifas e penetrar nos tecidos mais profundos. Usando o sistema "Bio-Cell Tracer", o crescimento de hifas de C. albicans foi observado dinamicamente a nível celular. Ritonavir, inibidor de protease do HIV, foi efetivo na inibição do crescimento de hifas com media de 0.8 mim/min.O presente estudo demonstrou o efeito in vitro de um agente anti-retroviral HIV sobre o crescimento de hifas de C. albicans.

  13. An audit on virological efficacy of anti-retroviral therapy in a specialist infectious disease clinic.

    LENUS (Irish Health Repository)

    Reyad, A

    2009-06-01

    We have assessed the efficacy of anti retroviral therapy (ART) using undetectable viral load (VL) (<50 RNA copies\\/ml) as a marker of virological success, in patients who have Human Immunodeficiency Virus (HIV) attending the Department of Infectious Disease. A cross-sectional review of patients\\' case notes was used to obtain their demographics and treatment details. 79% (253) of the hospital case notes of clinic population was available for analysis, which represents 90% of those receiving ART in the clinic. 166\\/253 of the cohort were receiving treatment at the time of this study and 95% (157\\/166) of these were on treatment for greater than 6 months. The total virological success rate is 93%, which is comparable to other centres and are as good as those from published clinical trials. 56% of those on therapy who have virological failure were Intravenous Drug Users (IVDUs). Case by case investigation for those with treatment failure is warranted.

  14. Avaliação ultra-sonográfica, ecocardiográfica fetal e resultados perinatais em gestantes portadoras do HIV em uso de terapia anti-retroviral Ultrasound examination, fetal echocardiography and prenatal outcome in HIV-positive pregnant women under antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Marco Antonio Borges Lopes

    2007-10-01

    Full Text Available OBJETIVO: descrever as alterações estruturais e/ou funcionais fetais à ultra-sonografia e à ecocardiografia fetais e os resultados perinatais em gestantes soropositivas para o vírus da imunodeficiência humana (HIV em relação a um grupo controle de pacientes atendidas pelo pré-natal de baixo risco. MÉTODOS: foram avaliadas, prospectivamente, 109 gestantes soropositivas para o HIV em uso de anti-retrovirais (Grupo de Estudo, GE e 200 gestantes controles (GC, sendo realizado acompanhamento ultra-sonográfico obstétrico mensal e ecocardiografia fetal e pós-natal com a avaliação do volume de líquido amniótico, da adequação do peso fetal, da presença de alterações estruturais fetais e dos resultados perinatais. RESULTADOS: foram observados oito casos de alterações estruturais fetais (7,3% contra dois (1% no GC (p=0,61. Observamos quatro casos de cardiopatia congênita e quatro de hidronefrose no GE, com diferença estatística para as cardiopatias (p=0,015. Foram diagnosticados, no GE, oito (7,3% casos de oligoidrâmnio e 11 (10% casos de polidrâmnio contra dois casos (1% de oligoidrâminio e nenhum de polidrâmnio (p de 0,004 e pPURPOSE: to evaluate fetal structural and/or functional abnormalities by ultrasound examination and fetal echocardiography, in pregnant women positive for human immunodeficiency virus (HIV. METHODS: we analyzed prospectively 109 HIV positive pregnant women under antiretroviral therapy (Study Group and 200 low risk pregnant patients (Control Group. All of them were submitted to ultrasound scan and fetal and neonatal echocardiography once a month. The amniotic fluid volume, fetal growth, fetal structural and functional alteration and the perinatal outcome were evaluated. RESULTS: there were eight (7.3% cases of fetal structural abnormality in the Study Group and two (1% in the Control Group (p=0.616. There were four cases of congenital heart disease and four cases of hydronephrosis in the Study Group

  15. Construction and characterization in vitro of a bicistronic retroviral vector coding endostatin and interleukin-2 for use in gene therapy; Construcao e caracterizacao in vitro de um vetor retroviral bicistronico codificando endostatina e interleucina-2 para utilizacao em terapia genica

    Energy Technology Data Exchange (ETDEWEB)

    Calvo, Fernanda Bernardes

    2009-07-01

    Gene therapy has been used in preclinical studies and clinical trials in order to alleviate or cure a disease. Retroviral vectors are a tool for gene transfer is widely used. Bicistronic vectors are an attractive alternative for treatment of complex diseases. A variety of options exists to simultaneously express two genes in genetically modified cells. The most common approach relies on bicistronic vectors in which the genes are linked to each other by an internal ribosome entry site allowing co-translational expression of both cistrons. Endostatin, the C-terminal fragment of collagen XVIII, is a potent angiogenesis inhibitor. At present, ES has been widely used in anti-angiogenic in a variety of experimental tumor models, and clinical trials to test it as an anti-tumor agent are already under way. Immunotherapy has been used as adjuvant treatment for tumors and has been used in several preclinical studies and clinical trials. The objective of this project was to construct and characterize 'in vitro' an IRES-based bicistronic retroviral vector encoding endostatin and interleukin-2. The construction of the vector was performed in three stages, the final construction was analyzed by restriction analysis and sequencing. Packaging cells were prepared. The endostatin and interleukin-2 levels were determined by Dot blot. Monocistronic and bicistronic mRNA expression were analyzed by real time RT-PCR. Bicistronic vector showed high levels of virus trites, ranging from 4.20x10{sup 5} to 1.53x10{sup 6}UFC/ml. Secreted levels of endostatin and interleukin-2 ranged from 1.08 to 2.08{mu}g/10{sup 6}cells.24h and 0.66 - 0.89{mu}g/10{sup 6}cells.24h, respectively. The mRNA expression of ES in the NIH3T3 clone pLend-IRES-IL2SN was 2 times higher than the level presented by the NIH3T3 clone pLendSN. The endostatin promoted inhibition (40%) of endothelial cell proliferation. Interleukin-2 promoted a proliferation of 10.6% lymphocytes CD4 and 8.9% of CD8. We conclude that

  16. Anti-Retroviral Lectins Have Modest Effects on Adherence of Trichomonas vaginalis to Epithelial Cells In Vitro and on Recovery of Tritrichomonas foetus in a Mouse Vaginal Model

    Science.gov (United States)

    Chatterjee, Aparajita; Ratner, Daniel M.; Ryan, Christopher M.; Johnson, Patricia J.; O’Keefe, Barry R.; Secor, W. Evan; Anderson, Deborah J.; Robbins, Phillips W.; Samuelson, John

    2015-01-01

    Trichomonas vaginalis causes vaginitis and increases the risk of HIV transmission by heterosexual sex, while Tritrichomonas foetus causes premature abortion in cattle. Our goals were to determine the effects, if any, of anti-retroviral lectins, which are designed to prevent heterosexual transmission of HIV, on adherence of Trichomonas to ectocervical cells and on Tritrichomonas infections in a mouse model. We show that Trichomonas Asn-linked glycans (N-glycans), like those of HIV, bind the mannose-binding lectin (MBL) that is part of the innate immune system. N-glycans of Trichomonas and Tritrichomonas bind anti-retroviral lectins (cyanovirin-N and griffithsin) and the 2G12 monoclonal antibody, each of which binds HIV N-glycans. Binding of cyanovirin-N appears to be independent of susceptibility to metronidazole, the major drug used to treat Trichomonas. Anti-retroviral lectins, MBL, and galectin-1 cause Trichomonas to self-aggregate and precipitate. The anti-retroviral lectins also increase adherence of ricin-resistant mutants, which are less adherent than parent cells, to ectocervical cell monolayers and to organotypic EpiVaginal tissue cells. Topical application of either anti-retroviral lectins or yeast N-glycans decreases by 40 to 70% the recovery of Tritrichomonas from the mouse vagina. These results, which are explained by a few simple models, suggest that the anti-retroviral lectins have a modest potential for preventing or treating human infections with Trichomonas. PMID:26252012

  17. Anti-Retroviral Lectins Have Modest Effects on Adherence of Trichomonas vaginalis to Epithelial Cells In Vitro and on Recovery of Tritrichomonas foetus in a Mouse Vaginal Model.

    Directory of Open Access Journals (Sweden)

    Aparajita Chatterjee

    Full Text Available Trichomonas vaginalis causes vaginitis and increases the risk of HIV transmission by heterosexual sex, while Tritrichomonas foetus causes premature abortion in cattle. Our goals were to determine the effects, if any, of anti-retroviral lectins, which are designed to prevent heterosexual transmission of HIV, on adherence of Trichomonas to ectocervical cells and on Tritrichomonas infections in a mouse model. We show that Trichomonas Asn-linked glycans (N-glycans, like those of HIV, bind the mannose-binding lectin (MBL that is part of the innate immune system. N-glycans of Trichomonas and Tritrichomonas bind anti-retroviral lectins (cyanovirin-N and griffithsin and the 2G12 monoclonal antibody, each of which binds HIV N-glycans. Binding of cyanovirin-N appears to be independent of susceptibility to metronidazole, the major drug used to treat Trichomonas. Anti-retroviral lectins, MBL, and galectin-1 cause Trichomonas to self-aggregate and precipitate. The anti-retroviral lectins also increase adherence of ricin-resistant mutants, which are less adherent than parent cells, to ectocervical cell monolayers and to organotypic EpiVaginal tissue cells. Topical application of either anti-retroviral lectins or yeast N-glycans decreases by 40 to 70% the recovery of Tritrichomonas from the mouse vagina. These results, which are explained by a few simple models, suggest that the anti-retroviral lectins have a modest potential for preventing or treating human infections with Trichomonas.

  18. Economic evaluation of task-shifting approaches to the dispensing of anti-retroviral therapy

    Directory of Open Access Journals (Sweden)

    Foster Nicola

    2012-09-01

    Full Text Available Abstract Background A scarcity of human resources for health has been identified as one of the primary constraints to the scale-up of the provision of Anti-Retroviral Treatment (ART. In South Africa there is a particularly severe lack of pharmacists. The study aims to compare two task-shifting approaches to the dispensing of ART: Indirectly Supervised Pharmacist’s Assistants (ISPA and Nurse-based pharmaceutical care models against the standard of care which involves a pharmacist dispensing ART. Methods A cross-sectional mixed methods study design was used. Patient exit interviews, time and motion studies, expert interviews and staff costs were used to conduct a costing from the societal perspective. Six facilities were sampled in the Western Cape province of South Africa, and 230 patient interviews conducted. Results The ISPA model was found to be the least costly task-shifting pharmaceutical model. However, patients preferred receiving medication from the nurse. This related to a fear of stigma and being identified by virtue of receiving ART at the pharmacy. Conclusions While these models are not mutually exclusive, and a variety of pharmaceutical care models will be necessary for scale up, it is useful to consider the impact of implementing these models on the provider, patient access to treatment and difficulties in implementation.

  19. Fluticasone furoate induced iatrogenic Cushing syndrome in a pediatric patient receiving anti-retroviral therapy.

    Science.gov (United States)

    van den Berg, S A A; van 't Veer, N E; Emmen, J M A; van Beek, R H T

    2017-01-01

    We present a case of iatrogenic Cushing's syndrome, induced by treatment with fluticasone furoate (1-2 dd, 27.5 µg in each nostril) in a pediatric patient treated for congenital HIV. The pediatric patient described in this case report is a young girl of African descent, treated for congenital HIV with a combination therapy of Lopinavir/Ritonavir (1 dd 320/80 mg), Lamivudine (1 dd 160 mg) and Abacavir (1 dd 320 mg). Our pediatric patient presented with typical Cushingoid features (i.e. striae of the upper legs, full moon face, increased body and facial hair) within weeks after starting fluticasone furoate therapy, which was exacerbated after increasing the dose to 2 dd because of complaints of unresolved rhinitis. Biochemical analysis fitted iatrogenic Cushing's syndrome, with a repeatedly low cortisol (iatrogenic Cushing's syndrome in patients treated for HIV due to the strong inhibition of CYP3 enzymes by Ritonavir. Upon discontinuation of fluticasone treatment, the pediatric patient improved both clinically and biochemically with normalisation of cortisol and ACTH within a couple of weeks. Fluticasone therapy may induce iatrogenic Cushing's syndrome in a patient treated with anti-retroviral therapy.Pharmacogenetic analysis, in particular CYP3A genotyping, provides useful information in patients treated for HIV with respect to possible future steroid treatment.Fluticasone furoate is not detected in the Siemens Immulite cortisol binding assay.

  20. Cost-effectiveness of anti-retroviral therapy at a district hospital in southern Ethiopia

    Directory of Open Access Journals (Sweden)

    Robberstad Bjarne

    2009-07-01

    Full Text Available Abstract Background As the resource implications of expanding anti-retroviral therapy (ART are likely to be large, there is a need to explore its cost-effectiveness. So far, there is no such information available from Ethiopia. Objective To assess the cost-effectiveness of ART for routine clinical practice in a district hospital setting in Ethiopia. Methods We estimated the unit cost of HIV-related care from the 2004/5 fiscal year expenditure of Arba Minch Hospital in southern Ethiopia. We estimated outpatient and inpatient service use from HIV-infected patients who received care and treatment at the hospital between January 2003 and March 2006. We measured the health effect as life years gained (LYG for patients receiving ART compared with those not receiving such treatment. The study adopted a health care provider perspective and included both direct and overhead costs. We used Markov model to estimate the lifetime costs, health benefits and cost-effectiveness of ART. Findings ART yielded an undiscounted 9.4 years expected survival, and resulted in 7.1 extra LYG compared to patients not receiving ART. The lifetime incremental cost is US$2,215 and the undiscounted incremental cost per LYG is US$314. When discounted at 3%, the additional LYG decreases to 5.5 years and the incremental cost per LYG increases to US$325. Conclusion The undiscounted and discounted incremental costs per LYG from introducing ART were less than the per capita GDP threshold at the base year. Thus, ART could be regarded as cost-effective in a district hospital setting in Ethiopia.

  1. Absolute lymphocyte count: A useful surrogate marker to initiate anti retroviral therapy in resource poor settings.

    Directory of Open Access Journals (Sweden)

    Tsewang Chorol1, Shukla Das

    2012-10-01

    Full Text Available Objective: Initiation of anti retroviral therapy (ART is routinely based on the algorithms that combine CD4, HIV load and clinical illness. But their high cost and unavailability at resource poor settings are one of its major limitations. An attempt has been made to find a correlation between CD4 count and Absolute lymphocyte count (ALC so that timely initiation of ART could be done in peripheral areas of developing countries where automation and established technologies have not been reached. Methods: This cross sectional study included 200 patients between 18-60 year of ages who are HIV seropositive with and without clinical evidence of oral candidiasis (100 case; 100 control. ALC was calculated as per the percentage of lymphocyte in total leukocyte count as seen in peripheral smear. CD4 cell count estimation was done by flow cytometry method. Results: A good correlation was found between CD4 count and ALC in both cases (R=0.656 and controls (R=0.642. There was an increase in sensitivity (St and decrease in specificity (Sp of predicting CD4 count <200 cells/mm3 and < 350 cells/ mm3 as the cut off value for ALC increased. ALC cut off value of 1700 cells/mm3 is likely to be the best predictor of CD4 count of < 200 cells/mm3 and ALC cut off value of 1800 cells/mm3 for CD4 count <350 cells/mm3. Conclusions: We recommend the use of ALC as a surrogate marker for or in combination with CD4 count to determine when to start therapy and to enable routine monitoring in resource poor settings .

  2. Global HIV-1 transmitted drug resistance in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial

    DEFF Research Database (Denmark)

    Baxter, J D; Dunn, D; White, E

    2015-01-01

    of resistance testing in START trial participants. METHODS: In the Strategic Timing of AntiRetroviral Treatment (START) trial, baseline genotypic resistance testing results were collected at study entry and analysed centrally to determine the prevalence of TDR in the study population. Resistance was based...... on a modified 2009 World Health Organization definition to reflect newer resistance mutations. RESULTS: Baseline resistance testing was available in 1946 study participants. Higher rates of testing occurred in Europe (86.7%), the USA (81.3%) and Australia (89.9%) as compared with Asia (22.2%), South America (1...

  3. Cost-Benefit Analysis of Anti-Retroviral Therapy (Art) for HIV/AIDS ...

    African Journals Online (AJOL)

    Antiretroviral therapy (ART) means treating retroviral infections like HIV with drugs. These drugs though do not kill the virus but slowed down the growth of the virus. When the virus is slowed down, Human Immunodeficiency Virus (HIV) disease is also slowed down. ART drugs are referred to as ARV and ARV therapy is ...

  4. Anti-retroviral therapy among HIV infected travelers to Hajj pilgrimage.

    Science.gov (United States)

    Habib, Abdulrazaq G; Abdulmumini, Murjanatu; Dalhat, Mahmoud M; Hamza, Muhammad; Iliyasu, Garba

    2010-01-01

    Many countries with high prevalence of human immunodeficiency virus (HIV) infection also have substantial Muslim populations. HIV-infected patients who travel to Hajj in Saudi-Arabia may encounter challenges regarding their anti-retroviral therapy (ART). In a cohort study in Nigeria, clinically stable patients on ART who were traveling for the 2008 to 2009 Hajj (Hajj-pilgrims [HP]) were selected and compared with consecutively selected Muslim patients who were clinically stable and traveled to and from distances within the country to access ART (non-pilgrims [NP]). Participants were clinically evaluated and interviewed regarding their adherence to ART pre-travel and post-travel, international border passage with medications and reasons for missing ART doses. Post-travel change in CD4 counts and RNA-PCR viral load were measured. Outcomes were proportion who missed >or=1 dose of ART during Hajj compared with pre-travel or post-travel and failure of ART, defined as decline in CD4 cell counts or high viral load or both. Thirty-one HP and 27 NP had similar characteristics and were away for (median [range]) 36 days (28-43 days) and 84 days (28-84 days), respectively (p or= 1 ART doses among HP and NP while away were 16/31 (51.6%) and 5/27 (18.5%), respectively with risk ratio (95% confidence interval [CI]) 2.79 (1.18-6.60). Among HP, the proportions who missed >or= 1 ART doses pre-travel and post-travel were lower than those who missed it during Hajj. Those who failed ART among HP compared with NP were 15/31 (48.4%) and 5/27 (18.5%), respectively with odds ratio (95% CI) 4.13 (1.10-17.21). Reasons for missing ART included forgetfulness, exhaustion of supplies, stigma, spiritual alternatives, or disinclination; five patients were unable to cross airports with medications. Patients who went on Hajj were more likely to miss medications and to have ART failure due to several reasons including inability to cross borders with medications.

  5. Tratamiento antirretroviral en pacientes con sida y micobacteriosis Anti-retroviral treatment in patients with AIDS and mycobacterial diseases

    Directory of Open Access Journals (Sweden)

    Marcelo E. Corti

    2005-08-01

    Full Text Available La tuberculosis y otras micobacteriosis constituyen asociaciones o coinfecciones frecuentes en pacientes con sida y se asocian con una elevada mortalidad. En esta revisión se actualizan los tratamientos de las principales enfermedades micobacterianas asociadas al sida (tuberculosis y micobacteriosis por Mycobacterium avium, con especial énfasis en las interacciones farmacológicas entre antimicobacterianos, principalmente rifampicina y claritromicina, y fármacos antirretrovirales. Se analizan los esquemas de tratamiento, su duración, la quimioprofilaxis primaria y secundaria y el momento óptimo de iniciación del tratamiento antirretroviral. Finalmente se describe el síndrome inflamatorio de reconstitución inmune y su tratamiento.Tuberculosis and other mycobacterial diseases are frequent coinfections in AIDS patients with an increased related mortality. In this review we have updated the treatment of the main mycobacterial diseases (tuberculosis and Mycobacterium avium disease, under the scope of pharmacological interactions between antimycobacterial drugs, specially rifampicin and clarithromycin, and anti-retroviral drugs. Antimycobacterial treatment schemes, their duration, primary and secondary chemoprophylaxis and the optimal time to start the anti-retroviral therapy are analized. Finally, the immnune reconstitution inflammatory syndrome and its treatment are discussed.

  6. Desenvolvimento de uma escala de auto-eficácia para adesão ao tratamento anti-retroviral

    Directory of Open Access Journals (Sweden)

    Leite José Carlos de Carvalho

    2002-01-01

    Full Text Available Uma escala de expectativa de auto-eficácia para seguir prescrição anti-retroviral em situações difíceis (21 itens foi desenvolvida pela análise do conteúdo de entrevistas com pacientes que estavam em tratamento ou que o abandonaram. A consistência interna e a validade de construto foram examinadas em 60 sujeitos que freqüentaram ambulatório para pacientes em estágios avançados da doença (hospital-dia. Um escore de expectativa de auto-eficácia para adesão ao tratamento foi derivado do primeiro componente da análise de componentes principais. A média do escore foi 0,25 para os sujeitos aderentes e -0,33 para os não-aderentes ao tratamento (teste t, p = 0,046. A chance de adesão duplicou quando o escore de expectativa de auto-eficácia era maior em uma unidade (OR = 2,07; IC95% = 1,002 a 4,26. A consistência interna foi alta (alfa de Cronbach = 0.96. A escala demonstrou validade de construto e confiabilidade para medir auto-eficácia para tratamento anti-retroviral nesses pacientes.

  7. Cognitive and Behavioural Correlates of Non-Adherence to HIV Anti-Retroviral Therapy: Theoretical and Practical Insight for Clinical Psychology and Health Psychology

    Science.gov (United States)

    Begley, Kim; McLaws, Mary-Louise; Ross, Michael W.; Gold, Julian

    2008-01-01

    This cross-sectional study identified variables associated with protease inhibitor (PI) non-adherence in 179 patients taking anti-retroviral therapy. Univariate analyses identified 11 variables associated with PI non-adherence. Multiple logistic regression modelling identified three predictors of PI non-adherence: low adherence self-efficacy and…

  8. Retroviral DNA Integration

    Science.gov (United States)

    2016-01-01

    The integration of a DNA copy of the viral RNA genome into host chromatin is the defining step of retroviral replication. This enzymatic process is catalyzed by the virus-encoded integrase protein, which is conserved among retroviruses and LTR-retrotransposons. Retroviral integration proceeds via two integrase activities: 3′-processing of the viral DNA ends, followed by the strand transfer of the processed ends into host cell chromosomal DNA. Herein we review the molecular mechanism of retroviral DNA integration, with an emphasis on reaction chemistries and architectures of the nucleoprotein complexes involved. We additionally discuss the latest advances on anti-integrase drug development for the treatment of AIDS and the utility of integrating retroviral vectors in gene therapy applications. PMID:27198982

  9. Toll-like Receptor 7 Controls the Anti-Retroviral Germinal Center Response

    Science.gov (United States)

    Browne, Edward P.

    2011-01-01

    The development of vaccines that can enhance immunity to viral pathogens is an important goal. However, the innate molecular pathways that regulate the strength and quality of the immune response remain largely uncharacterized. To define the role of Toll-like receptor (TLR) signaling in control of a model retroviral pathogen, Friend virus (FV), I generated mice in which the TLR signaling adapter Myd88 was selectively deleted in dendritic cell (DC) or in B cell lineages. Deletion of Myd88 in DCs had little effect on immune control of FV, while B cell specific deletion of Myd88 caused a dramatic increase in viral infectious centers and a significantly reduced antibody response, indicating that B cell-intrinsic TLR signaling plays a crucial role, while TLR signaling in DCs is less important. I then identified the single-stranded RNA sensing protein TLR7 as being required for antibody-mediated control of FV by analyzing mice deficient in TLR7. Remarkably, B cells in infected TLR7-deficient mice upregulated CD69 and CD86 early in infection, but failed to develop into germinal center B cells. CD4 T cell responses were also attenuated in the absence of TLR7, but CD8 responses were TLR7 independent, suggesting the existence of additional pathways for detection of retroviral particles. Together these results demonstrate that the vertebrate immune system detects retroviruses in vivo via TLR7 and that this pathway regulates a key checkpoint controlling development of germinal center B cells. PMID:21998589

  10. Toll-like receptor 7 controls the anti-retroviral germinal center response.

    Directory of Open Access Journals (Sweden)

    Edward P Browne

    2011-10-01

    Full Text Available The development of vaccines that can enhance immunity to viral pathogens is an important goal. However, the innate molecular pathways that regulate the strength and quality of the immune response remain largely uncharacterized. To define the role of Toll-like receptor (TLR signaling in control of a model retroviral pathogen, Friend virus (FV, I generated mice in which the TLR signaling adapter Myd88 was selectively deleted in dendritic cell (DC or in B cell lineages. Deletion of Myd88 in DCs had little effect on immune control of FV, while B cell specific deletion of Myd88 caused a dramatic increase in viral infectious centers and a significantly reduced antibody response, indicating that B cell-intrinsic TLR signaling plays a crucial role, while TLR signaling in DCs is less important. I then identified the single-stranded RNA sensing protein TLR7 as being required for antibody-mediated control of FV by analyzing mice deficient in TLR7. Remarkably, B cells in infected TLR7-deficient mice upregulated CD69 and CD86 early in infection, but failed to develop into germinal center B cells. CD4 T cell responses were also attenuated in the absence of TLR7, but CD8 responses were TLR7 independent, suggesting the existence of additional pathways for detection of retroviral particles. Together these results demonstrate that the vertebrate immune system detects retroviruses in vivo via TLR7 and that this pathway regulates a key checkpoint controlling development of germinal center B cells.

  11. In vivo mitochondrial function in HIV-infected persons treated with contemporary anti-retroviral therapy: a magnetic resonance spectroscopy study.

    Directory of Open Access Journals (Sweden)

    Brendan A I Payne

    Full Text Available Modern anti-retroviral therapy is highly effective at suppressing viral replication and restoring immune function in HIV-infected persons. However, such individuals show reduced physiological performance and increased frailty compared with age-matched uninfected persons. Contemporary anti-retroviral therapy is thought to be largely free from neuromuscular complications, whereas several anti-retroviral drugs previously in common usage have been associated with mitochondrial toxicity. It has recently been established that patients with prior exposure to such drugs exhibit irreversible cellular and molecular mitochondrial defects. However the functional significance of such damage remains unknown. Here we use phosphorus magnetic resonance spectroscopy ((31P-MRS to measure in vivo muscle mitochondrial oxidative function, in patients treated with contemporary anti-retroviral therapy, and compare with biopsy findings (cytochrome c oxidase (COX histochemistry. We show that dynamic oxidative function (post-exertional ATP (adenosine triphosphate resynthesis was largely maintained in the face of mild to moderate COX defects (affecting up to ∼10% of fibers: τ½ ADP (half-life of adenosine diphosphate clearance, HIV-infected 22.1±9.9 s, HIV-uninfected 18.8±4.4 s, p = 0.09. In contrast, HIV-infected patients had a significant derangement of resting state ATP metabolism compared with controls: ADP/ATP ratio, HIV-infected 1.24±0.08×10(-3, HIV-uninfected 1.16±0.05×10(-3, p = 0.001. These observations are broadly reassuring in that they suggest that in vivo mitochondrial function in patients on contemporary anti-retroviral therapy is largely maintained at the whole organ level, despite histochemical (COX defects within individual cells. Basal energy requirements may nevertheless be increased.

  12. Anti-inflammatory and vasoprotective activity of a retroviral-derived peptide, homologous to human endogenous retroviruses: endothelial cell effects.

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    George J Cianciolo

    Full Text Available Malignant and inflammatory tissues sometimes express endogenous retroviruses or their proteins. A highly-conserved sequence from retroviral transmembrane (TM proteins, termed the "immunosuppressive domain (ID", is associated with inhibition of immune and inflammatory functions. An octadecapeptide (MN10021 from the ID of retroviral TM protein p15E inhibits in vitro release of pro-inflammatory cytokines and increases synthesis of anti-inflammatory IL-10. We sought to determine if MN10021 has significant in vivo effects. MN10021, prepared by solid-phase synthesis, was dimerized through a naturally-occurring, carboxy-terminal cysteine. In vivo anti-inflammatory activity was determined using a murine model of sodium periodate (NaIO(4-induced peritonitis. In vivo vasoprotective effects were determined using: (1 a carrageenan-induced model of disseminated intravascular coagulation (DIC in mice; (2 a reverse passive Arthus model in guinea pigs; and (3 vasoregulatory effects in spontaneously hypertensive rats (SHR. In vitro studies included: (1 binding/uptake of MN10021 using human monocytes, cultured fibroblasts, and vascular endothelial cells (VEC; (2 gene expression by RT-PCR of MN10021-treated VEC; and (3 apoptosis of MN10021-treated VEC exposed to staurosporine or TNF-α. One-tenth nmol MN10021 inhibits 50 percent of the inflammatory response in the mouse peritonitis model. Furthermore, 73 nmol MN10021 completely protects mice in a lethal model of carrageenan-induced DIC and inhibits vascular leak in both the mouse DIC model and a guinea pig reverse passive Arthus reaction. MN10021 binds to and is taken up in a specific manner by both human monocytes and VEC but not by cultured human fibroblasts. Surprisingly, orally-administered MN10021 lowers blood pressure in SHR rats by 10-15% within 1 h suggesting a direct or indirect effect on the vascular endothelium. MN10021 and derived octapeptides induce iNOS (inducible nitric oxide synthase mRNA in VEC

  13. Circulating heat shock protein 60 levels are elevated in HIV patients and are reduced by anti-retroviral therapy.

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    Itaru Anraku

    Full Text Available Circulating heat shock protein 60 (Hsp60 and heat shock protein 10 (Hsp10 have been associated with pro- and anti-inflammatory activity, respectively. To determine whether these heat shock proteins might be associated with the immune activation seen in HIV-infected patients, the plasma levels of Hsp60 and Hsp10 were determined in a cohort of 20 HIV-infected patients before and after effective combination anti-retroviral therapy (cART. We show for the first time that circulating Hsp60 levels are elevated in HIV-infected patients, with levels significantly reduced after cART, but still higher than those in HIV-negative individuals. Hsp60 levels correlated significantly with viral load, CD4 counts, and circulating soluble CD14 and lipopolysaccharide levels. No differences or correlations were seen for Hsp10 levels. Elevated circulating Hsp60 may contribute to the immune dysfunction and non-AIDS clinical events seen in HIV-infected patients.

  14. Circulating heat shock protein 60 levels are elevated in HIV patients and are reduced by anti-retroviral therapy.

    Science.gov (United States)

    Anraku, Itaru; Rajasuriar, Reena; Dobbin, Caroline; Brown, Richard; Lewin, Sharon R; Suhrbier, Andreas

    2012-01-01

    Circulating heat shock protein 60 (Hsp60) and heat shock protein 10 (Hsp10) have been associated with pro- and anti-inflammatory activity, respectively. To determine whether these heat shock proteins might be associated with the immune activation seen in HIV-infected patients, the plasma levels of Hsp60 and Hsp10 were determined in a cohort of 20 HIV-infected patients before and after effective combination anti-retroviral therapy (cART). We show for the first time that circulating Hsp60 levels are elevated in HIV-infected patients, with levels significantly reduced after cART, but still higher than those in HIV-negative individuals. Hsp60 levels correlated significantly with viral load, CD4 counts, and circulating soluble CD14 and lipopolysaccharide levels. No differences or correlations were seen for Hsp10 levels. Elevated circulating Hsp60 may contribute to the immune dysfunction and non-AIDS clinical events seen in HIV-infected patients.

  15. Dental caries prevalence in human immunodeficiency virus infected patients receiving highly active anti-retroviral therapy in kermanshah, iran.

    Science.gov (United States)

    Rezaei-Soufi, Loghman; Davoodi, Poorandokht; Abdolsamadi, Hamid Reza; Jazaeri, Mina; Malekzadeh, Hossein

    2014-02-03

    Introduction of new approaches for the treatment of human immunodeficiency virus (HIV) infection such as anti-retroviral medicines has resulted in an increase in the life expectancy of HIV patient. Evaluating the dental health status as a part of their general health care is needed in order to improve the quality of life in these patients. The aim of this study was to compare the root and crown caries rate in HIV patients receiving highly active antiretroviral therapy (HAART) with that rate in HIV patients without treatment option. This cross sectional study consisting of 100 individuals of both genders with human immunodeficiency virus were divided into two groups: i. group 1 (treatment group) including 50 patients with acquired immunodeficiency syndrome (AIDS) receiving HAART and ii. group 2 (control group) including 50 HIV infected patients not receiving HAART. Dental examinations were done by a dentist under suitable light using periodontal probe. For each participant, numbers of decay (D), missed (M), filled (F), Decayed missed and filled teeth (DMFT), decay surface (Ds), missed surface (Ms), filled surface (Fs), Decayed missed and filled surfaces (DMFS), and tooth and root caries were recorded. Data were analyzed using Chi-square test and independent t test using SPSS 13.0, while p-value of <0.05 was considered statistically significant in all analysis. The mean and standard deviation (SD) of decayed, missed and filled teeth of those who were on highly active antiretroviral therapy was 6.86 ± 3.57, 6.39 ± 6.06 and 1.89 ± 1.93, respectively. There was no significant difference between these values regarding to the treatment of patients. The mean and standard deviation of DMFT, DMFS and the number of decayed root surfaces were 15.14 ± 6.09, 56.79 ± 28.56, and 4.96 ± 2.89 in patients treated by anti-retroviral medicine which were not significantly different compared to those without this treatment. According to the results of the present study, highly

  16. The First Synthesis and Anti-retroviral Activity of 5',5'-Difluoro-3'-Hydroxy-Apiosyl Nucleoside Cyclomonophosphonic Acid Analogs

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seyeon; Hong, Joon Hee [Chosun University, Gwangju (Korea, Republic of)

    2016-04-15

    The first synthesis of novel 5',5'-difluoro-30-hydroxy apiose nucleoside cyclomonophosphonic acid analogs was performed as potent anti-retroviral agents. Phosphonation was performed by direct displacement of a triflate intermediate with diethyl(lithiodifluoromethyl) phosphonate to give the corresponding(α, α-difluoroalkyl) phosphonate. Condensation successfully proceeded from a glycosyl donor with persilylated bases to yield the nucleoside phosphonate analogs. Deprotection of diethyl phosphonates provided the target nucleoside cyclomonophosphonic acid analogs. The synthesized nucleoside analogs were subjected to anti-viral screening against the human immunodeficiency virus-1 (HIV-1). Cytosine analogs show significant anti-HIV activity.

  17. Estado actual y futuro de la terapia anti-leishmaniásica en Colombia

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    Jaime Soto

    2006-10-01

    Full Text Available Los antimoniales pentavalentes son la primera elección para el tratamiento de la leishmaniasis en Colombia pero la dosis ha tenido que incrementarse en mas de 600% para mantener su eficacia que en distintos reportes varía entre 93 y 25%, lo cual puede reflejar diferencias en la sensibilidad de los parásitos pero más probablemente incumplimiento de los esquemas recomendados. Los resultados de su empleo, así como la situación actual de pentamidina, anfotericina B y miltefosina son revisados y se hace una proyección sobre el desarrollo de la terapia en los próximos años. Para definir el real estado de la respuesta a los medicamentos anti-leishmaniásicos y prolongarles su vida útil, es indispensable establecer mecanismos de vigilancia de los factores implicados en el manejo de la enfermedad por lo que se plantea una estrategia de sitios centinela que permitan observaciones puntuales en el tiempo, en áreas específicas y sobre situaciones particulares.

  18. Terapia antirretroviral directamente observada en mujeres privadas de libertad Directly observed anti-retroviral therapy amongst female inmates

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    L. De Carolis

    2009-02-01

    Full Text Available Objetivos: La adherencia al tratamiento antirretroviral de alta eficacia (TARV se considera el gold standard para el éxito del mismo. Para mejorar la adherencia en persona privadas de libertad viviendo con VIH-Sida, se propuso la utilización del tratamiento directamente observado tomando el modelo para el tratamiento de la tuberculosis. Material y métodos: se incluyeron las mujeres VIH positivas con criterios de TARV que voluntariamente decidieron participar. Los datos principales a evaluar fueron control inicial y final de CD4 y carga viral para VIH. Resultados: estudiamos 52 mujeres, edad promedio 34 años, entre 1 y 20 años de infección VIH. CD4 menor a 100 cél/ml inicial en 16 pacientes (30.7% y final en 4 pacientes (7.6%. Carga viral indetectable inicial en ninguna paciente y final en 33 pacientes (63.4% 21 % con infecciones oportunistas, principal tuberculosis. 17% coinfectadas con HCV. El esquema de TARV más utilizado fue 2 INTR más 1 INNTR. Conclusiones: La estrategia DOT aplicada al TARV fue efectiva en nuestras pacientes, evidenciado por el aumento de los CD4 y el mayor número de pacientes con disminución de la carga viral hasta permanecer indetectables. Si bien es difícil de implementar en tratamientos crónicos consideramos que es una herramienta útil para personas privadas de libertad.Objectives: It is considered that the gold standard for success in HAART is adherence. To improve adherence amongst inmates with HIV-AIDS, the use of directly observed treatment (DOT is proposed using the tuberculosis treatment model. Material and methods: HIV positive female patients with ARVT criteria who voluntarily participated were used for the study. The initial and final CD4 cell count and HIV viral load were the principal data used for assessment purposes. Results: 52 women with an average age of 34 years were studied, with an average HIV infection time span of between 1 and 20 years. Initial CD4 cell count of <100 copies/mL in 16 patients (30.7% and an equivalent final count in 4 patients (7.6% were found. Initial undetectable viral loads were not found in any patient, while final undetectable viral loads were found in 33 (63.4%. 21% of patients had opportunistic infections. The most important of these was tuberculosis, followed by HCV co-infection. The most frequently used ARVT schedule was two NRTI with one NNTRI. Conclusions: The application of DOT strategy to ARVT was effective amongst our patients, as shown by the increase in CD4 counts and the increased number of patients with reductions in viral loads to undetectable levels. While it is a tool that is not easy to use for cases of chronic treatment, we do consider it to be useful for prison inmates.

  19. "Every drug goes to treat its own disease ... " - a qualitative study of perceptions and experiences of taking anti-retrovirals concomitantly with anti-malarials among those affected by HIV and malaria in Tanzania

    OpenAIRE

    Mangesho, PE; Reynolds, J.; Lemnge, M; Vestergaard, LS; Chandler, CIR

    2014-01-01

    Background Little is known about how people living with human immunodeficiency virus (HIV) experience malaria and the concomitant use of anti-malarial treatments with anti-retrovirals (ARVs). An understanding of how patients make sense of these experiences is important to consider in planning and supporting the clinical management and treatment for co-infected individuals. Methods A qualitative study was conducted in Tanzania alongside a clinical trial of concomitant treatment for HIV and mal...

  20. Combination of nanoparticle-based therapeutic vaccination and transient ablation of regulatory T cells enhances anti-viral immunity during chronic retroviral infection.

    Science.gov (United States)

    Knuschke, Torben; Rotan, Olga; Bayer, Wibke; Sokolova, Viktoriya; Hansen, Wiebke; Sparwasser, Tim; Dittmer, Ulf; Epple, Matthias; Buer, Jan; Westendorf, Astrid M

    2016-04-14

    Regulatory T cells (Tregs) have been shown to limit anti-viral immunity during chronic retroviral infection and to restrict vaccine-induced T cell responses. The objective of the study was to assess whether a combinational therapy of nanoparticle-based therapeutic vaccination and concomitant transient ablation of Tregs augments anti-viral immunity and improves virus control in chronically retrovirus-infected mice. Therefore, chronically Friend retrovirus (FV)-infected mice were immunized with calcium phosphate (CaP) nanoparticles functionalized with TLR9 ligand CpG and CD8(+) or CD4(+) T cell epitope peptides (GagL85-93 or Env gp70123-141) of FV. In addition, Tregs were ablated during the immunization process. Reactivation of CD4(+) and CD8(+) effector T cells was analysed and the viral loads were determined. Therapeutic vaccination of chronically FV-infected mice with functionalized CaP nanoparticles transiently reactivated cytotoxic CD8(+) T cells and significantly reduced the viral loads. Transient ablation of Tregs during nanoparticle-based therapeutic vaccination strongly enhanced anti-viral immunity and further decreased viral burden. Our data illustrate a crucial role for CD4(+) Foxp3(+) Tregs in the suppression of anti-viral T cell responses during therapeutic vaccination against chronic retroviral infection. Thus, the combination of transient Treg ablation and therapeutic nanoparticle-based vaccination confers robust and sustained anti-viral immunity.

  1. Dynamical analysis of a multi-strain model of HIV in the presence of anti-retroviral drugs.

    Science.gov (United States)

    Sharomi, O; Gumel, A B

    2008-07-01

    One major drawback associated with the use of anti-retroviral drugs in curtailing HIV spread in a population is the emergence and transmission of HIV strains that are resistant to these drugs. This paper presents a deterministic HIV treatment model, which incorporates a wild (drug sensitive) and a drug-resistant strain, for gaining insights into the dynamical features of the two strains, and determining effective ways to control HIV spread under this situation. Rigorous qualitative analysis of the model reveals that it has a globally asymptotically stable disease-free equilibrium whenever a certain epidemiological threshold (R t 0) is less than unity and that the disease will persist in the population when this threshold exceeds unity. Further, for the case where R t 0 > 1, it is shown that the model can have two co-existing endemic equilibria, and competitive exclusion phenomenon occurs whenever the associated reproduction number of the resistant strain (R t r) is greater than that of the wild strain (R t w). Unlike in the treatment model, it is shown that the model without treatment can have a family of infinitely many endemic equilibria when its associated epidemiological threshold (R(0)) exceeds unity. For the case when [Formula in text], it is shown that the widespread use of treatment against the wild strain can lead to its elimination from the community if the associated reduction in infectiousness of infected individuals (treated for the wild strain) does not exceed a certain threshold value (in this case, the use of treatment is expected to make R t w < R t r.

  2. Prevalence and distribution of the GBV-C/HGV among HIV-1-infected patients under anti-retroviral therapy.

    Science.gov (United States)

    Alcalde, Rosana; Nishiya, Anna; Casseb, Jorge; Inocêncio, Lilian; Fonseca, Luiz A M; Duarte, Alberto J S

    2010-08-01

    Infection with GB virus C (GBV-C) or hepatitis G virus (HGV) is highly prevalent among HIV/AIDS patients. GBV-C/HGV viremia has not been associated with liver disease and seems to slow HIV disease progression. To study the GBV-C/HGV genotypes prevalence among HIV/AIDS patients and its association with HIV viral load (VL) and CD4+ lymphocyte counts. From February 2003 to February 2004, we analyzed 210 HIV-1-infected subjects who were on anti-retroviral therapy (ART). For 63 of them a PCR-nested to the non-coding 5' (5'NCR) region of the GBV-C/HGV was done, and for 49 a DNA direct sequencing was done. A phylogenetic analysis was performed by PHYLIP program. 63 (30%) of the HIV-1-infected patients were co-infected with GBV-C/HGV. The phylogenetic analysis revealed the following genotypes (and respective relative frequencies): 1 (10%), 2a (41%), 2b (43%), and 3 (6%). Co-infected patients presented lower HIV-1 VL and higher T CD4+ lymphocyte cells counts as compared with patients negative for GBV-C/HGV sequences (log=4.52 vs. 4.71, p=0.036), and T CD4+ lymphocyte counts (cells/mm(3)=322.6 vs. 273.5, p=0.081, respectively). T CD4+ cells counts equal to, or higher than, 200/mm(3) were significantly more common among co-infected patients than among HIV-infected-only patients (p=0.042). The lowest T CD4+ cells counts were associated with genotype 1 and the highest with genotype 2b (p=0.05). The GBV-C/HGV infection prevalence was 30% among HIV-1-infected subjects, and was associated with lower VL and higher CD4+ lymphocyte counts. GBV-C/HGV genotype 2b may be associated with better immunological response. Published by Elsevier B.V.

  3. [Effect of highly active anti-retroviral therapy on reducing HIV/AIDS related death in Hebei, 1989-2013].

    Science.gov (United States)

    Chen, Suliang; Ma, Lin; Lu, Xinli; Li, Yan; Wang, Wei; Wang, Yingying; Zhao, Cuiying; Zhang, Yuqi; Zhao, Hongru

    2015-05-01

    To investigate the effect of highly active anti-retroviral therapy (HAART) on reducing HIV/AIDS related death. The analysis was conducted by using the data of 4,148 HIV/AIDS cases reported in Hebei province from 1989 to 2013. Regular follow-up, CD4 detection, registration of death were carried out for them. Free HAART has been provided to people living with HIV/AIDS who met the treatment requirement since 2003. Of 4,148 HIV/AIDS cases, 12,451.48 person years were observed, 968 cases died due to all registered death causes. The death density was 7.77/100 person years. The death density was 2.87/100 person years for the HIV/AIDS cases receiving HAART, and 16.58/100 for the HIV/AIDS cases receiving no HAART. In 1,894 AIDS cases, a total of 4,774.48 person years were observed from onset to death, 581 cases died due to all registered death causes, and the death density was 121.69/100 person years. The death density was 4.77/100 person years for the cases receiving HAART, and 125.92/100 person years for the cases receiving no HAART. In the cases with CD less than 200/mm3, the death density was 22.9/100 person years for those receiving no HAART and 5.3/100 person years for those receiving HAART. The annual analysis found that the death rate due to all registered death causes declined as the increase of HAART coverage in people living with HIV/AIDS. The expanding of HAART coverage in people infected with HIV can reduce death rate among them. Further expanding of HAART can effectively reduce the death among people living with HIV/AIDS.

  4. Effect of Micronutrient and Probiotic Fortified Yogurt on Immune-Function of Anti-Retroviral Therapy Naive HIV Patients  

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    J. Dik F. Habbema

    2011-10-01

    Full Text Available Background: Micronutrient supplementation has been shown to reduce the progression of HIV but does not have an effect on the intestinal barrier or the intestinal microbiota of HIV patients. Studies have suggested that probiotics could potentially complement micronutrients in preserving the immune-function of HIV patients. Objective: Assess the impact of micronutrient supplemented probiotic yogurt on the immune function of HIV patients. Design: We performed a randomized, double blind, controlled trial with CD4 count as primary outcome among HIV patients naïve to anti-retroviral treatment. Secondary outcomes included hematological parameters, incidence of diarrhea and clinical symptoms. A total of 112 HIV patients were randomized to receive a micronutrient fortified yogurt with (n = 55 or without additional probiotic Lactobacillus rhamnosus GR-1 (n = 57 for four weeks. Results: An average decline in CD4 count of −70 cells/μL (95% CI: −154 to −15 was observed in the micronutrient, probiotic group versus a decrease of −63 cells/μL (95% CI: −157 to −30 in the micronutrient control group (p = 0.9. Additional probiotic supplementation was well tolerated and not associated with adverse events. No difference between groups was detected in incidence of diarrhea or clinical symptoms. An improvement of hemoglobin levels was observed for all subjects, based upon a mean difference from baseline of 1.4 g/L (SD = 6 (p = 0.02. Conclusion: The addition of probiotics to a micronutrient fortified yogurt was well tolerated by HIV patients but was not associated with a further increase in CD4 count after one month.

  5. Formulation and characterization of solid lipid nanoparticles for an anti-retroviral drug darunavir

    Science.gov (United States)

    Bhalekar, Mangesh; Upadhaya, Prashant; Madgulkar, Ashwini

    2017-02-01

    Darunavir, an anti-HIV drug having poor solubility in aqueous and lipid medium, illustrates degradation above its melting point, i.e. 74 °C, thus, posing a challenge to dosage formulation. Despite, the drug suffers from poor oral bioavailability (37%) owing to less permeability and being poly-glycoprotein and cyp3A metabolism substrate. The study aimed formulating a SLN system to overcome the formulation and bioavailability associated problems of the drug. Based on the drug solubility and stable dispersion findings, lipid and surfactant were chosen and nanoparticles were prepared using hot-homogenization technique. Optimization of variables such as lipid concentration, oil-surfactant and homogenization cycle was carried and their effect on particle size and entrapment efficiency was studied. Freeze-dried SLN further characterized using SEM, DSC and PXRD analysis revealed complete entrapment of the drug and amorphous nature of the SLN. In vitro pH release studies in 0.1 N HCl and 6.8 pH buffer demonstrated 84 and 80% release at the end of 12th h. The apparent permeability of the SLN across rat intestine was found to be 24 × 10-6 at 37 °C at the end of 30 min while at 4 °C the same was found to be 5.6 × 10-6 prompting involvement of endocytic processes in the uptake of SLN. Accelerated stability studies revealed no prominent changes upon storage.

  6. CD4 lymphocyte response following anti-retroviral therapy in HIV/AIDS patients - A study in Osmania General Hospital

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    Srinivasa Rao Nanyam

    2016-07-01

    Full Text Available The present study aims serial four year assessment of CD4 cell response after initiation of anti-retroviral therapy (ART in patients with HIV/AIDS attending Osmania General Hospital, Hyderabad. It was a retrospective hospital based observational study. We included 110 HIV/AIDS who were on ART. Data was collected over a period of 04 years from 2005 to 2008 in the ART Centre, Upgraded Department of General Medicine, Osmania General Hospital. Data regarding CD4 cell count over 4 years was assessed for mean CD4 cell count, trends, age and sex wise distribution. All patients were on ART as per National Aids Control Organisation (NACO guidelines. Complete blood picture, serum creatinine, blood urea, serum electrolytes, liver function tests, sputum for acid fast bacilli, chest radiography, CD4 cell count in all patients, fine needle aspiration and biopsy (if necessary, magnetic resonance imaging (if necessary, computerized tomography (if necessary, colonoscopy (if necessary. The present study showed mean CD4 count improvement of 128.78 cells/mm3 after 6 months of initiation of ART, 24.77cells /mm3 after 1 year, additional 67.53 cells/mm3 after 2nd year and after 3rd year 5.59cells/mm3 from base line CD4 cell count. Improvement in CD4 count was almost equal in both male and female and in age group <25 years and above 40 years age group also. Mean CD4 cell count improvement of 240.31 cells/mm3 in females and 220.54 cells/mm3 in males to the baseline after 3 years of treatment with ART. Present study clearly shows definite improvement in CD4 cell count after ART was more than 100% irrespective of age and sex. Regular intake of drugs will improve immunologic response. Therefore strict adherence to ART /regular counseling sessions at ART centres should be stressed upon. [J Med Allied Sci 2016; 6(2.000: 68-71

  7. Sustainability of a community-based anti-retroviral care delivery model - a qualitative research study in Tete, Mozambique.

    Science.gov (United States)

    Rasschaert, Freya; Decroo, Tom; Remartinez, Daniel; Telfer, Barbara; Lessitala, Faustino; Biot, Marc; Candrinho, Baltazar; Van Damme, Wim

    2014-01-01

    To overcome patients' reported barriers to accessing anti-retroviral therapy (ART), a community-based delivery model was piloted in Tete, Mozambique. Community ART Groups (CAGs) of maximum six patients stable on ART offered cost- and time-saving benefits and mutual psychosocial support, which resulted in better adherence and retention outcomes. To date, Médecins Sans Frontières has coordinated and supported these community-driven activities. To better understand the sustainability of the CAG model, we developed a conceptual framework on sustainability of community-based programmes. This was used to explore the data retrieved from 16 focus group discussions and 24 in-depth interviews with different stakeholder groups involved in the CAG model and to identify factors influencing the sustainability of the CAG model. We report the findings according to the framework's five components. (1) The CAG model was designed to overcome patients' barriers to ART and was built on a concept of self-management and patient empowerment to reach effective results. (2) Despite the progressive Ministry of Health (MoH) involvement, the daily management of the model is still strongly dependent on external resources, especially the need for a regulatory cadre to form and monitor the groups. These additional resources are in contrast to the limited MoH resources available. (3) The model is strongly embedded in the community, with patients taking a more active role in their own healthcare and that of their peers. They are considered as partners in healthcare, which implies a new healthcare approach. (4) There is a growing enabling environment with political will and general acceptance to support the CAG model. (5) However, contextual factors, such as poverty, illiteracy and the weak health system, influence the community-based model and need to be addressed. The community embeddedness of the model, together with patient empowerment, high acceptability and progressive MoH involvement

  8. Non-adherence to anti-retroviral therapy among HIV infected adults in Mon State of Myanmar

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    Win Lei Aye

    2017-05-01

    Full Text Available Abstract Background The provision of Anti-Retroviral Therapy (ART was started in Myanmar in 2005 in collaboration with the National AIDS Program and the private sector. Successful clinical management of HIV-infected patients is subject to optimal adherence. The aim of the study was to determine the prevalence of adherence to ART and identify factors associated with non-adherence to ART among HIV infected adults registered in a private sector setting in Mon State, Myanmar. Methods This cross-sectional study was conducted with adults living with HIV receiving ART at an HIV outpatient clinic between April and May 2016. A total of three hundred People Living with HIV(PLHIV were interviewed using a pretested and structured questionnaire. The 30 days Visual Analog Scale (VAS adherence instrument was used to assess the level of adherence. Multivariable logistic regression analysis was used to determine factors associated with non-adherence to ART. Results Among 300 patients (male 37.7% and female 62.3%, with a mean age of 41.3 years, standard deviation 8.7, 84% reported ≥95% adherence to ART in the past month. Among 16% of those reporting non-adherence, major reasons for skipping the medication were being busy (23%, being away from home (17.7% and being forgetful (12.3%. In multivariable logistic rgeression, low behavioural skills on ART adherence (OR = 0.31, 95% CI: 0.10-0.94, tobacco use (OR = 3.22, 95% CI:1.28-8.12, having disclosed their HIV status (OR = 0.07, 95% CI: 0.01-0.69, having a partner who was not on ART (OR = 4.25, 95% CI: 1.70-10.64 and among men, having erectile dysfunction (OR = 15.14, 95% CI: 1.41-162.66 were significant associated with ART non-adherence. Conclusion Non-adherence to ART was associated with individual moderating factors and behavioral skills. Priority measures such as addressing risk behaviour and behavioural change communication tailored to individual patients’ lifestyles requires comprehensive

  9. Incidence of WHO stage 3 and 4 conditions following initiation of anti-retroviral therapy in resource limited settings.

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    Andrea J Curtis

    Full Text Available OBJECTIVES: To determine the incidence of WHO clinical stage 3 and 4 conditions during early anti-retroviral therapy (ART in resource limited settings (RLS. DESIGN/SETTING: A descriptive analysis of routine program data collected prospectively from 25 Médecins Sans Frontières supported HIV treatment programs in eight countries between 2002 and 2010. SUBJECTS/PARTICIPANTS: 35,349 study participants with median follow-up on ART of 1.33 years (IQR 0.51-2.41. OUTCOME MEASURES: Incidence in 100 person-years of WHO stage 3 or 4 conditions during 5 periods after ART initiation. Diagnoses of conditions were made according to WHO criteria and relied upon clinical assessments supported by basic laboratory investigations. RESULTS: The incidence of any WHO clinical stage 3 or 4 condition over 3 years was 40.02 per 100 person-years (31.77 for stage 3 and 8.25 for stage 4. The incidence of stage 3 and 4 conditions fell by over 97% between months 0-3 and months 25-36 (77.81 to 2.40 for stage 3 and 28.70 to 0.64 for stage 4. During months 0-3 pulmonary tuberculosis was the most common condition diagnosed in adults (incidence 22.24 per 100 person-years and children aged 5-14 years (25.76 and oral candidiasis was the most common in children <5 years (25.79. Overall incidences were higher in Africa compared with Asia (43.98 versus 12.97 for stage 3 and 8.98 versus 7.05 for stage 4 conditions, p<0.001. Pulmonary tuberculosis, weight loss, oral and oesophageal candidiasis, chronic diarrhoea, HIV wasting syndrome and severe bacterial infections were more common in Africa. Extra-pulmonary tuberculosis, non-tuberculous mycobacterial infection, cryptococcosis, penicilliosis and toxoplasmosis were more common in Asia. CONCLUSIONS: The incidence of WHO stage 3 and 4 conditions during the early period after ART initiation in RLS is high, but greatly reduces over time. This is likely due to both the benefits of ART and deaths of the sickest patients occurring shortly

  10. Screening for Cryptococcal Antigenemia in Anti-Retroviral Naïve AIDS Patients in Benin City, Nigeria

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    Favour Osazuwa

    2012-05-01

    Full Text Available Objectives: Cryptococcus neoformans is the most incriminated fungal pathogen causing meningitis in acquired immune deficiency syndrome (AIDS patients, and is known to constitute a major cause of deaths in AIDS patients. This study thus aimed to determine the baseline sero-prevalence of Cryptococcus neoformans infection in anti-retroviral naïve (ART-naïve AIDS patients using the serum Cryptococcal antigen (crag detection method. Baseline effect of variation in CD4 counts, as well as sex and age with sero-positivity for crag were also determined.Methods: This descriptive cross-sectional study included 150 (61 males and 89 females ART-naïve AIDS patients attending the Human Immunodeficiency Virus clinic (HIV at the University of Benin Teaching hospital, Benin City, Nigeria, within the period from February 2011- July 2011. Forty (18 males and 22 females HIV positive outpatients with CD4 counts >200 cells/µl who were ART-naive were recruited and used as controls. The sero-prevalence of crag in the patients and the control group was measured using the cryptococcal antigen latex agglutination system (CALAS (Meridian Bioscience, Europe and CD4 counts were measured using flow cytometry (Partec flow cytometer, Germany.Results: Of the 150 ART-naïve AIDS patients with CD4 counts £200 cells/µL; 19 (12.7% were positive for serum Cryptococcal antigen. ART-naïve AIDS patients with CD4 count ≤50 cells/µl had the highest prevalence of serum crag. Lower CD4 counts were significantly associated with positivity for serum crag (p<0.001. Age and sex had no significant effect on the sero-positivity for serum crag. One (2.5% of the controls was sero-positive for crag. Thus, serum crag was significantly associated with AIDS but not with HIV (p<0.001.Conclusion: This study uncovers a high prevalence of crag in ART- naïve AIDS patients in Benin City. The prevalence of crag was higher in ART-naïve AIDS patients with lower CD4 counts. There is an urgent need to

  11. Human immunodeficiency virus infection and autoimmune hepatitis during highly active anti-retroviral treatment: a case report and review of the literature

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    Higgins Martha

    2011-06-01

    Full Text Available Abstract Introduction The emergence of hepatic injury in patients with human immunodeficiency virus infection during highly active therapy presents a diagnostic dilemma. It may represent treatment side effects or autoimmune disorders, such as autoimmune hepatitis, emerging during immune restoration. Case presentation We present the case of a 42-year-old African-American woman with human immunodeficiency virus infection who presented to our emergency department with severe abdominal pain and was found to have autoimmune hepatitis. A review of the literature revealed 12 reported cases of autoimmune hepatitis in adults with human immunodeficiency virus infection, only three of whom were diagnosed after highly active anti-retroviral treatment was initiated. All four cases (including our patient were women, and one had a history of other autoimmune disorders. In our patient (the one patient case we are reporting, a liver biopsy revealed interface hepatitis, necrosis with lymphocytes and plasma cell infiltrates and variable degrees of fibrosis. All four cases required treatment with corticosteroids and/or other immune modulating agents and responded well. Conclusion Our review suggests that autoimmune hepatitis is a rare disorder which usually develops in women about six to eight months after commencing highly active anti-retroviral treatment during the recovery of CD4 lymphocytes. It represents either re-emergence of a pre-existing condition that was unrecognized or a de novo manifestation during immune reconstitution.

  12. Pessoas vivendo com HIV/AIDS: variáveis associadas à adesão ao tratamento anti-retroviral Persons living with HIV/AIDS: factors associated with adherence to antiretroviral treatment

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    Eliane Maria Fleury Seidl

    2007-10-01

    Full Text Available O estudo objetivou descrever o comportamento de adesão ao tratamento anti-retroviral em pessoas vivendo com HIV/AIDS e investigar preditores da adesão entre as variáveis escolaridade, presença de efeitos colaterais, interrupção anterior da terapia anti-retroviral (TARV por conta própria, auto-estima, expectativa de auto-eficácia, estratégias de enfrentamento, suporte social e satisfação com a relação profissional de saúde-usuário. Adesão foi medida pelo auto-relato da perda do número de comprimidos/cápsulas dos medicamentos anti-retrovirais na última semana e mês, sendo considerada satisfatória na ocorrência de omissão inferior a 5% do total prescrito. Participaram 101 pessoas, 60,4% homens, idades entre 20 a 71 anos (M = 37,9 anos, 73,3% sintomáticos. A coleta de dados incluiu entrevista e instrumentos auto-aplicáveis. A maioria (n = 73; 72,3% relatou adesão igual ou superior a 95%. Nos resultados da regressão logística, interrupção anterior da TARV e expectativa de auto-eficácia foram preditores significativos da adesão. Faz-se necessária a qualificação da assistência pela constituição de equipes interdisciplinares, para o desenvolvimento de abordagens adequadas às dificuldades médicas e psicossociais de adesão das pessoas vivendo com HIV/AIDS.This study aimed to describe the adherence of persons living with HIV/AIDS to antiretroviral therapy (ART and to investigate adherence predictors among the following: level of schooling, presence of side effects, current or previous interruption of ART by the persons themselves, self-esteem, self-efficacy expectation, coping strategies, social support, and satisfaction with the health professional-patient relationship. Adherence was measured by self-reported number of ART pills/capsules missed during the previous week and previous month, evaluated as satisfactory when less than 5%. 101 HIV+ adults took part in this study, 60.4% males, ranging from 20 to 71 years

  13. Adesão à terapêutica anti-retroviral por indivíduos com HIV/AIDS assistidos em uma instituição do interior paulista Adhesión a la terapéutica anti-retroviral por los individuos con VIH/SIDA de uno servicio del interior paulista Adhesion to anti-retroviral therapy by individuals with HIV/AIDS attended at an institution in the interior of São Paulo

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    Elucir Gir

    2005-10-01

    Full Text Available A adesão indevida à terapêutica anti-retroviral acarreta sérios agravos aos indivíduos com aids. Assim, objetivou-se identificar os determinantes (facilitadores/dificultadores da adesão aos anti-retrovirais atribuídos pelos indivíduos com aids, seguidos em um hospital universitário do interior paulista. Constituíram sujeitos 200 usuários de anti-retrovirais há pelo menos 6 meses. Os dados foram coletados mediante entrevista semi-estruturada, individual e analisados quali-quantitativamente. Dos participantes, 59% eram do sexo masculino; idade média 38,2 anos, 51% cursaram ensino fundamental incompleto; 50,5% não exerciam atividade remunerada. Usavam anti-retrovirais em média há 5 anos. A quantidade diária de comprimidos variou de 3 a 24. As principais dificuldades apontadas: sabor, tamanho, quantidade, odor dos comprimidos (40%; efeitos colaterais intensos (14,4%; fatores psicológicos (13,7%; diferentes horários de medicação (10,8%. Quanto às facilidades, destacam-se horários coincidentes dos comprimidos (26,2%; nenhuma facilidade (16,4%, ingestão condicionada a algum hábito (16%. A enfermagem deve incrementar ações de vigilância supervisionada e educacionais interventivas.La terapéutica anti-retroviral requiere perfecta adhesión para evitarse complejos efectos colaterales. En esta investigación, el objetivo fue identificar los determinantes (facilitadores/dificultadores de la adhesión a los anti-retrovirales según individuos con sida, seguidos clínicamente en un hospital universitario del interior de São Paulo. Participaron del estudio 200 pacientes diagnosticados, usuarios de anti-retrovirales desde hace por lo menos 6 meses. Se realizó entrevistas semiestructuradas individuales. Los datos fueron analizados cuali-cuantitativamente. De los participantes, el 59% era del sexo masculino; edad promedia 38,2 años, el 51% no terminó la enseñanza fundamental; el 50,5% no ejercía actividad remunerada. Usaban anti

  14. Estudo da Adesão à Quimioprofilaxia Anti-retroviral para a Infecção por HIV em Mulheres Sexualmente Vitimadas Study of Adherence to Antiretroviral Chemoprophylaxis for HIV Infection in Sexually Abused Women

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    Jefferson Drezett

    1999-10-01

    Full Text Available Objetivos: embora não existam dados apropriados para estabelecer sua eficácia, alguns serviços tem utilizado, profilaticamente, a terapia anti-retroviral para o HIV nos casos de violência sexual. O objetivo deste estudo foi avaliar a aceitabilidade, tolerância e adesão a um esquema quimioprofilático para o HIV. Pacientes e método: foram avaliadas 62 mulheres vítimas de estupro e/ou atentado violento ao pudor com coito ectópico anal. Os agressores foram referidos como desconhecidos. A profilaxia foi iniciada dentro das primeiras 48 h da violência e mantida por 4 semanas, sendo administrados diariamente: zidovudina, 600 mg; indinavir, 2.400 mg e lamivudina, 300 mg. Resultados: a taxa de descontinuidade foi de 24,2%, sendo em 12 casos (80% decorrente de intolerância gástrica. Os efeitos colaterais estiveram presentes em 43 casos (69,4%, sendo as náuseas e vômitos os mais freqüentes. A complexidade posológica e o tempo de uso foram fatores possivelmente associados ao uso inadequado das drogas, ocorrendo em 10,6% dos casos. Conclusão: a taxa de descontinuidade da quimioprofilaxia foi semelhante à observada em outras indicações.Purpose: some medical institutions have been prophylactically ministrating anti-HIV therapy in cases of sexual violence, although there are no appropriate basic facts to establish its efficacy. The aim of the present study was to evaluate the acceptance, tolerance and adhesion of these women under a chemoprophylaxis plan for HIV. Methods: sixty-two women victims of rape and/or anal intercourse with unknown aggressors have been evaluated. Prophylaxis has been started within the first 48 h after violence and maintained for 4 weeks, with daily administration of zidovudine, 600 mg; indinavir, 2,400 mg and lamivudine, 300 mg. Results: the discontinuance rate was 24.2%, withe 12 cases (80% due to gastric intolerance. The side effects were present in 43 cases (69.4%, including nausea and vomitting as the most

  15. Long term reference change value of creatinine in HIV-positive patients with anti-retroviral therapy: A new tool in clinical practice.

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    Badiou, S; Cournil, A; Toubal, S; Bargnoux, A S; Dupuy, A M; Fernandez, C; Peyriere, H; Reynes, J; Cristol, J P

    2015-06-01

    The use of reference change value (RCV) instead of reference interval emerged as an alternative approach for longitudinal interpretation of biological marker. Follow-up of creatinine variation in HIV-positive adults remains a challenge in order to prevent renal complications. To determine the long term RCV of creatinine in HIV-positive adults receiving anti-retroviral therapy (ART) according to the use of tenofovir or ritonavir. Longitudinal study of 24 months that include 124 HIV-positive patients followed in HIV outpatient unit. Plasma creatinine was measured at 0, 6, 12 and 24 months in order to calculate the RCV. In the whole group, a 24-month RCV of creatinine was 22.5%. Whatever the ART, the index of individuality was serial creatinine results in HIV-positive adults. RCV of creatinine under ART was around 20% but reached 28% in case of association of tenofovir and ritonavir. Copyright © 2015. Published by Elsevier Inc.

  16. HIV reverse transcriptase gene mutations in anti-retroviral treatment naïve rural people living with HIV/AIDS

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    K Mohanakrishnan

    2015-01-01

    Full Text Available This study is designed to find out the mutational variations of reverse transcriptase (RT gene of HIV, after the traditional drug usage among anti-retroviral therapy naïve rural people living with HIV/AIDS. HIV Reactive patients, who were exposed for indigenous medicines such as Siddha, Ayurveda etc., for a minimum period of 6 months were taken for this study. Among 40 patients, two samples (5.55% demonstrated high-level mutational resistance variations for nucleoside RT inhibitor (NRTI and non-NRTI. The predominant polymorphisms detected were K122E (91.7%, V60I (91.7%, V35T (89%, Q207E (89%, D177E (89%, T200A (86.1%, S48T (83.33%, K173A (80.6%.

  17. Suplementação de N-acetilcisteína em pacientes infectados pelo HIV submetidos ao primeiro tratamento anti-retroviral: Avaliação do efeito sobre a carga viral, TNF-α, IL-6, IL-8, β2-microglobulina, IgA, IgG e IgM, haptoglobina e α1-glicoproteína ácida N-acetylcysteine supplementation of HIV-infected patients under the first anti-retroviral treatment: Evaluation of the effect on viral load, TNF-α, IL-6, IL-8, β2-microglobulin, IgA, IgG, IgM, haptoglobin and α1-acid glycoprotein

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    Aricio Treitinger

    2002-03-01

    Full Text Available Indivíduos infectados pelo vírus da imunodeficiência humana (HIV- 1 apresentam aumento progressivo da carga viral, da destruição do sistema de defesa imune celular e alterações imunológicas e inflamatórias, incluindo a elevação dos níveis séricos do fator de necrose tumoral alfa (TNF-α, interleucina 8 (IL-8, β2- microglobulina, IgA, IgG e IgM, haptoglobina e α1-glicoproteína ácida.O objetivo deste estudo foi avaliar os níveis séricos destes marcadores em indivíduos submetidos ao primeiro tratamento antiretroviral, suplementados ou não com N-acetilcisteína. Participaram deste estudo, duplo cego controlado por placebo, que teve a duração de 180 dias, 24 indivíduos que iniciaram a terapia antiretroviral O Grupo Estudo foi constituído por 11 indivíduos, que receberam suplementação de 600 mg/dia de Nacetilcisteína enquanto o Grupo Controle foi constituído por 13 indivíduo que receberam placebo. Os níveis dos marcadores avaliados foram determinados no dia anterior ao início do tratamento a que foram submetidos e após 60, 120 e 180 dias. Verificou-se diminuição significativa dos níveis de TNF-α (p=0,0001, IL-6 (p>0,05, IL-8 (p=0,0001, β2-microglobulina (p=0,0005, IgA (p=0,007, IgG (p=0,001, IgM (p=0,0001, haptoglobina (p=0,0001 e α1-glicoproteína ácida (p=0.012 em decorrência do tratamento anti-retroviral. A suplementação com N-acetilcisteína, na dose utilizada neste estudo, não teve efeitos aditivos ou sinérgicos sobre as variáveis analisadas. Em conclusão, a suplementação de pacientes HIV-positivos com 600 mg/dia de N-acetilcisteína não proporcionou benefícios adicionais àqueles decorrentes do tratamento anti-retroviral.Human immunodeficiency virus infection is associated with a progressive elevation of viral load and with a continuous destruction of the immune cellular defense system which is marked by immunological and inflammatory disorders characteristic of HIV-infected individuals. These

  18. Highly active anti-retroviral therapy (HAART) is associated with a lower level of CD4+ T cell apoptosis in HIV-infected patients

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    Roger, P-M; Breittmayer, J-P; Arlotto, C; Pugliese, P; Pradier, C; Bernard-Pomier, G; Dellamonica, P; Bernard, A

    1999-01-01

    HAART may increase CD4+ T cell counts despite a persistently detectable HIV load. The impact of HAART on apoptosis, which may play a role in the disease process in HIV-infected patients, has not been extensively studied. We performed a study to compare the level of spontaneous T cell apoptosis and anti-retroviral treatments in a cohort of HIV-1-infected patients. Data were obtained from a computerized medical record. Quantification of apoptotic cells was by cytofluorometric technique. From November 1995 to December 1997 we studied T cell apoptosis in 112 HIV-infected patients. Forty patients were classified A, 36 B and 36 C. Thirty patients were naive and 82 received an anti-retroviral treatment, 49 including a protease inhibitor (PI). The median plasma viraemia determined in 63 patients was 3.6 (range 1.3–5.6) log10. The median apoptotic cell count was 22% (range 2–73%) and 12% (range 2–60%) for CD4+ and CD8+ T cells, respectively. We did not observe any correlation between the HIV viraemia and the level of apoptosis of T cell subsets. Patients with HAART showed a lower percentage of apoptotic CD4+ T cells only: 16% (range 2–61%) versus 25% (range 5–73%) for patients receiving two nucleoside analogues (P = 0.02). This effect was significant in stage A patients and remained observable during the whole course of HIV disease. In conclusion, HAART, without any relation to plasma viraemia, is able to reduce apoptosis of CD4+ T cells. PMID:10594560

  19. Effects of PPARγ and RBP4 gene variants on metabolic syndrome in HIV-infected patients with anti-retroviral therapy.

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    Yuan-Pin Hung

    Full Text Available BACKGROUND: PPARγ and RBP4 are known to regulate lipid and glucose metabolism and insulin resistance. The influences of PPARγ (C1431T and Pro12Ala and RBP4 (-803GA polymorphisms on metabolic syndrome in HIV-infected patients receiving anti-retroviral therapy were examined in this study. MATERIALS AND METHODS: A cross-sectional study of HIV-1 infected adults with antiretroviral therapy for more than one year in the National Cheng Kung University Hospital was conducted. The gene polymorphisms were determined by quantitative PCR. RESULTS: Ninety-one patients were included in the study. Eighty-two (90.1% patients were males with a mean age of 44.4 years. For the C1431T polymorphism in PPARγ, while patients with the T allele (48.4% had trends toward lower rate of hypertriglyceridemia, the borderline significance together with insignificant power did not support the protective effect of the T allele against development of hypertriglyceridemia. For the Pro12Ala polymorphism in PPARγ, although patients with the Pro/Ala genotype (8.8% had a higher level of serum LDL (138.0 vs. 111.5 mg/dl, P = 0.04 and trends toward higher rates of hypercholesterolemia and serum LDL>110 mg/dl, these variables were found to be independent of the Pro/Ala genotype in the multivariate analysis. For the -803GA polymorphism in RBP4, patients with the A allele (23.1% more often had insulin resistance (HOMA>3.8; 33.3 vs. 8.7%, P = 0.01 and more often received anti-hypoglycemic drugs (14.3 vs. 1.4%, P = 0.04. The detrimental effect of the A allele in RBP4 -803GA polymorphism on development of insulin resistance was supported by the multivariate analysis adjusting for covariates. CONCLUSION: The impacts of PPARγ C1431T and Pro12Ala polymorphisms on metabolism in HIV-infected patients are not significant. RBP4 -803GA polymorphism has increased risk of insulin resistance in HIV-infected patients with anti-retroviral therapy.

  20. Evaluation of the association between Addiction Severity Index and depression with adherence to anti-retroviral therapy among HIV infected patients.

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    Paydary, Koosha; Ekhtiari, Hamed; Noori, Mehri; Rad, Mona V; Hajiabdolbaghi, Mahboubeh; SeyedAlinaghi, SeyedAhmad

    2015-01-01

    Adequate adherence to anti-retroviral therapy is required to achieve viral suppression and desirable treatment outcomes among HIV patients. The aim of this study was to examine the associations between adherence and severity of substance use as well as adherence and severity of depressive symptoms among Iranian HIV patients. In a prospective study, HIV patients with current substance use were assessed for adherence level via self report and pill count methods, severity of depressive symptoms (Beck Depression Inventory- II) and substance use (Addiction Severity Index) during a three months follow up after initiating antiretroviral therapy. The adherence level, severity of depressive symptoms and substance use were assessed one month, two months and three months after initiation of anti-retroviral therapy. Addiction Severity Index (ASI) composite scores were calculated for each domain and the associations between ASI domains and adherence as well as severity of depressive symptoms and adherence were assessed. Twenty six HIV patients with current substance use disorder completed the study. At the end of the first month, adherence to therapy via pill count and self-report were 80%±31.9% and 85.12%±32%, respectively. At the end of the second month, adherence to therapy via pill count and self report were 87%±32% and 93.94%±23% respectively. At the end of the third month, the measured adherence via pill count and self report were 85%±33.7% and 90.1%±25.7% respectively. Adherence was higher among married patients and those who used reminder systems. Composite scores of the medical status and psychiatric status were related to higher adherence after first month. Substance use was inversely associated with adherence at the second follow up (r=-0.4, p=0.04). Also, severity of depressive symptoms was not related to adherence level. The repeated measurement analysis showed a significant decrease in psychiatric status domain of the ASI composite score after three months

  1. Who is accessing public-sector anti-retroviral treatment in the Free State, South Africa? An exploratory study of the first three years of programme implementation.

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    Wouters, Edwin; Heunis, Christo; Ponnet, Koen; Van Loon, Francis; Booysen, Frederik le Roux; van Rensburg, Dingie; Meulemans, Herman

    2010-07-01

    Although South Africa has the largest public-sector anti-retroviral treatment (ART) programme in the world, anti-retroviral coverage in adults was only 40.2% in 2008. However, longitudinal studies of who is accessing the South African public-sector ART programme are scarce. This study therefore had one main research question: who is accessing public-sector ART in the Free State Province, South Africa? The study aimed to extend the current literature by investigating, in a quantitative manner and using a longitudinal study design, the participants enrolled in the public-sector ART programme in the period 2004-2006 in the Free State Province of South Africa. Differences in the demographic (age, sex, population group and marital status) socio-economic (education, income, neo-material indicators), geographic (travel costs, relocation for ART), and medical characteristics (CD4, viral load, time since first diagnosis, treatment status) among 912 patients enrolled in the Free State public-sector ART programme between 2004 and 2006 were assessed with one-way analysis of variance, Bonferroni post-hoc analysis, and cross tabulations with the chi square test. The patients accessing treatment tended to be female (71.1%) and unemployed (83.4%). However, although relatively poor, those most likely to access ART services were not the most impoverished patients. The proportion of female patients increased (P < 0.05) and their socio-economic situation improved between 2004 and 2006 (P < 0.05). The increasing mean transport cost (P < 0.05) to visit the facility is worrying, because this cost is an important barrier to ART uptake and adherence. Encouragingly, the study results revealed that the interval between the first HIV-positive diagnosis and ART initiation decreased steadily over time (P < 0.05). This was also reflected in the increasing baseline CD4 cell count at ART initiation (P < 0.05). Our analysis showed significant changes in the demographic, socio-economic, geographic

  2. Adesão à terapêutica anti-retroviral por indivíduos com HIV/AIDS assistidos em uma instituição do interior paulista

    OpenAIRE

    Elucir Gir; Carla Gisele Vaichulonis; Marcela Dias de Oliveira

    2005-01-01

    A adesão indevida à terapêutica anti-retroviral acarreta sérios agravos aos indivíduos com aids. Assim, objetivou-se identificar os determinantes (facilitadores/dificultadores) da adesão aos anti-retrovirais atribuídos pelos indivíduos com aids, seguidos em um hospital universitário do interior paulista. Constituíram sujeitos 200 usuários de anti-retrovirais há pelo menos 6 meses. Os dados foram coletados mediante entrevista semi-estruturada, individual e analisados quali-quantitativamente. D...

  3. Construção e caracterização in vitro  de um vetor retroviral bicistrônico codificando endostatina e interleucina-2 para utilização em terapia gênica

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    Fernanda Bernardes Calvo

    2009-01-01

    A terapia gênica tem sido empregada em estudos pré-clínicos e clínicos, com o intuito de amenizar ou curar uma doença. Vetores retrovirais são uma ferramenta de transferência gênica largamente utilizada. Vetores bicistrônicos são uma alternativa interessante para o tratamento de doenças complexas. Na construção de um vetor bicistrônico pode-se empregar várias estratégias dentre elas a utilização da sequência IRES. A endostatina, fragmento do colágeno XVIII, tem sido muito utilizada na terapia...

  4. Health related quality of life of HIV/AIDS patients on highly active anti-retroviral therapy at a university referral hospital in Ethiopia

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    Abdrrahman Shemsu Surur

    2017-11-01

    Full Text Available Abstract Background Highly active antiretroviral therapy improves the longevity of patients living with HIV/AIDS. We conducted the study in order to assess health related quality of life of HIV/AIDS patients and the association of socio-demographic and disease related variables with health related quality of life. Methods Health facility based cross-sectional study among 400 HIV/AIDS patients taking highly active anti-retroviral therapy from Gondar University referral hospital was conducted. A pre-tested semi-structured questionnaire, which was adopted from World Health Organization Quality of life brief instrument, was used. The data were then analyzed using SPSS version 20 software for Windows. Results The majority of the respondents reported to to have a good physical health (15.55. The World Health Organization clinical stage was found to be significantly associated with all the domains of health related quality of life. The current acute illness condition of the respondents, however, did not show significant association with any of the domains of health related quality of life. Conclusions The six domains of health related quality of life were found to be moderate. The physical health and spirituality of the patients were relatively higher than their social relationship. Sex, age, educational status, residence and marital status showed significant association with at least one domain of health related quality of life.

  5. Health related quality of life of HIV/AIDS patients on highly active anti-retroviral therapy at a university referral hospital in Ethiopia.

    Science.gov (United States)

    Surur, Abdrrahman Shemsu; Teni, Fitsum Sebsibe; Wale, Wondwessen; Ayalew, Yihenew; Tesfaye, Betel

    2017-11-15

    Highly active antiretroviral therapy improves the longevity of patients living with HIV/AIDS. We conducted the study in order to assess health related quality of life of HIV/AIDS patients and the association of socio-demographic and disease related variables with health related quality of life. Health facility based cross-sectional study among 400 HIV/AIDS patients taking highly active anti-retroviral therapy from Gondar University referral hospital was conducted. A pre-tested semi-structured questionnaire, which was adopted from World Health Organization Quality of life brief instrument, was used. The data were then analyzed using SPSS version 20 software for Windows. The majority of the respondents reported to to have a good physical health (15.55). The World Health Organization clinical stage was found to be significantly associated with all the domains of health related quality of life. The current acute illness condition of the respondents, however, did not show significant association with any of the domains of health related quality of life. The six domains of health related quality of life were found to be moderate. The physical health and spirituality of the patients were relatively higher than their social relationship. Sex, age, educational status, residence and marital status showed significant association with at least one domain of health related quality of life.

  6. Cost estimates of HIV care and treatment with and without anti-retroviral therapy at Arba Minch Hospital in southern Ethiopia

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    Robberstad Bjarne

    2009-04-01

    Full Text Available Abstract Background Little is known about the costs of HIV care in Ethiopia. Objective To estimate the average per person year (PPY cost of care for HIV patients with and without anti-retroviral therapy (ART in a district hospital. Methods Data on costs and utilization of HIV-related services were taken from Arba Minch Hospital (AMH in southern Ethiopia. Mean annual outpatient and inpatient costs and corresponding 95% confidence intervals (CI were calculated. We adopted a district hospital perspective and focused on hospital costs. Findings PPY average (95% CI costs under ART were US$235.44 (US$218.11–252.78 and US$29.44 (US$24.30–34.58 for outpatient and inpatient care, respectively. Estimates for the non-ART condition were US$38.12 (US$34.36–41.88 and US$80.88 (US$63.66–98.11 for outpatient and inpatient care, respectively. The major cost driver under the ART scheme was cost of ART drugs, whereas it was inpatient care and treatment in the non-ART scheme. Conclusion The cost profile of ART at a district hospital level may be useful in the planning and budgeting of implementing ART programs in Ethiopia. Further studies that focus on patient costs are warranted to capture all patterns of service use and relevant costs. Economic evaluations combining cost estimates with clinical outcomes would be useful for ranking of ART services.

  7. Evaluation of the Impact of Anti-Retroviral Therapy on the Prevalence of Oral Lesions in Human Immunodeficiency Virus Infected Patients

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    P. Davoodi

    2013-10-01

    Full Text Available Introduction & Objective: Oral lesions have important diagnostic and prognostic roles in HIV infected patients. It seems that HAART reduces the prevalence of oral lesions. The aim of the present study was to evaluate the prevalence of oral lesions in HIV infected patients on/not on HAART. Materials & Methods: In this retrospective study, 40 HIV infected patients receiving HAART and 40 who were not on HAART were evaluated in Behavioral Consultation Center in Kermanshah. The diagnosis of the oral lesions was recorded by using established presump-tive clinical criteria. Data were gathered and analyzed using SPSS version 16 by chi-square test. Results: In the current study 80 HIV infected patients with mean age of 38.86 were chosen. 72.5% and 27.5% of participants were male and female respectively. The most common le-sions in those receiving HAART were hairy leukoplakia, hairy tongue and oral pigmentation. However the prevalence of these lesions had declined in comparison to those who were not on HAART but the difference was not significant (P>0.05. Although comparing lesions in the two groups showed no significant difference, the total number of lesions significantly reduced in patients receiving HAART (P=0.046 Conclusion: According to the results of the present study using anti retroviral therapy leaded to reduction in the oral lesions in HIV infected patients. However, more research in this field seems necessary. (Sci J Hamadan Univ Med Sci 2013; 20 (3:215-222

  8. Associations between HIV, highly active anti-retroviral therapy, and hypertensive disorders of pregnancy among maternal deaths in South Africa 2011-2013.

    Science.gov (United States)

    Sebitloane, Hannah M; Moodley, Jagidesa; Sartorius, Benn

    2017-02-01

    To explore potential relationships between HIV and highly active anti-retroviral therapy (HAART), and hypertensive disorders of pregnancy (HDP). A retrospective secondary analysis of maternal-deaths data from the 2011-2013 Saving Mothers Report from South Africa. The incidence of HIV infection amongst individuals who died owing to HDP was determined and comparisons were made based on HIV status and the use of HAART. Among 4452 maternal deaths recorded in the Saving Mothers report, a lower risk of a maternal deaths being due to HDP was observed among women who had HIV infections compared with women who did not have HIV (relative risk [RR] 0.57, 95% confidence interval [CI] 0.51-0.64). Further, reduced odds of death being due to HDP were recorded among women with AIDS not undergoing HAART compared with women with HIV who did not require treatment (RR 0.42, 95% CI 0.3-0.58). Notably, among all women with AIDS, a greater risk of death due to HDP was demonstrated among those who received HAART compared with those who did not (RR 1.15, 95% CI 1.02-1.29). HIV and AIDS were associated with a decreased risk of HDP being the primary cause of death; the use of HAART increased this risk. © 2016 International Federation of Gynecology and Obstetrics.

  9. Assessment of arterial elasticity among HIV-positive participants with high CD4 cell counts: a substudy of the INSIGHT Strategic Timing of Anti Retroviral Treatment trial

    Science.gov (United States)

    Baker, Jason V.; Engen, Nicole Wyman; Huppler Hullsiek, Katherine; Stephan, Christoph; Jain, Mamta K.; Munderi, Paula; Pett, Sarah; Duprez, Daniel

    2014-01-01

    Introduction Both HIV infection and antiretroviral therapy (ART) may increase cardiovascular disease (CVD) risk. Assessments of vascular function and structure can be used to study the pathogenesis and progression of CVD, including the effects of ART and other interventions. Methods We review available methods to assess vascular (dys)function and report our experience using analysis of the diastolic blood pressure (BP) waveform to estimate arterial elasticity among a subset of participants in the Strategic Timing of AntiRetroviral Treatment (START) trial. Linear regression was used to study cross-sectional associations between baseline clinical factors and small or large arterial elasticity. Results Arterial elasticity measurement was chosen for its improved measurement reproducibility over other methodologies and the potential of small arterial elasticity to predict clinical risk. Analysis of baseline data demonstrates that small artery elasticity is impaired (lower) with older age and differs by race and between geographic region. No HIV-specific factors studied remained significantly associated with arterial elasticity in multivariate models. Conclusion Longitudinal analyses in this substudy will provide essential randomised data to study the effects of early ART initiation on the progression of vascular disease among a diverse global population. When combined with future biomarker analyses and clinical outcomes in START, these findings will expand our understanding of the pathogenesis of HIV-related CVD. PMID:25711329

  10. Microfinance and HIV mitigation among people living with HIV in the era of anti-retroviral therapy: emerging lessons from Cote d'Ivoire.

    Science.gov (United States)

    Holmes, Kathleen; Winskell, Kate; Hennink, Monique; Chidiac, Sybil

    2011-01-01

    The effects of HIV/AIDS have been far-reaching in Africa. Beyond adverse health outcomes and the tremendous toll on life, AIDS has serious economic impacts on households, increasing livelihood insecurity while simultaneously depleting socio-economic resources. Although microfinance is believed to have the potential to mitigate the economic impacts of HIV by helping affected households and communities better prepare for and cope with HIV-related economic shocks, little empirical research exists on this subject. This qualitative study examines the socio-economic impacts of economic strengthening activities on people living with HIV (PLHIV) in the era of increased access to anti-retroviral therapy to determine if savings-led, community-managed microfinance is a justified activity for HIV programmes. Findings from a village savings and loan programme, implemented by CARE International in Cote d'Ivoire, revealed that when appropriate medical treatment is available PLHIV are capable of participating in and benefit from microfinance activities, which increased HIV-positive clients' access to money and economic self-sufficiency. By bringing individuals with similar experiences together, savings and loan groups also acted as self-support groups providing psychosocial support while reducing stigmatisation and increasing members' sense of dignity and self-worth.

  11. Factors associated with neurocognitive test performance at baseline: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.

    Science.gov (United States)

    Wright, E J; Grund, B; Cysique, L A; Robertson, K R; Brew, B J; Collins, G; Shlay, J C; Winston, A; Read, T R H; Price, R W

    2015-04-01

    We describe neuropsychological test performance (NP) in antiretroviral treatment (ART)-naïve HIV-positive individuals with CD4 cell counts above 500 cells/μL. In a neurology substudy of the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) Strategic Timing of AntiRetroviral Treatment (START) study, eight neurocognitive tests were administered. The primary measure of NP was the quantitative NP z-score (QNPZ-8), the average of the z-scores for the eight tests. Associations of baseline factors with QNPZ-8 scores were assessed by multiple regression. Mild neurocognitive impairment (NCI) was defined as z-scores Argentina/Chile. This is the largest study of NP in ART-naïve HIV-positive adults with CD4 counts > 500 cells/μL. Demographic factors and diabetes were most strongly associated with NP. Unmeasured educational/sociocultural factors may explain geographical differences. Poorer NP was independently associated with longer time since HIV diagnosis, suggesting that untreated HIV infection might deleteriously affect NP, but the effect was small. © 2015 British HIV Association.

  12. A predominance of R5-like HIV genotypes in vaginal secretions is associated with elevated plasma HIV-1 RNA levels and the absence of anti-retroviral therapy

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    Lacour Nedra

    2008-07-01

    Full Text Available Abstract HIV expressed in genital secretions provides the inoculum from which transmitting variants are selected, both in sexual transmission and mother-to-infant transmission during partuition. Characterization of HIV levels and genotypes found in vaginal secretions and the impact of anti-retroviral therapy (ART on this virus can provide valuable insight for the prevention of HIV transmission. Vaginal HIV was evaluated in a cohort of 43 women attending a New Orleans HIV outpatient clinic. Predominant vaginal genotypes were characterized as R5- or X4-like by heteroduplex tracking analyses of the envelope V3 region. Most women (67.4% shed R5-like genotypes in vaginal secretions which was associated with elevated plasma HIV levels (≥ 10,000 copies HIV-RNA/mL and absence of ART. Because R5-like genotypes are more frequently associated with transmission, these observations suggest that the majority of women shedding HIV in genital secretions present a transmission risk. The levels of vaginal virus were similar between both groups, but shedding of X4-like genotypes was associated with lower plasma viral loads and the use of ART, suggesting that ART use may impact the genotypes of virus found in the female genital compartment.

  13. Tecnologia de obtenção de anti-retroviral à base de Mesilato de Nelfinavir

    OpenAIRE

    Cristina da Silva Monteiro, Vandessa

    2005-01-01

    Os Inibidores de protease (PI) constituem uma potente classe de drogas anti-retrovirais que mudou o tratamento e a evolução da infecção pelo HIV. Em março de 1997, um novo medicamento desta classe, o mesilato de nelfinavir foi aprovado pela Food and Drug Administration (FDA), sendo desde então, extensamente utilizado isoladamente ou em associação a Inibidores da Transcriptase Reversa (RTIs), obtendo-se considerável eficácia clínica no tratamento da AIDS. O mesilato de nelfinavir tem como prod...

  14. Predictors of fertility desire among people living with HIV attending anti-retroviral clinic in a tertiary health facility in Sokoto, Northern Nigeria

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    A U Kaoje

    2015-01-01

    Full Text Available Introduction: The pressure on couples and particularly women to have children is strong in developing countries where a childless woman is considered a social pariah. This study aimed to determine the predictors of fertility desire among people living with HIV. Materials and Methods : This is a descriptive cross-sectional study conducted among 400 HIV-positive clients receiving follow-up care at anti-retroviral (ART clinic in a tertiary health facility in Sokoto. A list of clients that came to the clinic was compiled and served as sampling frame. A two stage sampling method was used to select study respondents from the sampling frame. Interviewer- administered closed-ended questionnaire was used to collect the required data from the respondents. Ethical approval was granted for the conduct of the study and informed consent was obtained from the respondents. Descriptive, bivariate and multivariate analyses were carried out. Results : Majority (56.2% of the respondents were females. The overall mean age was 34.5 ± 0.4 years (male 38.4 ± 0.5 years, and (females, 31.4 ± 0.4 years. A large proportion of the respondents (67.7% reported desire to have children in future. Using logistic regression analysis, younger age (adjusted odd ratio [aOR] = 2.0, P = 0.023, marital status (aOR = 1.9, P < 0.001 and number of living children (aOR = 0.7, P < 0.001 were the key factors influencing respondents desire for children. Conclusion : Many HIV-positive clients in the clinic reported desire to have children. It is recommended that full reproductive health services be provided in the clinic to help them achieve their reproductive goal without risk to their partners and new born.

  15. Adherence to anti-retroviral therapy & factors associated with it: A community based cross-sectional study from West Bengal, India

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    Sobha Pahari

    2015-01-01

    Full Text Available Background & objectives: Failure to adhere to anti-retroviral therapy (ART can lead to a range of unfavourable consequences impacting upon people living with HIV (PLH and society. It is, therefore, paramount that ART adherence is measured in a reliable manner and factors associated with adherence are identified. Lack of such data from West Bengal necessitated undertaking the current study. Methods: Participants were included during August-October, 2011 from three Drop-In-Centres (DICs from the three districts of West Bengal, India. ART-adherence was calculated by using formula based on pill-count and records collected from ART-card in possession of each of the 128 consenting adult PLH. Information on self-reported adherence, socio-demography, and adherence influencing issues was also collected through interviewer-administered questionnaire. Results: Of the 128 PLH, 99 (77% and 93 (73% PLH had ≥90 per cent and ≥95 per cent adherence, respectively to ART. Conversely, subjective reporting captured much higher proportion of PLH as ′well adherent′; a finding having implications for ongoing ART programme. Factors, independently associated with poor adherence (<90%, were ′7 th to 12 th month period of ART intake′ (adjusted OR=9.5; 90% CI 1.9 - 47.3; p0 =0.02 and ′non-disclosure of HIV status to family members′ (adjusted OR=4; 90% CI 1.3 - 13; P=0.05. Results at 95 per cent adherence cut-off were similar. Interpretation & conclusions: Enabling environment, which would encourage people to disclose their HIV status and in turn seek adherence partners from families and beyond and ongoing adherence-counselling appear to be important issues in the programme. Relevance of these study findings in wider context is conceivable.

  16. Effect of concurrent use of anti-retroviral therapy and levonorgestrel sub-dermal implant for contraception on CD4 counts: a prospective cohort study in Kenya.

    Science.gov (United States)

    Hubacher, David; Liku, Jennifer; Kiarie, James; Rakwar, Joel; Muiruri, Peter; Omwenga, Jackline; Chen, Pai-Lien

    2013-03-01

    Simultaneous use of contraceptive hormones and anti-retroviral therapy (ART) may theoretically lessen the effectiveness of both. Women on ART need assurance that hormonal contraception is safe and effective. The sub-dermal implant is an ideal product to study: low and steady progestin release and no adherence uncertainties. We sought to determine if the medications' effectiveness is compromised. We conducted a prospective cohort study among women on first line ART (stavudine or zidovudine and lamivudine+nevirapine). We recruited new implant users and matched them to women not using hormonal contraception, based on age and baseline CD4. Participants were followed prospectively for up to two years, recording serial CD4 measures and medical histories. We used generalized growth curve models and Wald chi-square tests to compare changes in CD4 counts across study groups. Prospective CD4 measures were censored (excluded) if any of the following events occurred: change in ART, implant removal or use of any hormonal contraception among controls. We examined incidence of opportunistic infection and pregnancy. We matched 48 implant users to 33 non-hormonal controls. Over time, CD4 counts for both groups rose slightly but did not deviate significantly from each other (p=0.44). Opportunistic infection rates did not differ between the groups. None of the implant users and one of the non-hormonal controls became pregnant during follow-up. This small study found concurrent use of contraceptive implants and ART to be safe and effective. Although other hormonal contraceptive products and ART regimens may interact in unknown ways, the results of this study are reassuring.

  17. Partial recovery of senescence and differentiation disturbances in CD8(+) T cell effector-memory cells in HIV-1 infection after initiation of anti-retroviral treatment.

    Science.gov (United States)

    Eberhard, J M; Ahmad, F; Hong, H S; Bhatnagar, N; Keudel, P; Schulze Zur Wiesch, J; Schmidt, R E; Meyer-Olson, D

    2016-11-01

    Immune senescence as well as disturbed CD8(+) T cell differentiation are a hallmark of chronic HIV infection. Here, we investigated to what extent immune senescence is reversible after initiation of anti-retroviral treatment (ART). Peripheral blood mononuclear cells (PBMCs) from a cohort of HIV patients with different disease courses, including untreated viral controllers (n = 10), viral non-controllers (n = 16) and patients on ART (n = 20), were analysed and compared to uninfected controls (n = 25) by flow cytometry on bulk and HIV-specific major histocompatibility complex (MHC) class I tetramer(+) CD8(+) T cells for expression of the memory markers CCR7 and CD45RO, as well as the senescence marker CD57 and the differentiation and survival marker CD127. Furthermore, a subset of patients was analysed longitudinally before and after initiation of ART. Frequencies of CD57(+) CD8(+) T cells decreased after initiation of ART in central memory (Tcm) but not in effector memory T cell populations (TemRO and TemRA). The frequency of CD127(+) CD8(+) cells increased in Tcm and TemRO. We observed a reduction of CD127(-) T cells in Tcm, TemRO and partially in TemRA subsets after initiation of ART. Importantly, HIV-specific CD8(+) TemRO cells predominantly displayed a CD127(-) CD57(+) phenotype in untreated HIV-patients, whereas the CD127(+) CD57(-) phenotype was under-represented in these patients. The frequency of the CD127(+) CD57(-) CD8(+) T cell subpopulation correlated strongly with absolute CD4(+) counts in HIV-infected patients before and after initiation of ART. These findings can be interpreted as a phenotypical correlate of CD8(+) memory T cell differentiation and the premature 'ageing' of the immune system, which was even observed in successfully virally suppressed HIV patients. © 2016 British Society for Immunology.

  18. Evaluation of oral manifestations and oral health status among pediatric human immunodeficiency virus patients-under anti-retroviral therapy: A cross-sectional study

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    Monika Aroquiadasse

    2016-01-01

    Full Text Available Introduction: The human immunodeficiency virus (HIV acquired immunodeficiency syndrome disease has evolved to become a social and economic catastrophe, with far-reaching implications affecting every phase of life of the diseased individual. Data on adults and children diagnosed with HIV infection are useful for determining populations needing prevention and treatment services. Oral lesions may be the presenting symptoms of HIV infection and may differ entirely from those manifested in the adult population. Aim and Objective: We aimed to evaluate the prevalence of HIV related oral lesions among pediatric HIV patients and to assess the oral health status of HIV infected children residing in a selected childcare facility in Puducherry. Materials and Methods: A cross-sectional study was conducted during September 2015 in child care facility for HIV infected children located in Puducherry U.T, India. All children <18 years, who are diagnosed with HIV infection and are put on anti-retroviral therapy (ART or pre-ART care, were included in the study. After obtaining informed consent from the care-givers and assent of the children, they were interviewed and examined by a team comprising a qualified dental surgeon and a trained physician. Results: Majority of the children were under first-line ART (73% and were on ART for more than 4 years. The CD4 count of 23 (52.3 was between 500–1000 cells/μL. The recent viral load assay in 32 (72.7 patients was <150/not detected. Tooth decay was the most common oral manifestation with 28 (63.6 being affected. Nonspecific lymphadenopathy 26 (59.1 was the most common coexisting systemic illness. Conclusion: This study proves that constant surveillance by monitoring the general health status, CD4 counts, viral load coupled with stringent ART care has improved the overall quality of life of these children and consequently resulted in lesser oral manifestations.

  19. The Anti-TNF-α Therapy in the Rheumatoid Arthritis A Terapia Anti-TNF-α na Artrite Reumatóide

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    Lilian Resende Faleiro

    2011-06-01

    , estão disponíveis no mercado brasileiro, três agentes anti-TNF-α: infliximabe, etanercepte e adalimumabe. Estes agentes são relativamente seguros para Artrite Reumatóide, mas podem, no entanto, apresentar complicações infecciosas graves, como a reativação da tuberculose latente. O alto custo dessas drogas, seu uso em nível hospitalar e o risco a infecções oportunistas permanecem como fatores limitantes para sua ampla utilização no tratamento da Artrite Reumatóide em nosso meio. Este estudo tem como objetivo destacar a importância do surgimento de novas terapias com intuito de atenuar a progressão da Artrite Reumatóide, bem como analisar risco-benefício oferecidos pelo respectivo tratamento e ainda avaliar viabilidade e custo do mesmo.

  20. "Every drug goes to treat its own disease…" - a qualitative study of perceptions and experiences of taking anti-retrovirals concomitantly with anti-malarials among those affected by HIV and malaria in Tanzania.

    Science.gov (United States)

    Mangesho, Peter E; Reynolds, Joanna; Lemnge, Martha; Vestergaard, Lasse S; Chandler, Clare I R

    2014-12-13

    Little is known about how people living with human immunodeficiency virus (HIV) experience malaria and the concomitant use of anti-malarial treatments with anti-retrovirals (ARVs). An understanding of how patients make sense of these experiences is important to consider in planning and supporting the clinical management and treatment for co-infected individuals. A qualitative study was conducted in Tanzania alongside a clinical trial of concomitant treatment for HIV and malaria co-infection. Focus group discussions were held with people receiving treatment for HIV and/or malaria, and in-depth interviews with health workers responsible for HIV care and members of the clinical trial team. Data were analysed inductively to identify themes and develop theoretical narratives. Results suggest that people living with HIV perceived malaria to be more harmful to them due to their compromised immune status but saw the disease as unavoidable. For those enrolled in the clinical controlled study, taking anti-malarials together with ARVs was largely seen as unproblematic, with health workers' advice and endorsement of concomitant drug taking influential in reported adherence. However, perceptions of drug strength appeared to compel some people not enrolled in the clinical study to take the drugs at separate times to avoid anticipated harm to the body. Management of HIV and malaria concurrently often requires individuals to cross the domains of different disease programmes. In the context of a trial concerned with both diseases, patients experienced the support of clinicians in guiding and reassuring them about when and how to take drugs concomitantly. This points towards the need to continue to strive for integrated care for patients with HIV.

  1. Retroviral superinfection resistance

    NARCIS (Netherlands)

    Nethe, Micha; Berkhout, Ben; van der Kuyl, Antoinette C.

    2005-01-01

    The retroviral phenomenon of superinfection resistance (SIR) defines an interference mechanism that is established after primary infection, preventing the infected cell from being superinfected by a similar type of virus. This review describes our present understanding of the underlying mechanisms

  2. [Effect of highly active anti-retroviral therapy on prevention of mother to child transmission of HIV and on infant growth and development].

    Science.gov (United States)

    He, Yan; Luo, Yan; Ding, Yi-ling; Zheng, Yu-huang; Li, Jing; Huang, Jian; Li, Jie-min

    2011-10-01

    To identify the effect of highly active anti-retroviral therapy (HAART) on prevention of mother to child transmission (PMTCT) of HIV and on infant growth and development. A total of 16 HIV-infected women or pregnant women selected in this study received HAART before or 18 - 24 weeks after pregnancy. The treatment included taking Zidovudine (AZT) 0.3 g each time, twice a day, Lamivudine (3TC) 0.3 g each time, once a day and Nevirapine (NVP) 0.2 g each time, twice a day or Efavirenz (EFV) 0.6 g each time, once a day, as well as labor intervention and artificial feeding. The growth index for 17 infants from HIV-infected mothers (experimental group) and 16 normal infants (control group) were observed for 18 months. Neonatal hemoglobin (Hb), liver and kidney function, serum iron and calcium were detected at neonatal period and at 12(th) month, respectively. All the pregnant women were in good conditions and had tolerance with HAART. The birth weight, length and Apgar score of the newborns in the experimental group were (3.5 ± 0.9) kg, (54.2 ± 3.8) cm and 7 - 10 scores respectively, however those in the control group were (3.6 ± 0.8) kg, (55.6 ± 3.6) cm and 8 - 10 scores (t(weight) = 1.01, t(length) = 6.98, P > 0.05). Weight and length of infants in experimental group were (9.36 ± 1.8) kg and (76.3 ± 2.7) cm at 12(th) month, while those in control group were (9.86 ± 2.5) kg and (76.8 ± 2.9) cm (t(weight) = 0.83, t(length) = 1.00, P > 0.05). The level of Hb in experimental group was (126.2 ± 16.7) g/L, and was (148.6 ± 20.5) g/L in control group (t = -5.89, P = 0.11). At 12(th) month, the levels of Hb and the total bilirubin (TB) were (125.9 ± 19.8) g/L and (11.7 ± 3.5) µmol/L in experimental group; and those in the control group were (130.1 ± 18.7) g/L and (13.2 ± 3.7) µmol/L (t(Hb) = -3.82, t(TB) = -2.14, P > 0.05). Serum iron and calcium were (25.4 ± 5.7) µmol/L and (26.4 ± 7.2) µmol/L at neonatal period and were (2.3 ± 0.6) mol/L and (2.8 ± 0

  3. Predictors of treatment failure and time to detection and switching in HIV-infected Ethiopian children receiving first line anti-retroviral therapy

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    Bacha Tigist

    2012-08-01

    to have treatment failure retrospectively by the authors based on their records. Hence, they were not detected and these patients were not offered second line ARTs. Conclusions Having chronic malnutrition, low CD4 at base line, chronic diarrhea after initiation of first line ART, substitution of ART drugs and age less than 3 years old were found to be independent predictors of first line ART failure in children. Most of the first line ART failure cases were not detected early and those that were detected were not switched to second line drugs in a timely fashion. Children with the above risk factors should be closely monitored for a timely switch to second line highly active anti-retroviral therapy.

  4. Comparison of anti-retroviral therapy treatment strategies in prevention of mother-to-child transmission in a teaching hospital in Ethiopia.

    Science.gov (United States)

    Kumela, Kabaye; Amenu, Demisew; Chelkeba, Legese

    2015-01-01

    More than 90% of Human immunodeficiency virus (HIV) infection in children is acquired due to mother-to-child transmission, which is spreading during pregnancy, delivery or breastfeeding. To determine the effectiveness of highly active antiretroviral and short course antiretroviral regimens in prevention of mother-to-child transmission of HIV and associated factors Jimma University Specialized Hospital (JUSH). A hospital based retrospective cohort study was conducted on HIV infected pregnant mothers who gave birth and had follow up at anti-retroviral therapy (ART) clinic for at least 6 months during a time period paired with their infants. The primary and secondary outcomes were rate of infant infection by HIV at 6 weeks and 6 months respectively. The Chi-square was used for the comparison of categorical data multivariate logistic regression model was used to identify the determinants of early mother-to-child transmission of HIV at 6 weeks. Cox proportional hazard model was used to analyze factors that affect the 6 month HIV free survival of infants born to HIV infected mothers. A total of 180 mother infant pairs were considered for the final analysis, 90(50%) mothers received single dose nevirapine (sdNVP) designated as regimen-3, 67 (37.2%) mothers were on different types of ARV regimens commonly AZT + 3TC + NVP (regimen-1), while the rest 23 (12.8%) mothers were on short course dual regimen AZT + 3TC + sdNVP (regimen-2). Early mother-to-child transmission rate at 6 weeks for regimens 1, 2 and 3 were 5.9% (4/67), 8.6% (2/23), and 15.5% (14/90) respectively. The late cumulative mother-to-child transmission rate of HIV at 6 months regardless of regimen type was 15.5% (28/180). Postnatal transmission at 6 months was 28.5% (8/28) of infected children. Factors that were found to be associated with high risk of early mother-to-child transmission of HIV include duration of ARV regimen shorter than 2 months during pregnancy (OR=4.3, 95%CI =1.38-13.46), base line CD4 less

  5. Special Issue: Retroviral Enzymes

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    Luis Menéndez-Arias

    2010-05-01

    Full Text Available The retroviral RNA genome encodes for three enzymes essential for virus replication: (i the viral protease (PR, that converts the immature virion into a mature virus through the cleavage of precursor polypeptides; (ii the reverse transcriptase (RT, responsible for the conversion of the single-stranded genomic RNA into double-stranded proviral DNA; and (iii the integrase (IN that inserts the proviral DNA into the host cell genome. All of them are important targets for therapeutic intervention. This Special Issue provides authoritative reviews on the most recent research towards a better understanding of structure-function relationships in retroviral enzymes. The Issue includes three reviews on retroviral PRs, seven on RT and reverse transcription, and four dedicated to viral integration. [...

  6. Immunohistochemical localization of retroviral-related antigens expressed in normal baboon placental villous tissue.

    Science.gov (United States)

    Langat, D K; Johnson, P M; Rote, N S; Wango, E O; Owiti, G O; Mwenda, J M

    1998-12-01

    Endogenous retroviral particles (ERVs) have been detected in the genome of all eukaryotes. They are generally non-pathogenic except in mice where they have been found to induce tumors and immunological disorders. The ERVs have morphological features consistent with type-C retroviral particles and are commonly expressed in normal placental villous tissues. ERVs may have a role in the regulation of placental gene expression, syncytiotrophoblast formation, or pregnancy-related immunosuppression. In this study, well-characterized antibodies (monoclonal and polyclonal antibodies) raised against retroviral proteins (anti-HIV and anti-SIV) and endogenous retroviral (ERV) particles were assessed for their cross-reactivity (by using immunohistochemistry) with normal baboon placental and other adult tissues. The monoclonal antibodies to exogenous retroviral proteins (anti-HIV-2 gp120, anti-HIV-1 gp41, anti-SIVmac p27, anti-HIV-1 RT, and anti-HIV-2 core protein) showed specific immunohistochemical reactivity with the syncytiotrophoblast. Antibodies to endogenous retroviral gene products (anti-ERV3 env, anti-HERV-K RT, and anti-HERV-K env) also reacted in a similar manner and did not cross-react with other adult tissues. These studies have shown that retroviral-cross-reactive proteins are expressed in baboon placental syncytiotrophoblast and may have a role to play at the feto-maternal interface.

  7. Metabolic abnormalities and overweight in HIV/AIDS persons-treated with antiretroviral therapy Anormalidades metabólicas e sobrepeso em portadores de HIV/AIDS em terapia com anti-retrovirais

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    Luísa Helena Maia Leite

    2008-06-01

    Full Text Available OBJECTIVE: To describe the proportion of overweight among patients with human immunodeficiency virus/Acquired Immune Deficiency Syndrome and correlate overweight and highly active antiretroviral therapy with metabolic complications. METHODS: A cross-sectional study was conducted among human immunodeficiency virus/Acquired Immune Deficiency Syndrome outpatients undergoing nutritional therapy from 2000 to 2006 in a University Health Center. The sample consisted of 393 human immunodeficiency virus/Acquired Immune Deficiency Syndrome patients. Nutritional and medical records were used as a source of data on personal, clinical and biochemical information. Data analysis included descriptive statistics and the Chi-square test. RESULTS: Sixty-nine percent of the patients were males aging from 26 to 49 years. Overweight and obesity were identified in 49% of this population. The most important metabolic complications were low levels of high-density lipoprotein (70% and high levels of triglycerides (48% and cholesterol (40%. Higher body mass index was associated with higher lipid levels and more evidence of insulin resistance. CONCLUSION: This study demonstrated an important proportion of overweight and obesity among human immunodeficiency virus/Acquired Immune Deficiency Syndrome patients. These results suggest that nutritional interventions and lifestyle modifications may be useful strategies to decrease the cardiovascular risk in this population.OBJETIVO: Estimar a proporção de sobrepeso em pessoas com Vírus da Imunodeficiência Humana /Síndrome da Imunodeficiência Adquirida e avaliar a associação do sobrepeso e do uso da terapia anti-retroviral de alta potência (Highly Active Antiretroviral Therap com a presença de anormalidades metabólicas. MÉTODOS: Foi conduzido um estudo transversal entre pacientes ambulatoriais sob acompanhamento nutricional em um hospital universitário entre 2000-2006. A amostra incluiu 393 pacientes com Vírus da

  8. Rationale for anti-inflammatory therapy in dry eye syndrome Bases da terapia antiinflamatória em síndrome do olho seco

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    CS De Paiva

    2008-12-01

    Full Text Available Dry eye is a multifactorial condition that results in a dysfunctional lacrimal functional unit. Evidence suggests that inflammation is involved in the pathogenesis of the disease. Changes in tear composition including increased cytokines, chemokines, metalloproteinases and the number of T cells in the conjunctiva are found in dry eye patients and in animal models. This inflammation is responsible in part for the irritation symptoms, ocular surface epithelial disease, and altered corneal epithelial barrier function in dry eye. There are several anti-inflammatory therapies for dry eye that target one or more of the inflammatory mediators/pathways that have been identified and are discussed in detail.Olho seco é uma doença multifatorial que resulta em disfunção da unidade lacrimal glandular. Evidências sugerem que inflamação está involvida na patogênese da doença. Mudanças na composição das lágrimas, incluindo aumento de citocinas, quimiocinas, metaloproteinases e o número de células T na conjuntiva são encontrados em pacientes com olho seco e em modelos animais. Esta inflamação é responsável em parte pelos sintomas de irritação, doença epitelial de surperfície ocular e função epitelial de barreira alterada em olho seco. Existem várias terapias antiinflamatórias que se direcionam para um ou mais mediadores/vias que foram identificados e são discutidos em detalhe.

  9. Assessment of arterial elasticity among HIV-positive participants with high CD4 cell counts: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.

    Science.gov (United States)

    Baker, J V; Engen, N W; Huppler Hullsiek, K; Stephan, C; Jain, M K; Munderi, P; Pett, S; Duprez, D

    2015-04-01

    Both HIV infection and antiretroviral therapy (ART) may increase cardiovascular disease (CVD) risk. Assessments of vascular function and structure can be used to study the pathogenesis and progression of CVD, including the effects of ART and other interventions. The objective of this report is to understand methods to assess vascular (dys)function and report our experience in the Arterial Elasticity Substudy in the Strategic Timing of AntiRetroviral Treatment (START) trial. We review literature and analyze baseline data from the Arterial Elasticity Substudy, which estimated vascular (dys)function through analysis of the diastolic blood pressure (BP) waveform. Linear regression was used to study cross-sectional associations between baseline clinical factors and small or large arterial elasticity. Arterial elasticity measurement was chosen for its improved measurement reproducibility over other methodologies and the potential of small arterial elasticity to predict clinical risk. Analysis of baseline data demonstrates that small artery elasticity is impaired (lower) with older age and differs by race and between geographical regions. No HIV-specific factors studied remained significantly associated with arterial elasticity in multivariate models. Longitudinal analyses in this substudy will provide essential randomized data with which to study the effects of early ART initiation on the progression of vascular disease among a diverse global population. When combined with future biomarker analyses and clinical outcomes in START, these findings will expand our understanding of the pathogenesis of HIV-related CVD. © 2015 British HIV Association.

  10. Farmacoepidemiologia e farmacoeconomia della terapia anti-ipertensiva: uno studio osservazionale della popolazione della Asl di Ravenna

    Directory of Open Access Journals (Sweden)

    Luca Degli Esposti

    2003-05-01

    antihypertensive drug treatment. An administrative database kept by the Local Health Unit of Ravenna listing patient baseline characteristics, drug prescriptions and hospital admissions was used to perform a population-based cohort study. The study included all new users of antihypertensive drugs, 20 years of age or over receiving a first prescription for diuretics, beta-blockers, calcium channel-blockers, ACE inhibitors or angiotensin II antagonists (AIIAs between January 1st, 2000 and December 31st, 2000. All prescriptions for anti-hypertensive drugs filled during the 12-months follow-up period were considered. Patients were classified as continuers, switchers and discontinuers on the basis of their prescription dynamics. A total of 14.062 patients were included in the study of whom only 39,7% resulted persistent at 12 months. Patients initially prescribed for AIIAs were more likely to continue antihypertensive treatment than those started on other drug classes as well as those with older age, concurrent drug therapies and previous hospitalisation for cardiovascular diseases. The overall cost of the study cohort for antihypertensive drugs amounted to 1.238.752,37 euros of which 80,6% was used for persistent patients. The annual average cost for antihypertensive drugs was 171,73 euro for continuers, 205,10 euros for switchers and 28,29 euros for discontinuers. Factors associated to drug cost were age, pattern of persistence, number of prescribed drug classes, and class prescribed at enrolment. Nonpersistence with antihypertensive pharmacotherapy induced a high cost for the consumption of antihypertensive drug since discontinuers are responsible for a significant percentage of drug resources allocated on subjects exposed to therapy. A correlation between drug therapy cost and persistence with treatment is needed to evaluate the appropriateness of drug utilization and to perform cost-effectiveness analyses between alternative pharmacological agents.

  11. Queratinocitos humanos modificados genéticamente por medio de un vector retroviral

    Directory of Open Access Journals (Sweden)

    Arango M.

    2001-06-01

    Full Text Available Los queratinocitos poseen características ideales para la terapia génica: accesibles, modifi-cables por vectores retrovirales, conservan in vitro sus propiedades de proliferación y diferen-ciación, fácil remoción por efectos adversos. Nuestro objetivo fue evaluar estas células comoblanco de transferencia de genes empleando el vector retroviral Foch-29 NeoR.

  12. Retroviral integration: Site matters

    Science.gov (United States)

    Demeulemeester, Jonas; De Rijck, Jan

    2015-01-01

    Here, we review genomic target site selection during retroviral integration as a multistep process in which specific biases are introduced at each level. The first asymmetries are introduced when the virus takes a specific route into the nucleus. Next, by co‐opting distinct host cofactors, the integration machinery is guided to particular chromatin contexts. As the viral integrase captures a local target nucleosome, specific contacts introduce fine‐grained biases in the integration site distribution. In vivo, the established population of proviruses is subject to both positive and negative selection, thereby continuously reshaping the integration site distribution. By affecting stochastic proviral expression as well as the mutagenic potential of the virus, integration site choice may be an inherent part of the evolutionary strategies used by different retroviruses to maximise reproductive success. PMID:26293289

  13. Terapia periodontal no quirurgica

    National Research Council Canada - National Science Library

    Guzman Zuluaga, Isabel Cristina; Botero Zuluaga, Leticia; Bedoya Trujillo, Juan Sebastian; Botero Botero, Alejandro

    2012-01-01

    .... El principal objetivo de este articulo es demostrar la efectividad de la terapia periodontal no quirurgica evidenciada en multiples estudios con relacion a las indicaciones, aspectos microbiologicos...

  14. Enhancement of retroviral infection in vitro by anti-Le(y) IgG: reversal by humanization of monoclonal mouse antibody

    DEFF Research Database (Denmark)

    Hansen, J E; Sørensen, A M; Arendrup, M

    1993-01-01

    also enhanced infection, a human/mouse chimeric antibody and a fully humanized antibody had no enhancing effect on free virus infection. We suggest that binding of anti-Le(y) ABL 364 or its F(ab)2 fragment induced a conformational change in the gp120 oligomers facilitating the process of infection......, and that this function was abrogated by the IgG1 Fc of the chimeric and the humanized antibodies. The observations indicate that the non-paratope domains of antiviral antibodies can influence their function as neutralizing or enhancing for infection....

  15. Pharmacogenetics of toxicity, plasma trough concentration and treatment outcome with nevirapine-containing regimen in anti-retroviral-naïve HIV-infected adults: an exploratory study of the TRIANON ANRS 081 trial.

    Science.gov (United States)

    Gozalo, Claire; Gérard, Laurence; Loiseau, Pascale; Morand-Joubert, Laurence; Peytavin, Gilles; Molina, Jean-Michel; Dellamonica, Pierre; Becquemont, Laurent; Aboulker, Jean-Pierre; Launay, Odile; Verstuyft, Céline

    2011-12-01

    The aim of this exploratory study was to investigate in a homogeneous population of anti-retroviral naïve HIV-1-infected adults, the relationships between genetic polymorphisms involved in nevirapine metabolism [CYP2B6 516G>T, 785A>G and 1459C>T; CYP3A5 6986A>G (CYP3A5*3)], transport (ABCB1 2677G>T/A and 3435C>T), and antigen recognition (HLA-DRB1*0101), and the hepatic and/or cutaneous toxicity occurring within the first 8 or 72 weeks of treatment, plasma trough concentrations (C(trough) ) at week 8 and immuno-virological response to nevirapine at week 24. Associations between genetic polymorphisms and toxicity, C(trough) and response to nevirapine were performed in a population of 72 HIV-1 positive and nevirapine-treated patients followed during 72 weeks, as part of the previous study called: ANRS081 'Trianon' trial. Among the 18 patients who developed toxicity events during the 72 weeks of the study, 12 patients exhibited early toxicity before week 8. No significant association could be evidenced between any of the analysed single nucleotide polymorphisms (SNPs) and nevirapine early or global toxicity, pharmacokinetics and immuno-virological responses even though a possible association between CYP2B6 516G>T and 1459C>T and the trough level of nevirapine was suggested. © 2011 The Authors. Basic & Clinical Pharmacology & Toxicology © 2011 Nordic Pharmacological Society.

  16. Letrozole versus testosterone. a single-center pilot study of HIV-infected men who have sex with men on highly active anti-retroviral therapy (HAART) with hypoactive sexual desire disorder and raised estradiol levels.

    Science.gov (United States)

    Richardson, Daniel; Goldmeier, David; Frize, Graham; Lamba, Harpal; De Souza, Carl; Kocsis, Agnes; Scullard, George

    2007-03-01

    Since the advent of Highly Active Anti-Retroviral Therapy (HAART), men with HIV experience good quality of life and expect to have normal sexual function. However, it appears that men infected with HIV commonly complain of sexual problems. There is evidence that men on HAART develop low sexual desire that is associated with raised estradiol levels. It has been postulated that abnormal metabolism seen in this group of men increases the aromatization of testosterone to estradiol. We hypothesized that letrozole, an aromatase inhibitor that inhibits the conversion of testosterone to estradiol, would be beneficial in these men. The aim of this study was to compare the effects of testosterone vs. an aromatase inhibitor, letrazole, in HIV-infected men with raised estradiol and low sexual desire. Thirteen men who have sex with men on HAART with low sexual desire as well as raised estradiol levels (>120 pmol/L) were randomly allocated to receive either parenteral testosterone (Sustanon 250 intramuscular injection) (N = 6) or letrozole 2.5 mg orally daily (N = 7) for 6 weeks. Sex steroid hormone assays, sex hormone-binding globulin, virological, hematological, and biochemical parameters were measured before and after treatment. Each subject was given the Spector Sexual Desire Inventory and the Depression/Anxiety Stress Scale before and immediately after treatment. Subjects were also asked to estimate the number of actual sexual acts before and after treatment. Results. Inventory data showed a rise in dyadic desire in both treatment arms. Mean actual sexual acts rose from 0.33 to 1.5 in the testosterone group and from 0.43 to 1.29 for the letrozole group. Luteinizing hormone increased in seven of seven men on letrozole. Serum testosterone increased in seven of seven men on letrozole. There were no adverse events from either medication. Letrozole may be useful in the management of men on HAART who have low sexual desire.

  17. Terapia anti-TNFα en espondilitis anquilosante: control sintomático y modificación del daño estructural

    National Research Council Canada - National Science Library

    Andreu, José Luis; Otón, Teresa; Sanz, Jesús

    2011-01-01

    ...) y terapia física. A mediados de los años 90 del siglo xx , se objetivó la expresión de una citocina proinflamatoria, el TNFα, en las biopsias de articulaciones sacroilíacas de pacientes con EA 1 . Es más, a finales de los 90 se evidenció que, en los pacientes con enfermedad de Crohn y EA asociada, el tratamiento con infliximab, un anticuerpo quimérico ant...

  18. Associated oral lesions in human immunodefeciency virus infected children of age 1 to 14 years in anti retroviral therapy centers in Tamil Nadu

    Directory of Open Access Journals (Sweden)

    R Krishna Kumar

    2013-01-01

    Full Text Available Aim: To evaluate the prevalence of oral lesions status in human immunodeficiency virus (HIV infected children of age 1 to 14 years in Anti Retro viral therapy (ART centres in Tamil Nadu. Materials and Methods: A of total 326 HIV infected children, age 1 to 14 years of which 174 male children and 152 female children were examined for Oral lesions in the Department of Pedodontics and Preventive Dentistry, Rajah Muthiah Dental College and Hospital, Annamalai University in association with the ART centers in Villupuram, Vellore and HIV Homes in Thiruvannamalai, Trichy and Salem in Tamil Nadu towns. Statistical Analysis: Statistical Package for Social Science for Windows (version 11 code: 3000135939012345. Result: Of the total 326 children, 201 (61.65% had oral lesions. (68 [20.86%] with Oral Candidiasis [OC], 54 [16.56%] with Angular Cheilitis, 27 [8.28%] with Necrotizing Ulcerative Gingivitis [NUG], 25 [7.66%] with Necrotizing Ulcerative Periodontitis [NUP], 18 [5.53%] with Linear Gingival Erythema [LGE] and 9 [2.76%] with Apthous Ulcer. Conclusion Among the oral lesions in HIV infected children, OC 20.86% was the predominant oral lesion followed by Angular Chelitis 16.56%, NUG 8.28%, NUP 7.66%, LGE5.53% and Apthous Ulcer 2.76%.

  19. Niclosamide, an anti-helminthic molecule, downregulates the retroviral oncoprotein Tax and pro-survival Bcl-2 proteins in HTLV-1-transformed T lymphocytes.

    Science.gov (United States)

    Xiang, Di; Yuan, Yunsheng; Chen, Li; Liu, Xin; Belani, Chandra; Cheng, Hua

    2015-08-14

    Adult T cell leukemia and lymphoma (ATL) is a highly aggressive form of hematological malignancy and is caused by chronic infection of human T cell leukemia virus type 1 (HTLV-1). The viral genome encodes an oncogenic protein, Tax, which plays a key role in transactivating viral gene transcription and in deregulating cellular oncogenic signaling to promote survival, proliferation and transformation of virally infected T cells. Hence, Tax is a desirable therapeutic target, particularly at early stage of HTLV-1-mediated oncogenesis. We here show that niclosamide, an anti-helminthic molecule, induced apoptosis of HTLV-1-transformed T cells. Niclosamide facilitated degradation of the Tax protein in proteasome. Consistent with niclosamide-mediated Tax degradation, this compound inhibited activities of MAPK/ERK1/2 and IκB kinases. In addition, niclosamide downregulated Stat3 and pro-survival Bcl-2 family members such as Mcl-1 and repressed the viral gene transcription of HTLV-1 through induction of Tax degradation. Since Tax, Stat3 and Mcl-1 are crucial molecules for promoting survival and growth of HTLV-1-transformed T cells, our findings demonstrate a novel mechanism of niclosamide in inducing Tax degradation and downregulating various cellular pro-survival molecules, thereby promoting apoptosis of HTLV-1-associated leukemia cells. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Niclosamide, an anti-helminthic molecule, downregulates the retroviral oncoprotein Tax and pro-survival Bcl-2 proteins in HTLV-1-transformed T lymphocytes

    Energy Technology Data Exchange (ETDEWEB)

    Xiang, Di [Penn State Hershey Cancer Institute, Penn State University College of Medicine, Hershey, PA 17033 (United States); Yuan, Yunsheng [Penn State Hershey Cancer Institute, Penn State University College of Medicine, Hershey, PA 17033 (United States); Engineering Research Center of Cell and Therapeutic Antibody, Ministry of Education, School of Pharmacy, Shanghai Jiao Tong University, Shanghai (China); Chen, Li [Pharmacy College, Fujian University of Traditional Chinese Medicine, Fuzhou (China); Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201 (United States); Liu, Xin; Belani, Chandra [Penn State Hershey Cancer Institute, Penn State University College of Medicine, Hershey, PA 17033 (United States); Cheng, Hua, E-mail: hcheng@ihv.umaryland.edu [Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201 (United States); Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD 21201 (United States); Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201 (United States); Department Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201 (United States)

    2015-08-14

    Adult T cell leukemia and lymphoma (ATL) is a highly aggressive form of hematological malignancy and is caused by chronic infection of human T cell leukemia virus type 1 (HTLV-1). The viral genome encodes an oncogenic protein, Tax, which plays a key role in transactivating viral gene transcription and in deregulating cellular oncogenic signaling to promote survival, proliferation and transformation of virally infected T cells. Hence, Tax is a desirable therapeutic target, particularly at early stage of HTLV-1-mediated oncogenesis. We here show that niclosamide, an anti-helminthic molecule, induced apoptosis of HTLV-1-transformed T cells. Niclosamide facilitated degradation of the Tax protein in proteasome. Consistent with niclosamide-mediated Tax degradation, this compound inhibited activities of MAPK/ERK1/2 and IκB kinases. In addition, niclosamide downregulated Stat3 and pro-survival Bcl-2 family members such as Mcl-1 and repressed the viral gene transcription of HTLV-1 through induction of Tax degradation. Since Tax, Stat3 and Mcl-1 are crucial molecules for promoting survival and growth of HTLV-1-transformed T cells, our findings demonstrate a novel mechanism of niclosamide in inducing Tax degradation and downregulating various cellular pro-survival molecules, thereby promoting apoptosis of HTLV-1-associated leukemia cells. - Highlights: • Niclosamide is a promising therapeutic candidate for adult T cell leukemia. • Niclosamide employs a novel mechanism through proteasomal degradation of Tax. • Niclosamide downregulates certain cellular pro-survival molecules.

  1. Ophthalmic manifestations and risk factors for mortality of HIV patients in the post-highly active anti-retroviral therapy era.

    Science.gov (United States)

    Lai, Timothy Y Y; Wong, Raymond L M; Luk, Fiona O J; Chow, Vanissa W S; Chan, Carmen K M; Lam, Dennis S C

    2011-03-01

    To evaluate the ophthalmic manifestations and risk factors for mortality in HIV patients in the post-highly active anti-retrovirus therapy (HAART) era. Retrospective study. 151 patients with HIV infection. Review of all HIV patients who have attended the Hong Kong Eye Hospital between 2000 and 2007. Ocular findings especially opportunistic infections and medical information including mortality during follow up. At presentation, 139 (92.1%) patients were already diagnosed with HIV and 58 (41.7%) had an AIDS indicator condition. Fifty-one (33.8%) patients had HIV-related eye disease on presentation and the leading manifestations were cytomegalovirus (CMV) retinitis and HIV microangiopathy. Low baseline CD4 cell count presentation (P visual acuity compared with baseline (P = 0.13). 20 (19.0%) patients had one eye with final visual acuity of 20/200 or worse and the leading cause for poor vision was CMV retinitis. 11 (10.5%) patients died during the follow-up due to complications of HIV/AIDS. The presence of HIV retinal microangiopathy was significantly associated with mortality (P = 0.005). CMV retinitis remains the main HIV-related ocular disease in the post-HAART era. HIV retinal microangiopathy might be an important prognostic factor for mortality. Appropriate ophthalmic monitoring is justified to detect for ophthalmic complications in HIV patients regardless of HAART use in order for prompt initiation of treatment. © 2010 The Authors. Clinical and Experimental Ophthalmology © 2010 Royal Australian and New Zealand College of Ophthalmologists.

  2. Retroviral superinfection resistance

    Directory of Open Access Journals (Sweden)

    van der Kuyl Antoinette C

    2005-08-01

    Full Text Available Abstract The retroviral phenomenon of superinfection resistance (SIR defines an interference mechanism that is established after primary infection, preventing the infected cell from being superinfected by a similar type of virus. This review describes our present understanding of the underlying mechanisms of SIR established by three characteristic retroviruses: Murine Leukaemia Virus (MuLV, Foamy Virus (FV, and Human Immunodeficiency Virus (HIV. In addition, SIR is discussed with respect to HIV superinfection of humans. MuLV resistant mice exhibit two genetic resistance traits related to SIR. The cellular Fv4 gene expresses an Env related protein that establishes resistance against MuLV infection. Another mouse gene (Fv1 mediates MuLV resistance by expression of a sequence that is distantly related to Gag and that blocks the viral infection after the reverse transcription step. FVs induce two distinct mechanisms of superinfection resistance. First, expression of the Env protein results in SIR, probably by occupancy of the cellular receptors for FV entry. Second, an increase in the concentration of the viral Bet (Between-env-and-LTR-1-and-2 protein reduces proviral FV gene expression by inhibition of the transcriptional activator protein Tas (Transactivator of spumaviruses. In contrast to SIR in FV and MuLV infection, the underlying mechanism of SIR in HIV-infected cells is poorly understood. CD4 receptor down-modulation, a major characteristic of HIV-infected cells, has been proposed to be the main mechanism of SIR against HIV, but data have been contradictory. Several recent studies report the occurrence of HIV superinfection in humans; an event associated with the generation of recombinant HIV strains and possibly with increased disease progression. The role of SIR in protecting patients from HIV superinfection has not been studied so far. The phenomenon of SIR may also be important in the protection of primates that are vaccinated with live

  3. Determinantes da adesão ao tratamento anti-retroviral em Brasília, DF: um estudo de caso-controle Determinants of antiretroviral treatment adherence in Brasília, Federal District: a case-control study

    Directory of Open Access Journals (Sweden)

    Cláudio Viveiros de Carvalho

    2007-10-01

    Full Text Available Buscou-se avaliar os fatores relacionados à adesão ao tratamento anti-retroviral no Distrito Federal. De 150 pacientes entrevistados em sete centros de referência, 35 não aderentes foram definidos como casos, sendo selecionados 70 controles aderentes, pareados por idade. Avaliaram-se variáveis sócio-demográficas, hábitos, suporte social, qualidade de vida, questões relacionadas a doença, estado clínico, tratamento e serviço. Na análise bivariada, houve associação da adesão com raça/cor, escolaridade, centros de referência em que faz acompanhamento e renda familiar. Após ajuste, cor parda, centros de referência localizado no Plano Piloto, escolaridade alta e receber apoio dos amigos quanto às necessidades permaneceram associados com adesão. Retirando raça/cor do modelo, mantiveram-se centros de referência, escolaridade, profissão, renda, apoio (contar com alguém que demonstre gostar de você e satisfação com o atendimento na farmácia de dispensação. Além dos fatores já consolidados na literatura, questões relacionadas ao apoio no âmbito micro-social e aos serviços de assistência mostraram-se associados à observância terapêutica.We sought to evaluate factors relating to adherence to antiretroviral treatment in the Federal District. Out of 150 patients interviewed at seven reference centers; 35 non-adherent subjects were considered to be cases; we selected 70 age-matched adherent individuals as controls. Variables relating to sociodemographics, habits, social support, quality of life, disease-related issues, clinical conditions, treatment and healthcare services were evaluated. Bivariate analysis showed that adherence was associated with race/color, educational level, the reference center where the patient was followed up and familial income. After adjustments, mixed race (parda, reference center location in central Brasília, high educational level and friends’ support for needs remained associated with

  4. Transcriptional Silencing of Retroviral Vectors

    DEFF Research Database (Denmark)

    Lund, Anders Henrik; Duch, M.; Pedersen, F.S.

    1996-01-01

    Although retroviral vector systems have been found to efficiently transduce a variety of cell types in vitro, the use of vectors based on murine leukemia virus in preclinical models of somatic gene therapy has led to the identification of transcriptional silencing in vivo as an important problem...

  5. Terapia de choque

    DEFF Research Database (Denmark)

    Agustin, Oscar Garcia

    2012-01-01

    No hay alternativa, nos dicen. Ya no hay líneas rojas. Sólo un poco más de terapia de choque para aumentar el desorden bipolar entre los que tienen y los que no.......No hay alternativa, nos dicen. Ya no hay líneas rojas. Sólo un poco más de terapia de choque para aumentar el desorden bipolar entre los que tienen y los que no....

  6. terapias múltiples

    Directory of Open Access Journals (Sweden)

    Marcelo Valencia

    2006-01-01

    Full Text Available Se presenta la comparación de tres modalidades de intervención: terapia psicosocial, musicoterapia, y terapias múltiples, en 58 pacientes con esquizofrenia quienes fueron canalizados aleatoriamente a los tres grupos bajo estudio. Los pacientes fueron evaluados al inicio y al final de las intervenciones que tuvieron seis meses de duración. Los pacientes de las tres modalidades obtuvieron beneficios terapéuticos de distinta proporción en el funcionamiento psicosocial y en la actividad global, y con diferencias en la magnitud de la eficacia de cada intervención, siendo las más efectivas la terapia psicosocial, y la musicoterapia. No se encontraron diferencias estadísticamente significativas entre los tres grupos en cuanto a recaídas y rehospitalizaciones. En la terapia psicosocial y en la musicoterapia el grado de deserción fue en menor grado y de igual forma estas dos intervenciones presentaron un mayor nivel de adherencia terapéutica en comparación con las terapias múltiples

  7. Factors that affect cancer patient compliance to oral anti-neoplastic therapy Factores que influyen en la adhesión de pacientes con cáncer a la terapia antineoplásica oral Fatores que influenciam a adesão de pacientes com câncer à terapia antineoplásica oral

    Directory of Open Access Journals (Sweden)

    Patrícia Andréa Crippa Marques

    2008-01-01

    Full Text Available OBJECTIVES: To identify factors that can affect compliance to treatment with neoplastic oral drugs in a group of cancer patients. METHODS: Interviews were performed on 61 patients diagnosed with cancer and under anti-neoplastic oral therapy in a private hospital. The interviews were carried out using instruments to assess compliance. RESULTS: Most patients (95% reported the oral treatment was not difficult. The Morisky and Green Test were positive in 28% of the patients. Factors that may affect following the treatment were significantly (pOBJETIVOS: Identificar los factores asociados a la adhesión al tratamiento con drogas de acción antineoplásica por vía oral en pacientes con cáncer. MÉTODOS: Fueron entrevistados 61 pacientes con cáncer sometidos a terapia antineoplásica por vía oral en un hospital particular, con la aplicación de instrumentos para evaluar la adhesión. RESULTADOS: La mayoría de los pacientes (95% refirió que el tratamiento oral no es difícil. El test Morisky y Green fue positivo en el 28% de los pacientes. Los factores que pueden influir en la realización del tratamiento se asociaron de forma significativa (pOBJETIVOS: Identificar fatores associados à adesão ao tratamento com drogas de ação antineoplásica por via oral em pacientes com câncer. MÉTODOS: Foram entrevistados 61 pacientes com câncer sob terapia antineoplásica via oral em hospital particular, com a aplicação de instrumentos para avaliar a adesão. RESULTADOS: A maioria dos pacientes (95% referiu que o tratamento oral não é difícil. O Teste Morisky e Green foi positivo em 28% dos pacientes. Os fatores que podem influenciar a realização do tratamento se associaram de forma significativa (p<0,05 com a variável tempo, os pacientes que apresentaram mais dificuldade, tinham mais tempo de tratamento. CONCLUSÕES: Os pacientes apresentaram atitudes positivas frente ao tratamento com medicamentos antineoplásicos orais, porém foram

  8. Psoriasis y nuevas terapias

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    Edgardo N. Chouela R., Dr.

    2011-11-01

    Esta reseña de las nuevas terapias disponibles de la psoriasis y de las que están en camino de ser aprobadas por las autoridades sanitarias, permitirá al lector tener una idea del estado actual del tratamiento de esta enfermedad.

  9. Enhanced gene expression from retroviral vectors

    Directory of Open Access Journals (Sweden)

    Micklem David R

    2008-02-01

    Full Text Available Abstract Background Retroviruses are widely used to transfer genes to mammalian cells efficiently and stably. However, genetic elements required for high-level gene expression are incompatible with standard systems. The retroviral RNA genome is produced by cellular transcription and post-transcriptional processing within packaging cells: Introns present in the retroviral genomic transcript are removed by splicing, while polyadenylation signals lead to the production of ineffective truncated genomes. Furthermore strong enhancer/promoters within the retroviral payload lead to detrimental competition with the retroviral enhancer/promoter. Results By exploiting a new method of producing the retroviral genome in vitro it is possible to produce infectious retroviral particles carrying a high-level expression cassette that completely prohibits production of infectious retroviral particles by conventional methods. We produced an expression cassette comprising a strong enhancer/promoter, an optimised intron, the GFP open reading frame and a strong polyadenylation signal. This cassette was cloned into both a conventional MMLV retroviral vector and a vector designed to allow in vitro transcription of the retroviral genome by T7 RNA polymerase. When the conventional retroviral vector was transfected into packaging cells, the expression cassette drove strong GFP expression, but no infectious retrovirus was produced. Introduction of the in vitro produced uncapped retroviral genomic transcript into the packaging cells did not lead to any detectable GFP expression. However, infectious retrovirus was easily recovered, and when used to infect target primary human cells led to very high GFP expression – up to 3.5 times greater than conventional retroviral LTR-driven expression. Conclusion Retroviral vectors carrying an optimized high-level expression cassette do not produce infectious virions when introduced into packaging cells by transfection of DNA

  10. Avaliação dos efeitos da terapêutica anti-retroviral na progressão da infecção por virús da imunodeficiência humana tipo 2 através da quantificação de ácidos nucleicos e linfocitos T CD4+

    OpenAIRE

    França, Luís Gonçalo Ferreira Monteiro de Freitas

    2007-01-01

    Tese de mestrado em Doenças Infecciosas Emergentes, apresentada à Faculdade de Medicina da Universidade de Lisboa, 2008 A infecção por VIH-2 apresenta inúmeras características que a distinguem da infecção por VIH-1. Apesar de apresentar uma progressão mais lenta, quando comparada com a infecção por VIH-1, pode verificar-se imunodepressão marcada com necessidade de instituição de terapêutica anti-retroviral. Através dos resultados de estudos in vitro, sabe-se actualmente que a utilização de...

  11. Biosafety of onco-retroviral vectors.

    Science.gov (United States)

    VandenDriessche, Thierry; Collen, Désiré; Chuah, Marinee K L

    2003-12-01

    Extensive gene therapy studies in preclinical models and in clinical trials underscore the relative safety of onco-retroviral vectors. Up until recently, no adverse effects have been reported in nearly 2000 patients that were enrolled in gene therapy clinical trials involving onco-retroviral vectors. However, the main safety concern of using onco-retroviral vectors is related to the risk of malignant transformation following oncogene activation due to random onco-retroviral genomic integration. Based on primate studies, there is an apparent low risk of malignancy that is predominately associated with the occurrence of chronic retroviremia resulting from replication-competent retroviruses (RCR), particularly in immunosuppressed recipient hosts. However, in the latest packaging cell lines and vectors, the risk of RCR-generation has been drastically reduced, primarily by minimizing the homologous overlap between vector and helper sequences. Nevertheless, results from a recent preclinical study in mice and a clinical trial in patients suffering from SCID-X1 strongly suggest that onco-retroviral vectors devoid of RCR can contribute to lymphomagenesis by insertional activation of cellular oncogenes. The risk of inadvertent germline transmission of onco-retroviral vectors appears to be low, especially relative to the endogenous rate of germline insertion, which is known to occur naturally in the human population via transmission of endogenous retro-transposons. The strict dependency of onco-retroviral gene transfer on cell division is an important safety advantage that significantly limits the risks of horizontal transmission. Since improved onco-retroviral vectors or transduction protocols may result in an increased number of retroviral integrations per cell, this may concomitantly increase the risk of malignant transformation. The use of suicide genes, self-inactivating vectors and/or chromosomal insulators is, therefore, warranted to further enhance the safety features

  12. Terapia anti-hipertensiva utilizada por pacientes idosos de Porto Alegre/RS, Brasil = Antihypertensive therapy used by elderly patients from Porto Alegre/RS, Brazil

    Directory of Open Access Journals (Sweden)

    Schroeter, Guilherme

    2006-01-01

    Conclusões: Os diuréticos, inibidores da ECA e betabloqueadores foram os anti-hipertensivos mais utilizados. Muitas vezes o usuário comete erros na medicação, o que pode ser resolvido com uma assistência correta a esse paciente. Diante da prevalência da hipertensão entre os idosos, observa-se a necessidade de uma maior atenção dos profissionais de saúde a esses pacientes

  13. Efeito da terapia farmacológica anti-hipertensiva sobre densidade capilar e função endotelial microcirculatória

    OpenAIRE

    Sergio Emanuel Kaiser

    2012-01-01

    Hipertensos têm rarefação capilar e disfunção endotelial microcirculatória, tornando-se mais vulneráveis a lesões em órgãos-alvo. O estudo buscou avaliar o efeito de seis meses de tratamento farmacológico sobre densidade capilar e reatividade microvascular a estímulos fisiológicos e farmacológicos em hipertensos de baixo risco cardiovascular. Secundariamente testou-se a existência de diversidade nas respostas a diferentes estratégias anti-hipertensivas. Foram recrutados 44 pacientes, com 46,7...

  14. [Guidelines in RA treatment: concepts on safety and recommendations using anti-TNF-alpha inhibitors. Grupo de Estudio de Nuevas Terapias de Enfermedades reumáticas (GENTE)].

    Science.gov (United States)

    Díaz-Jouanen, Efraín; Abud-Mendoza, Carlos; Garza-Elizondo, Mario Alberto; Medrano-Ramírez, Gabriel; Burgos-Vargas, Rubén; Orozco-Alcalá, José Javier; Pacheco-Tena, César Francisco; Pineda, Carlos; Pozos-Espíndola, Juan Carlos; Ramos-Niembro, Francisco; Robles-San-Román, Manuel; Santana-Sahagún, Jesús Ernesto

    2009-01-01

    Recommendations for the use of Disease-Modifying Antirheumatic Drugs (DMARD) with both conventional and biological agents in Rheumatoid Arthritis (RA) must be based on their safety profile, adverse effects, risks, and advantages. With the purpose of presenting the most updated information about the safety of tumor necrosis factor alpha (TNFalpha) antagonists, in this article we summarize the literature published during the last three years about this sort of biological agents in specific clinical situations, such as risk of developing infections, cancer, cardiovascular diseases, and autoimmunity; as well as their administration to patients who will undergo surgical procedures, pregnant and/or breast-feeding women, and patients who need immunizations. Likewise, in this analysis we offer specific recommendations, based on evidence, for the best anti-TNF-alfa management.

  15. Terapia hipolipemiante em situações especiais: síndrome de imunodeficiência adquirida Hypolipidemic therapy under special conditions: acquired immune deficiency syndrome

    Directory of Open Access Journals (Sweden)

    Pai Ching Yu

    2005-10-01

    Full Text Available Dislipidemias podem ser observadas precocemente entre pacientes com AIDS. Frequentemente, estas anormalidades lipídicas incluem HDL baixo e moderado aumento dos triglicérides sanguíneos. A terapia anti-retroviral combinada (HAART pode agravar a dislipidemia nestes pacientes, com importante aumento nos triglicérides e no LDL. Vários mecanismos são propostos para explicar a dislipidemia mista observada nestes indivíduos, incluindo diferentes etapas do metabolismo lipídico. A importância do tratamento desses distúrbios lipídicos tem se tornado evidente com o aumento da expectativa de vida e os relatos de complicações cardiovasculares nestes pacientes. Existe um estado de resistência à insulina nos pacientes com AIDS em tratamento com HAART,que apresentam lipodistrofia, hipertrigliceridemia e baixos níveis de HDL. Drogas retro-antivirais são metabolizadas pelo CYP P450 3A4 e interações com algumas estatinas, especialmente com sinvastatina podem ocorrer. O tratamento com agentes hipolipemiantes deve ser baseado no perfil lipídico e no risco de coronariopatia. Para hipertrigliceridemias, fibratos (principalmente fenofibrato ou bezafibrato devem ser as drogas de escolha, bem como as estatinas (principalmente pravastatina. Terapia combinada usando estatinas mais fibratos é recomendada para dislipidemias mistas graves e sempre sob rigoroso monitoramento de efeitos adversos.Lipid alterations can be observed early among patients with AIDS disease. Commonly, these lipid abnormalities include low HDL-C and modest increase in triglyceride plasma levels. Highly Active Anti-Retroviral Therapy (HAART in these patients may aggravate the dyslipidemia, with notable increases in triglycerides as well as in LDL-C. There are several mechanisms proposed to explain the mixed hyperlipidemia observed in these subjects, including different steps in lipid metabolism. The importance of the treatment of dyslipidemia became evident with the increased life

  16. Terapia Génica

    OpenAIRE

    Ignacio Zarante

    2001-01-01

    Definición
    La terapia génica es el proceso por el cual se inserta material genético en una célula, con el fin de hacer que ésta produzca una proteína normal. Las utilidades van desde curar enfermedades unigénicas hasta modificar el equilibrio del sistema inmune, permitiendo la modulación de la respuesta contra cualquier antígeno. En esencia es cambiar la secuencia del genotipo de un organismo para que tenga implicaciones fenotípicas.

    &...

  17. Antisense gene therapy using anti-k-ras and antitelomerase oligonucleotides in colorectal cancer Eficacia de la terapia génica antisentido utilizando oligonucleótidos anti K-ras y antitelomerasa en cáncer colorrectal

    OpenAIRE

    S. Lledó; Alfonso, R; S. F. Aliño

    2005-01-01

    Aim: to test the efficacy of anti-k-ras and antitelomerase oligonucleotides for disabling colorectal cancer cell growth. Material and methods: an established human colorectal cancer cell line (SW 480, ATTC®) was used. Oligodeoxiribonucleotides (ODNs) have a phosphorotioate modification to ensure intracellular intake. We used an antitelomerase ODN (Telp5) and two anti-k-ras ODNs (AS-KRAS and ISIS). AS-KRAS is designed to join the k-ras oncogene's exon 1. ISIS links to the terminal transcriptio...

  18. Terapia Génica

    Directory of Open Access Journals (Sweden)

    Ignacio Zarante

    2001-08-01

    Full Text Available

    Definición
    La terapia génica es el proceso por el cual se inserta material genético en una célula, con el fin de hacer que ésta produzca una proteína normal. Las utilidades van desde curar enfermedades unigénicas hasta modificar el equilibrio del sistema inmune, permitiendo la modulación de la respuesta contra cualquier antígeno. En esencia es cambiar la secuencia del genotipo de un organismo para que tenga implicaciones fenotípicas.

    Historia
    Desde el descubrimiento de las enzimas de restricción en el año de 1970 por Arber y Hamilton se sentaron las bases para transferir genes entre diferentes células u organismos, inclusive pertenecientes a diferentes especies. En 1978 se realizó la primera hormona recombinante insertando el gen de la insulina en una bacteria E. coli. De allí en adelante se afianzaron los conocimientos necesarios para transferir genes a células humanas con el fin de alterar el fenotipo patológico y generar una nueva forma terapéutica. La primera transferencia se realizó en el año de 1989 en un paciente con una inmunodeficiencia. Aunque no se encontraron efectos clínicos se explicitó que tampoco había efectos deletéreos como muchos apocalípticamente habían pronosticado. En 1990 se trató con terapia génica un paciente que padecía de la deficiencia de la enzima adenosin-deaminasa presentando infecciones bacterianas a repetición.

    Aunque la mejoría fue temporal, con este ensayo se comprobó que la terapia génica tenía posibilidades terapéuticas reales....

  19. Psoriasis y nuevas terapias

    OpenAIRE

    Chouela R., Edgardo N.

    2011-01-01

    La psoriasis es una enfermedad compleja, sistémica y crónica, que compromete la calidad de vida de los pacientes desde muy temprana edad y que requiere del compromiso del médico tratante para su manejo terapéutico. El mejor conocimiento de la fisiopatología de la enfermedad ha permitido el desarrollo de nuevas terapéuticas, algunas ya disponibles y otras en vías de serlo en los próximos años. Esta reseña de las nuevas terapias disponibles de la psoriasis y de las que están en camino de ...

  20. Bats and Rodents Shape Mammalian Retroviral Phylogeny.

    Science.gov (United States)

    Cui, Jie; Tachedjian, Gilda; Wang, Lin-Fa

    2015-11-09

    Endogenous retroviruses (ERVs) represent past retroviral infections and accordingly can provide an ideal framework to infer virus-host interaction over their evolutionary history. In this study, we target high quality Pol sequences from 7,994 Class I and 8,119 Class II ERVs from 69 mammalian genomes and surprisingly find that retroviruses harbored by bats and rodents combined occupy the major phylogenetic diversity of both classes. By analyzing transmission patterns of 30 well-defined ERV clades, we corroborate the previously published observation that rodents are more competent as originators of mammalian retroviruses and reveal that bats are more capable of receiving retroviruses from non-bat mammalian origins. The powerful retroviral hosting ability of bats is further supported by a detailed analysis revealing that the novel bat gammaretrovirus, Rhinolophus ferrumequinum retrovirus, likely originated from tree shrews. Taken together, this study advances our understanding of host-shaped mammalian retroviral evolution in general.

  1. Reflexiones humanistas sobre conocimiento y servicios en terapia física, terapia ocupacional y terapia del lenguaje

    OpenAIRE

    H. de Alvarado, Marie Luise; Cuervo E., Clemencia; Trujillo R., Alicia

    2012-01-01

    Este artículo constituyó la ponencia central del XX Aniversario de las Carreras de Terapia Física, Terapia Ocupacional y Terapia del Lenguaje en la Universidad Nacional de Colombia, celebrado en marzo de 1986. Tiene como propósito fomentar la reflexión sobre la relación entre las dimensiones disciplinar y de formación del profesional de servicios humanos en Terapia Física, Terapia Ocupacional y Terapia del Lenguaje, de acuerdo a una concepción humanista.

  2. Prevalence of adverse drug reactions in adult patients on anti ...

    African Journals Online (AJOL)

    Background: There has been an increased access to anti-retrovirals in resourceconstrained settings. However, few studies have addressed the area of adverse drug reactions in these settings. Objective: To determine the prevalence of adverse drugs reactions in HIV-infected persons receiving anti-retrovirals. Design: A ...

  3. Effect of hypotonic stress on retroviral transduction.

    Science.gov (United States)

    Lee, Yu-Hsiang; Peng, Ching-An

    2009-12-25

    Short half-life has long been known as a main barrier for retroviral gene delivery due to quick degradation that seriously limited application of retrovirus-mediated methodology in the clinical use. To circumvent this challenge, many physical and chemical approaches have been developed to maximize contact opportunity of retroviruses and cells before viral vectors decay. However, most of methods are not easy to be followed due to complicated equipment settings and/or long procedures. In this study, we introduced an easy, cost-effective, efficient, and scalable strategy to enhance retroviral transduction by hypo-osmotic stress. It has been demonstrated that under hypotonic exposure, cell membrane is permeabilized to allow numerous exterior molecules accessing to cytoplasm through an intensive endocytosis, yielding high efficiency of cellular uptake. We hypothesized this hypotonic stress-induced internalization may provide a unique opportunity of cell entry for retroviruses without the need of receptor binding, and thus overcome the insufficient transduction rate due to loss of envelope protein. Indeed, our results showed that with assistance of hypotonic stress, retroviral transduction rates dramatically increased about 5.6- and 17.7-fold using fresh and decayed retroviruses, respectively, in comparison with corresponding groups without hypotonic stress. In summary, hypotonic stress was shown as a promising tool for enhancement of retroviral transduction efficiency without limitation of short half-life.

  4. Antisense gene therapy using anti-k-ras and antitelomerase oligonucleotides in colorectal cancer Eficacia de la terapia génica antisentido utilizando oligonucleótidos anti K-ras y antitelomerasa en cáncer colorrectal

    Directory of Open Access Journals (Sweden)

    S. Lledó

    2005-07-01

    Full Text Available Aim: to test the efficacy of anti-k-ras and antitelomerase oligonucleotides for disabling colorectal cancer cell growth. Material and methods: an established human colorectal cancer cell line (SW 480, ATTC® was used. Oligodeoxiribonucleotides (ODNs have a phosphorotioate modification to ensure intracellular intake. We used an antitelomerase ODN (Telp5 and two anti-k-ras ODNs (AS-KRAS and ISIS. AS-KRAS is designed to join the k-ras oncogene's exon 1. ISIS links to the terminal transcription unit 5' of k-ras. Telp5 joins the template region of the hTR telomerase subunit. ODNs have been tested in different concentrations (1, 5, 10, 20 micromolar. Cell viability has been tested at 48 and 72 hours. Statistical analysis and graphic design were made with the statistical package "Analyzing Data with GraphPad Prism-1999", GraphPad Sofware Inc., San Diego CA©. We used the Student's t test for statistical analysis. Results: the lowest dose (1 µM was not effective. Using the highest dose (20 mM for 48 hours of combined AS-KRAS and Telp5 cell viability decreased to 99.67%. The rest of results varied depending on ODN type, dose, and exposure time. Conclusions: tested antisense ODNs stop colorectal cancer cell growth, and a combination of anti-telomerase and anti-k-ras is the most useful treatment. Efficacy is best with a higher dose and longer treatment period.Objetivo: evaluar la eficacia de oligonucleótidos anti k-ras y antitelomerasa para detener el crecimiento tumoral en el cáncer colorrectal. Material y métodos: se ha empleado una línea celular establecida de cáncer colorrectal humano (SW 480, ATTC®. Los oligodesoxirribonucleótidos (ODN utilizados en el presente trabajo presentan modificación fosforotioato con el fin de mejorar su estabilidad en presencia de fluidos biológicos. Hemos utilizado un ODN antitelomerasa (Telp5, y dos ODN anti k-ras (AS-KRAS e ISIS. AS-KRAS actúa en el exón 1 e ISIS actúa a nivel de la unidad terminal de

  5. Multivalent system for therapy of non-Hod king lymphomas based on Anti-CD20 conjugated to gold nanoparticles; Sistema multivalente para terapia de linfomas no-Hodking basado en Anti-CD20 conjugado a nanoparticulas de oro

    Energy Technology Data Exchange (ETDEWEB)

    Miranda O, R. M.

    2014-07-01

    In recent publications has been reported that gold nanoparticles have an effect in reducing the expression of the oncogene Bcl -2 and have a high biocompatibility , this is the importance for using gold nanoparticles for this work. The antibody CD20 is an antibody that specifically binds to that over expressed CD20 antigen on the cell membrane of B lymphoma cell non- Hodgkin (cell line Raji) behold the importance of combining this bio molecule to gold nanoparticles since they have a high specificity with CD20 positive cells , also to carry out the antigen- antibody immunological reactions triggered mediating cell lysis, possibly by cytotoxicity and apoptosis. Therefore, this system must have characteristics of both components to eliminate B cell non- Hodgkin lymphoma.In this work it was studied a multivalent system composed of gold nanoparticles and anti-CD20 antibody, the term multi valency refers to the number of biomolecules attached to the surface of the gold nanoparticle. The synthesis and characterization of the gold nanoparticles and the multivalent system was performed and the effect of the multivalent system on the expression of oncogene Bcl-2 (group of proteins associated with the apoptotic pathway) was evaluated. Characterization of raw materials and the multivalent system was performed using spectroscopic and microscopic techniques, this to verify structural changes in raw materials and thus confirm the formation of CD20 binding to the surface of the nanoparticle gold by the bond between gold and sulfur in the cysteines of CD20. Taking advantage that the metal nanoparticles have the optical property of surface plasmon resonance, the absorption of gold nanoparticles was measured on the UV-Vis as it is affected by the surface molecules bind to it, showing a bathochromic displacement effected. The hydrodynamic diameter of the gold nanoparticles was measured to verify that the antibody is bound to the surface; this evidence was complemented by micrographs

  6. Mechanisms of retroviral integration and mutagenesis.

    Science.gov (United States)

    Cavazza, Alessia; Moiani, Arianna; Mavilio, Fulvio

    2013-02-01

    Gene transfer vectors derived from oncoretroviruses or lentiviruses are the most robust and reliable tools to stably integrate therapeutic transgenes in human cells for clinical applications. Integration of these vectors in the genome may, however, have undesired effects caused by insertional deregulation of gene expression at the transcriptional or post-transcriptional level. The occurrence of severe adverse events in several clinical trials involving the transplantation of stem cells genetically corrected with retroviral vectors showed that insertional mutagenesis is not just a theoretical event, and that retroviral transgenesis is associated with a finite risk of genotoxicity. In addressing these issues, the gene therapy community offered a spectacular example of how scientific knowledge and technology can be put to work to understand the causes of unpredicted side effects, design new vectors, and develop tools and models to predict their safety and efficacy. As an added benefit, these efforts brought new basic knowledge on virus-host interactions and on the biology and dynamics of human somatic stem cells. This review summarizes the current knowledge on the interactions between retroviruses and the human genome and addresses the impact of target site selection on the safety of retroviral vector-mediated gene therapy.

  7. Improved Coinfection with Amphotropic Pseudotyped Retroviral Vectors

    Directory of Open Access Journals (Sweden)

    Yuehong Wu

    2009-01-01

    Full Text Available Amphotropic pseudotyped retroviral vectors have typically been used to infect target cells without prior concentration. Although this can yield high rates of infection, higher rates may be needed where highly efficient coinfection of two or more vectors is needed. In this investigation we used amphotropic retroviral vectors produced by the Plat-A cell line and studied coinfection rates using green and red fluorescent proteins (EGFP and dsRed2. Target cells were primary human fibroblasts (PHF and 3T3 cells. Unconcentrated vector preparations produced a coinfection rate of ∼4% (defined as cells that are both red and green as a percentage of all cells infected. Optimized spinoculation, comprising centrifugation at 1200 g for 2 hours at 15∘C, increased the coinfection rate to ∼10%. Concentration by centrifugation at 10,000 g or by flocculation using Polybrene increased the coinfection rate to ∼25%. Combining the two processes, concentration by Polybrene flocculation and optimized spinoculation, increased the coinfection rate to 35% (3T3 or >50% (PHF. Improved coinfection should be valuable in protocols that require high transduction by combinations of two or more retroviral vectors.

  8. Terapia de linguagem na afasia

    Directory of Open Access Journals (Sweden)

    Mauro Spinelli

    1977-12-01

    Full Text Available A terapia da linguagem na afasia foi estudada em 15 pacientes, 8 do sexo masculino e 7 do sexo feminino; a idade variou de menos de 10 anos a mais de 50 anos; em 11 casos a afasia era sequela de acidente vascular cerebral e, em 4, de traumatismo crânio-encefálico. Quanto ao tipo de afasia, 5 pacientes apresentavam déficits predominantemente de expressão e 10 apresentavam déficits receptivos e expressivos em graus equiparáveis. Em 6 casos a terapia foi iniciada dentro dos 3 primeiros meses de instalação do quadro; nos restantes foi iniciada mais tardiamente. Dos 15 pacientes, 11 apresentaram evolução satisfatória, a qual não depndeu do grau de afasia, do tipo de afasia, da idade do paciente, do tipo de patologia e do intervalo entre a instalação do quadro afásico e o início da terapia. A terapia da linguagem no paciente afásico é efetiva, o prognóstico não pode ser feito a priori. Somente a evolução do caso com sua retestagem criteriosa poderá dar dados realmente úteis para se falar em evolução.

  9. Terapia gestáltica

    Directory of Open Access Journals (Sweden)

    Rómulo Burga

    1981-01-01

    Full Text Available La terapia gestáltica a través de sus fundamentos básicos proporciona al hombre los medios necesarios para obtener el atoareness, que genera la auto-realización o auto-apoyo, y así alcanzar el cierre de una gestalt inconclusa, logrando la satisfacción de sus necesidades

  10. Eficacia de terapias biológicas de tipo anti-angiogénico en el cáncer colorrectal metastásico revisión sistemática de la literatura

    OpenAIRE

    Montañez Rivera, Edwin Alexander; Prieto Ruiz, Natalia

    2016-01-01

    Introducción: El cáncer colorrectal (CCR) se encuentra entre los 5 tipos de cáncer con mayor incidencia a nivel mundial. Alrededor del 20% de los casos son diagnosticados en estadios metastásico, donde el tratamiento inicialmente era quimioterapia con una supervivencia global a 5 años de 12 a 14 meses. Es así que se investiga el papel de la angiogénesis tumoral, orientado al desarrollo de terapias, implementando su uso en estadios avanzados. Metodología: Se realizó una búsqueda sistemática...

  11. Amplification and chromosomal dispersion of human endogenous retroviral sequences

    Energy Technology Data Exchange (ETDEWEB)

    Steele, P.E.; Martin, M.A.; Rabson, A.B.; Bryan, T.; O' Brien, S.J.

    1986-09-01

    Endogenous retroviral sequences have undergone amplification events involving both viral and flanking cellular sequences. The authors cloned members of an amplified family of full-length endogenous retroviral sequences. Genomic blotting, employing a flanking cellular DNA probe derived from a member of this family, revealed a similar array of reactive bands in both humans and chimpanzees, indicating that an amplification event involving retroviral and associated cellular DNA sequences occurred before the evolutionary separation of these two primates. Southern analyses of restricted somatic cell hybrid DNA preparations suggested that endogenous retroviral segments are widely dispersed in the human genome and that amplification and dispersion events may be linked.

  12. The use of retroviral vectors for gene therapy-what are the risks? A review of retroviral pathogenesis and its relevance to retroviral vector-mediated gene delivery

    Science.gov (United States)

    Anson, Donald S

    2004-01-01

    Retroviral vector-mediated gene transfer has been central to the development of gene therapy. Retroviruses have several distinct advantages over other vectors, especially when permanent gene transfer is the preferred outcome. The most important advantage that retroviral vectors offer is their ability to transform their single stranded RNA genome into a double stranded DNA molecule that stably integrates into the target cell genome. This means that retroviral vectors can be used to permanently modify the host cell nuclear genome. Recently, retroviral vector-mediated gene transfer, as well as the broader gene therapy field, has been re-invigorated with the development of a new class of retroviral vectors which are derived from lentiviruses. These have the unique ability amongst retroviruses of being able to infect non-cycling cells. Vectors derived from lentiviruses have provided a quantum leap in technology and seemingly offer the means to achieve significant levels of gene transfer in vivo. The ability of retroviruses to integrate into the host cell chromosome also raises the possibility of insertional mutagenesis and oncogene activation. Both these phenomena are well known in the interactions of certain types of wild-type retroviruses with their hosts. However, until recently they had not been observed in replication defective retroviral vector-mediated gene transfer, either in animal models or in clinical trials. This has meant the potential disadvantages of retroviral mediated gene therapy have, until recently, been seen as largely, if not entirely, hypothetical. The recent clinical trial of γc mediated gene therapy for X-linked severe combined immunodeficiency (X-SCID) has proven the potential of retroviral mediated gene transfer for the treatment of inherited metabolic disease. However, it has also illustrated the potential dangers involved, with 2 out of 10 patients developing T cell leukemia as a consequence of the treatment. A considered review of

  13. Terapia ocupacional en medicina paliativa

    OpenAIRE

    Nicora, Yamila

    2009-01-01

    Terapia ocupacional interviene en el tratamiento de pacientes desde muy temprana edad (recién nacidos) hasta ancianos con déficit en el desempeño de alguna o todas las áreas ocupacionales: - Actividades de la vida diaria (AVD) básicas y personales - AVDI (instrumentales) - Educación - Trabajo - Juego - Ocio - Participación Social Se tienen en cuenta las habilidades de desempeño (motoras, de procesamiento...

  14. Duelo, duelo patológico y terapia interpersonal

    National Research Council Canada - National Science Library

    Millán-González, Ricardo; Solano-Medina, Nicolás

    2010-01-01

    .... La terapia interpersonal (TI) aborda cuatro elementos principales, uno de ellos el duelo. Objetivo: Revisar la literatura existente sobre duelo, duelo patologico y tratamiento con terapia interpersonal...

  15. THE EVOLUTION OF ANTI-RETROVIRAL THERAPY IN NIGERIA ...

    African Journals Online (AJOL)

    HIV/AIDS not only represents the most severe ... scourge of HIV-AIDS. The National Agency for the. Control of AIDS (NACA) estimated that as at 2010,. 3.1 million Nigerian were living with the virus and that .... A system for rapid testing of agents with activity against HIV was established at the National Cancer Institute,.

  16. Default from Anti-Retroviral Treatment Programme in Sagamu, Nigeria

    African Journals Online (AJOL)

    To determine the rate and reason for default from antiretroviral treatment (ART) program in Sagamu Nigeria, a cohort of 100 patients on ART was followed up for 12 months at the centre for special studies Olabisi Onabanjo University Teaching Hospital Sagamu between July 2000 and September 2003. The patient chart at ...

  17. Seroprevalance of Helicobacter pylori amongst anti retroviral naive ...

    African Journals Online (AJOL)

    Background and objectives: HIV Infection at any stage alters patients' immunity. The pattern of several diseases including incidence and prevalence has changed due to the HIV pandemic. Infections, infestations and malignancies present more frequently and often in an unusual pattern. Helicobacter pylori is the main cause ...

  18. reasons for change of anti-retroviral therapy (art) drugs

    African Journals Online (AJOL)

    2013-12-01

    Dec 1, 2013 ... and reasons for change, their CD4+ cell counts and clinical events in the course of. HAART. Design: A prospective, observational study. Setting: Kisumu District Hospital and Nairobi Rheumatology Clinic. Subjects: Twenty nine of the 101 patients who were on HAART. Main Outcome Measures: Resistance ...

  19. 5. Gaps in implementation of Anti-Retroviral Treatment

    African Journals Online (AJOL)

    Esem

    Treatment: A case for addressing gender and mental .... lot challenges such as anxiety, suicidal behavior, depression and Post ... suggests cognitive impairment in HIV positive individuals. ... Zambian NGOs and CBOs play a critical role in.

  20. Lipid Profile of Anti Retroviral Treatment Naive HIV Infected Patients ...

    African Journals Online (AJOL)

    hypercholesterolemia [22.4% (22/98) vs. 10.4% (11/106), P = 0.02]. Lower HDL.C was associated with CD4+ cell count < 200 cells/ƒÊL (P = 0.02). Conclusion: Lipid abnormalities are common in treatment.naive HIV.infected patients even in the absence of major host.related risk factors for dyslipidemia. HIV.infected patients ...

  1. reasons for change of anti-retroviral therapy (art) drugs

    African Journals Online (AJOL)

    2013-12-01

    Dec 1, 2013 ... Few studies have been done in resource constrained setting to assess these factors that have a bearing ... surveillance without HAART, CD4+ cell count, HIV viral load and clinical assessment are in patients on parameters to .... no available simple test, for example, urine or saliva test to quantify and prove ...

  2. 5. Gaps in implementation of Anti-Retroviral Treatment

    African Journals Online (AJOL)

    Esem

    ABSTRACT. This paper looks at the current status of HIV infection in. Zambia. The results show that Zambia is among the worst affected with a prevalence of 14.3% in the age group of. 15-49 (ZDHS, 2011). Further it is noted that Prevention and control of HIV and AIDS has been a priority of the. Zambian Government ...

  3. Patients' perceptions of a rural decentralised anti-retroviral therapy ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... management and its impact on direct out-of-pocket spending. Monique Lines1, Fatima Suleman2. 1. Postgraduate Student, Discipline of Pharmaceutical Sciences, School of Health Sciences, University of. KwaZulu-Natal,. 2. Prof Fatima Suleman, Associate Professor, Discipline of Pharmaceutical Sciences, ...

  4. challenges experienced by unemployed adults on anti-retroviral

    African Journals Online (AJOL)

    J MUGUMBATE

    willing to assist but had no sufficient resources to cater for the needs of the unemployed adult on ART. This supports UNICEF, (2006) findings that the extended family needs support in order to efficiently assist other family members. This shows Durkheim's solidarity theory where he postulated the importance of a society's.

  5. Membrane interaction of retroviral Gag proteins

    Directory of Open Access Journals (Sweden)

    Robert Alfred Dick

    2014-04-01

    Full Text Available Assembly of an infectious retroviral particle relies on multimerization of the Gag polyprotein at the inner leaflet of the plasma membrane. The three domains of Gag common to all retroviruses-- MA, CA, and NC-- provide the signals for membrane binding, assembly, and viral RNA packaging, respectively. These signals do not function independently of one another. For example, Gag multimerization enhances membrane binding and is more efficient when NC is interacting with RNA. MA binding to the plasma membrane is governed by several principles, including electrostatics, recognition of specific lipid head groups, hydrophobic interactions, and membrane order. HIV-1 uses many of these principles while Rous sarcoma virus (RSV appears to use fewer. This review describes the principles that govern Gag interactions with membranes, focusing on RSV and HIV-1 Gag. The review also defines lipid and membrane behavior, and discusses the complexities in determining how lipid and membrane behavior impact Gag membrane binding.

  6. Biochemical characterization of novel retroviral integrase proteins.

    Directory of Open Access Journals (Sweden)

    Allison Ballandras-Colas

    Full Text Available Integrase is an essential retroviral enzyme, catalyzing the stable integration of reverse transcribed DNA into cellular DNA. Several aspects of the integration mechanism, including the length of host DNA sequence duplication flanking the integrated provirus, which can be from 4 to 6 bp, and the nucleotide preferences at the site of integration, are thought to cluster among the different retroviral genera. To date only the spumavirus prototype foamy virus integrase has provided diffractable crystals of integrase-DNA complexes, revealing unprecedented details on the molecular mechanisms of DNA integration. Here, we characterize five previously unstudied integrase proteins, including those derived from the alpharetrovirus lymphoproliferative disease virus (LPDV, betaretroviruses Jaagsiekte sheep retrovirus (JSRV, and mouse mammary tumor virus (MMTV, epsilonretrovirus walleye dermal sarcoma virus (WDSV, and gammaretrovirus reticuloendotheliosis virus strain A (Rev-A to identify potential novel structural biology candidates. Integrase expressed in bacterial cells was analyzed for solubility, stability during purification, and, once purified, 3' processing and DNA strand transfer activities in vitro. We show that while we were unable to extract or purify accountable amounts of WDSV, JRSV, or LPDV integrase, purified MMTV and Rev-A integrase each preferentially support the concerted integration of two viral DNA ends into target DNA. The sequencing of concerted Rev-A integration products indicates high fidelity cleavage of target DNA strands separated by 5 bp during integration, which contrasts with the 4 bp duplication generated by a separate gammaretrovirus, the Moloney murine leukemia virus (MLV. By comparing Rev-A in vitro integration sites to those generated by MLV in cells, we concordantly conclude that the spacing of target DNA cleavage is more evolutionarily flexible than are the target DNA base contacts made by integrase during integration

  7. Stavudine, an anti‑retroviral drug induces reactive astrocytes in ...

    African Journals Online (AJOL)

    Stavudine, an anti‑retroviral drug induces reactive astrocytes in motor cortex of albino mice. Agnes A. Nwakanma, Theresa B. Ekanem, Moses B. Ekong, Mokutima A. Eluwa, Eme E. Osim, Terkula Kpela ...

  8. Terapia periodontal no quirúrgica

    OpenAIRE

    Botero Zuluaga, Leticia; Botero Botero, Alejandro; Bedoya Trujillo, Juan Sebastián; Guzmán Zuluaga, Isabel Cristina

    2012-01-01

    Introducción: en el tratamiento de las enfermedades periodontales contamos con la terapia periodontal no quirúrgica, la cual ha sido avalada científicamente mostrando su efectividad. El principal objetivo de este artículo es demostrar la efectividad de la terapia periodontal no quirúrgica evidenciada en múltiples estudios con relación a las indicaciones, aspectos microbiológicos, efectos en los tejidos y la importancia de la terapia de mantenimiento una vez finalizado el tratamiento. Métodos:...

  9. Menopausia y terapia hormonal de reemplazo

    OpenAIRE

    Cobo, Edgard; Fundación Valle de Lili

    1996-01-01

    La terapia hormonal en la menopausia/ menopausia y terapia hormonal de reemplazo (THR)/¿Qué es la menopausia?/ ¿Porqué hay tanto “ruido” acerca de la menopausia, si es un evento natural en la vida de toda mujer?/ ¿Qué significa terapia hormonal de reemplazo?(THR)/ ¿Cuáles son las ventajas de recibir la THR?/ Mejoraría en la calidad de vida/ Prevención de enfermedad/ ¿Quiere esto decir que absolutamente todas las mujeres deber recibir una THR?/ ¿Cuáles son las molestias más frecuentes a las qu...

  10. Identifying Cancer Driver Genes Using Replication-Incompetent Retroviral Vectors

    Directory of Open Access Journals (Sweden)

    Victor M. Bii

    2016-10-01

    Full Text Available Identifying novel genes that drive tumor metastasis and drug resistance has significant potential to improve patient outcomes. High-throughput sequencing approaches have identified cancer genes, but distinguishing driver genes from passengers remains challenging. Insertional mutagenesis screens using replication-incompetent retroviral vectors have emerged as a powerful tool to identify cancer genes. Unlike replicating retroviruses and transposons, replication-incompetent retroviral vectors lack additional mutagenesis events that can complicate the identification of driver mutations from passenger mutations. They can also be used for almost any human cancer due to the broad tropism of the vectors. Replication-incompetent retroviral vectors have the ability to dysregulate nearby cancer genes via several mechanisms including enhancer-mediated activation of gene promoters. The integrated provirus acts as a unique molecular tag for nearby candidate driver genes which can be rapidly identified using well established methods that utilize next generation sequencing and bioinformatics programs. Recently, retroviral vector screens have been used to efficiently identify candidate driver genes in prostate, breast, liver and pancreatic cancers. Validated driver genes can be potential therapeutic targets and biomarkers. In this review, we describe the emergence of retroviral insertional mutagenesis screens using replication-incompetent retroviral vectors as a novel tool to identify cancer driver genes in different cancer types.

  11. Síndrome de lipodistrofia en pacientes con VIH/sida que reciben terapia antirretroviral de gran actividad en Tepic, México Lipodystrophy syndrome in HIV/AIDS patients receiving highly active antiretroviral therapy in Tepic, Mexico

    Directory of Open Access Journals (Sweden)

    Rogelio Alberto Fernández Argüelles

    2012-06-01

    Full Text Available Objetivo: determinar la relación entre la manifestación del síndrome de lipodistrofia y la terapia antirretroviral de gran actividad en pacientes con VIH/sida. Métodos: se realizó un estudio descriptivo, transversal y correlacional en pacientes con VIH/sida que reciben terapia antirretroviral de gran actividad, atendidos entre marzo y diciembre de 2007 en el Centro Ambulatorio de Prevención y Atención del Sida e Infecciones de Transmisión Sexual (CAPASITS de Tepic, Nayarit, México. La definición y diagnóstico del síndrome se realizó mediante el método de The National Centre in HIV Epidemiology and Clinical Research (NCHECR de Australia. Se utilizó la prueba de chi cuadrado para evaluar la dependencia entre el síndrome y la terapia. Se evaluaron 175 pacientes (128 hombres y 47 mujeres, de 19 a 72 años de edad. Resultados: se diagnosticaron 141 pacientes (80,6 con síndrome de lipodistrofia (IC95% 74,7-86.4 %; el 82,6 % correspondió a hombres y el 74,5 % a mujeres. Según la severidad, el porcentaje fue de 17 % de grado 1, 3 % de grado 2, 10 % de grado 3 y 51 % de grado IV. Las pruebas de chi cuadrado para evaluar dependencia entre el síndrome y la terapia resultaron no significativas. Conclusiones: el síndrome de lipodistrofia severo resulta un serio problema para la apariencia de pacientes de VIH/sida que reciben o no la terapia antirretroviral y que agrega un riesgo cardiovascular importante que debe ser considerado para intentar su prevención o tratamiento. Aunque los resultados pueden presentar sesgos y limitaciones, aportan una aproximación importante para sustentar y planificar intervenciones sanitarias que disminuirían el impacto del síndrome en la salud de los pacientes con VIH/sida.Objective: to establish the relationship between lipodystrophy syndrome and highly active anti-retroviral therapy in HIV/AIDS patients. Methods: a cross-sectional, descriptive and co-relational study was conducted in HIV/AIDS patients

  12. The Host RNAs in Retroviral Particles

    Directory of Open Access Journals (Sweden)

    Alice Telesnitsky

    2016-08-01

    Full Text Available As they assemble, retroviruses encapsidate both their genomic RNAs and several types of host RNA. Whereas limited amounts of messenger RNA (mRNA are detectable within virion populations, the predominant classes of encapsidated host RNAs do not encode proteins, but instead include endogenous retroelements and several classes of non-coding RNA (ncRNA, some of which are packaged in significant molar excess to the viral genome. Surprisingly, although the most abundant host RNAs in retroviruses are also abundant in cells, unusual forms of these RNAs are packaged preferentially, suggesting that these RNAs are recruited early in their biogenesis: before associating with their cognate protein partners, and/or from transient or rare RNA populations. These RNAs’ packaging determinants differ from the viral genome’s, and several of the abundantly packaged host ncRNAs serve cells as the scaffolds of ribonucleoprotein particles. Because virion assembly is equally efficient whether or not genomic RNA is available, yet RNA appears critical to the structural integrity of retroviral particles, it seems possible that the selectively encapsidated host ncRNAs might play roles in assembly. Indeed, some host ncRNAs appear to act during replication, as some transfer RNA (tRNA species may contribute to nuclear import of human immunodeficiency virus 1 (HIV-1 reverse transcription complexes, and other tRNA interactions with the viral Gag protein aid correct trafficking to plasma membrane assembly sites. However, despite high conservation of packaging for certain host RNAs, replication roles for most of these selectively encapsidated RNAs—if any—have remained elusive.

  13. Vital role for CD8+ cells in controlling retroviral infections.

    Science.gov (United States)

    Kane, Melissa; Case, Laure K; Golovkina, Tatyana V

    2011-04-01

    Antiviral adaptive immune defenses consist of humoral and cell-mediated responses, which together eliminate extracellular and intracellular virus. As most retrovirus-infected individuals do not raise efficient protective antivirus immune responses, the relative importance of humoral and cell-mediated responses in restraining retroviral infection is not well understood. We utilized retrovirus-resistant I/LnJ mice, which control infection with mouse mammary tumor virus (MMTV) and murine leukemia virus (MuLV) via an adaptive immune mechanism, to assess the contribution of cellular responses and virus-neutralizing antibodies (Abs) to the control of retroviral infection. We found that in retrovirus-infected CD8-deficient I/LnJ mice, viral titers exceed the neutralizing capability of antiviral Abs, resulting in augmented virus spread and disease induction. Thus, even in the presence of robust neutralizing Ab responses, CD8-mediated responses are essential for full protection against retroviral infection.

  14. A look inside HIV resistance through retroviral protease interaction maps.

    Directory of Open Access Journals (Sweden)

    Aleksejs Kontijevskis

    2007-03-01

    Full Text Available Retroviruses affect a large number of species, from fish and birds to mammals and humans, with global socioeconomic negative impacts. Here the authors report and experimentally validate a novel approach for the analysis of the molecular networks that are involved in the recognition of substrates by retroviral proteases. Using multivariate analysis of the sequence-based physiochemical descriptions of 61 retroviral proteases comprising wild-type proteases, natural mutants, and drug-resistant forms of proteases from nine different viral species in relation to their ability to cleave 299 substrates, the authors mapped the physicochemical properties and cross-dependencies of the amino acids of the proteases and their substrates, which revealed a complex molecular interaction network of substrate recognition and cleavage. The approach allowed a detailed analysis of the molecular-chemical mechanisms involved in substrate cleavage by retroviral proteases.

  15. Retroviral integration profiles: their determinants and implications for gene therapy

    Directory of Open Access Journals (Sweden)

    Kwang-il Lim

    2012-04-01

    Full Text Available Retroviruses have often been used for gene therapy because oftheir capacity for the long-term expression of transgenes via stableintegration into the host genome. However, retroviral integrationcan also result in the transformation of normal cells into cancercells, as demonstrated by the incidence of leukemia in a recentretroviral gene therapy trial in Europe. This unfortunate outcomehas led to the rapid initiation of studies examining variousbiological and pathological aspects of retroviral integration. Thisreview summarizes recent findings from these studies, includingthe global integration patterns of various types of retroviruses,viral and cellular determinants of integration, implications ofintegration for gene therapy and retrovirus-mediated infectiousdiseases, and strategies to shift integration to safe host genomicloci. A more comprehensive and mechanistic understanding ofretroviral integration processes will eventually make it possible togenerate safer retroviral vector platforms in the near future. [BMBreports 2012; 45(4: 207-212

  16. Acute retroviral syndrome in Slovenian patients infected with HIV

    Directory of Open Access Journals (Sweden)

    Mateja Pirš

    2005-06-01

    Full Text Available Background: Two to six weeks after primary infection with HIV 50 to 90 percent of patients develop an acute retroviral syndrome which usually presents with mononucleosis or flu-like illness. Due to nonspecific symptoms ARS is frequently misdiagnosed.Patients and methods: Data of Slovenian patients with acute retroviral syndrome is shown, as well as their symptoms, approaches to management and diagnostic particularities of primary HIV infection.Conclusions: The combination of particular symptoms and epidemiological data should lead us to consider the possibility of an early HIV infection.

  17. Análise de interações medicamentosas e alimentares em pacientes com AIDS em uso da TARV associada à terapia de resgate

    Directory of Open Access Journals (Sweden)

    Adriana Antônia Cruz Furini

    2016-07-01

    the rescue therapy in the Syndrome Immunodeficiency Acquired increases the risks of drug and food interactions. The aim in this study was to analyze the risk to drug and food interactions in the use of the antiretroviral therapy with drugs of the rescue by 40 AIDS patients of a quaternary hospital of the northwest region of the State of São Paulo. This is an exploratory, descriptive study, with an approach quantitative and qualitative that it was realized in the period between 2012 and 2013. The patients were interviewed through a questionnaire developed by the multidisciplinary healthcare team. The interviews were conducted by team of pharmacists. The interactions were evaluated by computerized databases. The scheme composed by darunavir, enfuvirtide, lamivudine, raltegravir and ritonavir was the most used (32.5 % by the patients. The antiretroviral drugs that more presented risk to food interactions were ritonavir, darunavir and tenofovir, in 31 (77.5 %, 29 (72.5 % and 21 (52.5 % patients, respectively. Were identified 87 potential drug interactions and seven interactions were classified as major level. In this study all prescriptions presented risks to drug interactions and this demonstrated the need of monitoring. However, the most of the drug interactions was beneficial and result of the potentiating of the therapeutic effect as consequence of the synergism between the drugs of the antiretroviral therapy. The interaction between pharmacists and prescribers can help to provide to rational and safe pharmacotherapy to the patient.Keywords: Acquired Immunodeficiency Syndrome. HIV. Anti-Retroviral Agents. Drug Interactions. Food-Drug Interactions.

  18. Terapia nutricional e sepse neonatal

    Directory of Open Access Journals (Sweden)

    Brunnella Alcantara Chagas de Freitas

    2011-12-01

    Full Text Available O objetivo do presente artigo é revisar a literatura acerca dos conhecimentos atuais relativos à terapia nutricional - enteral e parenteral - para os recém-nascidos pré-termo, principalmente os de muito baixo peso, destacando seu efeito protetor na sepse neonatal e na enterocolite necrosante. As diferentes modalidades de alimentação do recém-nascido prematuro - especialmente para aqueles de muito baixo peso - e seu efeito protetor na diminuição de complicações (mormente as infecciosas foram analisadas. A utilização preferencial do leite materno na nutrição enteral, o controle das ofertas energético-protéicas, o início precoce da nutrição enteral mínima, a introdução precoce da alimentação parenteral - nas primeiras 24 horas - e a utilização dos imunonutrientes que tenham estudos suficientes para fundamentar sua indicação podem se constituir em boas diretrizes adjuvantes na prevenção da sepse neonatal e da enterocolite necrosante. Sem embargo, percebe-se a necessidade de mais estudos - preferencialmente multicêntricos, controlados e randomizados - para esclarecer o papel protetor da nutrição no RNPT, não somente na prevenção de infecções, mas também para auxiliar o desenvolvimento neural e a prevenção de consequências deletérias futuras.

  19. Terapia cognitivo-comportamental da fobia social

    OpenAIRE

    Ito,Lígia M; Roso,Miréia C; Tiwari,Shilpee; Kendall,Philip C; Asbahr,Fernando R

    2008-01-01

    OBJETIVO: Este artigo revisa aspectos relevantes da fobia social e os estágios de tratamento através da terapia cognitivo-comportamental em crianças, adolescentes e adultos. MÉTODO: A partir do banco de dados Medline, realizou-se revisão da literatura publicada a respeito do tratamento da fobia social por meio da terapia cognitivo-comportamental. RESULTADOS: Revisão da literatura sugere que a fobia social é uma condição prevalente e crônica, caracterizada por inibição social e timidez excessi...

  20. Terapia familiar y de pareja de ancianos

    OpenAIRE

    Garrido Fernández, Miguel; Cosano, Andrés; Ojeda Moreno, Mª P.; Rodríguez Testal, Juan Francisco

    1998-01-01

    La revisión bibliográfica que presentamos en este trabajo muestra el creciente interés en relación con la participación de las personas mayores en la terapia familiar y de pareja. Se ponen de relieve las peculiaridades de esta población por los estresores que habitualmente experimentan pero, especial y significativamente, por la capacidad o potencial de cambio que tienen las personas de edad avanzada. Por ello, es preciso que la terapia se ajuste a sus características y l...

  1. Insulators to Improve the Safety of Retroviral Vectors for HIV Gene Therapy

    Science.gov (United States)

    Browning, Diana L.; Trobridge, Grant D.

    2016-01-01

    Retroviral vector gene therapy is a promising approach to treating HIV-1. However, integrated vectors are mutagens with the potential to dysregulate nearby genes and cause severe adverse side effects. Leukemia has already been a documented severe adverse event in gene therapy clinical trials for the treatment of primary immunodeficiencies. These side effects will need to be reduced or avoided if retroviral vectors are to be used clinically for HIV-1 treatment. The addition of chromatin insulators to retroviral vectors is a potential strategy for reducing adverse side effects. Insulators have already been effectively used in retroviral vectors to reduce genotoxicity in pre-clinical studies. Here, we will review how insulators function, genotoxicity in gene therapy clinical trials, the design of insulated retroviral vectors, promising results from insulated retroviral vector studies, and considerations for the development of insulated retroviral treatment vectors for HIV-1 gene therapy. PMID:28424756

  2. Retroviral gene transfer into primary human NK cells activated by IL-2 and K562 feeder cells expressing membrane-bound IL-21.

    Science.gov (United States)

    Streltsova, Maria A; Barsov, Eugene; Erokhina, Sofia A; Kovalenko, Elena I

    2017-11-01

    Natural killer (NK) cells are capable of rapidly recognizing and efficiently killing tumor cells. This makes them a potentially promising agent for cancer immunotherapy. Additional genetic modifications of NK cells may further improve their anti-tumor efficacy. Numerous technical challenges associated with gene delivery into NK cells have significantly tempered this approach. We achieved efficient retroviral vector transduction of primary human NK cells that were stimulated by a combination of IL-2 and engineered K562 cells expressing membrane-bound IL-21. The activated NK cells were in less differentiated state and expressed NK cell activation receptors NKG2D, NKp30, CD16, and were highly HLA-DR-positive. This NK cell population was highly susceptible to the transduction by both GFP- and NGFR-expressing retroviral vectors, with transduction efficiency exceeding 50%. More mature CD57+ NK cell population was generally resistant to retroviral vector transduction because of poor response to the stimulation. Our findings may facilitate retroviral vector-mediated genetic engineering of human primary NK cells for future immunotherapies. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Interleukin-Encoding Adenoviral Vectors as Genetic Adjuvant for Vaccination against Retroviral Infection

    Science.gov (United States)

    Ohs, Inga; Windmann, Sonja; Wildner, Oliver; Dittmer, Ulf; Bayer, Wibke

    2013-01-01

    Interleukins (IL) are cytokines with stimulatory and modulatory functions in the immune system. In this study, we have chosen interleukins which are involved in the enhancement of TH2 responses and B cell functions to analyze their potential to improve a prophylactic adenovirus-based anti-retroviral vaccine with regard to antibody and virus-specific CD4+ T cell responses. Mice were vaccinated with an adenoviral vector which encodes and displays the Friend Virus (FV) surface envelope protein gp70 (Ad.pIXgp70) in combination with adenoviral vectors encoding the interleukins IL4, IL5, IL6, IL7 or IL23. Co-application of Ad.pIXgp70 with Ad.IL5, Ad.IL6 or Ad.IL23 resulted in improved protection with high control over FV-induced splenomegaly and reduced viral loads. Mice co-immunized with adenoviral vectors encoding IL5 or IL23 showed increased neutralizing antibody responses while mice co-immunized with Ad.IL6 or Ad.IL23 showed improved FV-specific CD4+ T cell responses compared to mice immunized with Ad.pIXgp70 alone. We show that the co-application of adenoviral vectors encoding specific interleukins is suitable to improve the vaccination efficacy of an anti-retroviral vaccine. Improved protection correlated with improved CD4+ T cell responses and especially with higher neutralizing antibody titers. The co-application of selected interleukin-encoding adenoviral vectors is a valuable tool for vaccination with regard to enhancement of antibody mediated immunity. PMID:24349306

  4. Interleukin-encoding adenoviral vectors as genetic adjuvant for vaccination against retroviral infection.

    Directory of Open Access Journals (Sweden)

    Inga Ohs

    Full Text Available Interleukins (IL are cytokines with stimulatory and modulatory functions in the immune system. In this study, we have chosen interleukins which are involved in the enhancement of TH2 responses and B cell functions to analyze their potential to improve a prophylactic adenovirus-based anti-retroviral vaccine with regard to antibody and virus-specific CD4(+ T cell responses. Mice were vaccinated with an adenoviral vector which encodes and displays the Friend Virus (FV surface envelope protein gp70 (Ad.pIXgp70 in combination with adenoviral vectors encoding the interleukins IL4, IL5, IL6, IL7 or IL23. Co-application of Ad.pIXgp70 with Ad.IL5, Ad.IL6 or Ad.IL23 resulted in improved protection with high control over FV-induced splenomegaly and reduced viral loads. Mice co-immunized with adenoviral vectors encoding IL5 or IL23 showed increased neutralizing antibody responses while mice co-immunized with Ad.IL6 or Ad.IL23 showed improved FV-specific CD4(+ T cell responses compared to mice immunized with Ad.pIXgp70 alone. We show that the co-application of adenoviral vectors encoding specific interleukins is suitable to improve the vaccination efficacy of an anti-retroviral vaccine. Improved protection correlated with improved CD4(+ T cell responses and especially with higher neutralizing antibody titers. The co-application of selected interleukin-encoding adenoviral vectors is a valuable tool for vaccination with regard to enhancement of antibody mediated immunity.

  5. Prospects for Foamy Viral Vector Anti-HIV Gene Therapy

    Directory of Open Access Journals (Sweden)

    Arun K. Nalla

    2016-03-01

    Full Text Available Stem cell gene therapy approaches for Human Immunodeficiency Virus (HIV infection have been explored in clinical trials and several anti-HIV genes delivered by retroviral vectors were shown to block HIV replication. However, gammaretroviral and lentiviral based retroviral vectors have limitations for delivery of anti-HIV genes into hematopoietic stem cells (HSC. Foamy virus vectors have several advantages including efficient delivery of transgenes into HSC in large animal models, and a potentially safer integration profile. This review focuses on novel anti-HIV transgenes and the potential of foamy virus vectors for HSC gene therapy of HIV.

  6. Anti-Human Immunodeficiency Virus (HIV) Agents | Okolie | Journal ...

    African Journals Online (AJOL)

    This article gives a brief review of anti-retroviral agents with activity against the Human Immunodeficiency Virus (HIV) the causative agen of Acquired Immunodeficiency Syndrome (AIDS). It also outlines the principles, mode of action of anti-HIV agents and their sites of therapeutic intervention. Zidovudine or Azidothymidine ...

  7. Identification of Retroviral Late Domains as Determinants of Particle Size

    OpenAIRE

    Garnier, Laurence; Parent, Leslie J.; Rovinski, Benjamin; Cao, Shi-Xian; Wills, John W.

    1999-01-01

    Retroviral Gag proteins, in the absence of any other viral products, induce budding and release of spherical, virus-like particles from the plasma membrane. Gag-produced particles, like those of authentic retrovirions, are not uniform in diameter but nevertheless fall within a fairly narrow distribution of sizes. For the human immunodeficiency virus type 1 (HIV-1) Gag protein, we recently reported that elements important for controlling particle size are contained within the C-terminal region...

  8. Terapia familiar sistêmica e idosos: contribuições e desafios

    National Research Council Canada - National Science Library

    Maria Clara P. de Paula Couto; Laíssa Eschiletti Prati; Deusivania Vieira da Silva Falcão; Sílvia Helena Koller

    2008-01-01

    .... Quatro modalidades terapêuticas são abordadas: a terapia individual com idosos, a terapia de casal na terceira idade, o atendimento familiar com membros idosos e o idoso percebido como recurso à terapia familiar...

  9. Retroviral Vectors: Post Entry Events and Genomic Alterations

    Directory of Open Access Journals (Sweden)

    Christof von Kalle

    2011-04-01

    Full Text Available The curative potential of retroviral vectors for somatic gene therapy has been demonstrated impressively in several clinical trials leading to sustained long-term correction of the underlying genetic defect. Preclinical studies and clinical monitoring of gene modified hematopoietic stem and progenitor cells in patients have shown that biologically relevant vector induced side effects, ranging from in vitro immortalization to clonal dominance and oncogenesis in vivo, accompany therapeutic efficiency of integrating retroviral gene transfer systems. Most importantly, it has been demonstrated that the genotoxic potential is not identical among all retroviral vector systems designed for clinical application. Large scale viral integration site determination has uncovered significant differences in the target site selection of retrovirus subfamilies influencing the propensity for inducing genetic alterations in the host genome. In this review we will summarize recent insights gained on the mechanisms of insertional mutagenesis based on intrinsic target site selection of different retrovirus families. We will also discuss examples of side effects occurring in ongoing human gene therapy trials and future prospectives in the field.

  10. Terapia celular antiparkinsoniana con cuerpo carotídeo

    OpenAIRE

    Toledo, Juan José

    2015-01-01

    La terapia celular es una terapia avanzada en la que las células pueden ser usadas como auténticos medicamentos. Como elemento esencial de la medicina regenerativa, el objetivo principal de estas terapias es la sustitución de tejidos dañados o deficientes por otros sanos o funcionales. Este tipo de terapias son una gran esperanza para el tratamiento de enfermedades prevalentes como algunas enfermedades neurodegenerativas, cuya mortalidad y morbilidad se incrementa año a año en relación con...

  11. Terapia génica: estado actual y perspectivas

    OpenAIRE

    Cayón Somacarrera, Silvia

    2017-01-01

    El objetivo de la terapia génica es llevar a cabo modificaciones genéticas de las células del paciente con un fin terapéutico. Actualmente, la única modalidad de terapia génica en desarrollo es la dirigida a células somáticas, no germinales, lo que asegura que la transferencia sólo afecte al individuo en tratamiento y no a su descendencia. En este tipo de terapia las células a las cuales se dirige la terapia suelen ser aquellas involucradas en el proceso patogénico, sin embargo, en ciertas oc...

  12. An automated system for screening retroviral expression constructs in microplate format.

    Science.gov (United States)

    Stump, Mark D; Di Sera, Leonardo; Rebentisch, Matthew; Endo, Mark; Pierce, Michael; Kamb, Alexander

    2002-06-01

    Retroviruses are useful for genetics studies to deliver genes that express proteins, peptides, and RNAs. Several steps, including DNA preparation, transfection, packaging, transduction, and assay, are required to execute screens using retroviral constructs. Unlike screens with purified components, whole-cell assays using retroviral constructs need a large number of steps with microplate manipulations. The nature of these steps, especially the involvement of cultured mammalian cells, limits the throughput of such screens. To improve the efficiency of genetic experiments with retroviral expression vectors, an automated system for retroviral screening in microplates was devised and tested. The system, called Somata, provides high throughputs and robust, reproducible performance.

  13. DE LA TERAPIA CELULAR A LA REGENERACION PERIODONTAL

    National Research Council Canada - National Science Library

    Pérez Borrego, Amparo; Domínguez Rodríguez, Libia; Ilisástigui Ortueta, C. Zaida Teresa

    2009-01-01

    .... La terapia celular regenerativa es un proceder que está dando sus primeros pasos, no obstante se han obtenido avances en múltiples enfermedades, por lo que la aplicación de las células madre adultas constituye una terapia muy esperanzadora para la regeneración periodontal.

  14. Delivery of Short Hairpin RNA Sequences by Using a Replication-Competent Avian Retroviral Vector

    OpenAIRE

    Bromberg-White, Jennifer L.; Webb, Craig P; Patacsil, Veronique S.; Miranti, Cindy K.; Williams, Bart O.; Holmen, Sheri L.

    2004-01-01

    While recent studies have demonstrated that retroviral vectors can be used to stably express short hairpin RNA (shRNA) to inhibit gene expression, these studies have utilized replication-defective retroviruses. We describe the creation of a replication-competent, Gateway-compatible retroviral vector capable of expressing shRNA that inhibits the expression of specific genes.

  15. Delivery of short hairpin RNA sequences by using a replication-competent avian retroviral vector.

    Science.gov (United States)

    Bromberg-White, Jennifer L; Webb, Craig P; Patacsil, Veronique S; Miranti, Cindy K; Williams, Bart O; Holmen, Sheri L

    2004-05-01

    While recent studies have demonstrated that retroviral vectors can be used to stably express short hairpin RNA (shRNA) to inhibit gene expression, these studies have utilized replication-defective retroviruses. We describe the creation of a replication-competent, Gateway-compatible retroviral vector capable of expressing shRNA that inhibits the expression of specific genes.

  16. Terapia familiar en los trastornos de personalidad

    OpenAIRE

    Laura Rodríguez Moya; José Carlos Peláez

    2013-01-01

    La enfermedad mental afecta no solo al paciente sino también a su familia, dificulta la comunicación intrafamiliar, puede generar patologías adicionales en los familiares y todo ello empeorar la evolución del trastorno. Las terapias familiares de tipo psicoeducativo mejoran el pronóstico de la enfermedad y además previenen la aparición de otros trastornos en los familiares. Los elementos más importantes de estas intervenciones son la psicoeducación sobre el trastorno, el re-establecimiento de...

  17. Terapia cognitivo-conductual y psicosis

    OpenAIRE

    CARLOS CUEVAS-YUST; SALVADOR PERONA-GARCELÁN

    2002-01-01

    En una patología, la psicosis, tradicionalmente reservada al tratamiento psiquiátrico, resulta especialmente interesante y prometedora la aparición de las intervenciones psicológicas. De hecho, la terapia cognitivo-conductual (TCC) está mostrando ser una aproximación efectiva en el tratamiento de síntomas psicóticos positivos resistentes a la medicación neuroléptica, existiendo incluso alguna evidencia de que podría contribuir a la reducción de las recaídas. En el presente trabajo describimos...

  18. Terapia Ocupacional Pediátrica

    OpenAIRE

    Pérez Fernández, Germán

    2016-01-01

    El artículo muestra la naturaleza y las actividades propias de la Terapia Ocupacional, y especifica sus posibilidades para promover el desarrollo global de los niños con Síndrome de Down, de modo que alcancen un nivel óptimo de funcionamiento en el hogar, la escuela y el juego o, lo que es lo mismo, logrando así un nivel de autonomía e independencia. Describe el procesamiento e integración sensorial, es decir, su capacidad para organizar e integrar los estímulos sensoriales, aplicándolos a la...

  19. Tratamiento del hombro doloroso mediante terapia manual

    OpenAIRE

    Gabucio López, Pedro

    2008-01-01

    Introducción: Las disfunciones de hombro son un problema de salud común en las sociedades occidentales. Algunos protocolos de tratamiento han sido desarrollados mediante ensayos clínicos con pacientes que presentan dolor de hombro. Sin embargo, no hay evidencias que sustenten que un protocolo es mejor que otros. El principal objetivo de este trabajo es presentar un caso clínico en el que mediante terapia manual y la prescripción de ejercicios físicos se consigue la resolución del ...

  20. Los ritmos como terapia para la impulsividad

    Directory of Open Access Journals (Sweden)

    Mónica Triviño

    2012-10-01

    Full Text Available Investigaciones recientes muestran que el uso de patrones rítmicos facilita la respuesta óptima en el tiempo, por lo que el entrenamiento mediante ritmos podría proponerse como terapia novedosa ante problemas como la impulsividad. Esto podría beneficiar a pacientes con daño prefrontal o personas con trastorno por déficit de atención e hiperactividad (TDAH, que suelen mostrar conductas impulsivas, así como dificultad para estimar el paso del tiempo.

  1. Células madre y terapia celular

    Directory of Open Access Journals (Sweden)

    Elso Manuel Cruz Cruz

    2015-03-01

    Full Text Available Una célula madre (CM o célula troncal es aquella capaz de dividirse indefinidamente y diferenciarse a distintos tipos de células especializadas, no sólo morfológica sino también funcionalmente. Las células madre pueden clasificarse atendiendo a su origen en células madre adultas (CMA y células madre embrionarias (CME. Por sus características, las CM tienen potencialidades para diversos usos en la práctica clínica. La primera es como vehículo terapéutico de genes, en el caso de enfermedades monogénicas o incluso como vehículo de terapias antitumorales o antiangiogénicas. La segunda y principal aplicación es, aprovechando su potencial de diferenciación, en la regeneración de tejidos destruidos o dañados, como terapia de reemplazo celular o medicina regenerativa. En esta área se están desarrollando trabajos de investigación donde se busca reemplazar células dañadas por otras que restituyan la función normal de los tejidos u órganos; en enfermedades como: diabetes mellitus, enfermedades cardiovasculares, enfermedad de Parkinson y enfermedades de células sanguíneas. Actualmente existen muchas investigaciones enfocadas a descubrir células progenitoras que sirvan como banco de células para usos terapéuticos. Se reporta el empleo de varias estrategias, las que incluyen: terapias celulares derivadas de células autólogas; terapias celulares derivadas de líneas celulares establecidas desde una variedad de CM que incluyen MO, cordón umbilical, CME, así como células de tejidos y órganos de animales genéticamente modificados. Las principales aplicaciones se realizan con CM de la médula ósea (MO, ya que esta es un recurso celular propio, accesible y abundante para la terapia celular. (1 En la MO existe un grupo heterogéneo de CMA; además de las hematopoyéticas (CMH están las: endoteliales, mesenquimales (CMM, de la población lateral, progenitoras adultas multipotentes, ovales y también células madre muy peque

  2. Retroviral transcriptional regulation and embryonic stem cells: war and peace.

    Science.gov (United States)

    Schlesinger, Sharon; Goff, Stephen P

    2015-03-01

    Retroviruses have evolved complex transcriptional enhancers and promoters that allow their replication in a wide range of tissue and cell types. Embryonic stem (ES) cells, however, characteristically suppress transcription of proviruses formed after infection by exogenous retroviruses and also of most members of the vast array of endogenous retroviruses in the genome. These cells have unusual profiles of transcribed genes and are poised to make rapid changes in those profiles upon induction of differentiation. Many of the transcription factors in ES cells control both host and retroviral genes coordinately, such that retroviral expression patterns can serve as markers of ES cell pluripotency. This overlap is not coincidental; retrovirus-derived regulatory sequences are often used to control cellular genes important for pluripotency. These sequences specify the temporal control and perhaps "noisy" control of cellular genes that direct proper cell gene expression in primitive cells and their differentiating progeny. The evidence suggests that the viral elements have been domesticated for host needs, reflecting the wide-ranging exploitation of any and all available DNA sequences in assembling regulatory networks. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  3. Novel Principles of Gamma-Retroviral Insertional Transcription Activation in Murine Leukemia Virus-induced End-stage Tumors

    DEFF Research Database (Denmark)

    Sokol, Martin; Wabl, Matthias; Rius Ruiz, Irene

    2014-01-01

    Background Insertional mutagenesis screens of retrovirus-induced mouse tumors have proven valuable in human cancer research and for understanding adverse effects of retroviral-based gene therapies. In previous studies, the assignment of mouse genes to individual retroviral integration sites has b......, and for understanding fundamental cellular regulatory principles and retroviral biology.......Background Insertional mutagenesis screens of retrovirus-induced mouse tumors have proven valuable in human cancer research and for understanding adverse effects of retroviral-based gene therapies. In previous studies, the assignment of mouse genes to individual retroviral integration sites has...

  4. Gestalt-Terapia e Terapia Sistêmica: o corpo em psicoterapia

    Directory of Open Access Journals (Sweden)

    Marília Toscano de Araujo Gurgel

    2008-06-01

    Full Text Available Este trabalho demonstra a contribuição da abordagem corporal da Gestalt-Terapia para a Terapia Familiar Sistêmica. O método utilizado foi a gravação de uma oficina de corpo estruturada em saberes das duas abordagens. A oficina proporcionou, a cada participante, maior qualidade de atenção, presença, contato e criatividade, uma forma mais integrada de construir sua identidade. O entrecruzamento das duas abordagens trouxe às pessoas maior consciência de quem são e como são no "mundo", ajudando-as no processo de assunção da história que contam. A experiência mostrou aos terapeutas as possibilidades que o trabalho corporal oferece como método de apreensão da realidade co-construída.

  5. The study of labeling with Iodine-131 of monoclonal antibody anti-CD20 used for the treatment of non-Hodgkin lymphoma; Estudo de marcacao com Iodo-131 de anticorpo monoclonal anti-CD20 na terapia de linfoma nao-Hodgkin

    Energy Technology Data Exchange (ETDEWEB)

    Akanji, Akinkunmi Ganiyu

    2006-07-01

    Lymphomas are malignancies of the lymphatic system, described by Thomas Hodgkin in 1932. Traditionally, lymphomas are classified in two basic groups: Hodgkin disease and non-Hodgkin lymphoma (NHL). Patients with NHL were earlier treated with radiotherapy alone or in combination with immunotherapy using monoclonal antibody anti-CD20 (ex., Rituximab-Mabthera, Roche). However, Radioimmunotherapy is a new modality of treatment for patients with NHL, in which cytotoxic radiation from therapeutic radioisotopes is delivered to tumors through monoclonal antibodies. This study focused on labeling conditions of monoclonal antibody anti-CD20 (Rituximab-Mabthera, Roche) with iodine-131, by direct radioiodination method using Chloramine-T as oxidizing agent. Labeling parameters investigated were: Radiochemical purity (RP), method of purification, incubation time, antibody mass, oxidative agent mass, stability in vitro, stability in vivo, immunoreactivity and biological distribution performed in normal Swiss mouse. Product of high radiochemical purity was obtained with no notable difference between the methods applied. No clear evidence of direct influence of incubation time on radiochemical purity of the labeled antibody was observed. Whereas, a clear evidence of direct influence of activity on radiochemical purity of the labeled antibody was observed when antibody mass was varied. After purification, the labeled product presented radiochemical purity of approximately 100 %. Product of superior radiochemical yield was observed when standard condition of labeling was used. The labeled product presented variation in radiochemical purity using five different stabilizer conditions. The condition in which gentisic acid was combined with freeze appears more suitable and capable of minimizing autoradiolysis of the antibody labeled with high therapeutic activity of iodine-131. The labeled product presented low immunoreactivity when compared to the literature. Biological distribution in

  6. Hearing disorder in HIV positive adult patients not on Anti ...

    African Journals Online (AJOL)

    Objectives: To determine the prevalence and type of hearing disorders in HIV positive patients not on anti - retroviral drugs (ARVs) and correlate this with the world health Organization (WHO) stage of HIV disease and CD4 positive cell counts. Design: Case control study. Setting: comprehensive care clinic (CCC) and ...

  7. Mechanisms and factors that influence high frequency retroviral recombination

    DEFF Research Database (Denmark)

    Delviks-Frankenberry, Krista; Galli, Andrea; Nikolaitchik, Olga

    2011-01-01

    With constantly changing environmental selection pressures, retroviruses rely upon recombination to reassort polymorphisms in their genomes and increase genetic diversity, which improves the chances for the survival of their population. Recombination occurs during DNA synthesis, whereby reverse...... transcriptase undergoes template switching events between the two copackaged RNAs, resulting in a viral recombinant with portions of the genetic information from each parental RNA. This review summarizes our current understanding of the factors and mechanisms influencing retroviral recombination, fidelity...... of the recombination process, and evaluates the subsequent viral diversity and fitness of the progeny recombinant. Specifically, the high mutation rates and high recombination frequencies of HIV-1 will be analyzed for their roles in influencing HIV-1 global diversity, as well as HIV-1 diagnosis, drug treatment...

  8. Terapia cognitivo-conductual y psicosis

    Directory of Open Access Journals (Sweden)

    CARLOS CUEVAS-YUST

    2002-01-01

    Full Text Available En una patología, la psicosis, tradicionalmente reservada al tratamiento psiquiátrico, resulta especialmente interesante y prometedora la aparición de las intervenciones psicológicas. De hecho, la terapia cognitivo-conductual (TCC está mostrando ser una aproximación efectiva en el tratamiento de síntomas psicóticos positivos resistentes a la medicación neuroléptica, existiendo incluso alguna evidencia de que podría contribuir a la reducción de las recaídas. En el presente trabajo describimos las etapas de la TCC en la psicosis, así como su adaptación a esta patología.

  9. Alteration of blood-brain barrier integrity by retroviral infection.

    Directory of Open Access Journals (Sweden)

    Philippe V Afonso

    2008-11-01

    Full Text Available The blood-brain barrier (BBB, which forms the interface between the blood and the cerebral parenchyma, has been shown to be disrupted during retroviral-associated neuromyelopathies. Human T Lymphotropic Virus (HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP is a slowly progressive neurodegenerative disease associated with BBB breakdown. The BBB is composed of three cell types: endothelial cells, pericytes and astrocytes. Although astrocytes have been shown to be infected by HTLV-1, until now, little was known about the susceptibility of BBB endothelial cells to HTLV-1 infection and the impact of such an infection on BBB function. We first demonstrated that human cerebral endothelial cells express the receptors for HTLV-1 (GLUT-1, Neuropilin-1 and heparan sulfate proteoglycans, both in vitro, in a human cerebral endothelial cell line, and ex vivo, on spinal cord autopsy sections from HAM/TSP and non-infected control cases. In situ hybridization revealed HTLV-1 transcripts associated with the vasculature in HAM/TSP. We were able to confirm that the endothelial cells could be productively infected in vitro by HTLV-1 and that blocking of either HSPGs, Neuropilin 1 or Glut1 inhibits this process. The expression of the tight-junction proteins within the HTLV-1 infected endothelial cells was altered. These cells were no longer able to form a functional barrier, since BBB permeability and lymphocyte passage through the monolayer of endothelial cells were increased. This work constitutes the first report of susceptibility of human cerebral endothelial cells to HTLV-1 infection, with implications for HTLV-1 passage through the BBB and subsequent deregulation of the central nervous system homeostasis. We propose that the susceptibility of cerebral endothelial cells to retroviral infection and subsequent BBB dysfunction is an important aspect of HAM/TSP pathogenesis and should be considered in the design of future therapeutics strategies.

  10. Terapias cognitivo-conductuales en la fobia social, en adultos

    OpenAIRE

    San Vicente Montalbán, Ainara

    2015-01-01

    La fobia social es una enfermedad psiquiátrica que causa costes socioeconómicos significativos y que presenta una alta comorbilidad. Las terapias cognitivo-conductuales (TCC) pueden ser una alternativa de tratamiento efectiva, ya que buscan el cambio de pensamientos y comportamientos adquiridos en una enfermedad con un alto componente de aprendizaje. Objetivo: Verificar la efectividad de las terapias cognitivo-conductuales (TCC) con respecto a otros tratamientos empleados en la fobia soci...

  11. Multidrug resistance and retroviral transduction potential in human small cell lung cancer cell lines

    DEFF Research Database (Denmark)

    Theilade, M D; Gram, G J; Jensen, P B

    1999-01-01

    Multidrug resistance (MDR) remains a major problem in the successful treatment of small cell lung cancer (SCLC). New treatment strategies are needed, such as gene therapy specifically targeting the MDR cells in the tumor. Retroviral LacZ gene-containing vectors that were either pseudotyped...... cells, and that MLV-A as well as GALV-1 retroviral vectors are suitable for further development of gene therapy in SCLC....

  12. Contracepção hormonal e anti-retrovirais em mulheres infectadas pelo HIV Hormonal contraception and antiretroviral therapy among HIV-infected women

    Directory of Open Access Journals (Sweden)

    Eliana Amaral

    2006-11-01

    Full Text Available Há controvérsia sobre a relação entre o uso de contraceptivos hormonais e o risco de adquirir o vírus da imunodeficiência humana (HIV, e pouco se sabe sobre os efeitos da contracepção hormonal em mulheres infectadas (efeitos colaterais, distúrbios menstruais, progressão da doença, interações com terapias anti-retrovirais. O objetivo deste artigo foi revisar os dados disponíveis quanto à vulnerabilidade ao HIV e à sua transmissibilidade na vigência do uso de contraceptivos hormonais bem como as conseqüências potenciais do uso desses contraceptivos por mulheres HIV-positivas sob terapia anti-retroviral (TARV, com ênfase nas interações medicamentosas. Concluiu-se que ainda não é possível elaborar recomendações, baseadas em evidências, sobre a contracepção hormonal em mulheres portadoras do HIV sob TARV. Assim, os infectologistas e os ginecologistas devem estar atentos às interações potenciais que possam representar aumento de efeitos adversos, individualizando a orientação sobre os esteróides contraceptivos, suas doses e vias de administração, considerando a TARV em uso.There is much controversy regarding the realtionship between the use of hormonal contraceptives and the risk of acquiring human immunodeficiency virus (HIV, and little is known about the effects of hormonal contraception in HIV-infected women (adverse events, menstrual disorders, disease progression, antiretroviral therapy interactions. The aim of the present study was to review available data regarding HIV vulnerability and transmission associated with hormonal contraceptives and the use of these contraceptives by women on antiretroviral therapy, with emphasis on drug interactions. In conclusion, it was not possible to offer evidence-based recommendations for the use of hormonal contraceptives among HIV-infected women under antiretroviral therapy. Infectious disease specialists and gynecologists providing care should be cautious about potential

  13. Terapia biológica en enfermedades reumatológicas

    Directory of Open Access Journals (Sweden)

    Manuel F Ugarte-Gil

    2013-04-01

    Full Text Available El advenimiento del uso de terapias biológicas en Reumatología ha modificado significativamente el pronóstico de pacientes portadores de artritis reumatoide (AR, artritis juvenil (AJ, espondilitis anquilosante (EA, entre otras enfermedades. A diferencia de las terapias convencionales estos productos biológicos se dirigen a los llamados blancos terapéuticos ya sea estas una línea celular, un mediador inflamatorio o un receptor de superficie. Estos compuestos son producidos por células vivas mediante la tecnología del ADN recombinante. Estos compuestos pueden tener componentes humano y animal [quiméricos (Xi, humanizados (Zu], o completamente humanos (H lo cual se reconoce por las letras que se incluyen en el nombre de cada uno. En el campo de la Reumatología, el primer compuesto utilizado fue el etanercept (anti-factor de necrosis tumoral o anti-TNF aprobado en 1998, pero otros anti-TNF han demostrado su beneficio en AR, como en EA y AJ. Los inhibidores de Interleucina (IL-1 casi no se usan en AR actualmente, pero si los inhibidores de IL-6, así como los agentes contra las células B y los agonistas de CTLA-4 (Cytotoxic T lymphocyte antigen. Existe asimismo un compuesto dirigido al BLyS (B-lymphocyte stimulator el cual se usa en lupus eritematoso sistémico y otro dirigido al receptor activador del factor nuclear κB (RANKL, receptor activator of nuclear factor-κB ligand que se usa en osteoporosis. Con el avance en el conocimiento de la patogenia de las enfermedades reumαticas, se vienen reconociendo otra blancos terapιuticas. En los aρos venideros, este campo ha de expandirse en proporciones geomιtricas

  14. Immune response after neonatal transfer of a human factor IX-expressing retroviral vector in dogs, cats, and mice.

    Science.gov (United States)

    Xu, Lingfei; Mei, Manxue; Haskins, Mark E; Nichols, Timothy C; O'donnell, Patricia; Cullen, Karyn; Dillow, Aaron; Bellinger, Dwight; Ponder, Katherine P

    2007-01-01

    Gene therapy could prevent bleeding in hemophilia. However, antibodies could inhibit coagulation, while cytotoxic T lymphocytes could destroy modified cells. The immaturity of the newborn immune system might prevent these immune responses from occurring after neonatal gene therapy. Newborn dogs, cats, or mice were injected intravenously with a retroviral vector expressing human Factor IX. Plasma was evaluated for antigen and anti-human Factor IX antibodies. Cytotoxic T lymphocyte responses were evaluated indirectly by analysis of retroviral vector RNA in liver. Lymphocytes were evaluated for cytokine secretion and the ability to suppress an immune response to human Factor IX in mice. Hemophilia B dogs that achieved 942+/-500 ng/ml (19% normal) or 5+/-0.4 ng/ml (0.1% normal) of human Factor IX in plasma only bled 0 or 1.2 times per year, respectively, and were tolerant to infusion of human Factor IX. Normal cats expressed human Factor IX at 118+/-29 ng/ml (2% normal) in plasma without antibody formation. However, plasma human Factor IX disappeared at late times in 1 of 4 cats, which was probably due to a cytotoxic T lymphocyte response that destroyed cells with high expression. C3H mice were tolerant to human Factor IX after neonatal gene therapy, which may involve clonal deletion of human Factor IX-responsive cells. These data demonstrate that neonatal gene therapy does not induce antibodies to human Factor IX in dogs, cats, or mice. The putative cytotoxic T lymphocyte response in one cat requires further study.

  15. Terapia familiar en los trastornos de personalidad

    Directory of Open Access Journals (Sweden)

    Laura Rodríguez Moya

    2013-06-01

    Full Text Available La enfermedad mental afecta no solo al paciente sino también a su familia, dificulta la comunicación intrafamiliar, puede generar patologías adicionales en los familiares y todo ello empeorar la evolución del trastorno. Las terapias familiares de tipo psicoeducativo mejoran el pronóstico de la enfermedad y además previenen la aparición de otros trastornos en los familiares. Los elementos más importantes de estas intervenciones son la psicoeducación sobre el trastorno, el re-establecimiento de una relación sana entre paciente-familia, el establecimiento de límites, la mejora de la comunicación familiar y el establecimiento de relaciones con la red social extensa, para evitar el aislamiento tanto de la familia como del paciente. Las intervenciones mixtas, individuales y familiares, han demostrado ser muy útiles en el caso de los trastornos de personalidad, en concreto en el Trastorno Límite de Personalidad (TLP.

  16. Sendo enfermeira no centro de terapia intensiva

    Directory of Open Access Journals (Sweden)

    Adrina Katia Corrêa

    1995-09-01

    Full Text Available Encaminhando-me na perspectiva da fenomenologia, minha proposta é apreender, através dos depoimentos das enfermeiras que trabalham no CTI, os significados que as mesmas atribuem a essa vivência. Ao refletir sobre tais significados, aliando-os à minha experiência profissional, busco compreender o fenômeno ser enfermeira no CTI. Coletei depoimentos escritos das enfermeiras que atuavam no centro de terapia intensiva da Unidade de Emergência do Hospital das Clínicas da Faculdade de Medicina - Ribeirão Preto - USP, tendo como questão orientadora: o que significa para você ser enfermeira no CTI. Da análise desses depoimentos (MARTINS, 1992, emergiram as categorias temáticas, revelando que ser enfermeira no CTI é cuidar diretamente dos pacientes, é ter capacidade administrativa, é conviver com máquinas e equipamentos, exige muitos requisitos e o domínio de conhecimentos específicos, é desempenhar um trabalho importante, de responsabilidade e gratificante, bem como, conviver com situações limitantes e de estresse. A partir de uma reflexão compreensiva do modo de ser da enfermeira desse CTI, pretendo contribuir para busca de novas perspectivas do fazer, ampliando seu horizonte de possibilidades.

  17. Utilización de terapias herbales por parte de practicantes de terapias complementarias y alternativas en Bogotá

    Directory of Open Access Journals (Sweden)

    José Manuel Calvo

    2014-01-01

    Full Text Available Antecedentes. Dentro de las Medicinas Complementarias y Alternativas, las terapias herbales son de las más utilizadas. Es escasa la evidencia sobre el tipo de terapias herbales usadas en Colombia para el tratamiento de trastornos psiquiátricos. Objetivo. Explorar, en un grupo de practicantes de MCA cómo se da el uso de terapias herbales para el tratamiento de los síndromes psiquiátricos más frecuentes (depresión, ansiedad, psicosis, manía. Materiales y métodos. Se efectuó una búsqueda de practicantes de MCA en anuncios de publicidad, internet y referencias de pacientes. De 130 terapeutas ubicados, solo 25 aceptaron participar. A cada terapeuta se le realizó una entrevista en profundidad en la que se exploró el uso de estas terapias con la ayuda de viñetas que ilustraban casos representativos. Resultados. Se identificaron 17 productos herbales diferentes para tratar trastornos psiquiátricos. En los casos correspondientes a psicosis, depresión y ansiedad, se utilizaron 8, 10 y 7 productos diferentes, respectivamente; en el caso de la manía solo se reportó el uso de un producto. Se utilizan combinaciones de terapias herbales y de diferentes tipos de terapias complementarias y alternativas. La mayoría de productos han sido estudiados en investigaciones científicas para evaluar su utilidad terapéutica. Conclusiones. Los psiquiatras deben reconocer que el uso de terapias herbales es una práctica frecuente entre sus pacientes. El desconocimiento sobre su uso puede estar limitando la disponibilidad de nuevas modalidades terapéuticas, afectando la relación médico paciente y poniendo en riesgo a los pacientes ante la posibilidad de interacciones medicamentosas graves.

  18. Adherencia a TARGA: enfoque multi-dimensional

    OpenAIRE

    Vadillo, Sandra; López, Rosalie; Moreno, Jacqueline

    2015-01-01

    Letter to editor Leímos con interés el artículo de Varela y cols.1 sobre depresión y adherencia a terapia anti-retroviral en Chile, tema importante en el éxito de la terapia. Quisiéramos comentar lo siguiente: en primer lugar, muchos estudios coinciden en que las enfermedades psiquiátricas son las co-morbilidades que afectan en mayor medida a la adherencia terapia anti-retroviral de gran actividad (TARGA) directa o indirectamente2. En forma directa porque es la enfer...

  19. Análisis del concepto 'justicia' en terapia ocupacional

    Directory of Open Access Journals (Sweden)

    Eliana Isabel Parra-Esquivel

    2015-07-01

    Full Text Available Antecedentes. El campo de estudio de la terapia ocupacional ha venido ampliándose debido a la necesidad de dar respuesta a las demandas sociales, específicamente las necesidades ocupacionales de las personas, comunidades y sociedades, teniendo en cuenta sus fortalezas y especialmente los aspectos que desean mejorar. En este sentido, es preciso profundizar sobre el tema de justicia en la profesión. Objetivo. Analizar el concepto "justicia" en Terapia Ocupacional en el periodo comprendido entre los años 2000 y 2014 a través de los distintos textos encontrados. Materiales y métodos. El estudio es una investigación documental en la cual se realizó una revisión de literatura y análisis de la misma, teniendo en cuenta los conceptos encontrados en los textos y su aporte teórico y práctico para la terapia ocupacional. Resultados. El concepto de justicia se ha incorporado al campo de estudio de la terapia ocupacional, encontrando las categorías justicia social y justicia ocupacional. Conclusión. Se recomienda continuar construyendo conceptualmente la justicia ocupacional a partir de la reflexión en la profesión y la experiencia dada por la aplicación de estos conceptos en terapia ocupacional.

  20. Autoimmune disease: A role for new anti-viral therapies?

    Science.gov (United States)

    Dreyfus, David H

    2011-12-01

    Many chronic human diseases may have an underlying autoimmune mechanism. In this review, the author presents a case of autoimmune CIU (chronic idiopathic urticaria) in stable remission after therapy with a retroviral integrase inhibitor, raltegravir (Isentress). Previous reports located using the search terms "autoimmunity" and "anti-viral" and related topics in the pubmed data-base are reviewed suggesting that novel anti-viral agents such as retroviral integrase inhibitors, gene silencing therapies and eventually vaccines may provide new options for anti-viral therapy of autoimmune diseases. Cited epidemiologic and experimental evidence suggests that increased replication of epigenomic viral pathogens such as Epstein-Barr Virus (EBV) in chronic human autoimmune diseases such as rheumatoid arthritis (RA), systemic lupus Erythematosus (SLE), and multiple sclerosis (MS) may activate endogenous human retroviruses (HERV) as a pathologic mechanism. Memory B cells are the reservoir of infection of EBV and also express endogenous retroviruses, thus depletion of memory b-lymphocytes by monoclonal antibodies (Rituximab) may have therapeutic anti-viral effects in addition to effects on B-lymphocyte presentation of both EBV and HERV superantigens. Other novel anti-viral therapies of chronic autoimmune diseases, such as retroviral integrase inhibitors, could be effective, although not without risk. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. EVOLUCIÓN DE LA TERAPIA SUSTITUTIVA RENAL

    OpenAIRE

    Coronada-Daza Jorge Antonio

    2015-01-01

    La enfermedad renal crónica (ERC) es un problema de salud pública mundial. La cuenta de alto costo de Colombia a 2013 reportó la existencia de 22.926 pacientes en terapia de diálisis, 5.941 con trasplante renal y 1.015.124 pacientes con ERC en estadios I - IV, potenciales a progresar y requerir terapia sustitutiva renal (TSR), para una incidencia aproximada de ingreso a diálisis de 65 personas por millón de habitantes (1). En Estados Unidos en el 2011 se encontra...

  2. TERAPIA DE INTERACCIÓN PADRES-HIJOS (PCIT)

    OpenAIRE

    Rafael Ferro García; Lourdes Ascanio Velasco

    2014-01-01

    La Terapia de Interacción Padres-Hijos (PCIT) es una terapia breve para tratar los problemas de conducta en la infancia. Es un tratamiento que está demostrado válido empíricamente y puede ser considerada como un tratamiento bien establecido para tratar conductas problema en la infancia según las normas de la APA. Este trabajo expone sus características principales, sus componentes clínicos, y los factores que afectan a la efectividad. Hace una revisión de la literatura existente de las invest...

  3. Terapia miofuncional orofacial em crianças respiradoras orais

    OpenAIRE

    Gallo, Júlia; Campiotto,Alcione Ramos

    2009-01-01

    OBJETIVO: descrever a evolução de crianças respiradoras orais, submetidas à terapia miofuncional orofacial com ênfase no trabalho de fortalecimento da musculatura dos órgãos fonoarticulatórios e treino da respiração nasal. MÉTODOS: participaram da pesquisa seis crianças, com idades entre 5 e 11 anos, que haviam realizado triagem no Setor de Terapia Fonoaudiológica da Irmandade Santa Casa de Misericórdia de São Paulo, durante o ano de 2007, que apresentavam respiração oral ou oronasal e sintom...

  4. As terapias alternativas na assistência de enfermagem

    Directory of Open Access Journals (Sweden)

    Jackçon L. Savi

    1995-12-01

    Full Text Available Na seqüência do acompanhamento da disciplina "Métodos Terapêuticos Alternativos" (MTA. implantada no Curso de Graduação em Enfermagem da UFSC em 1990. focalizou-se os egressos com o objetivo de verificar a utilização das terapias alternativas na assistência de enfermagem que prestam como enfermeiros. Nenhum dos entrevistados posicionou-se contrário e a maioria confirmou utilizar uma ou mais terapias na assistência que prestam aos usuários dos serviços onde atuam.

  5. As terapias alternativas na assistência de enfermagem

    Directory of Open Access Journals (Sweden)

    Jackçon L. Savi

    Full Text Available Na seqüência do acompanhamento da disciplina "Métodos Terapêuticos Alternativos" (MTA. implantada no Curso de Graduação em Enfermagem da UFSC em 1990. focalizou-se os egressos com o objetivo de verificar a utilização das terapias alternativas na assistência de enfermagem que prestam como enfermeiros. Nenhum dos entrevistados posicionou-se contrário e a maioria confirmou utilizar uma ou mais terapias na assistência que prestam aos usuários dos serviços onde atuam.

  6. Actitudes terapéuticas en terapia de pareja.

    OpenAIRE

    Rafael Manrique Solana

    1992-01-01

    El artículo expone diversas actitudes que un terapeuta puede desarrollar en la terapia con parejas. Estas actitudes pueden ser de dos tipos: 1. Aquellas actitudes generales que se han de sostener a lo largo de cualquier terapia. 2. Aquellas destinadas a establecer una adecuada relación terapéutica con la pareja. El conjunto de ambas actitudes permite establecer un marco de relación en el que la conversación terapéutica es posible.

  7. Hematologic abnormalities associated with retroviral infections in the cat.

    Science.gov (United States)

    Shelton, G H; Linenberger, M L

    1995-11-01

    Feline patients with unexplained peripheral blood cytopenias, circulating immature or neoplastic cells, dysplastic or dysmorphic bone marrow abnormalities, and/or lymphoid tumors are likely suffering from an underlying retroviral infection with feline leukemia virus (FeLV) and/or feline immunodeficiency virus (FIV). Cytopenic hematologic disorders are often caused by the direct or indirect hematosuppressive effects of these retroviruses. Alternatively, secondary infections, nutritional deficiencies, and/or hematopoietic neoplasms may be important cofactors in the development of blood and bone marrow abnormalities in retrovirus-positive patients. Mild to moderate nonregenerative anemia, with or without concurrent granulocytopenia and/or thrombocytopenia, is one of the most frequent hematologic disorders encountered with either infectious agent. Severe, isolated anemia with absent reticulocytes (pure red blood cell aplasia) specifically suggests infection with FeLV subgroup C. Hemolytic (regenerative) anemia, more commonly associated with FeLV infection, may be caused by an autoimmune process and/or coinfection with Haemobartonella felis. Lymphopenia is a hallmark of chronic, symptomatic FIV infection. Neutropenia may accompany a panleukopenia-like syndrome in FeLV-positive cats or it may be associated with acute primary infection or an adverse drug effect in the FIV-infected patient. FeLV and, to a lesser extent, FIV are both causally related to lymphoid neoplasms in domestic cats, but with dissimilar epidemiologic, clinical, and host cell phenotypic features. Clinicians must be cognizant of the wide spectrum of hematologic manifestations of FeLV and FIV infections to recognize and appropriately manage these complications in their feline patients.

  8. Impact of maternal anti retroviral drugs during pregnancy on risk of ...

    African Journals Online (AJOL)

    However, antiretroviral therapy could also have adverse effects on the pregnant woman or developing fetus e.g. preterm delivery and low birth weight. Preterm birth and low birth weight contribute significantly to perinatal morbidity and mortality. This review examined the impact of HAART on preterm birth and low birth ...

  9. Prevalence of anti-retroviral treatment failure and salvage therapy in ...

    African Journals Online (AJOL)

    With long term therapy with ARVs however, problems arise due to poor adherence. The concept of “salvage therapy” was conceived subsequent to experiencing multiple treatment failures to ARV combinations. It implies a final attempt, in the battle against HIV/AIDS. Objective: To determine the prevalence of treatment ...

  10. Spontaneous resolution of a case of anti-retroviral treatmentnaïve ...

    African Journals Online (AJOL)

    The outcomes of some ARDs may be better in individuals with HIV when compared with individuals without HIV. Here we report the first case of spontaneous resolution of HIV-Associated Polymyositis (HAM) presenting with profound proximal muscle weakness occurring in a treatment-naïve patient with HIV and discuss the ...

  11. Causes of Death in Hospitalized HIV Patients in the Early Anti-Retroviral Therapy Era.

    Science.gov (United States)

    Lartey, M; Asante-Quashie, A; Essel, A; Kenu, E; Ganu, V; Neequaye, A

    2015-03-01

    To establish the cause(s) of death among persons with HIV and AIDS admitted to the Fevers Unit of the Korle-Bu Teaching Hospital (KBTH) in 2007 and to determine whether they were AIDS-related in the era of availability of HAART. Retrospective chart review of all deaths that occurred in the year 2007 among inpatients with HIV infection. Cause of Death (COD) was established with post mortem diagnosis, where not available ICD-10 was reviewed independently by two physicians experienced in HIV medicine and a consensus reached as to the most likely COD. In the year under review, 215 (97%) of the 221 adult deaths studied were caused by AIDS and HIV-associated illnesses. Of these, 123 (55.7%) were due to an AIDS-defining illness as described in CDC Category 3 or WHO stage 4. Infections accounted for most of the deaths 158 (71.5%), many of them opportunistic 82 (51.8%). Tuberculosis was the commonest COD. Clinical diagnosis of TB was accurate in 54% of deaths, but was not validated by autopsy in 36% of deaths. There were few deaths (14.5%) in patients on HAART. In a developing country like Ghana where HAART was still not fully accessible, AIDS-related events remained the major causes of death in persons living with HIV. Total scale-up of the ART programme with continuous availability of antiretrovirals is therefore imperative to reduce deaths from AIDS and HIV associated illnesses. There is need for interventions for early diagnosis as well as reduction in late presentation and also better diagnostic tools for tuberculosis.

  12. Serum lipid profile of anti-retroviral (ARV) naïve human ...

    African Journals Online (AJOL)

    Background: Human immunodeficiency virus infection has become pandemic in Nigeria and affects the immune system. Most HIV/ AIDS patients develop multiple metabolic abnormalities including insulin resistance, lipodystrophy and dyslipidemia leading to increased risk of cardiovascular disease (CVD). Objective: To ...

  13. The effect of interrupted anti-retroviral treatment on the reconstitution ...

    African Journals Online (AJOL)

    Getriatric Research Center Clinical Core, Louis Stoves Cleveland VA Medicine Center. 5. Department of pathology, Makerere University College of Veterinary Medicine, Animal resources and biosecurity ... Sophie Nalukwago,. Joint Clinical Research Centre,. TB Immunology laboratory,. Lubowa Hill: Plot 101 Entebbe Road,.

  14. Drug-drug interactions between anti-retroviral therapies and drugs of abuse in HIV systems.

    Science.gov (United States)

    Kumar, Santosh; Rao, P S S; Earla, Ravindra; Kumar, Anil

    2015-03-01

    Substance abuse is a common problem among HIV-infected individuals. Importantly, addictions as well as moderate use of alcohol, smoking, or other illicit drugs have been identified as major reasons for non-adherence to antiretroviral therapy (ART) among HIV patients. The literature also suggests a decrease in the response to ART among HIV patients who use these substances, leading to failure to achieve optimal virological response and increased disease progression. This review discusses the challenges with adherence to ART as well as observed drug interactions and known toxicities with major drugs of abuse, such as alcohol, smoking, methamphetamine, cocaine, marijuana, and opioids. The lack of adherence and drug interactions potentially lead to decreased efficacy of ART drugs and increased ART, and drugs of abuse-mediated toxicity. As CYP is the common pathway in metabolizing both ART and drugs of abuse, we discuss the possible involvement of CYP pathways in such drug interactions. We acknowledge that further studies focusing on common metabolic pathways involving CYP and advance research in this area would help to potentially develop novel/alternate interventions and drug dose/regimen adjustments to improve medication outcomes in HIV patients who consume drugs of abuse.

  15. Early Mortality among HIV-positive Children Initiated Anti-retroviral ...

    African Journals Online (AJOL)

    Science, Technology and Arts Research Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 2 (2015) >. Log in or Register to get access to full text downloads.

  16. Implementing tools to promote adherence to anti-retroviral therapy at ...

    African Journals Online (AJOL)

    Background: Lack of effective systems and tools to identify and track defaulters are some of the factors that pose challenges in adherence monitoring for patients on antiretroviral treatment (ART). An intervention was performed to introduce a facilitybased appointment keeping system, and a revised clinic form to monitor ...

  17. Early Mortality among HIV-positive Children Initiated Anti-retroviral ...

    African Journals Online (AJOL)

    RAGHAVENDRA

    2 Department of Public Health, College of H. Abstract. About 1,400 children under the age of 15 years are infec .... hospital; eight government health centers; and n health posts that provide health care services. T health service ... eral police hospital; one Army neral hospitals; one Fistula health centers; and nineteen.

  18. Pregnancy outcome of HIV-infected women on anti-retroviral therapy ...

    African Journals Online (AJOL)

    Introduction: There are conflicting reports of adverse pregnancy outcomes following the administration of antiretroviral treatment (ARVs) to HIV-positive pregnant women. The aim of this study was to assess the magnitude of adverse effects of antiretroviral drugs and to underscore their importance in limiting adverse ...

  19. Anti-Retroviral Therapy Increases the Prevalence of Dyslipidemia in South African HIV-Infected Patients.

    Directory of Open Access Journals (Sweden)

    Joel A Dave

    Full Text Available Data on the prevalence of dyslipidaemia and associated risk factors in HIV-infected patients from sub-Saharan Africa is sparse. We performed a cross-sectional analysis in a cohort of HIV-infected South African adults.We studied HIV-infected patients who were either antiretroviral therapy (ART-naive or receiving non-nucleoside reverse transcriptase inhibitor (NNRTI-based or protease inhibitor (PI-based ART. Evaluation included fasting lipograms, oral glucose tolerance tests and clinical anthropometry. Dyslipidemia was defined using the NCEP ATPIII guidelines.The median age of the participants was 34 years (range 19-68 years and 78% were women. The prevalence of dyslipidemia in 406 ART-naive and 551 participants on ART was 90.0% and 85%, respectively. Low HDL-cholesterol (HDLC was the most common abnormality [290/406 (71% ART-naïve and 237/551 (43% ART- participants]. Participants on ART had higher triglycerides (TG, total cholesterol (TC, LDL-cholesterol (LDLC and HDLC than the ART-naïve group. Severe dyslipidaemia, (LDLC> 4.9 mmol/L or TG >5.0 mmol/L was present in <5% of participants. In multivariate analyses there were complex associations between age, gender, type and duration of ART and body composition and LDLC, HDLC and TG, which differed between ART-naïve and ART-participants.Participants on ART had higher TG, TC, LDLC and HDLC than those who were ART-naïve but severe lipid abnormalities requiring evaluation and treatment were uncommon.

  20. hearing disorders in hiv positive adult patients not on anti - retroviral ...

    African Journals Online (AJOL)

    2010-09-01

    Sep 1, 2010 ... HNO 1988;. 36: 489 - 492. 4. Moazzez, A. H. and Alvi, A. Head and neck manifestations of AIDS in adults, Am Fam Physician. 1998; 57: 1813-1822. 5. Tami, T. A. and Lee, K. E. AIDS and the. Otolaryngologist. Alexandria, VA: American. Academy of Otolaryngology-Head and Neck Surgery. Foundation, 1993 ...

  1. A decade of Anti-Retroviral Therapy in Nigeria: Efficacy of First Line ...

    African Journals Online (AJOL)

    Alasia Datonye

    rapid scale-up in the subsequent years. Currently, nearly. 30% of about 860,000 HIV/AIDS patients requiring treatment in Nigeria are receiving highly active antiretroviral therapy (HAART) according to the WHO. 2006 criteria for initiating ART; a significant, though inadequate, increase when compared with ART coverage.

  2. A decade of Anti-Retroviral Therapy in Nigeria: Efficacy of First Line ...

    African Journals Online (AJOL)

    Alasia Datonye

    treatment-naive patients following widespread use of ART after a significant period of time. In this study, we evaluated the efficacy of the commonly used first line ARVs in treatment-naive HIV infected patients following widespread use of ARVs. Our primary measures were body mass index (BMI), CD4+ cell counts and viral ...

  3. Retrospective study of HIV infection in Anti Retroviral Treatment center of Mahendranagar, Nepal.

    Science.gov (United States)

    Chapagain, R H; Adhikari, K; Kamar, S B; Singh, D R

    2016-01-01

    Background Being the most backward region, The Far Western Development Region has high illiteracy rate, low socioeconomic status and high migration rate contributing the progression of epidemiological status of Human Immunodeficiency Virus (HIV) towards generalized form. Objective To study the demographic profile of the HIV positive patients, along with their CD4 status and tuberculosis during diagnosis. Method A retrospective descriptive study carried out from May 2006 to July 2012 in 271 HIV patients registered in HIV clinic of Mahakali Zonal Hospital, Mahendranagar. Result Among 271 patients enrolled, 48.30% (131) were male and 51.7% (140) were females. Thirty seven (13.7%) were less than 15 years and 76.3% (207) were of age 16-45 years. 38.7% were household workers by occupation and 34.50% were involved in agriculture and 3.70%were migrant labour. At the time of presentation, 22.4% (60) were stage I according to WHO staging and 18.5% (50), 58.5 (158) and 0.7% (2) were of stage II, III and IV respectively. Similarly, 33.0% (89) had more than 350 CD4 count at the time of presentation. 20.8% (56) of patients were infected with tuberculosis. Among 236 families, 2 or more members were found to be affected in 24 families. In most of the cases, female were diagnosed first followed by male in the families, where both the couple were infected. Conclusion Most of the HIV infected patients were of productive age group. Majority of patients were uneducated and Tuberculosis was found to be common opportunistic infections associated with HIV infection.

  4. cost-benefit analysis of anti-retroviral therapy (art) for hiv/aids ...

    African Journals Online (AJOL)

    user

    reported among hemophiliacs, heterosexual intravenous drug users, and Haitian immigrants. 2.2 ... new cities changed women thinking, they felt relatively liberated from rural tribal rules and many remained .... for women and 53 years for men in 1991 to 48 years for women and 46 for men in 2009. This has created severe ...

  5. Vital Role for CD8+ Cells in Controlling Retroviral Infections ▿

    Science.gov (United States)

    Kane, Melissa; Case, Laure K.; Golovkina, Tatyana V.

    2011-01-01

    Antiviral adaptive immune defenses consist of humoral and cell-mediated responses, which together eliminate extracellular and intracellular virus. As most retrovirus-infected individuals do not raise efficient protective antivirus immune responses, the relative importance of humoral and cell-mediated responses in restraining retroviral infection is not well understood. We utilized retrovirus-resistant I/LnJ mice, which control infection with mouse mammary tumor virus (MMTV) and murine leukemia virus (MuLV) via an adaptive immune mechanism, to assess the contribution of cellular responses and virus-neutralizing antibodies (Abs) to the control of retroviral infection. We found that in retrovirus-infected CD8-deficient I/LnJ mice, viral titers exceed the neutralizing capability of antiviral Abs, resulting in augmented virus spread and disease induction. Thus, even in the presence of robust neutralizing Ab responses, CD8-mediated responses are essential for full protection against retroviral infection. PMID:21248041

  6. Application of Live-Cell RNA Imaging Techniques to the Study of Retroviral RNA Trafficking

    Directory of Open Access Journals (Sweden)

    Darrin V. Bann

    2012-06-01

    Full Text Available Retroviruses produce full-length RNA that serves both as a genomic RNA (gRNA, which is encapsidated into virus particles, and as an mRNA, which directs the synthesis of viral structural proteins. However, we are only beginning to understand the cellular and viral factors that influence trafficking of retroviral RNA and the selection of the RNA for encapsidation or translation. Live cell imaging studies of retroviral RNA trafficking have provided important insight into many aspects of the retrovirus life cycle including transcription dynamics, nuclear export of viral RNA, translational regulation, membrane targeting, and condensation of the gRNA during virion assembly. Here, we review cutting-edge techniques to visualize single RNA molecules in live cells and discuss the application of these systems to studying retroviral RNA trafficking.

  7. An XMRV Derived Retroviral Vector as a Tool for Gene Transfer

    Directory of Open Access Journals (Sweden)

    Rojas-Martinez Augusto

    2011-06-01

    Full Text Available Abstract Background Retroviral vectors are widely used tools for gene delivery and gene therapy. They are useful for gene expression studies and genetic manipulation in vitro and in vivo. Many retroviral vectors are derived from the mouse gammaretrovirus, murine leukemia virus (MLV. These vectors have been widely used in gene therapy clinical trials. XMRV, initially found in prostate cancer tissue, was the first human gammaretrovirus described. Findings We developed a new retroviral vector based on XMRV called pXC. It was developed for gene transfer to human cells and is produced by transient cotransfection of LNCaP cells with pXC and XMRV-packaging plasmids. Conclusions We demonstrated that pXC mediates expression of inserted transgenes in cell lines. This new vector will be a useful tool for gene transfer in human and non-human cell lines, including gene therapy studies.

  8. Improved retroviral suicide gene transfer in colon cancer cell lines after cell synchronization with methotrexate

    Directory of Open Access Journals (Sweden)

    Nordlinger Bernard

    2011-10-01

    Full Text Available Abstract Background Cancer gene therapy by retroviral vectors is mainly limited by the level of transduction. Retroviral gene transfer requires target cell division. Cell synchronization, obtained by drugs inducing a reversible inhibition of DNA synthesis, could therefore be proposed to precondition target cells to retroviral gene transfer. We tested whether drug-mediated cell synchronization could enhance the transfer efficiency of a retroviral-mediated gene encoding herpes simplex virus thymidine kinase (HSV-tk in two colon cancer cell lines, DHDK12 and HT29. Methods Synchronization was induced by methotrexate (MTX, aracytin (ara-C or aphidicolin. Gene transfer efficiency was assessed by the level of HSV-TK expression. Transduced cells were driven by ganciclovir (GCV towards apoptosis that was assessed using annexin V labeling by quantitative flow cytometry. Results DHDK12 and HT29 cells were synchronized in S phase with MTX but not ara-C or aphidicolin. In synchronized DHDK12 and HT29 cells, the HSV-TK transduction rates were 2 and 1.5-fold higher than those obtained in control cells, respectively. Furthermore, the rate of apoptosis was increased two-fold in MTX-treated DHDK12 cells after treatment with GCV. Conclusions Our findings indicate that MTX-mediated synchronization of target cells allowed a significant improvement of retroviral HSV-tk gene transfer, resulting in an increased cell apoptosis in response to GCV. Pharmacological control of cell cycle may thus be a useful strategy to optimize the efficiency of retroviral-mediated cancer gene therapy.

  9. Terapia antiviral para VIH-SIDA

    Directory of Open Access Journals (Sweden)

    Alicia Tarinas Reyes

    2000-12-01

    Full Text Available En los últimos años, muchos agentes antivirales nuevos han sido incorporados a la quimioterapéutica. En esta revisión se resumen tanto los fármacos establecidos de años atrás como los nuevos medicamentos desarrollados para el tratamiento de individuos infectados por VIH. El AZT fue el primero aprobado en marzo de 1987, le siguió el ddl (1991, ddC (1992, d4T (1994, 3TC (1995. Luego fue aprobado el primer inhibidor de proteasa, saquinavir en diciembre de 1995, seguido de ritonavir (1996, indinavir (1996, nelfinavir (1997; además de otros inhibidores de la reverso transcriptasa como nevirapine (1996, delavirdine (1997, efavirenz (1998, entre otros. En estos momentos se siguen buscando y desarrollando nuevas terapias alternativas para esta afección. En este trabajo se exponen algunas de las características de dichos medicamentos, como son: mecanismos de acción (sobre qué enzima actúa cada uno y cómo lo hacen, el ciclo viral, dosificación, incompatibilidades y reacciones adversas.During the last years many new antiviral agents have been incorporated to the chemotherapeutics. The pharmaceuticals established years ago as well as the new ones developed to treat HIV infected individuals are included in this review. The AZT was the first approved in March, 1987, followed by ddl (1991, ddc (1992, d4t (1994, and 3TC (1995. Later, the first protease inhibitor, saquinovir, was approved in December, 1995, followed by ritonavir (1996, indinavir (1996, and nelfinavir (1997; in addition to other inhibitors of the reverse transcriptase as neviparine (1996, delavirdine (1997, and efavirenz (1998, among others. At present new alternative therapies for this affection are being searched and developed. Some of the characteristics of these dugs, such as: action mechanisms (on which enzime each of them act and how they do it, viral cycle, dosage, incompatibilites and adverse reactions are dealt with in this paper.

  10. Novas terapias para hipertensão endocraniana New therapies for intracranial hypertension

    Directory of Open Access Journals (Sweden)

    Arnaldo Prata Barbosa

    2003-11-01

    Full Text Available OBJETIVOS: São revistos os principais conceitos envolvidos na abordagem terapêutica da hipertensão endocraniana, desde a abordagem tradicional até a apresentação das novas terapias preconizadas. FONTES DOS DADOS: Foram revistas as principais bases de dados da literatura médica, particularmente o Medline e o Lilacs, nos últimos 10 anos, além de livros textos consagrados e teses dedicadas ao assunto. SÍNTESE DOS DADOS: A hipertensão endocraniana pode estar associada a diversas lesões neurológicas cerebrais, sejam de origem traumática, infecciosa ou metabólica, podendo, nos casos graves, se constituir em importante fator de morbimortalidade. O aumento da pressão intracraniana interfere com o fluxo sangüíneo cerebral, de modo que para se manter uma pressão de perfusão cerebral adequada, é necessário tanto a redução e o controle da hipertensão endocraniana, como o combate agressivo à hipotensão arterial, desde as fases iniciais do atendimento. A monitorização adequada é fundamental, e as principais medidas adotadas no tratamento convencional envolvem a elevação da cabeceira do leito a 30 graus, o posicionamento centrado da cabeça, a hipocapnia otimizada, o perfeito equilíbrio hidroeletrolítico e metabólico, a sedação, a terapia anticonvulsiva, a drenagem liquórica, o uso de barbitúricos, manitol e furosemida. As novas terapias que vêm sendo estudadas incluem, principalmente, o dexanabinol, as soluções salinas hipertônicas, a hipotermia moderada, a craniotomia descompressiva, a otimização da pressão de perfusão cerebral e a redução da pressão na microvasculatura cerebral (terapia de Lund. CONCLUSÕES: O uso de novas terapias para o controle eficaz da hipertensão endocraniana, particularmente em casos refratários ao tratamento usual, representam um cenário promissor na abordagem destes quadros.OBJECTIVE: The main concepts involved in the therapeutic management of intracranial hypertension are

  11. The pattern of hearing disorders in HIV positive patients on anti ...

    African Journals Online (AJOL)

    Objectives: To determine if patients on Anti - retroviral drugs (ARVs) develop hearing impairment. Design: The comprehensive care clinic (CCC), Kenyatta National Hospital (KNH), Nairobi. Setting: Case controlled study. Subjects: Two hundred and seventy one human immunodeficiency virus (HIV) positive patients on ARVs ...

  12. the pattern of hearing disorders in hiv positive patients on anti

    African Journals Online (AJOL)

    2010-10-10

    Oct 10, 2010 ... after taking into account noise exposure, immune status and age. The results of this prospective pilot study did not support the notion that treatment with nucleoside anti - retrovirals damages hearing (7). In this study, patients who had been on ARVs for less than six months experienced worse hearing.

  13. Disclosing the Parameters Leading to High Productivity of Retroviral Producer Cells Lines: Evaluating Random Versus Targeted Integration.

    Science.gov (United States)

    Bandeira, Vanessa S; Tomás, Hélio A; Alici, Evren; Carrondo, Manuel J T; Coroadinha, Ana S

    2017-04-01

    Gammaretrovirus and lentivirus are the preferred viral vectors to genetically modify T and natural killer cells to be used in immune cell therapies. The transduction efficiency of hematopoietic and T cells is more efficient using gibbon ape leukemia virus (GaLV) pseudotyping. In this context gammaretroviral vector producer cells offer competitive higher titers than transient lentiviral vectors productions. The main aim of this work was to identify the key parameters governing GaLV-pseudotyped gammaretroviral vector productivity in stable producer cells, using a retroviral vector expression cassette enabling positive (facilitating cell enrichment) and negative cell selection (allowing cell elimination). The retroviral vector contains a thymidine kinase suicide gene fused with a ouabain-resistant Na + ,K + -ATPase gene, a potential safer and faster marker. The establishment of retroviral vector producer cells is traditionally performed by randomly integrating the retroviral vector expression cassette codifying the transgene. More recently, recombinase-mediated cassette exchange methodologies have been introduced to achieve targeted integration. Herein we compared random and targeted integration of the retroviral vector transgene construct. Two retroviral producer cell lines, 293 OuaS and 293 FlexOuaS, were generated by random and targeted integration, respectively, producing high titers (on the order of 10 7 infectious particles·ml -1 ). Results showed that the retroviral vector transgene cassette is the key retroviral vector component determining the viral titers notwithstanding, single-copy integration is sufficient to provide high titers. The expression levels of the three retroviral constructs (gag-pol, GaLV env, and retroviral vector transgene) were analyzed. Although gag-pol and GaLV env gene expression levels should surpass a minimal threshold, we found that relatively modest expression levels of these two expression cassettes are required. Their levels of

  14. Use of anti-retroviral therapy in tuberculosis patients on second-line anti-TB regimens: a systematic review.

    Directory of Open Access Journals (Sweden)

    Matthew Arentz

    Full Text Available Use of antiretroviral therapy (ART during treatment of drug susceptible tuberculosis (TB improves survival. However, data from HIV infected individuals with drug resistant TB are lacking. Second line TB drugs when combined with ART may increase drug interactions and lead to higher rates of toxicity and greater noncompliance. This systematic review sought to determine the benefit of ART in the setting of second line drug therapy for drug resistant TB.We included individual patient data from studies that evaluated treatment of drug-resistant tuberculosis in HIV-1 infected individuals published between January 1980 and December of 2009. We evaluated the effect of ART on treatment outcomes, time to smear and culture conversion, and adverse events.Ten observational studies, including data from 217 subjects, were analyzed. Patients using ART during TB treatment had increased likelihood of cure (hazard ratio (HR 3.4, 95% CI 1.6-7.4 and decreased likelihood of death (HR 0.4, 95% CI 0.3-0.6 during treatment for drug resistant TB. These associations remained significant in patients with a CD4 less than 200 cells/mm(3 and less than 50 cells/mm(3, and when correcting for drug resistance pattern.We identified only observational studies from which individual patient data could be drawn. Limitations in study design, and heterogeneity in a number of the outcomes of interest had the potential to introduce bias.While there are insufficient data to determine if ART use increases adverse drug interactions when used with second line TB drugs, ART use during treatment of drug resistant TB appears to improve cure rates and decrease risk of death. All individuals with HIV appear to benefit from ART use during treatment for TB.

  15. Integrating retroviral cassette extends gene delivery of HSV-1 expression vectors to dividing cells.

    Science.gov (United States)

    de Felipe, P; Izquierdo, M; Wandosell, F; Lim, F

    2001-08-01

    Retroviral vectors have long been used in a wide variety of gene transfer applications but have certain drawbacks, such as small cargo size, limited tropism, and low titers. HSV expression vectors overcome these disadvantages, but, because they persist in target cells as nonreplicative episomes, they are not retained in all the progeny of dividing cells. Chimeric HSV/AAV products that can mediate transgene integration in human mitotic cells have been constructed, but, to date, genetic modification of dividing cells in animal models using HSV products has not been possible. Here, we report the construction of hybrid HSV/retroviral vectors that exhibit up to 50-fold higher transgene integration efficiency compared to vectors containing only HSV-1 components. Efficient integration of a retroviral transgene cassette encoding pac in human cells required expression of the Moloney murine leukemia virus gag-pol genes, but in murine cells, could also be mediated by endogenous activities, albeit at a lower level. Gene delivery was equally efficient in BHK21, a cell line resistant to retroviral infection, and transgene retention and expression were observed to be stable for least one month in Hs683 human glioma cells. These vectors have wide applications for the genetic modification of many cell types.

  16. Characterization of retroviral infectivity and superinfection resistance during retrovirus-mediated transduction of mammalian cells.

    Science.gov (United States)

    Liao, J; Wei, Q; Fan, J; Zou, Y; Song, D; Liu, J; Liu, F; Ma, C; Hu, X; Li, L; Yu, Y; Qu, X; Chen, L; Yu, X; Zhang, Z; Zhao, C; Zeng, Z; Zhang, R; Yan, S; Wu, T; Wu, X; Shu, Y; Lei, J; Li, Y; Zhang, W; Wang, J; Reid, R R; Lee, M J; Huang, W; Wolf, J M; He, T-C; Wang, J

    2017-06-01

    Retroviral vectors including lentiviral vectors are commonly used tools to stably express transgenes or RNA molecules in mammalian cells. Their utilities are roughly divided into two categories, stable overexpression of transgenes and RNA molecules, which requires maximal transduction efficiency, or functional selection with retrovirus (RV)-based libraries, which takes advantage of retroviral superinfection resistance. However, the dynamic features of RV-mediated transduction are not well characterized. Here, we engineered two murine stem cell virus-based retroviral vectors expressing dual fluorescence proteins and antibiotic markers, and analyzed virion production efficiency and virion stability, dynamic infectivity and superinfection resistance in different cell types, and strategies to improve transduction efficiency. We found that the highest virion production occurred between 60 and 72 h after transfection. The stability of the collected virion supernatant decreased by >60% after 3 days in storage. We found that RV infectivity varied drastically in the tested human cancer lines, while low transduction efficiency was partially overcome with increased virus titer, prolonged infection duration and/or repeated infections. Furthermore, we demonstrated that RV receptors PIT1 and PIT2 were lowly expressed in the analyzed cells, and that PIT1 and/or PIT2 overexpression significantly improved transduction efficiency in certain cell lines. Thus, our findings provide resourceful information for the optimal conditions of retroviral-mediated gene delivery.

  17. Mesenchymal stromal cells retrovirally transduced with prodrug-converting genes are suitable vehicles for cancer gene therapy.

    Science.gov (United States)

    Ďuriniková, E; Kučerová, L; Matúšková, M

    2014-01-01

    Mesenchymal stem/stromal cells (MSC) possess a set of several fairly unique properties which make them ideally suitable both for cellular therapies and regenerative medicine. These include: relative ease of isolation, the ability to differentiate along mesenchymal and non-mesenchymal lineages in vitro and the ability to be extensively expanded in culture without a loss of differentiative capacity. MSC are not only hypoimmunogenic, but they mediate immunosuppression upon transplantation, and possess pronounced anti-inflammatory properties. They are able to home to damaged tissues, tumors, and metastases following systemic administration. The ability of homing holds big promise for tumor-targeted delivery of therapeutic agents. Viruses are naturally evolved vehicles efficiently transferring their genes into host cells. This ability made them suitable for engineering vector systems for the delivery of genes of interest. MSC can be retrovirally transduced with genes encoding prodrug-converting genes (suicide genes), which are not toxic per se, but catalyze the formation of highly toxic metabolites following the application of a nontoxic prodrug. The homing ability of MSC holds advantages compared to virus vehicles which display many shortcomings in effective delivery of the therapeutic agents. Gene therapies mediated by viruses are limited by their restricted ability to track cancer cells infiltrating into the surrounding tissue, and by their low migratory capacity towards tumor. Thus combination of cellular therapy and gene delivery is an attractive option - it protects the vector from immune surveillance, and supports targeted delivery of a therapeutic gene/protein to the tumor site.

  18. Fates of retroviral core components during unrestricted and TRIM5-restricted infection.

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    Sebla B Kutluay

    2013-03-01

    Full Text Available TRIM5 proteins can restrict retroviral infection soon after delivery of the viral core into the cytoplasm. However, the molecular mechanisms by which TRIM5α inhibits infection have been elusive, in part due to the difficulty of developing and executing biochemical assays that examine this stage of the retroviral life cycle. Prevailing models suggest that TRIM5α causes premature disassembly of retroviral capsids and/or degradation of capsids by proteasomes, but whether one of these events leads to the other is unclear. Furthermore, how TRIM5α affects the essential components of the viral core, other than capsid, is unknown. To address these questions, we devised a biochemical assay in which the fate of multiple components of retroviral cores during infection can be determined. We utilized cells that can be efficiently infected by VSV-G-pseudotyped retroviruses, and fractionated the cytosolic proteins on linear gradients following synchronized infection. The fates of capsid and integrase proteins, as well as viral genomic RNA and reverse transcription products were then monitored. We found that components of MLV and HIV-1 cores formed a large complex under non-restrictive conditions. In contrast, when MLV infection was restricted by human TRIM5α, the integrase protein and reverse transcription products were lost from infected cells, while capsid and viral RNA were both solubilized. Similarly, when HIV-1 infection was restricted by rhesus TRIM5α or owl monkey TRIMCyp, the integrase protein and reverse transcription products were lost. However, viral RNA was also lost, and high levels of preexisting soluble CA prevented the determination of whether CA was solubilized. Notably, proteasome inhibition blocked all of the aforementioned biochemical consequences of TRIM5α-mediated restriction but had no effect on its antiviral potency. Together, our results show how TRIM5α affects various retroviral core components and indicate that proteasomes are

  19. High-resolution structure of a retroviral protease folded as a monomer

    Energy Technology Data Exchange (ETDEWEB)

    Gilski, Miroslaw [A. Mickiewicz University, 60-780 Poznan (Poland); Polish Academy of Sciences, 61-704 Poznan (Poland); Kazmierczyk, Maciej; Krzywda, Szymon [A. Mickiewicz University, 60-780 Poznan (Poland); Zábranská, Helena [Academy of Sciences of the Czech Republic, 166 10 Prague (Czech Republic); Cooper, Seth; Popović, Zoran [University of Washington, Box 352350, Seattle, WA 98195 (United States); Khatib, Firas; DiMaio, Frank; Thompson, James; Baker, David [University of Washington, Box 357350, Seattle, WA 98195 (United States); Pichová, Iva [Academy of Sciences of the Czech Republic, 166 10 Prague (Czech Republic); Jaskolski, Mariusz, E-mail: mariuszj@amu.edu.pl [A. Mickiewicz University, 60-780 Poznan (Poland); Polish Academy of Sciences, 61-704 Poznan (Poland)

    2011-11-01

    The crystal structure of Mason–Pfizer monkey virus protease folded as a monomer has been solved by molecular replacement using a model generated by players of the online game Foldit. The structure shows at high resolution the details of a retroviral protease folded as a monomer which can guide rational design of protease dimerization inhibitors as retroviral drugs. Mason–Pfizer monkey virus (M-PMV), a D-type retrovirus assembling in the cytoplasm, causes simian acquired immunodeficiency syndrome (SAIDS) in rhesus monkeys. Its pepsin-like aspartic protease (retropepsin) is an integral part of the expressed retroviral polyproteins. As in all retroviral life cycles, release and dimerization of the protease (PR) is strictly required for polyprotein processing and virion maturation. Biophysical and NMR studies have indicated that in the absence of substrates or inhibitors M-PMV PR should fold into a stable monomer, but the crystal structure of this protein could not be solved by molecular replacement despite countless attempts. Ultimately, a solution was obtained in mr-rosetta using a model constructed by players of the online protein-folding game Foldit. The structure indeed shows a monomeric protein, with the N- and C-termini completely disordered. On the other hand, the flap loop, which normally gates access to the active site of homodimeric retropepsins, is clearly traceable in the electron density. The flap has an unusual curled shape and a different orientation from both the open and closed states known from dimeric retropepsins. The overall fold of the protein follows the retropepsin canon, but the C{sup α} deviations are large and the active-site ‘DTG’ loop (here NTG) deviates up to 2.7 Å from the standard conformation. This structure of a monomeric retropepsin determined at high resolution (1.6 Å) provides important extra information for the design of dimerization inhibitors that might be developed as drugs for the treatment of retroviral infections

  20. TERAPIA DE INTERACCIÓN PADRES-HIJOS (PCIT

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    Rafael Ferro García

    2014-09-01

    Full Text Available La Terapia de Interacción Padres-Hijos (PCIT es una terapia breve para tratar los problemas de conducta en la infancia. Es un tratamiento que está demostrado válido empíricamente y puede ser considerada como un tratamiento bien establecido para tratar conductas problema en la infancia según las normas de la APA. Este trabajo expone sus características principales, sus componentes clínicos, y los factores que afectan a la efectividad. Hace una revisión de la literatura existente de las investigaciones sobre su efectividad y eficacia. También, se exponen las últimas adaptaciones en diferentes contextos, formatos, problemas y distintas poblaciones.

  1. Cuidado paliativo e enfermeiros de terapia intensiva: sentimentos que ficam

    OpenAIRE

    Natyele Rippel Silveira; Eliane Regina Pereira do Nascimento; Luciana Martins da Rosa; Walnice Jung; Sabrina Regina Martins; Moisés dos Santos Fontes

    2016-01-01

    RESUMO Objetivo: conhecer os sentimentos dos enfermeiros acerca dos cuidados paliativos em unidades de terapia intensiva de adultos. Método: estudo qualitativo, cujo referencial teórico adotado foi o das Representações Sociais, realizado com 30 enfermeiros do estado de Santa Catarina incluídos por amostragem Bola de Neve. Os dados foram coletados por meio de entrevistas semiestruturadas realizadas de abril a agosto de 2015, organizados e analisados por meio do Discurso do Sujeito Coletivo. ...

  2. Novos conceitos em cuidados paliativos na unidade de terapia intensiva

    Directory of Open Access Journals (Sweden)

    Cristina Bueno Terzi Coelho

    Full Text Available RESUMO Alguns dos pacientes admitidos em uma unidade de terapia intensiva podem enfrentar condições de doença terminal, que geralmente levam à morte. O conhecimento sobre cuidados paliativos é recomendado para os profissionais de saúde encarregados do cuidado destes pacientes. Em muitas situações, os pacientes devem ser avaliados diariamente, já que a introdução de novos tratamentos pode ou não ser benéfica para eles. As discussões entre os membros da equipe de saúde, relacionadas ao prognóstico e aos objetivos do tratamento, devem ser avaliadas cuidadosamente em cooperação com os pacientes e seus familiares. A adoção na unidade de terapia intensiva de protocolos relacionados a pacientes em final da vida é fundamental. É importante ter uma equipe multidisciplinar para determinar se é necessário deixar de iniciar ou mesmo retirar tratamentos avançados. Além disto, pacientes e familiares devem ser informados de que os cuidados paliativos envolvem o melhor tratamento possível para aquela situação específica, assim como respeitar suas vontades e considerar as bases sociais e espirituais dos mesmos. Assim, o objetivo desta revisão foi apresentar os cuidados paliativos como uma opção razoável para dar suporte à equipe da unidade de terapia intensiva na assistência a pacientes com doença terminal. São apresentadas atualizações com relação a dieta, ventilação mecânica e diálise nestes pacientes. Ainda, discutiremos o programa, comum nos Estados Unidos, conhecido como filosofia hospice, como alternativa ao ambiente da unidade de terapia intensiva/hospital.

  3. Terapia comportamental cognitiva: uma comparação entre perspectivas

    Directory of Open Access Journals (Sweden)

    Rachel Rodrigues Kerbauy

    Full Text Available A Terapia Comportamental Cognitiva desenvolveu-se a partir de dados e maneiras de trabalhar da Terapia Cognitiva e da Terapia Comportamental. Essas origens e as várias influências parecem determinar maneiras diferentes de conduzir a terapia o que se procurou analisar neste trabalho. Optou-se pela apresentação do trabalho de três autores: Ellis, Beck e Meichembaum como representativos da área embora se reconheça que há diferenças entre algumas concepções e também unanimidade na explicação de comportamentos, especialmente emocionais.

  4. Células madre: problemas biológicos que dificultan la terapia celular

    OpenAIRE

    Zapata, Agustín

    2015-01-01

    La terapia celular es una terapia avanzada en la que las células pueden ser usadas como auténticos medicamentos. Como elemento esencial de la medicina regenerativa, el objetivo principal de estas terapias es la sustitución de tejidos dañados o deficientes por otros sanos o funcionales Las células madre (células stem), ya sean estas embrionarias, pluripotentes inducidas o adultas, son una fuente potencialmente ilimitada de células para la investigación o para su uso clínico en terapia celul...

  5. Tendencias actuales y futuras de la terapia de familias

    Directory of Open Access Journals (Sweden)

    Francisco Almagro Domínguez

    1996-06-01

    Full Text Available Se exponen brevemente la situación actual y las perspectivas de la terapia familiar a partir de la información obtenida en el Séptimo Congreso de IFTA (International Family Therapy Association, celebrado en Guadalajara, México, en Octubre de 1995. Los criterios actuales abarcan desde el ciclo vital y las técnicas nuevas, hasta el tratamiento familiar del SIDA y el cáncer. El futuro se considera, en general, promisorio para estas terapias. Se habla de relacionar diagnósticos, enseñanza integrada a planes de estudio y entrenamiento de personal comunitario; todo ello como perspectiva de la terapia de familiasThe present situation and the outlooks of family therapy based on the information obtained at the 7th Congress of the International Family Therapy Association, held in Guadalajara, Mexico, in October, 1995, are briefly explained. New criteria embrace from the vital cycle and the new techniques to the family treatment of AIDS and cancer. In general, the future is considered as promising for these therapies. It is talked about relating diagnoses, integrating teaching to curricula, and training community personal; all of it as a prospect of family therapy.

  6. Uso de terapias integrativas e complementares por pacientes em quimioterapia

    Directory of Open Access Journals (Sweden)

    Julyane Felipette Lima

    2015-09-01

    Full Text Available Objetivo: Conhecer as terapias integrativas e complementares utilizadas pelos pacientes em quimioterapia oncológica. Metodologia: Estudo qualitativo, realizado com seis pacientes oncológicos em tratamento quimioterápico, em um serviço de oncologia do sul do Rio Grande do Sul, Brasil. Os dados foram coletados por meio de entrevista, em junho de 2010, sendo a análise de conteúdo tipo temática. Resultados: As terapias apontadas neste estudo foram a homeopatia, a fitoterapia e as plantas medicinais e percebeu-se que elas aumentam a sensação de bem-estar, possibilitam o estabelecimento de vínculos positivos com profissionais da saúde, e fazem parte do saber popular e estão interligadas ao conhecimento científico. Conclusões: Apreende-se que uso de terapias integrativas e complementares em oncologia permite a aproximação do profissional enfermeiro com o paciente em quimioterapia, conhecendo-o em sua complexidade.

  7. Terapia celular em doenças pulmonares: existem perspectivas?

    Directory of Open Access Journals (Sweden)

    João T. Ribeiro-Paes

    Full Text Available A terapia celular poderia ser conceituada de forma ampla e genérica como o emprego de células para tratamento de doenças. Apesar de um número não tão expressivo de relatos tendo o pulmão como objeto de estudo na terapia celular em pacientes humanos, há dados consistentes da literatura, tanto em humanos, quanto em modelos animais,que evidenciam a migração de células-tronco da medula óssea para o pulmão,em diferentes situações experimentais. Esses resultados forneceram o embasamento experimental para o emprego de células-tronco na regeneração do tecido pulmonar em modelos animais. Em nosso laboratório, vários projetos de pesquisa têm sido conduzidos com a finalidade de avaliar a resposta pulmonar (morfológica e funcional ao tratamento com células-tronco adultas em camundongos com doença pulmonar obstrutiva crônica (DPOC induzida experimentalmente. Os resultados obtidos, aliados àqueles de outros grupos de pesquisa, permitem aventar a possibilidade de aplicação, a curto prazo, da terapia celular em pacientes com DPOC. Em outra patologia pulmonar, fibrose cística (FC, cuja abordagem terapêutica com células-tronco apresenta aspectos particulares em relação às patologias pulmonares crônico-degenerativas, há avanços promissores e potencialmente interessantes; no entanto, os resultados podem ser considerados incipientes e deve-se assinalar, portanto, que a associação da terapia gênica e celular apresenta-se como uma alternativa possível, mas ainda muito distante quanto à sua consolidação e incorporação como opção terapêutica segura e eficaz em FC. Por outro lado, tendo por embasamento os resultados obtidos em modelos experimentais, é possível postular que a terapia celular com células-tronco hematopoéticas (ou de outras fontes encerra perspectivas consistentes de aplicação em diversas outras patologias pulmonares humanas, especialmente em DPOC.

  8. Adeno-associated virus Rep-mediated targeting of integrase-defective retroviral vector DNA circles into human chromosome 19

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Shuohao [Graduate School of Systems Life Sciences, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395 (Japan); Kawabe, Yoshinori; Ito, Akira [Department of Chemical Engineering, Faculty of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395 (Japan); Kamihira, Masamichi, E-mail: kamihira@chem-eng.kyushu-u.ac.jp [Graduate School of Systems Life Sciences, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395 (Japan); Department of Chemical Engineering, Faculty of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka 819-0395 (Japan)

    2012-01-06

    Highlights: Black-Right-Pointing-Pointer Adeno-associated virus (AAV) is capable of targeted integration in human cells. Black-Right-Pointing-Pointer Integrase-defective retroviral vector (IDRV) enables a circular DNA delivery. Black-Right-Pointing-Pointer A targeted integration system of IDRV DNA using the AAV integration mechanism. Black-Right-Pointing-Pointer Targeted IDRV integration ameliorates the safety concerns for retroviral vectors. -- Abstract: Retroviral vectors have been employed in clinical trials for gene therapy owing to their relative large packaging capacity, alterable cell tropism, and chromosomal integration for stable transgene expression. However, uncontrollable integrations of transgenes are likely to cause safety issues, such as insertional mutagenesis. A targeted transgene integration system for retroviral vectors, therefore, is a straightforward way to address the insertional mutagenesis issue. Adeno-associated virus (AAV) is the only known virus capable of targeted integration in human cells. In the presence of AAV Rep proteins, plasmids possessing the p5 integration efficiency element (p5IEE) can be integrated into the AAV integration site (AAVS1) in the human genome. In this report, we describe a system that can target the circular DNA derived from non-integrating retroviral vectors to the AAVS1 site by utilizing the Rep/p5IEE integration mechanism. Our results showed that after G418 selection 30% of collected clones had retroviral DNA targeted at the AAVS1 site.

  9. Interferon-alpha Subtype 11 Activates NK Cells and Enables Control of Retroviral Infection

    OpenAIRE

    Kathrin Gibbert; Jara J Joedicke; Andreas Meryk; Mirko Trilling; Sandra Francois; Janine Duppach; Anke Kraft; Lang, Karl S.; Ulf Dittmer

    2012-01-01

    The innate immune response mediated by cells such as natural killer (NK) cells is critical for the rapid containment of virus replication and spread during acute infection. Here, we show that subtype 11 of the type I interferon (IFN) family greatly potentiates the antiviral activity of NK cells during retroviral infection. Treatment of mice with IFN-α11 during Friend retrovirus infection (FV) significantly reduced viral loads and resulted in long-term protection from virus-induced leukemia. T...

  10. DNA minicircles clarify the specific role of DNA structure on retroviral integration

    OpenAIRE

    Pasi, Marco; Mornico, Damien; Volant, Stevenn; Juchet, Anna; Batisse, Julien; Bouchier, Christiane; Parissi, Vincent; Ruff, Marc; Lavery, Richard; Lavigne, Marc

    2016-01-01

    International audience; Chromatin regulates the selectivity of retroviral integration into the genome of infected cells. At the nucleosome level, both histones and DNA structure are involved in this regulation. We propose a strategy that allows to specifically study a single factor: the DNA distortion induced by the nucleosome. This strategy relies on mimicking this distortion using DNA minicircles (MCs) having a fixed rotational orientation of DNA curvature, coupled with atomic-resolution mo...

  11. Efficient and specific internal cleavage of a retroviral palindromic DNA sequence by tetrameric HIV-1 integrase.

    Directory of Open Access Journals (Sweden)

    Olivier Delelis

    Full Text Available BACKGROUND: HIV-1 integrase (IN catalyses the retroviral integration process, removing two nucleotides from each long terminal repeat and inserting the processed viral DNA into the target DNA. It is widely assumed that the strand transfer step has no sequence specificity. However, recently, it has been reported by several groups that integration sites display a preference for palindromic sequences, suggesting that a symmetry in the target DNA may stabilise the tetrameric organisation of IN in the synaptic complex. METHODOLOGY/PRINCIPAL FINDINGS: We assessed the ability of several palindrome-containing sequences to organise tetrameric IN and investigated the ability of IN to catalyse DNA cleavage at internal positions. Only one palindromic sequence was successfully cleaved by IN. Interestingly, this symmetrical sequence corresponded to the 2-LTR junction of retroviral DNA circles-a palindrome similar but not identical to the consensus sequence found at integration sites. This reaction depended strictly on the cognate retroviral sequence of IN and required a full-length wild-type IN. Furthermore, the oligomeric state of IN responsible for this cleavage differed from that involved in the 3'-processing reaction. Palindromic cleavage strictly required the tetrameric form, whereas 3'-processing was efficiently catalysed by a dimer. CONCLUSIONS/SIGNIFICANCE: Our findings suggest that the restriction-like cleavage of palindromic sequences may be a general physiological activity of retroviral INs and that IN tetramerisation is strongly favoured by DNA symmetry, either at the target site for the concerted integration or when the DNA contains the 2-LTR junction in the case of the palindromic internal cleavage.

  12. Murine leukemias with retroviral insertions at Lmo2 are predictive of the leukemias induced in SCID-X1 patients following retroviral gene therapy.

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    Utpal P Davé

    2009-05-01

    Full Text Available Five X-linked severe combined immunodeficiency patients (SCID-X1 successfully treated with autologous bone marrow stem cells infected ex vivo with an IL2RG-containing retrovirus subsequently developed T-cell leukemia and four contained insertional mutations at LMO2. Genetic evidence also suggests a role for IL2RG in tumor formation, although this remains controversial. Here, we show that the genes and signaling pathways deregulated in murine leukemias with retroviral insertions at Lmo2 are similar to those deregulated in human leukemias with high LMO2 expression and are highly predictive of the leukemias induced in SCID-X1 patients. We also provide additional evidence supporting the notion that IL2RG and LMO2 cooperate in leukemia induction but are not sufficient and require additional cooperating mutations. The highly concordant nature of the genetic events giving rise to mouse and human leukemias with mutations at Lmo2 are an encouraging sign to those wanting to use mice to model human cancer and may help in designing safer methods for retroviral gene therapy.

  13. Rapid transcriptional pulsing dynamics of high expressing retroviral transgenes in embryonic stem cells.

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    Mandy Y M Lo

    Full Text Available Single cell imaging studies suggest that transcription is not continuous and occurs as discrete pulses of gene activity. To study mechanisms by which retroviral transgenes can transcribe to high levels, we used the MS2 system to visualize transcriptional dynamics of high expressing proviral integration sites in embryonic stem (ES cells. We established two ES cell lines each bearing a single copy, self-inactivating retroviral vector with a strong ubiquitous human EF1α gene promoter directing expression of mRFP fused to an MS2-stem-loop array. Transfection of MS2-EGFP generated EGFP focal dots bound to the mRFP-MS2 stem loop mRNA. These transcription foci colocalized with the transgene integration site detected by immunoFISH. Live tracking of single cells for 20 minutes detected EGFP focal dots that displayed frequent and rapid fluctuations in transcription over periods as short as 25 seconds. Similarly rapid fluctuations were detected from focal doublet signals that colocalized with replicated proviral integration sites by immunoFISH, consistent with transcriptional pulses from sister chromatids. We concluded that retroviral transgenes experience rapid transcriptional pulses in clonal ES cell lines that exhibit high level expression. These events are directed by a constitutive housekeeping gene promoter and may provide precedence for rapid transcriptional pulsing at endogenous genes in mammalian stem cells.

  14. Comparing the landcapes of common retroviral insertion sites across tumor models

    Science.gov (United States)

    Weishaupt, Holger; Čančer, Matko; Engström, Cristopher; Silvestrov, Sergei; Swartling, Fredrik J.

    2017-01-01

    Retroviral tagging represents an important technique, which allows researchers to screen for candidate cancer genes. The technique is based on the integration of retroviral sequences into the genome of a host organism, which might then lead to the artificial inhibition or expression of proximal genetic elements. The identification of potential cancer genes in this framework involves the detection of genomic regions (common insertion sites; CIS) which contain a number of such viral integration sites that is greater than expected by chance. During the last two decades, a number of different methods have been discussed for the identification of such loci and the respective techniques have been applied to a variety of different retroviruses and/or tumor models. We have previously established a retrovirus driven brain tumor model and reported the CISs which were found based on a Monte Carlo statistics derived detection paradigm. In this study, we consider a recently proposed alternative graph theory based method for identifying CISs and compare the resulting CIS landscape in our brain tumor dataset to those obtained when using the Monte Carlo approach. Finally, we also employ the graph-based method to compare the CIS landscape in our brain tumor model with those of other published retroviral tumor models.

  15. Éxito de la terapia breve centrada en soluciones en su seguimiento

    OpenAIRE

    Domínguez del Val, Ángela

    2011-01-01

    A patir de una muestra (N=40) extraída del Centro Clínico en Terapia Sistémica de la Universidad Pontificia de Salamanca se estudia el éxito que tiene la aplicación de la Terapia Breve Centrada en Soluciones (TBCS)

  16. NRE57/12: Plan de Estudios de Graduado o Graduada en Terapia Ocupacional

    OpenAIRE

    Universidad de Granada

    2012-01-01

    Plan de Estudios de Graduado o Graduada en Terapia Ocupacional. Resoluci??n de 22 de febrero de 2012, de la Universidad de Granada, por la que se hace p??blico el Plan de Estudios de Graduado o Graduada en Terapia Ocupacional

  17. Asistencia ventricular izquierda para terapia de destino: primera experiencia en septuagenarios

    Directory of Open Access Journals (Sweden)

    Sebastian V. Rojas

    2016-10-01

    Conclusiones: Nuestros resultados iniciales demuestran que el implante mínimamente invasivo de DAVI puede ser realizado de manera eficaz, segura y con buenos resultados en pacientes septuagenarios terapia de destino. Los bajos niveles de eventos adversos durante el seguimiento por 2 años demuestran que la terapia de destino puede ser realizada incluso en pacientes septuagenarios.

  18. Mindfulness: terapia alternativa para el tratamiento del dolor en la lesión medular

    OpenAIRE

    Torres Sanz, Sandra

    2013-01-01

    El Minfulness como procedimiento terapéutico se encuentra en el desarrollo de las denominadas nuevas terapias conductuales. Este tipo de terapias surgen al considerar el contexto como elemento principal, en la explicación e intervención. Se analiza la aplicación de este procedimineto en pacientes con lesión medular

  19. Introducción a la terapia asistida con animales: tipologías de terapia en España

    OpenAIRE

    García Martín, Carmen

    2011-01-01

    Se hace una revisión teórico-bibliográfica sobre la terapia asistida con animales, centrándose en animales como perros, caballos y delfines, en los diferentes ámbitos de intervención en España, incluyendo datos recogidos sobre los resultados de este tipo de terapia en algunas asociaciones del país

  20. Positive Selection of Iris, a Retroviral Envelope-Derived Host Gene in Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    2005-10-01

    Full Text Available Eukaryotic genomes can usurp enzymatic functions encoded by mobile elements for their own use. A particularly interesting kind of acquisition involves the domestication of retroviral envelope genes, which confer infectious membrane-fusion ability to retroviruses. So far, these examples have been limited to vertebrate genomes, including primates where the domesticated envelope is under purifying selection to assist placental function. Here, we show that in Drosophila genomes, a previously unannotated gene (CG4715, renamed Iris was domesticated from a novel, active Kanga lineage of insect retroviruses at least 25 million years ago, and has since been maintained as a host gene that is expressed in all adult tissues. Iris and the envelope genes from Kanga retroviruses are homologous to those found in insect baculoviruses and gypsy and roo insect retroviruses. Two separate envelope domestications from the Kanga and roo retroviruses have taken place, in fruit fly and mosquito genomes, respectively. Whereas retroviral envelopes are proteolytically cleaved into the ligand-interaction and membrane-fusion domains, Iris appears to lack this cleavage site. In the takahashii/suzukii species groups of Drosophila, we find that Iris has tandemly duplicated to give rise to two genes (Iris-A and Iris-B. Iris-B has significantly diverged from the Iris-A lineage, primarily because of the "invention" of an intron de novo in what was previously exonic sequence. Unlike domesticated retroviral envelope genes in mammals, we find that Iris has been subject to strong positive selection between Drosophila species. The rapid, adaptive evolution of Iris is sufficient to unambiguously distinguish the phylogenies of three closely related sibling species of Drosophila (D. simulans, D. sechellia, and D. mauritiana, a discriminative power previously described only for a putative "speciation gene." Iris represents the first instance of a retroviral envelope-derived host gene

  1. Positive selection of Iris, a retroviral envelope-derived host gene in Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    Harmit S Malik

    2005-10-01

    Full Text Available Eukaryotic genomes can usurp enzymatic functions encoded by mobile elements for their own use. A particularly interesting kind of acquisition involves the domestication of retroviral envelope genes, which confer infectious membrane-fusion ability to retroviruses. So far, these examples have been limited to vertebrate genomes, including primates where the domesticated envelope is under purifying selection to assist placental function. Here, we show that in Drosophila genomes, a previously unannotated gene (CG4715, renamed Iris was domesticated from a novel, active Kanga lineage of insect retroviruses at least 25 million years ago, and has since been maintained as a host gene that is expressed in all adult tissues. Iris and the envelope genes from Kanga retroviruses are homologous to those found in insect baculoviruses and gypsy and roo insect retroviruses. Two separate envelope domestications from the Kanga and roo retroviruses have taken place, in fruit fly and mosquito genomes, respectively. Whereas retroviral envelopes are proteolytically cleaved into the ligand-interaction and membrane-fusion domains, Iris appears to lack this cleavage site. In the takahashii/suzukii species groups of Drosophila, we find that Iris has tandemly duplicated to give rise to two genes (Iris-A and Iris-B. Iris-B has significantly diverged from the Iris-A lineage, primarily because of the "invention" of an intron de novo in what was previously exonic sequence. Unlike domesticated retroviral envelope genes in mammals, we find that Iris has been subject to strong positive selection between Drosophila species. The rapid, adaptive evolution of Iris is sufficient to unambiguously distinguish the phylogenies of three closely related sibling species of Drosophila (D. simulans, D. sechellia, and D. mauritiana, a discriminative power previously described only for a putative "speciation gene." Iris represents the first instance of a retroviral envelope-derived host gene

  2. Modelos en desarrollo de terapias derivadas de biotecnologia

    OpenAIRE

    Jaimes Monroy, Gustavo

    2008-01-01

    El objetivo de la terapia génica para el tratamiento del cáncer es eliminar las células tumorales preservando el tejido normal. Diversas estrategias para llevar acabo este objetivo han demostrado resultados promisorios en el laboratorio, incluyendo moléculas que pueden tener blancos específicamente predeterminados en secuencias en el ADN y el ARNm; estas secuencias proporcionan un medio para modular la función de genes endógenos. Diferentes tipos de moléculas: inductores de hélices triples, o...

  3. Rendimiento escolar: su abordaje desde la terapia de juego familiar

    OpenAIRE

    Padilla, Xóchitl; Ruiz, Verónica

    2016-01-01

    La evaluación del área emocional cuando existe bajo aprovechamiento escolar permite tener más herramientas para el diagnóstico. Adicionalmente la revisión bibliográfica, el trabajo interdisciplinario y el juego ofrecen herramientas para la toma de decisiones. En este trabajo, se describe el proceso de evaluación e intervención clínica de una menor de nueve años con dificultades académicas. La madre solicitó terapias de aprendizaje debido a “bajas calificaciones y problemas de socialización”. ...

  4. Terapia gênica para osteoporose Gene therapy for osteoporosis

    Directory of Open Access Journals (Sweden)

    Rafael Pacheco da Costa

    2011-01-01

    Full Text Available A osteoporose é considerada um dos problemas de saúde mais comuns e sérios da população idosa mundial. É uma doença crônica e progressiva, caracterizada pela diminuição da massa óssea e deterioração da microarquitetura do tecido ósseo. A terapia gênica representa uma nova abordagem para o tratamento da osteoporose e tem como princípio devolver a função comprometida pelo metabolismo. Esta revisão visa focar os trabalhos relevantes desenvolvidos nos últimos anos, disponibilizados nas bases de dados médicas, e que utilizaram a terapia gênica para o tratamento da osteoporose em modelos animais, bem como, as perspectivas futuras desta terapia. A maioria dos estudos utiliza os genes BMPs, PTH e OPG na tentativa de restabelecer a massa óssea. Apesar da carência de novas moléculas, todos os genes empregados nos estudos se mostraram eficientes no tratamento da doença. Os benefícios que a terapia gênica proporcionará aos pacientes no futuro devem contribuir substancialmente para o aumento na qualidade de vida dos idosos. Em breve, protocolos clínicos envolvendo humanos irão beneficiar os indivíduos com osteoporose.Osteoporosis is considered one of the most common and serious problems affecting the elderly population worldwide. It is a chronic and progressive disease, characterized by decreased bone mass and degeneration of the microarchitecture of the bone tissue. Gene therapy represents a new approach in osteoporosis treatment, and its main function is to restore the compromised function in the metabolism. This review aims to elucidate the main studies on gene therapy in recent years, in the medical databases, that use gene therapy for the treatment of osteoporosis in animal models, as well as the future prospects of this therapy. The majority of the studies use the BMP, PTH and OPG genes, in an attempt to reestablish bone mass. Despite the lack of new molecules, all genes employed in these studies have proven to be

  5. Factores de riesgo de neumonía nosocomial en terapia intensiva. Hospital “Dr. Ernesto Guevara”

    Directory of Open Access Journals (Sweden)

    Yadira Santiesteban Escalona

    2015-11-01

    Full Text Available Se realizó un estudio analítico, de tipo caso control pareados 1:2, para determinar los factores de riesgo de neumonía nosocomial en pacientes ingresados en terapia intensiva del Hospital “Dr. Ernesto Guevara de la Serna” de Las Tunas, en el período de enero de 2010 a diciembre de 2011. El universo fue de 1035 pacientes ingresados en terapia intensiva (UCI, en dicho período, de ellos constituyeron la muestra, denominada “casos”, 56 pacientes que desarrollaron Neumonía Nosocomial durante su estadía en UCI. Para el “control” de los factores de confusión, por cada caso, se parearon dos pacientes sin diagnóstico de neumonía. La información se obtuvo de fuentes secundarias (historias clínicas. A los casos y a los controles se les llenó una planilla de vaciamiento de datos con las variables analizadas. Los datos se procesaron utilizando el paquete de programas estadísticos Epinfo, versión 6. Para el estudio de los factores de riesgo se realizaron análisis univariados, evaluándose: ODDS RATIO, intervalo de confianza y probabilidad. Resultaron ser factores de riesgo para presentar neumonía nosocomial: la intubación endotraqueal, los trastornos de conciencia, el aislamiento de bacilos no fermentadores, citrobacter diversus y/o klebsiella ssp., haber requerido neurocirugía, el uso de tratamiento antibiótico previo, antiácidos anti H2, nutrición parenteral y la estadía en UCI mayor de siete días.

  6. Terapia antihipertensiva en enfermedad renal crónica

    Directory of Open Access Journals (Sweden)

    V. Rodrigo Tagle, Dr.

    2010-07-01

    Full Text Available La enfermedad renal crónica (ERC constituye una de las causas más frecuentes de hipertensión arterial (HTA secundaria. Existe una nueva clasificación de la ERC basada en la presencia de un daño estructural con o sin un deterioro de la velocidad de filtración glomerular (VFG. La prevalencia de la HTA varía principalmente según la magnitud de la VFG y la etiología de la enfermedad del parénquima renal. Los mecanismos hipertensógenos primordiales son: la retención de sodio e hipervolemia, y la activación del eje renina angiotensina aldosterona. La HTA es también un factor de progresión de la ERC. La terapia se basa en la restricción de sodio, diuréticos y bloqueadores del eje renina angiotensina. Consideraciones farmacológicas y clínicas son fundamentales para un efectivo uso de esta terapia. Los objetivos son la prevención cardiovascular y renal, a través de la obtención de determinados niveles de presión arterial (PA.

  7. Stability of Retroviral Vectors Against Ultracentrifugation Is Determined by the Viral Internal Core and Envelope Proteins Used for Pseudotyping.

    Science.gov (United States)

    Kim, Soo-Hyun; Lim, Kwang-Il

    2017-05-31

    Retroviral and lentiviral vectors are mostly pseudotyped and often purified and concentrated via ultracentrifugation. In this study, we quantified and compared the stabilities of retroviral [murine leukemia virus (MLV)-based] and lentiviral [human immunodeficiency virus (HIV)-1-based] vectors pseudotyped with relatively mechanically stable envelope proteins, vesicular stomatitis virus glycoproteins (VSVGs), and the influenza virus WSN strain envelope proteins against ultracentrifugation. Lentiviral genomic and functional particles were more stable than the corresponding retroviral particles against ultracentrifugation when pseudotyped with VSVGs. However, both retroviral and lentiviral particles were unstable when pseudotyped with the influenza virus WSN strain envelope proteins. Therefore, the stabilities of pseudotyped retroviral and lentiviral vectors against ultracentrifugation process are a function of not only the type of envelope proteins, but also the type of viral internal core (MLV or HIV-1 core). In addition, the fraction of functional viral particles among genomic viral particles greatly varied at times during packaging, depending on the type of envelope proteins used for pseudotyping and the viral internal core.

  8. Lineage-specific expansions of retroviral insertions within the genomes of African great apes but not humans and orangutans.

    Directory of Open Access Journals (Sweden)

    Chris T Yohn

    2005-04-01

    Full Text Available Retroviral infections of the germline have the potential to episodically alter gene function and genome structure during the course of evolution. Horizontal transmissions between species have been proposed, but little evidence exists for such events in the human/great ape lineage of evolution. Based on analysis of finished BAC chimpanzee genome sequence, we characterize a retroviral element (Pan troglodytes endogenous retrovirus 1 [PTERV1] that has become integrated in the germline of African great ape and Old World monkey species but is absent from humans and Asian ape genomes. We unambiguously map 287 retroviral integration sites and determine that approximately 95.8% of the insertions occur at non-orthologous regions between closely related species. Phylogenetic analysis of the endogenous retrovirus reveals that the gorilla and chimpanzee elements share a monophyletic origin with a subset of the Old World monkey retroviral elements, but that the average sequence divergence exceeds neutral expectation for a strictly nuclear inherited DNA molecule. Within the chimpanzee, there is a significant integration bias against genes, with only 14 of these insertions mapping within intronic regions. Six out of ten of these genes, for which there are expression data, show significant differences in transcript expression between human and chimpanzee. Our data are consistent with a retroviral infection that bombarded the genomes of chimpanzees and gorillas independently and concurrently, 3-4 million years ago. We speculate on the potential impact of such recent events on the evolution of humans and great apes.

  9. Terapias Psicológicas para el Tratamiento del Dolor Crónico

    Directory of Open Access Journals (Sweden)

    Jenny Moix

    2011-01-01

    Full Text Available A pesar de que existe abundante literatura que muestra la efectividad del tratamiento cognitivo-conductual del dolor crónico, en nuestro país, se carecía de un manual del mismo. Por este motivo, diseñamos un protocolo donde se describen las diferentes técnicas de dicha terapia. En el presente artículo, realizamos una detallada descripción del mismo. Antes de adentrarnos en la terapia cognitivo-conductual, presentamos una revisión de las principales terapias psicológicas que se emplean en el tratamiento del dolor crónico.

  10. Terapias Cognitiva e Cognitivo-Comportamental em dependência química

    OpenAIRE

    Silva,Cláudio Jerônimo da; Serra,Ana Maria

    2004-01-01

    Este artigo descreve o estado atual da Terapia Cognitiva, Comportamental, Prevenção de Recaída e Treinamento de Habilidades no tratamento de usuários de drogas. O objetivo é apresentar uma revisão sobre teorias e técnicas da Terapia Cognitiva e outras abordagens que dela derivam. Terapias Cognitiva e Comportamental, bem como Prevenção da Recaída e Treinamento de Habilidades, são tratamentos limitados no tempo, orientados em uma meta, e que utilizam sessões estruturadas, assumindo, assim, uma ...

  11. Habilidades clínicas en la terapia conductual de tercera generación

    OpenAIRE

    Barraca, J. (Javier)

    2009-01-01

    En este artículo se repasan las técnicas de tres de las terapias de tercera generación conductual (Terapia de Aceptación y Compromiso, Psicoterapia Analítico Funcional y Terapia Conductual Dialéctica) para reflexionar sobre el tipo de destrezas que el terapeuta debe desarrollar si pretende lograr una actuación competente al practicarlas. Este examen lleva a distinguir entre: (1) habilidades de escucha y discriminación de respuesta; (2) habilidades de fluidez, repertorio y ...

  12. La terapia breve: una alternativa de intervención psicológica efectiva

    OpenAIRE

    Carlos Andrés Gantiva Díaz; Nohelia Hewitt Ramírez

    2009-01-01

    El objetivo de este trabajo es describir y estructurar los orígenes, bases teóricas y los procedimientos de la terapia breve desde la perspectiva terapéutica cognitivo conductual. Se inicia con la identifi cación de las bases teóricas de la terapia breve, principalmente las teorías motivacionales relacionadas con la disponibilidad al cambio y la autoefi cacia desde la teoría social cognitiva. Se realiza un paralelo entre las características principales de la terapia breve en contraposición co...

  13. Historia e institucionalización de la terapia neural en Colombia

    OpenAIRE

    Sarmiento Rodríguez, Luz Dary

    2014-01-01

    La historia de la Terapia Neural que el mundo médico conoce data de tan sólo nueve décadas atrás, con la apertura generada por los estudios de los hermanos Huneke. Investigaciones recientes permiten concluir que las bases científicas de la Terapia Neural parten de la corriente rusa, desde la primera mitad del siglo XIX, a través de la escuela del Nervismo1 . La Terapia Neural en los países occidentales se encuentra en un proceso de definirse como un sistema médico, lo que exige...

  14. La eficacia de la terapia musical Vs. Diacepam para disminuir la ansiedad preoperatoria

    OpenAIRE

    Berbel Sánchez, Pere

    2015-01-01

    La terapia musical puede y debe constituir una herramienta más del arsenal terapéutico actual del que se dispone para el tratamiento de distintas enfermedades. Es una terapia individual y coadyuvante de otras aceptadas como estándar a las que complementa pero no substituye. En el apartado 1, se hace una exhaustiva revisión histórica para situarnos y poder entender mejor el significado y objeto de la terapia musical y se describen las razones que han llevado a realizar este trabajo. En el apar...

  15. Cross-packaging of genetically distinct mouse and primate retroviral RNAs

    Directory of Open Access Journals (Sweden)

    Jaballah Soumeya

    2009-07-01

    Full Text Available Abstract Background The mouse mammary tumor virus (MMTV is unique from other retroviruses in having multiple viral promoters, which can be regulated by hormones in a tissue specific manner. This unique property has lead to increased interest in studying MMTV replication with the hope of developing MMTV based vectors for human gene therapy. However, it has recently been reported that related as well as unrelated retroviruses can cross-package each other's genome raising safety concerns towards the use of candidate retroviral vectors for human gene therapy. Therefore, using a trans complementation assay, we looked at the ability of MMTV RNA to be cross-packaged and propagated by an unrelated primate Mason-Pfizer monkey virus (MPMV that has intracellular assembly process similar to that of MMTV. Results Our results revealed that MMTV and MPMV RNAs could be cross-packaged by the heterologous virus particles reciprocally suggesting that pseudotyping between two genetically distinct retroviruses can take place at the RNA level. However, the cross-packaged RNAs could not be propagated further indicating a block at post-packaging events in the retroviral life cycle. To further confirm that the specificity of cross-packaging was conferred by the packaging sequences (ψ, we cloned the packaging sequences of these viruses on expression plasmids that generated non-viral RNAs. Test of these non-viral RNAs confirmed that the reciprocal cross-packaging was primarily due to the recognition of ψ by the heterologous virus proteins. Conclusion The results presented in this study strongly argue that MPMV and MMTV are promiscuous in their ability to cross-package each other's genome suggesting potential RNA-protein interactions among divergent retroviral RNAs proposing that these interactions are more complicated than originally thought. Furthermore, these observations raise the possibility that MMTV and MPMV genomes could also co-package providing substrates for

  16. Large-scale Clinical-grade Retroviral Vector Production in a Fixed-Bed Bioreactor

    Science.gov (United States)

    Wang, Xiuyan; Olszewska, Malgorzata; Qu, Jinrong; Wasielewska, Teresa; Bartido, Shirley; Hermetet, Gregory; Sadelain, Michel

    2015-01-01

    The successful genetic engineering of patient T cells with γ-retroviral vectors expressing chimeric antigen receptors or T-cell receptors for phase II clinical trials and beyond requires the large-scale manufacture of high-titer vector stocks. The production of retroviral vectors from stable packaging cell lines using roller bottles or 10- to 40-layer cell factories is limited by a narrow harvest window, labor intensity, open-system operations, and the requirement for significant incubator space. To circumvent these shortcomings, we optimized the production of vector stocks in a disposable fixed-bed bioreactor using good manufacturing practice–grade packaging cell lines. High-titer vector stocks were harvested over 10 days, representing a much broader harvest window than the 3-day harvest afforded by cell factories. For PG13 and 293Vec packaging cells, the average vector titer and the vector stocks’ yield in the bioreactor were higher by 3.2- to 7.3-fold, and 5.6- to 13.1-fold, respectively, than those obtained in cell factories. The vector production was 10.4 and 18.6 times more efficient than in cell factories for PG13 and 293Vec cells, respectively. Furthermore, the vectors produced from the fixed-bed bioreactors passed the release test assays for clinical applications. Therefore, a single vector lot derived from 293Vec is suitable to transduce up to 500 patients cell doses in the context of large clinical trials using chimeric antigen receptors or T-cell receptors. These findings demonstrate for the first time that a robust fixed-bed bioreactor process can be used to produce γ-retroviral vector stocks scalable up to the commercialization phase. PMID:25751502

  17. Terapia Craneal en Agua Vs Terapia Craneal en Sala: Efectividad de la Terapia Cráneo-Sacral en el Medio Acuático con Pacientes que Sufren Estrés.

    OpenAIRE

    Belmonte Marín, Enrique

    2017-01-01

    La sociedad actual, regida por la falta de tiempo y la sobreabundancia de compromisos, actualmente sufre de estrés, disponiéndose ésta, como una de las afecciones más comunes en nuestra vida cotidiana. En el ámbito de la fisioterapia cada vez es mayor el interés por la terapia manual y sobre todo por una indolora y suave, siendo la terapia cráneo-sacral una de las técnicas más indicadas. El objetivo principal del presente estudio trata de evaluar si el medio acuático con la terapia cráneo-sac...

  18. Multidrug resistance and retroviral transduction potential in human small cell lung cancer cell lines

    DEFF Research Database (Denmark)

    Theilade, M D; Gram, G J; Jensen, P B

    1999-01-01

    Multidrug resistance (MDR) remains a major problem in the successful treatment of small cell lung cancer (SCLC). New treatment strategies are needed, such as gene therapy specifically targeting the MDR cells in the tumor. Retroviral LacZ gene-containing vectors that were either pseudotyped...... for the gibbon ape leukemia virus (GALV-1) receptor or had specificity for the amphotropic murine leukemia virus (MLV-A) receptor were used for transduction of five SCLC cell lines differing by a range of MDR mechanisms. Transduction efficiencies in these cell lines were compared by calculating the percentage...

  19. Spontaneous silencing of humanized green fluorescent protein (hGFP) gene expression from a retroviral vector by DNA methylation

    DEFF Research Database (Denmark)

    Gram, G J; Nielsen, S D; Hansen, J E

    1998-01-01

    We have constructed a functional murine leukemia virus (MLV)-derived retroviral vector transducing two genes encoding the autofluorescent humanized green fluorescent protein (hGFP) and neomycin phosphotransferase (Neo). This was done to determine whether hGFP could function as a marker gene...... in a retroviral vector and to investigate the expression of genes in a retroviral vector. Surprisingly, clonal vector packaging cell lines showed variable levels of hGFP expression, and expression was detected in as few as 49% of the cells in a clonally derived culture. This indicated that hGFP expression...... was silenced in individual cells. This silencing could be diminished by selective culturing of the vector packaging cells with the neomycin analog G418 and was reduced by a 3-day treatment with the demethylating agent 5-azacytidine. The 5-azacytidine effect was transient, and hGFP expression in the vector...

  20. BASES FISIOPATOLÓGICAS DA APLICAÇÃO DA TERAPIA A LASER DE BAIXA INTENSIDADE NO HERPES ZOSTER E NEURALGIA PÓS-HERPÉTICA COM ACOMETIMENTO OROFACIAL

    Directory of Open Access Journals (Sweden)

    Davidson Ribeiro Costa

    2017-12-01

    Full Text Available O herpes-zóster facial é definida como uma doença infecciosa, que durante seu desenvolvimento apresenta lesões dolorosas na região orofacial. A Neuralgia pós-herpética é uma complicação da herpes-zóster facial que é caracteriza pela sintomatologia  extremamente dolorosa. Tanto a herpes-zóster facial como a Neuralgia pós-herpética diminuem drasticamente a qualidade de vida de seus portadores. A terapia com laser  de baixa intensidade (TLBI tem sido amplamente divulgada nos meios científicos, devido o seu efeito positivo  no tratamento de uma série de condições. Nesse contexto, o presente estudo objetivou analisar os principais efeitos da TLBI de forma a apresentar uma nova abordagem terapêutica, que pode ser empregada no tratamento da HZ facial e NPHT, salientando as doses e os possíveis locais para a irradiação em cada fase. A TLBI é uma terapia não invasiva, que não apresenta efeitos adversos, quando empregada de maneira correta. Essa terapia apresenta efeitos antiálgico, anti-inflamatório, de reparo tecidual e neuronal, o que justifica a sua utilização no tratamento da HZ facial e NPHT.

  1. Tratamiento de Terapia Ocupacional en el accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    Domingo García, AM

    2006-02-01

    Full Text Available RESUMENEntre los muchos pacientes que necesitan tratamiento rehabilitador en Terapia Ocupacional están los que en la edad adulta han sufrido un accidente cerebrovascular.Uno de los factores de riesgo asociados con más frecuencia a las alteraciones del sistema nervioso central es el progresivo envejecimiento de la población, debido a esto orientaré el siguiente artículo hacia la intervención sobre la población geriátrica.La Terapia Ocupacional ofrece un tratamiento global que abarca las áreas funcional, motriz, sensorial, perceptivo y cognitiva. No debemos olvidar el asesoramiento realizado al paciente, a la familia y/ o cuidadores sobre el manejo de la persona que ha sufrido un ictus, la adaptación del entorno y la prescripción, uso y manejo de ayudas técnicas cuando sea necesario.Las propuestas terapéuticas que expondré a continuación, no son recetas únicas que se puedan emplear del mismo modo en todos las personas que hayan sufrido un ictus. Con cada paciente será necesario una evaluación individualizada de su situación y una adaptación de la terapia según sus déficit específicos.La meta final de la Terapia Ocupacional es la integración óptima del paciente dentro de su entorno familiar y social, con el mayor grado de autonomía posible.ABSTRACTAmong the patients who need Occupational Therapy’s rehabilitation treatment, there are those who have suffered a cerebrovascular damage when elderly.People’s gradual ageing is one of the risk factors in the nervous central system’s alterations and this is why I am going to write about intervention on geriatric population.The Occupational Therapy’s rehabilitation treatment works on the functional, motor, sensorial, perceptive and cognitive areas. Moreover, we should not forget to advise the patient and his/her family or caregivers about the way of treating ,the environment’s adaptation, the prescription and use of technical aids when needed.The following therapeutic

  2. Prevenzione delle infezioni ospedaliere in una terapia intensiva

    Directory of Open Access Journals (Sweden)

    G.B. Orsi

    2003-05-01

    Full Text Available

    Obiettivi: sorveglianza delle infezioni ospedaliere (IO nell’unità di terapia intensiva (UTI di un grande ospedale romano.

    Metodi. tutti i pazienti ricoverati nell’UTI tra il 1.1.2000 ed il 31.12.2001 per ›48 ore. Lo studio, applicando le definizioni di caso dei CDC, ha considerato le seguenti infezioni: infezioni polmonari (POL, setticemie (SET, infezioni delle vie urinarie (IVU, infezioni della ferita chirurgica (IFC. Inoltre sono stati valutati eventuali fattori di rischio preesistenti, procedure invasive, isolamento dei microrganismi e loro suscettibilità agli antibiotici.

    Sulla base dei risultati epidemiologici preliminari, dall’ottobre 2000 al marzo 2001 sono stati effettuati una serie di interventi che hanno modificato alcune importanti variabili associate alle IO.

  3. 216. Experiencia con la terapia de aspiración continua como tratamiento de la mediastinitis

    Directory of Open Access Journals (Sweden)

    S. Ramis

    2010-01-01

    Conclusiones: La terapia VAC es un método seguro, que permite lograr una estabilidad torácica completa, logrando disminuir las complicaciones, tanto sépticas como respiratorias, en los pacientes con mediastinitis aguda.

  4. Terapia con celulas madre en cirrosis.(Perspectiva general de la enfermedad/trastorno)

    National Research Council Canada - National Science Library

    Pulido, Cesar Daniel Nino; Restrepo Gutierrez, Juan Carlos; Hoyos Vanegas, Natalia Andrea; Londono Agudelo, Jessica Maria

    2011-01-01

    En este articulo se presenta una revision de la literatura sobre las celulas madre como terapia para la cirrosis hepatica, con enfasis en describir la situacion cientifica actual y las implicaciones...

  5. Evidencia de la eficacia de los fármacos anti-TNF Alfa en el tratamiento de la espondilitis anquilosante

    OpenAIRE

    Montilla Salas, Juan Manuel

    2011-01-01

    OBJETIVO Establecer la evidencia de los estudios clínicos sobre la eficacia de las terapias anti-TNF alfa para el tratamiento de la espondilitis anquilosante (EA). MÉTODOS Se realizó una búsqueda con los diferentes fármacos anti-NTF alfa actualmente utilizados en terapia de la espondilitis anquilosante (Infiximab, Etanercept y Adalimumab). La revisión bibliográfica se realizó en Medline, Embase y la librería Cochrane para los estudios controlados y randomizados publicados hasta 1-enero-2005. ...

  6. The evolution of novel fungal genes from non-retroviral RNA viruses

    Directory of Open Access Journals (Sweden)

    Bruenn Jeremy

    2009-12-01

    Full Text Available Abstract Background Endogenous derivatives of non-retroviral RNA viruses are thought to be absent or rare in eukaryotic genomes because integration of RNA viruses in host genomes is impossible without reverse transcription. However, such derivatives have been proposed for animals, plants and fungi, often based on surrogate bioinformatic evidence. At present, there is little known of the evolution and function of integrated non-retroviral RNA virus genes. Here, we provide direct evidence of integration by sequencing across host-virus gene boundaries and carry out phylogenetic analyses of fungal hosts and totivirids (dsRNA viruses of fungi and protozoans. Further, we examine functionality by tests of neutral evolution, comparison of residues that are necessary for viral capsid functioning and assays for transcripts, dsRNA and viral particles. Results Sequencing evidence from gene boundaries was consistent with integration. We detected previously unknown integrated Totivirus-like sequences in three fungi (Candida parapsilosis, Penicillium marneffei and Uromyces appendiculatus. The phylogenetic evidence strongly indicated that the direction of transfer was from Totivirus to fungus. However, there was evidence of transfer of Totivirus-like sequences among fungi. Tests of selection indicated that integrated genes are maintained by purifying selection. Transcripts were apparent for some gene copies, but, in most cases, the endogenous sequences lacked the residues necessary for normal viral functioning. Conclusions Our findings reveal that horizontal gene transfer can result in novel gene formation in eukaryotes despite miniaturized genomic targets and a need for co-option of reverse transcriptase.

  7. Retroviral hybrid LTR vector strategy: functional analysis of LTR elements and generation of endothelial cell specificity.

    Science.gov (United States)

    Richardson, T B; Kaspers, J; Porter, C D

    2004-05-01

    Transcriptional targeting is an important aspect of developing gene therapy vectors in order to restrict transgene expression to selected target cells. One approach, when using retroviral vectors, is to replace viral transcriptional control elements within the long terminal repeat (LTR) with sequences imparting the desired specificity. We have developed such hybrid LTR retroviruses, incorporating sequences from each of the human promoters for flt-1, ICAM-2 and KDR, as part of our antivascular cancer gene therapy strategy targeting tumour endothelial cells. The chosen fragments were used to replace the enhancer or combined enhancer and proximal promoter regions of the viral LTR. All showed activity in primary human breast microvascular endothelial cells, with viruses incorporating ICAM-2 sequences exhibiting the greatest specificity versus nonendothelial cells in vitro and a marked alteration of specificity towards endothelial cells in a subcutaneous xenograft model in vivo. Moreover, our study documents the effect of enhancer and/or proximal promoter deletion on LTR activity and reports that differential dependence in different cell lines can give the false impression of specificity if experiments are not adequately controlled. This finding also has implications for other retroviral vector designs seeking to provide transcriptional specificity and for their safety with respect to prevention of gene activation at sites of proviral integration.

  8. Evolution of endogenous non-retroviral genes integrated into plant genomes

    Directory of Open Access Journals (Sweden)

    Hyosub Chu

    2014-08-01

    Full Text Available Numerous comparative genome analyses have revealed the wide extent of horizontal gene transfer (HGT in living organisms, which contributes to their evolution and genetic diversity. Viruses play important roles in HGT. Endogenous viral elements (EVEs are defined as viral DNA sequences present within the genomes of non-viral organisms. In eukaryotic cells, the majority of EVEs are derived from RNA viruses using reverse transcription. In contrast, endogenous non-retroviral elements (ENREs are poorly studied. However, the increasing availability of genomic data and the rapid development of bioinformatics tools have enabled the identification of several ENREs in various eukaryotic organisms. To date, a small number of ENREs integrated into plant genomes have been identified. Of the known non-retroviruses, most identified ENREs are derived from double-strand (ds RNA viruses, followed by single-strand (ss DNA and ssRNA viruses. At least eight virus families have been identified. Of these, viruses in the family Partitiviridae are dominant, followed by viruses of the families Chrysoviridae and Geminiviridae. The identified ENREs have been primarily identified in eudicots, followed by monocots. In this review, we briefly discuss the current view on non-retroviral sequences integrated into plant genomes that are associated with plant-virus evolution and their possible roles in antiviral resistance.

  9. Retrovirus Integration Database (RID): a public database for retroviral insertion sites into host genomes.

    Science.gov (United States)

    Shao, Wei; Shan, Jigui; Kearney, Mary F; Wu, Xiaolin; Maldarelli, Frank; Mellors, John W; Luke, Brian; Coffin, John M; Hughes, Stephen H

    2016-07-04

    The NCI Retrovirus Integration Database is a MySql-based relational database created for storing and retrieving comprehensive information about retroviral integration sites, primarily, but not exclusively, HIV-1. The database is accessible to the public for submission or extraction of data originating from experiments aimed at collecting information related to retroviral integration sites including: the site of integration into the host genome, the virus family and subtype, the origin of the sample, gene exons/introns associated with integration, and proviral orientation. Information about the references from which the data were collected is also stored in the database. Tools are built into the website that can be used to map the integration sites to UCSC genome browser, to plot the integration site patterns on a chromosome, and to display provirus LTRs in their inserted genome sequence. The website is robust, user friendly, and allows users to query the database and analyze the data dynamically. https://rid.ncifcrf.gov ; or http://home.ncifcrf.gov/hivdrp/resources.htm .

  10. Cloning, expression, and functional analysis of genomic miRNA using retroviral system in cancer cells.

    Science.gov (United States)

    Rezaeian, Abdol Hossein; Gao, Yuan; Lin, Hui-Kuan

    2013-01-01

    MicroRNAs have emerged as important post-transcriptional regulators of gene expression. Identification of cancer-regulated microRNAs or other classes of endogenous small RNAs have advanced our knowledge in cancer progression and metastasis. Among many tools, small RNA cloning is a powerful method to identify new microRNAs (miRNAs) and to profile miRNA expression and function. Retroviral system is also the minimum requirement for the studying of miRNAs in a highly stable population of cancer cells or other primary cell types with high expression. This chapter describes a step-by-step protocol that is optimized to clone directly one of the miRNA miR-145, as an example, from genomic DNA into retroviral vector to yield ultimate overexpression for functional study in prostate cancer cells. The small RNAs cloned by this protocol will have an easy and simple way of cloning from genomic DNA to maintain the necessary motifs of native enhancer for enhancement of mature miRNA expression. Furthermore, the procedure eliminates miRNA extraction and cDNA synthesis before cloning and sequential cloning of more than one miRNA makes this protocol cost- and time-effective to eliminate many frequent cell culturing.

  11. Identification and Characterization of Enhancer-Blocking Insulators to Reduce Retroviral Vector Genotoxicity

    Science.gov (United States)

    Wang, Hao; Lovelett, Emilie; Emery, David W.

    2013-01-01

    The chromatin insulator cHS4 can reduce silencing chromosomal position effects and genotoxicity associated with integrating viral vectors. However, the fully active version of this element can also reduce vector titers and is only partially effective. In order to identify alternatives to cHS4, we developed a functional lentiviral vector-based reporter screen for enhancer-blocking insulators. Using this system, we screened candidate sequences that were initially identified by chromatin profiling for binding by CTCF and for DNase hypersensitivity. All 12 analyzed candidates blocked enhancer-promoter activity. The enhancer-blocking activity of the top two candidates was confirmed in two complementary plasmid-based assays. Studies in a gammaretroviral reporter vector indicated these two candidates have little to no effect on vector titers, and do not diminish vector expression in primary mouse bone marrow cultures. Subsequent assessment in a mouse in vivo tumor formation model demonstrated that both candidates reduced the rate of gammaretroviral vector-mediated genotoxicity as effectively as the cHS4 insulator. In summary, we have developed a novel lentiviral vector-based method of screening candidate elements for insulator activity, and have used this method to identify two new insulator elements capable of improving the safety of retroviral vectors without diminishing vector titers or expression. These findings expand the limited arsenal of insulators functionally validated to reduce the rate of retroviral vector-mediated genotoxicity. PMID:24098520

  12. Detection of retroviral super-infection from non-invasive samples.

    Directory of Open Access Journals (Sweden)

    Adeelia S Goffe

    Full Text Available While much attention has been focused on the molecular epidemiology of retroviruses in wild primate populations, the correlated question of the frequency and nature of super-infection events, i.e., the simultaneous infection of the same individual host with several strains of the same virus, has remained largely neglected. In particular, methods possibly allowing the investigation of super-infection from samples collected non-invasively (such as faeces have never been properly compared. Here, we fill in this gap by assessing the costs and benefits of end-point dilution PCR (EPD-PCR and multiple bulk-PCR cloning, as applied to a case study focusing on simian foamy virus super-infection in wild chimpanzees (Pan troglodytes. We show that, although considered to be the gold standard, EPD-PCR can lead to massive consumption of biological material when only low copy numbers of the target are expected. This constitutes a serious drawback in a field in which rarity of biological material is a fundamental constraint. In addition, we demonstrate that EPD-PCR results (single/multiple infection; founder strains can be well predicted from multiple bulk-PCR clone experiments, by applying simple statistical and network analyses to sequence alignments. We therefore recommend the implementation of the latter method when the focus is put on retroviral super-infection and only low retroviral loads are encountered.

  13. High Expression of Endogenous Retroviral Envelope Gene in the Equine Fetal Part of the Placenta.

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    Valentina Stefanetti

    Full Text Available Endogenous retroviruses (ERVs are proviral phases of exogenous retroviruses that have co-evolved with vertebrate genomes for millions of years. Previous studies have identified the envelope (env protein genes of retroviral origin preferentially expressed in the placenta which suggests a role in placentation based on their membrane fusogenic capacity and therefore they have been named syncytins. Until now, all the characterized syncytins have been associated with three invasive placentation types: the endotheliochorial (Carnivora, the synepitheliochorial (Ruminantia, and the hemochorial placentation (human, mouse where they play a role in the syncytiotrophoblast formation. The purpose of the present study was to evaluate whether EqERV env RNA is expressed in horse tissues as well and investigate if the horse, possessing an epitheliochorial placenta, has "captured" a common retroviral env gene with syncytin-like properties in placental tissues. Interestingly, although in the equine placenta there is no syncytiotrophoblast layer at the maternal-fetal interface, our results showed that EqERV env RNA is highly expressed at that level, as expected for a candidate syncytin-like gene but with reduced abundance in the other somatic tissues (nearly 30-fold lower thus suggesting a possible role in the placental tissue. Although the horse is one of the few domestic animals with a sequenced genome, few studies have been conducted about the EqERV and their expression in placental tissue has never been investigated.

  14. Passive Immunotherapy for Retroviral Disease: Influence of Major Histocompatibility Complex Type and T-Cell Responsiveness

    Science.gov (United States)

    Hasenkrug, Kim J.; Brooks, Diane M.; Chesebro, Bruce

    1995-11-01

    Administration of virus-specific antibodies is known to be an effective early treatment for some viral infections. Such immunotherapy probably acts by antibody-mediated neutralization of viral infectivity and is often thought to function independently of T-cell-mediated immune responses. In the present experiments, we studied passive antibody therapy using Friend murine leukemia virus complex as a model for an immunosuppressive retroviral disease in adult mice. The results showed that antibody therapy could induce recovery from a well-established retroviral infection. However, the success of therapy was dependent on the presence of both CD4^+ and CD8^+ T lymphocytes. Thus, cell-mediated responses were required for recovery from infection even in the presence of therapeutic levels of antibody. The major histocompatibility type of the mice was also an important factor determining the relative success of antibody therapy in this system, but it was less critical for low-dose than for high-dose infections. Our results imply that limited T-cell responsiveness as dictated by major histocompatibility genes and/or stage of disease may have contributed to previous immunotherapy failures in AIDS patients. Possible strategies to improve the efficacy of future therapies are discussed.

  15. Identification and characterization of enhancer-blocking insulators to reduce retroviral vector genotoxicity.

    Directory of Open Access Journals (Sweden)

    Amy C Groth

    Full Text Available The chromatin insulator cHS4 can reduce silencing chromosomal position effects and genotoxicity associated with integrating viral vectors. However, the fully active version of this element can also reduce vector titers and is only partially effective. In order to identify alternatives to cHS4, we developed a functional lentiviral vector-based reporter screen for enhancer-blocking insulators. Using this system, we screened candidate sequences that were initially identified by chromatin profiling for binding by CTCF and for DNase hypersensitivity. All 12 analyzed candidates blocked enhancer-promoter activity. The enhancer-blocking activity of the top two candidates was confirmed in two complementary plasmid-based assays. Studies in a gammaretroviral reporter vector indicated these two candidates have little to no effect on vector titers, and do not diminish vector expression in primary mouse bone marrow cultures. Subsequent assessment in a mouse in vivo tumor formation model demonstrated that both candidates reduced the rate of gammaretroviral vector-mediated genotoxicity as effectively as the cHS4 insulator. In summary, we have developed a novel lentiviral vector-based method of screening candidate elements for insulator activity, and have used this method to identify two new insulator elements capable of improving the safety of retroviral vectors without diminishing vector titers or expression. These findings expand the limited arsenal of insulators functionally validated to reduce the rate of retroviral vector-mediated genotoxicity.

  16. Fenômeno vivido por familiares de pacientes internados em unidade de terapia intensiva

    OpenAIRE

    Comassetto, Isabel; Enders, Bertha Cruz

    2009-01-01

    COMASSETTO, Isabel, ENDERS, Bertha Cruz. Fenômeno vivido por familiares de pacientes internados em Unidade de Terapia Intensiva. Revista Gaúcha de Enfermagem., Porto Alegre(RS), v.30,n., p.46-53. Mar. 2009. Disponivel em: . RESUMO: O propósito deste estudo foi compreender o fenômeno vivido pelos familiares durante a internação do seu parente na Unidade de Terapia Intensiva (UTI). Teve como referencial a fenomenol...

  17. EFECTIVIDAD ANALGÉSICA POST EXODONCIA SIMPLE DE LA TERAPIA PROFILÁCTIVA Y LA TERAPIA CONTINUADA CON NAPROXENO SÓDICO

    OpenAIRE

    Asmat Abanto, Angel Steven

    2015-01-01

    Objetivo: comparar la efectividad analgésica post exodoncia simple entre la terapia profiláctica y la terapia continuada con naproxeno sódico. Material y métodos: el presente ensayo clínico, prospectivo aleatorizado, paralelo y simple ciego, se desarrolló en la Clínica Estomatológica de la Universidad Alas Peruanas Filial Trujillo. Los pacientes, quienes requerían exodoncia simple por caries dental, fueron distribuidos aleatoriamente en tres grupos: 30 recibieron naproxeno sódico 550 mg en e...

  18. Efecto de la terapia física y terapia ocupacional en una paciente con Síndrome de West: Reporte de un caso

    Directory of Open Access Journals (Sweden)

    Herminio Teófilo Camacho-Conchucos

    2014-10-01

    Full Text Available Se presenta el caso de una niña de 12 años con diagnóstico de Síndrome de West. Asistió a consulta médica por primera vez a los 8 meses de edad, sus convulsiones se acentuaron a la edad de dos años y medio, lo que agravó el retraso psicomotor. Inicio terapia física y terapia ocupacional, empleando técnicas de neurodesarrollo y marcos de referencia respectivamente. A la presentación del caso se observaron avances favorables en aspectos cualitativos más que cuantitativos.

  19. Efecto de la terapia física y terapia ocupacional en una paciente con Síndrome de West: Reporte de un caso

    OpenAIRE

    Herminio Teófilo Camacho-Conchucos; Fanny Matheus-Berrocal; Giannina Valdez-Maguiña; Rocío Cartolin-Principe

    2014-01-01

    Se presenta el caso de una niña de 12 años con diagnóstico de Síndrome de West. Asistió a consulta médica por primera vez a los 8 meses de edad, sus convulsiones se acentuaron a la edad de dos años y medio, lo que agravó el retraso psicomotor. Inicio terapia física y terapia ocupacional, empleando técnicas de neurodesarrollo y marcos de referencia respectivamente. A la presentación del caso se observaron avances favorables en aspectos cualitativos más que cuantitativos.

  20. ¿que es terapia física? una reflexión sobre la identidad profesional

    OpenAIRE

    Heine de Alvarado, Marie Luise

    2012-01-01

    En este ensayo se exponen las dimensiones que caracterizan la profesión de terapia física. EI texto se compone de tres secciones: la primera caracteriza la terapia física como profesión de los servicios humanos, la segunda la precisa como campo de investigación y en la última se conceptualiza la terapia física como una praxis.

  1. Improving the ex vivo retroviral-mediated suicide-gene transfer process in T lymphocytes to preserve immune function

    NARCIS (Netherlands)

    Robinet, E; Fehse, B; Ebeling, S; Sauce, D; Ferrand, C; Tiberghien, P

    The retroviral-mediated transfer of a suicide gene into donor T cells has been proposed as a method to control alloreactivity after hematopoietic stem cell (HSC) transplantation. Gene-modified cells (GMC) may be infused into the patient either at the time of transplantation, together with a T-cell

  2. High-definition mapping of retroviral integration sites defines the fate of allogeneic T cells after donor lymphocyte infusion.

    Directory of Open Access Journals (Sweden)

    Claudia Cattoglio

    2010-12-01

    Full Text Available The infusion of donor lymphocytes transduced with a retroviral vector expressing the HSV-TK suicide gene in patients undergoing hematopoietic stem cell transplantation for leukemia/lymphoma promotes immune reconstitution and prevents infections and graft-versus-host disease. Analysis of the clonal dynamics of genetically modified lymphocytes in vivo is of crucial importance to understand the potential genotoxic risk of this therapeutic approach. We used linear amplification-mediated PCR and pyrosequencing to build a genome-wide, high-definition map of retroviral integration sites in the genome of peripheral blood T cells from two different donors and used gene expression profiling and bioinformatics to associate integration clusters to transcriptional activity and to genetic and epigenetic features of the T cell genome. Comparison with matched random controls and with integrations obtained from CD34(+ hematopoietic stem/progenitor cells showed that integration clusters occur within chromatin regions bearing epigenetic marks associated with active promoters and regulatory elements in a cell-specific fashion. Analysis of integration sites in T cells obtained ex vivo two months after infusion showed no evidence of integration-related clonal expansion or dominance, but rather loss of cells harboring integration events interfering with RNA post-transcriptional processing. The study shows that high-definition maps of retroviral integration sites are a powerful tool to analyze the fate of genetically modified T cells in patients and the biological consequences of retroviral transduction.

  3. La terapia integral conductual de pareja (IBCT). Descripción, técnicas y aplicación

    OpenAIRE

    Barraca, J.

    2013-01-01

    La Terapia Integral Conductual de Pareja (IBCT) es una intervención evolucionada desde la terapia conductual de pareja que desarrollaran Jacobson y Margolin en los añossetenta. Este nuevo modelo de trabajo se inscribe dentro de las terapias de conducta de tercera generación y, como tal, pone un énfasis especial en el concepto de aceptación, que se desarrolla de forma característica y propia para el entorno de la pareja. La terapia aporta una formulación de los problemas de par...

  4. Simultaneous RNA quantification of human and retroviral genomes reveals intact interferon signaling in HTLV-1-infected CD4+ T cell lines

    Directory of Open Access Journals (Sweden)

    Moens Britta

    2012-08-01

    Full Text Available Abstract Background IFN-α contributes extensively to host immune response upon viral infection through antiviral, pro-apoptotic, antiproliferative and immunomodulatory activities. Although extensively documented in various types of human cancers and viral infections, controversy exists in the exact mechanism of action of IFN-α in human immunodeficiency virus type 1 (HIV-1 and human T-lymphotropic virus type 1 (HTLV-1 retroviral infections. Results IFN-α displayed strong anti-HIV-1 effects in HIV-1/HTLV-1 co-infected MT-4 cells in vitro, demonstrated by the dose-dependent inhibition of the HIV-1-induced cytopathic effect (IC50 = 83.5 IU/ml, p 50 = 1.2 IU/ml, p  Conclusions Taken together, our results indicate that both the absence of in vitro antiproliferative and pro-apoptotic activity as well as the modest post-transcriptional antiviral activity of IFN-α against HTLV-1, were not due to a cell-intrinsic defect in IFN-α signalisation, but rather represents a retrovirus-specific phenomenon, considering the strong HIV-1 inhibition in co-infected cells.

  5. Creation and validation of a ligation-independent cloning (LIC retroviral vector for stable gene transduction in mammalian cells

    Directory of Open Access Journals (Sweden)

    Patel Asmita

    2012-01-01

    Full Text Available Abstract Background Cloning vectors capable of retroviral transduction have enabled stable gene overexpression in numerous mitotic cell lines. However, the relatively small number of feasible restriction enzyme sequences in their cloning sites can hinder successful generation of overexpression constructs if these sequences are also present in the target cDNA insert. Results Utilizing ligation-independent cloning (LIC technology, we have modified the highly efficient retroviral transduction vector, pBABE, to eliminate reliance on restriction enzymes for cloning. Instead, the modified plasmid, pBLIC, utilizes random 12/13-base overhangs generated by T4 DNA polymerase 3' exonuclease activity. PCR-based introduction of the complementary sequence into any cDNA of interest enables universal cloning into pBLIC. Here we describe creation of the pBLIC plasmid, and demonstrate successful cloning and protein overexpression from three different cDNAs, Bax, catalase, and p53 through transduction into the human prostate cancer cell line, LNCaP or the human lung cancer line, H358. Conclusions Our results show that pBLIC vector retains the high transduction efficiency of the original pBABE while eliminating the requirement for checking individual cDNA inserts for internal restriction sites. Thus it comprises an effective retroviral cloning system for laboratory-scale stable gene overexpression or for high-throughput applications such as creation of retroviral cDNA libraries. To our knowledge, pBLIC is the first LIC vector for retroviral transduction-mediated stable gene expression in mammalian cells.

  6. Terapia psicológica para la esquizofrenia: Una realidad

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    Jennifer Del Toro Granados

    2013-10-01

    Full Text Available Resumen La esquizofrenia es entendida como un cuadro psiquiátrico, crónico y altamente discapacitante; en la cual, a pesar de las variaciones de la evolución en cada paciente, se observan los siguientes síntomas: ideas delirantes, alucinaciones, comportamiento desorganizado (síntomas positivos y aplanamiento afectivo (síntomas negativos. A finales de los años 70 se produce un cambio en la concepción etiológica de los trastornos psicóticos que comienzan a explicarse desde una perspectiva multicausal, es decir, como predeterminados e influidos por condiciones biopsicosociales. Uno de los más completos paquetes de intervención es la Terapia Psicológica Integral para la esquizofrenia (IPT. Los autores de este protocolo terapéutico parten del supuesto que los pacientes que reúnen criterios para esquizofrenia muestran déficits en varios niveles funcionales de organización de la conducta (nivel atencional-perceptivo, nivel cognitivo, nivel micro-social y nivel macro-social. En el presente análisis, se describen los hallazgos en términos de eficacia de la terapia psicológica integral para la esquizofrenia combinada con farmacoterapia; los distintos estudios reseñados indican que la IPT muestra superioridad terapéutica frente a otro tipo de intervenciones. (DUAZARY 2011, 93 - 98 AbstractSchizophrenia is defined as a table psychiatric, chronic and highly disabling, in the which, despite changes in the evolution of each patient, observe the following symptoms: ideas delusions, hallucinations, disorganized behavior (positive symptoms and blunted affect (symptoms negative. In the late 70’s is a change in the etiological concept of psychotic disorders starting to explain from a causes, ie as default and influenced by biopsychosocial conditions. One of the most complete packages of intervention is the therapy Comprehensive psychological schizophrenia (IPT. The authors of this therapeutic format asume Patients who meet criteria for

  7. CD4 expression on EL4 cells as an epiphenomenon of retroviral transduction and selection.

    Science.gov (United States)

    Logan, Grant J; Spinoulas, Afroditi; Alexander, Stephen I; Smythe, Jason A; Alexander, Ian E

    2004-04-01

    The EL4 murine tumour cell line, isolated from a chemically induced lymphoma over 50 years ago, has been extensively exploited in immunological research. The conclusions drawn from many of these studies have been based on the presumption that EL4 cells maintain a stable phenotype during experimental manipulation. To the contrary, we have observed 100-fold greater expression of cell surface CD4 (CD4(high)) on a subpopulation of EL4 cells following retroviral transduction and G418 selection when compared with unmodified populations. Although the mechanism responsible for this effect remains to be elucidated, the unexpected expression of CD4, a molecule that functions as both a coreceptor with the T-cell receptor and ligand for the pro-inflammatory cytokine IL-16, has the potential to influence experimental outcomes. Upregulation of CD4 should be excluded when EL4 cells are utilized in experiments requiring a consistent immuno-phenotype.

  8. Cell cultures and retroviral particles from a tumor of a moray eel.

    Science.gov (United States)

    Buck, C; Walsh, C; Davis, R; Toumadje, A; Kusamoto, K; Helmrich, A; Chapline, C; Mericko, P; Barnes, D

    2001-06-01

    Until recently, fish cell culture primarily has been useful only in the propagation and study of epidemic viruses significant to the fishing industry. Such fish cell lines derived were developed by appropriating classical techniques of mammalian cell culture, with serum as the major growth supplement. Using an approach in which culture medium is formulated in a cell-type-specific manner with minimal serum and a variety of synergistic supplements, several fish cell lines have been derived that may serve multiple uses. We established cell lines from a potentially tumorous skin lesion of a green moray eel (Gymnothorax funebris) and control tissues, and identified putative retroviral particles in the medium from the tumor cells that are not present in medium from cultures of normal cells from the same eel. The relationship between the virus and the cause of the tumor is not clear, but the genomic structure of this virus should provide useful information in understanding the evolution of retroviruses in general.

  9. Apoptosis Gene Hunting Using Retroviral Expression Cloning: Identification of Vacuolar ATPase Subunit E

    Directory of Open Access Journals (Sweden)

    Claire L. Anderson

    2003-01-01

    Full Text Available Over the past 10-15 years there has been an explosion of interest in apoptosis. The delayed realisation that cell death is an essential part of life for any multicellular organism has meant that, despite the recent and rapid developments of the last decade, the precise biochemical pathways involved in apoptosis remain incomplete and potentially novel genes may, as yet, remain undiscovered. The hunt is therefore on to bridge the remaining gaps in our knowledge. Our contribution to this research effort utilises a functional cloning approach to isolate important regulatory genes involved in apoptosis. This mini-review focuses on the use and advantages of a retroviral expression cloning strategy and describes the isolation and identification of one such potential apoptosis regulatory gene, namely that encoding vacuolar ATPase subunit E.

  10. Phosphorylation-Dependent Activation of the ESCRT Function of ALIX in Cytokinetic Abscission and Retroviral Budding.

    Science.gov (United States)

    Sun, Sheng; Sun, Le; Zhou, Xi; Wu, Chuanfen; Wang, Ruoning; Lin, Sue-Hwa; Kuang, Jian

    2016-02-08

    The modular adaptor protein ALIX is a key player in multiple ESCRT-III-mediated membrane remodeling processes. ALIX is normally present in a closed conformation due to an intramolecular interaction that renders ALIX unable to perform its ESCRT functions. Here we demonstrate that M phase-specific phosphorylation of the intramolecular interaction site within the proline-rich domain (PRD) of ALIX transforms cytosolic ALIX from closed to open conformation. Defining the role of this mechanism of ALIX regulation in three classical ESCRT-mediated processes revealed that phosphorylation of the intramolecular interaction site in the PRD is required for ALIX to function in cytokinetic abscission and retroviral budding, but not in multivesicular body sorting of activated epidermal growth factor receptor. Thus, phosphorylation of the intramolecular interaction site in the PRD is one of the major mechanisms that activates the ESCRT function of ALIX. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Boosting of HIV-1 neutralizing antibody responses by a distally related retroviral envelope protein

    DEFF Research Database (Denmark)

    Uchtenhagen, Hannes; Schiffner, Torben; Bowles, Emma

    2014-01-01

    glycoprotein (Env). In this article, we report an immunization strategy composed of a trivalent HIV-1 (clade B envs) DNA prime, followed by a SIVmac239 gp140 Env protein boost that aimed to focus the immune response to structurally conserved parts of the HIV-1 and simian immunodeficiency virus (SIV) Envs....... Heterologous NAb titers, primarily to tier 1 HIV-1 isolates, elicited during the trivalent HIV-1 env prime, were significantly increased by the SIVmac239 gp140 protein boost in rabbits. Epitope mapping of Ab-binding reactivity revealed preferential recognition of the C1, C2, V2, V3, and V5 regions....... These results provide a proof of concept that a distally related retroviral SIV Env protein boost can increase pre-existing NAb responses against HIV-1....

  12. Involvement of human endogenous retroviral syncytin-1 in human osteoclast fusion

    DEFF Research Database (Denmark)

    Søe, Kent; Andersen, Thomas Lykke; Hobolt-Pedersen, Anne-Sofie

    2011-01-01

    Generation of osteoclasts through fusion of mono-nucleated precursors is a key event of bone physiology and bone resorption is inefficient without osteoclast fusion. Several factors playing a critical role in the fusion process have already been recognized, but the factors involved in the actual...... fusion of the lipid bilayers of their cell membranes are still unknown. Syncytin-1 is a protein encoded by a human endogenous retroviral gene which was stably integrated into the human ancestor genome more than 24 million years ago. Upon activation, syncytin-1 is able to destabilize the lipid bilayer....... This was documented through Q-PCR, Western blot and immunofluorescence analyses. These in vitro findings were confirmed by immunohistochemical stainings in human iliac crest biopsies. A syncytin-1 inhibitory peptide reduced the number of nuclei per osteoclast by 30%, as well as TRACP activity. From a mechanistic...

  13. Multiple sulfatase deficiency: catalytically inactive sulfatases are expressed from retrovirally introduced sulfatase cDNAs.

    Science.gov (United States)

    Rommerskirch, W; von Figura, K

    1992-04-01

    Multiple sulfatase deficiency (MSD) is an inherited lysosomal storage disease characterized by the deficiency of at least seven sulfatases. The basic defect in MSD is thought to be in a post-translational modification common to all sulfatases. In accordance with this concept, RNAs of normal size and amount were detected in MSD fibroblasts for three sulfatases tested. cDNAs encoding arylsulfatase A, arylsulfatase B, or steroid sulfatase were introduced into MSD fibroblasts and fibroblasts with a single sulfatase deficiency by retroviral gene transfer. Infected fibroblasts overexpressed the respective sulfatase polypeptides. While in single-sulfatase-deficiency fibroblasts a concomitant increase of sulfatase activities was observed, MSD fibroblasts expressed sulfatase polypeptides with a severely diminished catalytic activity. From these results we conclude that the mutation in MSD severely decreases the capacity of a co- or post-translational process that renders sulfatases enzymatically active or prevents their premature inactivation.

  14. Size distribution of retrovirally marked lineages matches prediction from population measurements of cell cycle behavior

    Science.gov (United States)

    Cai, Li; Hayes, Nancy L.; Takahashi, Takao; Caviness, Verne S Jr; Nowakowski, Richard S.

    2002-01-01

    Mechanisms that regulate neuron production in the developing mouse neocortex were examined by using a retroviral lineage marking method to determine the sizes of the lineages remaining in the proliferating population of the ventricular zone during the period of neuron production. The distribution of clade sizes obtained experimentally in four different injection-survival paradigms (E11-E13, E11-E14, E11-E15, and E12-E15) from a total of over 500 labeled lineages was compared with that obtained from three models in which the average behavior of the proliferating population [i.e., the proportion of cells remaining in the proliferative population (P) vs. that exiting the proliferative population (Q)] was quantitatively related to lineage size distribution. In model 1, different proportions of asymmetric, symmetric terminal, and symmetric nonterminal cell divisions coexisted during the entire developmental period. In model 2, the developmental period was divided into two epochs: During the first, asymmetric and symmetric nonterminal cell divisions occurred, but, during the second, asymmetric and symmetric terminal cell divisions occurred. In model 3, the shifts in P and Q are accounted for by changes in the proportions of the two types of symmetric cell divisions without the inclusion of any asymmetric cell divisions. The results obtained from the retroviral experiments were well accounted for by model 1 but not by model 2 or 3. These findings demonstrate that: 1) asymmetric and both types of symmetric cell divisions coexist during the entire period of neurogenesis in the mouse, 2) neuron production is regulated in the proliferative population by the independent decisions of the two daughter cells to reenter S phase, and 3) neurons are produced by both asymmetric and symmetric terminal cell divisions. In addition, the findings mean that cell death and/or tangential movements of cells in the proliferative population occur at only a low rate and that there are no

  15. Tumor-specific suicide gene therapy for hepatocellular carcinoma by transcriptionally targeted retroviral replicating vectors.

    Science.gov (United States)

    Lai, Y-H; Lin, C-C; Chen, S-H; Tai, C-K

    2015-02-01

    Replicating virus vectors are attractive tools for anticancer gene therapy, but the potential for adverse events due to uncontrolled spread of the vectors has been a major concern. To design a tumor-specific retroviral replicating vector (RRV), we replaced the U3 region of the RRV ACE-GFP with a regulatory sequence consisting of the hepatitis B virus enhancer II (EII) and human α-fetoprotein (AFP) core promoter to produce ACE-GFP-EIIAFP, a hepatocellular carcinoma (HCC)-targeting RRV. Similar to ACE-GFP, ACE-GFP-EIIAFP exhibited robust green fluorescent protein (GFP) expression in HCC cells and, most importantly, it exhibited HCC-specific replication and did not replicate in non-HCC tumor cells or normal liver cells. We sequenced the promoter region of ACE-GFP-EIIAFP collected from serial infection cycles to examine the genomic stability of the vector during its replicative spread, and found that the vector could retain the hybrid promoter in the genome for at least six infection cycles. In vitro studies revealed that ACE-CD-EIIAFP and ACE-PNP-EIIAFP, which express the yeast cytosine deaminase and Escherichia coli purine nucleoside phosphorylase, respectively, exert a highly potent cytotoxic effect on HCC cells in the presence of their respective prodrugs. In vivo, ACE-CD-EIIAFP-mediated suicide gene therapy efficiently suppressed HCC tumor growth and no detectable RRV signal was observed in extratumoral tissues. These results suggest that the tumor-specific, suicide-gene-encoding RRV may fulfill the promise of retroviral gene therapy for cancer.

  16. Regulation of human heme oxygenase in endothelial cells by using sense and antisense retroviral constructs.

    Science.gov (United States)

    Quan, S; Yang, L; Abraham, N G; Kappas, A

    2001-10-09

    Our objective was to determine whether overexpression and underexpression of human heme oxygenase (HHO)-1 could be controlled on a long-term basis by introduction of the HO-1 gene in sense (S) and antisense (AS) orientation with an appropriate vector into endothelial cells. Retroviral vector (LXSN) containing viral long terminal repeat promoter-driven human HO-1 S (LSN-HHO-1) and LXSN vectors containing HHO-1 promoter (HOP)-controlled HHO-1 S and AS (LSN-HOP-HHO-1 and LSN-HOP-HHO-1-AS) sequences were constructed and used to transfect rat lung microvessel endothelial cells (RLMV cells) and human dermal microvessel endothelial cells (HMEC-1 cells). RLMV cells transduced with HHO-1 S expressed human HO-1 mRNA and HO-1 protein associated with elevation in total HO activity compared with nontransduced cells. Vector-mediated expression of HHO-1 S or AS under control of HOP resulted in effective production of HO-1 or blocked induction of endogenous human HO-1 in HMEC-1 cells, respectively. Overexpression of HO-1 AS was associated with a long-term decrease (45%) of endogenous HO-1 protein and an increase (167%) in unmetabolized exogenous heme in HMEC-1 cells. Carbon monoxide (CO) production in HO-1 S- or AS-transduced HMEC-1 cells after heme treatment was increased (159%) or decreased (50%), respectively, compared with nontransduced cells. HO-2 protein levels did not change. These findings demonstrate that HHO-1 S and AS retroviral constructs are functional in enhancing and reducing HO activity, respectively, and thus can be used to regulate cellular heme levels, the activity of heme-dependent enzymes, and the rate of heme catabolism to CO and bilirubin.

  17. Foxp3 represses retroviral transcription by targeting both NF-kappaB and CREB pathways.

    Directory of Open Access Journals (Sweden)

    2006-04-01

    Full Text Available Forkhead box (Fox/winged-helix transcription factors regulate multiple aspects of immune responsiveness and Foxp3 is recognized as an essential functional marker of regulatory T cells. Herein we describe downstream signaling pathways targeted by Foxp3 that may negatively impact retroviral pathogenesis. Overexpression of Foxp3 in HEK 293T and purified CD4+ T cells resulted in a dose-dependent and time-dependent decrease in basal levels of nuclear factor-kappaB (NF-kappaB activation. Deletion of the carboxyl-terminal forkhead (FKH domain, critical for nuclear localization and DNA-binding activity, abrogated the ability of Foxp3 to suppress NF-kappaB activity in HEK 293T cells, but not in Jurkat or primary human CD4+ T cells. We further demonstrate that Foxp3 suppressed the transcription of two human retroviral promoters (HIV-1 and human T cell lymphotropic virus type I [HTLV-I] utilizing NF-kappaB-dependent and NF-kappaB-independent mechanisms. Examination of the latter identified the cAMP-responsive element binding protein (CREB pathway as a target of Foxp3. Finally, comparison of the percent Foxp3+CD4+CD25+ T cells to the HTLV-I proviral load in HTLV-I-infected asymptomatic carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis suggested that high Foxp3 expression is associated with low proviral load and absence of disease. These results suggest an expanded role for Foxp3 in regulating NF-kappaB- and CREB-dependent cellular and viral gene expression.

  18. Cognitive and psychosocial development of HIV pediatric patients receiving highly active anti-retroviral therapy: a case-control study

    Directory of Open Access Journals (Sweden)

    Theodoridou Maria

    2010-12-01

    Full Text Available Abstract Background The psychosocial development of pediatric HIV patients has not been extensively evaluated. The study objectives were to evaluate whether emotional and social functions are differentially associated with HIV-related complications. Methods A matched case-control study design was conducted. The case group (n = 20 consisted of vertically infected children with HIV (aged 3-18 years receiving HAART in Greece. Each case was matched with two randomly selected healthy controls from a school-based population. CNS imaging and clinical findings were used to identify patients with HIV-related neuroimaging abnormalities. The Wechsler Intelligence Scale III and Griffiths Mental Abilities Scales were applied to assess cognitive abilities. The age specific Strengths and Difficulties Questionnaire was used to evaluate emotional adjustment and social skills. The Fisher's exact test, student's t-test, and Wilcoxon rank sum test were used to compare categorical, continuous, and ordinal scores, respectively, of the above scales between groups. Results HIV patients without neuroimaging abnormalities did not differ from patients with neuroimaging abnormalities with respect to either age at HAART initiation (p = 0.306 or months of HAART treatment (p = 0.964. While HIV patients without neuroimaging abnormalities had similar cognitive development with their healthy peers, patients with neuroimaging abnormalities had lower mean General (p = 0.027 and Practical (p = 0.042 Intelligence Quotient scores. HIV patients without neuroimaging abnormalities had an increased likelihood of both Abnormal Emotional Symptoms (p = 0.047 and Hyperactivity scores (p = 0.0009. In contrast, HIV patients with neuroimaging abnormalities had an increased likelihood of presenting with Abnormal Peer Problems (p = 0.033. Conclusions HIV patients without neuroimaging abnormalities are more likely to experience maladjustment with respect to their emotional and activity spheres, while HIV patients with neuroimaging abnormalities are more likely to present with compromised social skills. Due to the limited sample size and age distribution of the study population, further studies should investigate the psychosocial development of pediatric HIV patients following the disclosure of their condition.

  19. Impact of Protease Inhibitor-Based Anti-Retroviral Therapy on Outcomes for HIV+ Kidney Transplant Recipients.

    Science.gov (United States)

    Sawinski, D; Shelton, B A; Mehta, S; Reed, R D; MacLennan, P A; Gustafson, S; Segev, D L; Locke, J E

    2017-07-11

    Excellent outcomes have been demonstrated among select HIV-positive kidney transplant (KT) recipients with well-controlled infection, but to date, no national study has explored outcomes among HIV+ KT recipients by antiretroviral therapy (ART) regimen. Intercontinental Marketing Services (IMS) pharmacy fills (1/1/01-10/1/12) were linked with Scientific Registry of Transplant Recipients (SRTR) data. A total of 332 recipients with pre- and posttransplantation fills were characterized by ART at the time of transplantation as protease inhibitor (PI) or non-PI-based ART (88 PI vs. 244 non-PI). Cox proportional hazards models were adjusted for recipient and donor characteristics. Comparing recipients by ART regimen, there were no significant differences in age, race, or HCV status. Recipients on PI-based regimens were significantly more likely to have an Estimated Post Transplant Survival (EPTS) score of >20% (70.9% vs. 56.3%, p = 0.02) than those on non-PI regimens. On adjusted analyses, PI-based regimens were associated with a 1.8-fold increased risk of allograft loss (adjusted hazard ratio [aHR] 1.84, 95% confidence interval [CI] 1.22-2.77, p = 0.003), with the greatest risk observed in the first posttransplantation year (aHR 4.48, 95% CI 1.75-11.48, p = 0.002), and a 1.9-fold increased risk of death as compared to non-PI regimens (aHR 1.91, 95% CI 1.02-3.59, p = 0.05). These results suggest that whenever possible, recipients should be converted to a non-PI regimen prior to kidney transplantation. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  20. A profile of patients attending an Anti Retroviral Therapy (ART centre at a tertiary care hospital in South India

    Directory of Open Access Journals (Sweden)

    Sanjeev Badiger

    2010-06-01

    Full Text Available In 2004, the Indian government began providing free antiretroviral therapy (ART through established ART centers. Despite the fact that ART is provided free by the government, there are a large number of sero positive people who do not come forward to receive treatment. Non-adherence is further confounds efforts to offer effective treatment. This study reports the profile of patients who attend an ART centres in southern India.

  1. ANALISIS ADVERSE DRUG REACTIONS OBAT ANTI RETROVIRAL PADA PENGOBATAN PASIEN HIV/AIDS DI RSUD GUNUNG JATI CIREBON TAHUN 2013

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    Nur Rahmi Hidayati

    2016-05-01

    Full Text Available Acquired Immunodeficiency Syndrome (AIDS is a disease caused by infection with Human Immunodeficiency Virus (HIV. The pharmacology treatment for the infection was antiretroviral therapy. The problem from the use of antiretroviral drugs (ARV is the emergence of unwanted drug reactions (adverse drug reaction. The purpose of this study was to identify and analyze the incidence of adverse drug reactions from the use of antiretroviral drugs in the treatment of patients with HIV / AIDS that occurred in RSUD Gunung Jati Cirebon. This study involves 122 patients. Data were obtained from medical records and patient interview form. The data were evaluated with a descriptive analysis of demographic profile of patients and the percentage of adverse drug reaction (ADR The results showed an adverse drug reaction (ADR on the use of antiretroviral drugs in the treatment of patients with HIV / AIDS in RSUD Gunung Jati Cirebon. ARV regimens are the most widely used is the combination of Zidovudine + Lamivudine + Nevirapine / Efavirenz (AZT + 3TC + EFV as much as 31.2% (38 people. Duration of therapy ARV in Seroja Clinic RSUD Gunung Jati Cirebon most is> 2 years - 4 years 28.7% (35 people. Types of adverse drug reaction (ADR, which occurs in the use of antiretroviral drugs in the treatment of patients with HIV / AIDS in RSUD Gunung Jati Cirebon include: headache (22.1%, fatigue (6.8%, anemia (9.3%, itching (14.4%, nausea / vomiting (20.1%, diarrhea (7.2%, lipodystrophy (2.0%, rash (11.3%, skin discoloration (1.6%, neuropathy (1.6% and sleep disorders (3.6%.

  2. Integrating community pharmacy into community based anti-retroviral therapy program: A pilot implementation in Abuja, Nigeria.

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    Yohanna Kambai Avong

    Full Text Available The landscape of Human Immunodeficiency Virus (HIV epidemic control is shifting with the United Nations Programme on HIV/AIDS (UNAIDS 90-90-90 benchmarks for epidemic control. Community-based Antiretroviral Therapy (CART models have improved treatment uptake and demonstrated good clinical outcomes. We assessed the feasibility of integrating community pharmacy as a task shift structure for differentiated community ART in Abuja-Nigeria.Stable patients on first line ART regimens from public health facilities were referred to community pharmacies in different locations within the Federal Capital Territory, Abuja for prescription refills and treatment maintenance. Bio-demographic and clinical data were collected from February 25, 2016 to May 31st, 2017 and descriptive statistics analysis applied. The outcomes of measure were prescription refill and patient retention in care at the community pharmacy.Almost 10% of stable patients on treatment were successfully devolved from eight health facilities to ten community pharmacies. Median age of the participants was 35 years [interquartile range (IQR; 30, 41] with married women in the majority. Prescription refill was 100% and almost all the participants (99.3% were retained in care after they were devolved to the community pharmacies. Only one participant was lost-to-follow-up as a result of death.Excellent prescription refill and high retention in care with very low loss-to-follow-up were associated with the community pharmacy model. The use of community pharmacy for community ART is feasible in Nigeria. We recommend the scale up of the model in all the 36 states of Nigeria.

  3. Impact of anti-retroviral therapy on sexual behaviour among Villa-Maria hospital clients, Maska district Uganda

    OpenAIRE

    Yiga, Dominic Bukenya

    2008-01-01

    Behavioural change programmes specifically those promoting faithfulness, partner reduction and consistent right condom use contributed to the early declines in HIV incidence and prevalence in Uganda. To guard against treatment optimism and continued risky sexual practices which might result from improved health status, ART clients are also subjected to intensive behavioural change intervention campaigns in Uganda. However, comprehensive evaluation of behavioural change interventions /programm...

  4. Magnitude and Predictors of Anti-Retroviral Treatment (ART Failure in Private Health Facilities in Addis Ababa, Ethiopia.

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    Yesunesh Teshome Yimer

    Full Text Available The public health approach to antiretroviral treatment management encourages the public private partnership in resource limited countries like Ethiopia. As a result, some private health facilities are accredited to provide antiretroviral treatment free services. Evidence on magnitude and predictors of treatment failure are crucial for timely actions. However, there are few studies in this regard.To assess the magnitude and predictors of ART failure in private health facilities in Addis Ababa, Ethiopia.The study followed retrospective cohort design, with 525 adult antiretroviral treatment clients who started the treatment since October 2009 and have at least six months follow up until December 31, 2013. Kaplan Meier survival analysis and Cox proportional hazard model were used for analysis.Treatment failure, using the three WHO antiretroviral treatment failure criteria, was 19.8%. The immunologic, clinical, and virologic failures were 15%, 6.3% and 1.3% respectively. The mean and median survival times in months were 41.17 with 95% Confidence Interval (CI [39.69, 42.64] and 49.00, 95% CI [47.71, 50.29] respectively. The multivariate cox regression analysis showed years since HIV diagnosis (Adjusted Hazard Ratio (AHR=13.87 with 95% CI [6.65, 28.92], disclosure (AHR=0.59, 95% CI [0.36, 0.96], WHO stage at start (AHR=1.84, 95% CI [1.16, 2.93], weight at baseline (AHR=0.58, 95% CI [0.38, 0.89], and functionality status at last visit (AHR=2.57, 95% CI [1.59, 4.15] were independent predictors of treatment failure.The study showed that the treatment failure is high among the study subjects. The predictors for antiretroviral treatment failure were years since HIV diagnosis, weight at start, WHO stage at start, status at last visit and disclosure.Facilities need to monitor antiretroviral treatment clients to avoid disease progression and drug resistance.

  5. Magnitude and Predictors of Anti-Retroviral Treatment (ART) Failure in Private Health Facilities in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Teshome Yimer, Yesunesh; Yalew, Alemayehu Worku

    2015-01-01

    The public health approach to antiretroviral treatment management encourages the public private partnership in resource limited countries like Ethiopia. As a result, some private health facilities are accredited to provide antiretroviral treatment free services. Evidence on magnitude and predictors of treatment failure are crucial for timely actions. However, there are few studies in this regard. To assess the magnitude and predictors of ART failure in private health facilities in Addis Ababa, Ethiopia. The study followed retrospective cohort design, with 525 adult antiretroviral treatment clients who started the treatment since October 2009 and have at least six months follow up until December 31, 2013. Kaplan Meier survival analysis and Cox proportional hazard model were used for analysis. Treatment failure, using the three WHO antiretroviral treatment failure criteria, was 19.8%. The immunologic, clinical, and virologic failures were 15%, 6.3% and 1.3% respectively. The mean and median survival times in months were 41.17 with 95% Confidence Interval (CI) [39.69, 42.64] and 49.00, 95% CI [47.71, 50.29] respectively. The multivariate cox regression analysis showed years since HIV diagnosis (Adjusted Hazard Ratio (AHR)=13.87 with 95% CI [6.65, 28.92]), disclosure (AHR=0.59, 95% CI [0.36, 0.96]), WHO stage at start (AHR=1.84, 95% CI [1.16, 2.93]), weight at baseline (AHR=0.58, 95% CI [0.38, 0.89]), and functionality status at last visit (AHR=2.57, 95% CI [1.59, 4.15]) were independent predictors of treatment failure. The study showed that the treatment failure is high among the study subjects. The predictors for antiretroviral treatment failure were years since HIV diagnosis, weight at start, WHO stage at start, status at last visit and disclosure. Facilities need to monitor antiretroviral treatment clients to avoid disease progression and drug resistance.

  6. Why do Patients in Pre-Anti Retroviral Therapy (ART) Care Default: A Cross-Sectional Study.

    Science.gov (United States)

    Chakravarty, Jaya; Kansal, Sangeeta; Tiwary, Narendra; Sundar, Shyam

    2016-01-01

    Approximately, 40% of the patients registered in the National AIDS Control Program in India are not on antiretroviral therapy (ART), i.e., are in pre-ART care. However, there are scarce data regarding the retention of pre-ART patients under routine program conditions. The main objective of this study was to find out the reasons for default among patients in pre-ART care. Patients enrolled in the ART Centre, Banaras Hindu University (BHU) between January and December 2009 and in pre-ART care were included in the study. Defaulters were those pre-ART patients who missed their last appointment of CD4 count by more than 1 month. Defaulters were traced telephonically in 2011 and those who returned and gave their consent for the study were interviewed using a semi-structured questionnaire. Out of 620 patients in pre-ART care, 384 (68.2%) were defaulters. One hundred forty-four of the defaulters were traced and only 83 reached the ART center for interview. Among defaulters who did not reach the ART center, illiterate and unmarried were significantly more and mean duration from registration to default was also significantly less as compared to those who came back for the interview. Most defaulters gave more than one reason for defaulting that were as follows: Inconvenient clinic timings (98%), need for multiple mode of transport (92%), perceived improved health (65%), distance of center from home (61%), lack of social support (62%), and financial difficulty (59%). Active tracing of pre-ART patients through outreach and strengthening of the Link ART centers will improve the retention of patients in the program.

  7. The factors that influence adherence of pregnant women with HIV/AIDS to anti-retroviral therapy

    Directory of Open Access Journals (Sweden)

    Valéria Lima de Barros

    2011-12-01

    Full Text Available Objective: To learn the experiences of pregnant women with HIV/AIDS in relation to adherence to antiretroviral therapy in two public hospitals of reference for HIV/AIDS in Fortaleza-CE, Brazil. Methods: A descriptive study conducted with 24 pregnant women who were in prenatal care and use of antiretroviral therapy. Sociodemographic and obstetric data and information regarding the experience with antiretroviral therapy adherence were collected from July to September 2009, through a semi-structured interview. Results: Womenhad a mean age of 29, low income, low education and a stable partner. It was found that some factors affect pregnant women adherence to antiretroviral therapy. Among these, stand out not accepting the diagnosis and the absence of signs and symptoms of AIDS. However,the fear of transmitting the virus to the baby acted as a stimulus for pregnant women adhere to treatment. Conclusion: The non-acceptance of diagnosis and the absence of signs and symptoms of AIDS negatively affect pregnant women adherence to antiretroviral treatment. On the other hand, the fear that the child be born with the virus and the desire to continue to live are stimuli to adherence.

  8. Computer-Aided Optimization of Combined Anti-Retroviral Therapy for HIV: New Drugs, New Drug Targets and Drug Resistance.

    Science.gov (United States)

    Zazzi, Maurizio; Cozzi-Lepri, Alessandro; Prosperi, Mattia C F

    2016-01-01

    Resistance to antiretroviral drugs is a complex and evolving area with relevant implications in the treatment of human immunodeficiency virus (HIV) infection. Several rules, algorithms and full-fledged computer programs have been developed to assist the HIV specialist in the choice of the best patient-tailored therapy. Experts' rules and statistical/machine learning algorithms for interpreting HIV drug resistance, along with their program implementations, were retrieved from PubMed and other on-line resources to be critically reviewed in terms of technical approach, performance, usability, update, and evolution (i.e. inclusion of novel drugs or expansion to other viral agents). Several drug resistance prediction algorithms for the nucleotide/nucleoside/non-nucleoside reverse transcriptase, protease and integrase inhibitors as well as coreceptor antagonists are currently available, routinely used, and have been validated thoroughly in independent studies. Computer tools that combine single-drug genotypic/phenotypic resistance interpretation and optimize combination antiretroviral therapy have been also developed and implemented as web applications. Most of the systems have been updated timely to incorporate new drugs and few have recently been expanded to meet a similar need in the Hepatitis C area. Prototype systems aiming at predicting virological response from both virus and patient indicators have been recently developed but they are not yet being routinely used. Computing HIV genotype to predict drug susceptibility in vitro or response to combination antiretroviral therapy in vivo is a continuous and productive research field, translating into successful treatment decision support tools, an essential component of the management of HIV patients.

  9. Ten-year trends in anti-retroviral therapy persistence among US medicaid beneficiaries, 2001-2010.

    Science.gov (United States)

    Youn, Bora; Shireman, Theresa I; Lee, Yoojin; Galárraga, Omar; Rana, Aadia I; Justice, Amy C; Wilson, Ira B

    2017-05-16

    Whether the rate of HIV antiretroviral therapy (ART) persistence has improved over time in the U.S. is unknown. We examined ART persistence trends between 2001 and 2010, using non-HIV medications as a comparator. We conducted a retrospective cohort study using Medicaid claims. We defined persistence as the duration of treatment from the first to the last fill date before a 90-day permissible gap, and used Kaplan-Meier curves and Cox proportional hazard models to assess crude and adjusted non-persistence. The secular trends of ART persistence in 43 598 HIV patients were compared with the secular trends of persistence with angiotensin-converting enzyme inhibitors (ACE) or angiotensin receptor blockers (ARB), statins, and metformin in (1) non-HIV-infected patients and (2) subgroups of HIV patients who started these control medications while using ART. Median time to ART non-persistence increased from 23.9 months in 2001-2003 to 35.4 months in 2004-2006, and was not reached for those starting ART in 2007-2010. In adjusted models, ART initiators in 2007-2010 had 11% decreased hazards of non-persistence compared with those who initiated in 2001-2003 (p negative controls.

  10. Tratamiento antirretroviral en pacientes con sida y micobacteriosis Anti-retroviral treatment in patients with AIDS and mycobacterial diseases

    OpenAIRE

    Corti,Marcelo E.; Palmero, Domingo J.

    2005-01-01

    La tuberculosis y otras micobacteriosis constituyen asociaciones o coinfecciones frecuentes en pacientes con sida y se asocian con una elevada mortalidad. En esta revisión se actualizan los tratamientos de las principales enfermedades micobacterianas asociadas al sida (tuberculosis y micobacteriosis por Mycobacterium avium), con especial énfasis en las interacciones farmacológicas entre antimicobacterianos, principalmente rifampicina y claritromicina, y fármacos antirretrovirales. Se analizan...

  11. Effect of micronutrient and probiotic fortified yogurt on immune-function of anti-retroviral therapy naive HIV patients

    NARCIS (Netherlands)

    R.B.S. Hummelen (Ruben); J. Hemsworth (Jaimie); J. Changalucha (John); N.L. Butamanya (Nicodemus); S. Hekmat (Sharareh); J.D.F. Habbema (Dik); G. Reid (Gregor)

    2011-01-01

    textabstractBackground: Micronutrient supplementation has been shown to reduce the progression of HIV but does not have an effect on the intestinal barrier or the intestinal microbiota of HIV patients. Studies have suggested that probiotics could potentially complement micronutrients in preserving

  12. Incubation periods under various anti-retroviral therapies in homogeneous mixing and age-structured dynamical models: A theoretical approach

    CERN Document Server

    Rao, Arni S R Srinivasa

    2008-01-01

    Abstract. We consider previously well-known models in epidemiology where the parameter for incubation period is used as one of the important components to explain the dynamics of the variables. Such models are extended here to explain the dynamics with respect to a given therapy that prolongs the incubation period. A deconvolution method is demonstrated for estimation of parameters in the situations when no-therapy and multiple therapies are given to the infected population. The models and deconvolution method are extended in order to study the impact of therapy in age-structured populations. A generalisation for a situation when n-types of therapies are available is given.

  13. Terapia manual no tratamento da espondilólise e espondilolistese: revisão de literatura Manual therapy for treating spondylolysis and spondylolisthesis: a literature review

    National Research Council Canada - National Science Library

    Fabrício José Jassi; Leila Suzuki Saita; Ana Carolina Pimenta Grecco; Margarete Kazue Tamashiro; Danilo Santos Catelli; Paulo Roberto Carvalho do Nascimento; Heloyse Uliam Kuriki; Rubén de Faria Negrão Filho

    2010-01-01

    ... terapia manual, a fim de ajudar os terapeutas na prescrição de intervenções eficazes. Os resultados mostram que tanto a terapia manual como a fisioterapia convencional apresentam efeitos benéficos na...

  14. AS CORES DO AMBIENTE DA UNIDADE DE TERAPIA INTENSIVA

    Directory of Open Access Journals (Sweden)

    Nélio Barbosa Boccanera

    2004-12-01

    Full Text Available Os objetivos deste trabalho foram descrever as cores mais freqüentemente utilizadas nas paredes, tetos, mobiliários e roupas das Unidades de Terapia Intensiva e verificar com os funcionários e pacientes desta unidade as cores que gostariam que existissem dentro deste ambiente e a associação que eles estabelecem com as cores. Foi realizada pesquisa descritiva exploratória, com enfoque quanti-qualitativo. A amostra foi constituída de pacientes e profissionais da UTI de três hospitais públicos de Goiânia em 2002. Observou-se a existência de cores monótonas e neutras nestes ambientes, em tons que vão do branco ao preto, enquanto outras nuanças de cores aparecem num percentual menor. Constatou-se uma preferência pelas cores azul-claro, branco, verde-claro e amarelo entre os dois seguimentos pesquisados. Concluiu-se que as pessoas estabelecem associações com as cores; que a cor pode auxiliar no estabelecimento do equilíbrio e contribuir para harmonia do corpo, da mente e das emoções.

  15. La terapia breve: una alternativa de intervención psicológica efectiva

    Directory of Open Access Journals (Sweden)

    Nohelia Hewitt Ramírez

    2009-10-01

    Full Text Available El objetivo de este trabajo es describir y estructurar los orígenes, bases teóricas y los procedimientos de la terapia breve desde la perspectiva terapéutica cognitivo conductual. Se inicia con la identificación de las bases teóricas de la terapia breve, principalmente las teorías motivacionales relacionadas con la disponibilidad al cambio y la autoeficacia desde la teoría social cognitiva. Se realiza un paralelo entre las características principales de la terapia breve en contraposición con las terapias tradicionales. Por último, se propone una estructura procedimental general de estrategias clínicas a emplear en la terapia breve con soporte empírico, la cual puede ser utilizada en diferentes problemáticas con variaciones específicas de acuerdo con el problema tratado o las características específicas del consultante.

  16. La terapia breve: una alternativa de intervención psicológica efectiva

    Directory of Open Access Journals (Sweden)

    Carlos Andrés Gantiva Díaz

    2009-06-01

    Full Text Available El objetivo de este trabajo es describir y estructurar los orígenes, bases teóricas y los procedimientos de la terapia breve desde la perspectiva terapéutica cognitivo conductual. Se inicia con la identifi cación de las bases teóricas de la terapia breve, principalmente las teorías motivacionales relacionadas con la disponibilidad al cambio y la autoefi cacia desde la teoría social cognitiva. Se realiza un paralelo entre las características principales de la terapia breve en contraposición con las terapias tradicionales. Por último, se propone una estructura procedimental general de estrategias clínicas a emplear en la terapia breve con soporte empírico, la cual puede ser utilizada en diferentes problemáticas con variaciones específi cas de acuerdo con el problema tratado o las características específi cas del consultante

  17. Antibody reactivity to the HRES-1 endogenous retroviral element identifies a subset of patients with systemic lupus erythematosus and overlap syndromes. Correlation with antinuclear antibodies and HLA class II alleles.

    Science.gov (United States)

    Perl, A; Colombo, E; Dai, H; Agarwal, R; Mark, K A; Banki, K; Poiesz, B J; Phillips, P E; Hoch, S O; Reveille, J D

    1995-11-01

    To evaluate the correlation between the presence of antibodies to an endogenous retroviral element-encoded nuclear protein autoantigen, HRES-1, and the presence of other antinuclear antibodies and HLA class II alleles in patients with systemic lupus erythematosus (SLE) and overlap syndromes. Antibody reactivities to native and recombinant proteins and synthetic peptides were assessed by counterimmunoelectrophoresis, enzyme-linked immunosorbent assay, and Western blotting. HLA class II alleles were determined by oligonucleotide typing. Forty-eight percent of the 153 patients with autoimmune disease, and 52% of the subgroup with SLE, had HRES-1 antibodies. In contrast, 3.6% of 111 normal donors, and none of 42 patients with the acquired immunodeficiency syndrome or 50 asymptomatic human immunodeficiency virus 1-infected patients, had HRES-1 antibodies. Chi-square analyses revealed a significant association between anti-HRES-1 and anti-RNP and an inverse correlation between HRES-1 and Ro/La autoantibodies in patients with SLE or overlap syndromes. Antigenic epitopes of HRES-1 and the retroviral gag-related region of the 70-kd protein component of U1 small nuclear RNP, which share 3 consecutive highly charged amino acids (Arg-Arg-Glu), an additional Arg, and functionally similar Arg/Lys residues, represent cross-reactive epitopes between the two proteins. Selective removal of HRES-1 antibodies from sera of HRES-1-seropositive/RNP-seropositive patients by absorption on recombinant HRES-1/glutathione-S-transferase-conjugated agarose beads had no effect on anti-RNP reactivities. A comparative multivariate analysis of HLA class II genes revealed a differential segregation of DQB1 alleles in HRES-1-seropositive versus HRES-1-seronegative patients (P = 0.04). While a relative increase of DQB1*0402 among HRES-1-seropositive patients was noted across ethnic groups (P = 0.02), a decrease of DQB1*0201 and DQB1*0301 was found in white HRES-1-seropositive patients (P = 0

  18. Unciaphenol, an Oxygenated Analogue of the Bergman Cyclization Product of Uncialamycin Exhibits Anti-HIV Activity.

    Science.gov (United States)

    Williams, David E; Bottriell, Helen; Davies, Julian; Tietjen, Ian; Brockman, Mark A; Andersen, Raymond J

    2015-11-06

    Unciaphenol (2), an oxygenated analogue of the Bergman cyclization product of the enediyne uncialamycin (1), has been isolated along with 1 from cultures of the actinomycete Streptomyces uncialis. It is proposed that the C-22 OH substituent in 2 might arise from the attack of a nucleophilic oxygen species on the p-benzyne diradical intermediate IA in the Bergman cyclization of 1. 2 shows in vitro anti-HIV activity against viral strains that are resistant to clinically utilized anti-retroviral therapies.

  19. Aplicación de la terapia de interacción padres-hijos en un caso de trastorno negativista desafiante

    OpenAIRE

    Ferro, Rafael; Vives, Carmen; Ascanio, Lourdes

    2010-01-01

    La terapia de interacción padres-hijos (PCIT) es una forma de terapia para tratar problemas de la infancia que integra la terapia de juego tradicional y los métodos clásicos operantes. Ha demostrado ser útil en problemas como: desobediencia, hiperac

  20. Nunez, A. C. y Tobon, S. . Terapia cognitivo conductual: el modelo procesual de la salud mental como camino para la integracion, la investigacion y la clinica

    National Research Council Canada - National Science Library

    Castrillon Moreno, Diego

    2007-01-01

    .... Analisis critico del eclecticismo en la Terapia Cognitivo Conductual. 3. Sintesis experimental del comportamiento y Terapia Cognitivo Conductual. 4. La integracion en la Terapia Psicologica: hacia un Modelo Procesual de la Salud Mental. 5. Antecedentes, filosofia y dimensiones centrales del Modelo Procesual de la Salud Mental. 6. Una perspec...

  1. Complementation of a primer binding site-impaired murine leukemia virus-derived retroviral vector by a genetically engineered tRNA-like primer

    DEFF Research Database (Denmark)

    Lund, Anders Henrik; Duch, M; Lovmand, J

    1997-01-01

    , but not with a noncomplementary tRNA-like molecule. The engineered primer was shown to be involved in both the initiation of first-strand synthesis and second-strand transfer. These results provide an in vivo demonstration that the retroviral replication machinery may recognize sequence complementarity rather than actual primer...... binding site and 3' primer sequences. Use of mutated primer binding site vectors replicating via engineered primers may add additional control features to retroviral gene transfer technology....

  2. Synergic Investigation Of The Self-Assembly Structure And Mechanism Of Retroviral Capsid Proteins By Solid State NMR, Transmission Electron Microscopy And Multiscale simulation

    Science.gov (United States)

    2017-03-29

    AFRL-AFOSR-VA-TR-2017-0074 Synergic investigation of the self-assembly structure and mechanism of retroviral capsid proteins by solid state NMR...assembly structure and mechanism of retroviral capsid proteins by solid state NMR, transmission electron microscopy and multiscale simulation 5a.  CONTRACT...capsid protein (CA). In vitro, tubular assembly can be obtained with the CA with similar underlying structural properties as the authentic RSV capsid

  3. A terapia cognitiva de Aaron Beck como reflexividade na alta modernidade: uma sociologia do conhecimento

    Directory of Open Access Journals (Sweden)

    Cláudio Ivan de Oliveira

    Full Text Available Uma sociologia do conhecimento interpreta a produção do conhecimento como vinculada a situações sociais. Partindo dessa premissa epistemológica, nosso artigo objetivou interpretar a terapia cognitiva de Aaron Beck como conhecimento construído e construtor do fenômeno de reflexividade da alta modernidade, conforme interpretada por Anthony Giddens. Nossa hipótese é que a reorientação do sistema de crenças do cliente, proposta pela terapia cognitiva, é uma forma de reconstrução reflexiva da autoidentidade, visando superar conflitos típicos da instabilidade da alta modernidade. Assinalamos aspectos na terapia cognitiva que a identificam com a reflexividade, sobretudo a ideia de que a construção da autoidentidade é uma tarefa na qual o indivíduo se engaja reflexivamente.

  4. NUEVAS HERRAMIENTAS PARA LA PSICOLOGÍA CLÍNICA: Las Terapias Basadas en la Evidencia

    Directory of Open Access Journals (Sweden)

    Kathleen Stevens

    2007-01-01

    Full Text Available Tanto las diversas necesidades psicosociales emerge ntes, como el visible crecimiento expansivo de los trastornos psicológicos y psiquiátricos en diferent es países, hacen patente la necesidad de un reajust e en la aplicación de terapias psicológicas que demue stren eficacia, efectividad y eficiencia. La escasa utilización de Terapias Apoyadas en la Evidencia (T BE en las prácticas clínicas, y la pobre investigación que presenta Chile al respecto, sugie re la existencia de variables que condicionan la adscripción de los profesionales a este modelo. Se revisan los antecedentes teóricos y el estado en qu e se encuentran las TBE en la actualidad nacional, ad emás de las críticas y perspectivas realizadas en torno al auge de estas terapias.

  5. Sobre la terapia génica para enfermedades de la retina.

    Science.gov (United States)

    Fischer, M Dominik

    2017-07-11

    Las mutaciones en un gran número de genes provocan degeneración de la retina y ceguera sin que exista actualmente cura alguna. En las últimas décadas, la terapia génica para enfermedades de la retina ha evolucionado y se ha convertido en un nuevo y prometedor paradigma terapéutico para estas enfermedades poco comunes. Este artículo refleja las ideas y los conceptos que parten de la ciencia básica hacia la aplicabilidad de la terapia génica en el ámbito clínico. Se describen los avances y las reflexiones actuales sobre la eficacia de los ensayos clínicos en la actualidad y se discuten los posibles obstáculos y soluciones de cara al futuro de la terapia génica para enfermedades de la retina. © 2017 S. Karger AG, Basel.

  6. NUEVAS TERAPIAS EN EL MANEJO DE LOS GLIOMAS DE ALTO GRADO

    OpenAIRE

    Dr. Raúl Valenzuela

    2017-01-01

    El reto de mejorar el tratamiento actual de los gliomas de alto grado ha sido abordado con inmensa creatividad, desarrollándose una gran variedad de estrategias para este fin. El análisis interino de un estudio fase III mostró que el beneficio de la terapia standard mejora al complementarla con terapia de campos eléctricos alternantes (Novo TTF-100 A); dadas las limitaciones de un análisis interino, queda por establecer la real magnitud y relevancia clínica de esta mejoría. El presunto benefi...

  7. CONTRIBUIÇÕES DA TERAPIA COGNITIVO COMPORTAMENTAL NO TRATAMENTO DA OBESIDADE

    OpenAIRE

    Ana Raquel Mattoso Chagas Martins; Alice Pessanha Rocha de Assis; Amanda Barbosa de Freitas; Bianca Machado da Silva Rangel; Larissa Barreto Bastos; Erika Costa Barreto Monteiro de Barros

    2016-01-01

    Levando em consideração que o homem é o único animal capaz de modificar seu corpo através do pensamento, a Terapia Cognitivo Comportamental (TCC) vem se configurando como um importante aliado no combate à obesidade, proporcionando uma reestruturação cognitiva capaz de modificar não apenas um corpo obeso, mas modificar todo um estilo de vida. A terapia cognitivo-comportamental (TCC) tem sido amplamente usada no tratamento da obesidade em associação com outras intervenções, como o acompanhament...

  8. A atuação do profissional fisioterapeuta em unidades de terapia intensiva neonatal

    OpenAIRE

    Rita Casciane Simão Reis Theis; Laís Rodrigues Gerzson; Carla Skilhan Almeida

    2016-01-01

    Objetivo: revisar na literatura atual, a atuação do profissional fisioterapeuta em unidades de terapia intensiva neonatal. Método: como estratégia, foi realizada busca nas bases de dados MEDLINE (via PubMed), Cochrane CENTRAL, Lilacs e PEDro, publicado nos últimos dez anos. Além de busca manual em referências de estudos já publicados sobre o assunto. Foram encontrados 20 artigos. A busca compreendeu os seguintes descritores "Fisioterapia motora”, “Unidade de terapia intensiva neonatal”, “técn...

  9. Terapia génica: ¿Qué es y para qué sirve?

    OpenAIRE

    Ruiz-Castellanos, M. (M.); Sangro, B. (Bruno)

    2005-01-01

    La terapia génica se ha desarrollado como un método de acercamiento al tratamiento de las enfermedades humanas basado en la transferencia de material genético a las células de un individuo. Habitualmente la finalidad de esta transferencia de material genético es restablecer una función celular que estaba abolida o defectuosa, introducir una nueva función o bien interferir con una función existente. Así, las distintas estrategias de la terapia génica se basan en la combinación de tres elemento...

  10. Uso de kits desechables para optimizar tiempos, movimientos y apego a protocolos de la terapia intravenosa

    OpenAIRE

    José Juan Escamilla Zamudio; Gretta Itzel Ramírez Chávez

    2017-01-01

    Introducción: En México un 95% de los pacientes hospitalizados requerirán un acceso vascular y terapia intravenosa; sin embargo, el uso de intervenciones estandarizadas favorece a la prevención y reducción de infecciones asociadas a catéter vascular. El objetivo es demostrar el beneficio al implementar el uso de kits desechables en procedimientos de terapia intravenosa en comparación con el método tradicional en instituciones de salud en México. Materiales y Métodos: Estudio prospectivo cuasi...

  11. Terapia compresiva en úlceras de extremidad inferior de etiología venosa

    OpenAIRE

    Cuesta Primo, Sara

    2015-01-01

    Las úlceras venosas son las más prevalentes dentro del conjunto de heridas crónicas. Se trata de lesiones con pérdida de sustancia, originadas por una insuficiencia venosa crónica. Su abordaje es complicado, siendo necesario combinar varias formas de tratamiento para conseguir su cicatrización y, evitar, en la medida de lo posible, las recidivas. La terapia compresiva, es considerada, la terapia estrella y fundamental para este tipo de heridas, ofreciendo grandes beneficios ...

  12. Prevención cardiovascular y de la osteoporosis con terapia hormonal sustitutiva

    OpenAIRE

    Martinez-Gonzalez, M.A. (Miguel Ángel); López-García, G. (Guillermo)

    1999-01-01

    Se recomienda actualmente que todo médico -sea cual sea su especialidad- aproveche la oportunidad que supone la atención clínica a cualquier mujer postmenopáusica o que se halle en torno a la menopausia para aconsejarle acerca de los beneficios y riesgos que supone la terapia hormonal sustitutiva (THS) con estrógenos y progesterona. Una vez que sea adecuadamente informada de estos beneficios y riesgos, debe ser la propia mujer quien decida si va a iniciar o no esta terapia, teniendo ...

  13. Terapia comportamental construtiva: uma outra face da clínica comportamental

    OpenAIRE

    Luc Vandenberghe

    2007-01-01

    Este artigo apresenta a terapia comportamental construtiva conforme elaborada por Beata Bakker-de Pree. A abordagem, desenvolvida nos Países Baixos, traz uma filosofia do processo terapêutico que é compatível com a de várias terapias comportamentais conhecidas. Acrescenta uma perspectiva valiosa em sua descrição explícita de alguns ingredientes importantes do trabalho clínico, que não estão em destaque nos outros modelos comportamentais, sendo estas a técnica de diferenciação livre e a anális...

  14. Conforto na perspectiva de familiares de pessoas internadas em Unidade de Terapia Intensiva

    OpenAIRE

    Freitas, Kátia Santana; Menezes, Igor Gomes; Mussi, Fernanda Carneiro

    2012-01-01

    O estudo objetivou compreender o significado de conforto para familiares de pessoas em Unidade de Terapia Intensiva. Trata-se de pesquisa qualitativa realizada na Unidade de Terapia Intensiva de um hospital, em Salvador-Bahia. Entrevistaram-se quatorze familiares. Recorreu-se aos pressupostos teóricos do Interacionismo Simbólico e à técnica de análise de dados qualitativos. Os resultados apontaram que as categorias Segurança, Acolhimento, Informação, Proximidade, Suporte social e espiritual, ...

  15. Efectividad de la terapia con sanguijuelas. Revisión bibliográfica

    OpenAIRE

    Angulo Sánchez, Enrique

    2017-01-01

    Objetivo: Encontrar evidencias actuales que demuestren la efectividad de la terapia con sanguijuelas en diferentes ámbitos de la salud, así como los beneficios potenciales de esta terapia natural y los posibles efectos secundarios, si los hubiese. Metodo: Revisión sistemática en Medline a través de Pubmed, CINALH, Instituto Joanna Brigs, Biblioteca Cochrane, Instituto Médico Español. Publicados entre 2006 y 2016. Ensayos clínicos aleatorizados controlados, sin grupo de control,...

  16. A física da terapia de captura de nêutrons pelo boro

    OpenAIRE

    Bruno-Machado,A.C.; Fortes,E.C.F.S.; Tijero,M.C.

    2010-01-01

    Neste artigo fazemos uma breve exposicão de como um dos conceitos fundamentais da física nuclear fissão nuclear e seus produtos tem aplicação na medicina, na chamada terapia de captura do nêutron pelo boro (BNCT na sigla em inglês). Essa terapia foi concebida como um tratamento alternativo para o câncer podendo, em determinados casos, substituir a cirurgia, quimioterapia e radioterapia. Na BNCT, o fármaco atuante é o boro 10 que, após ser injetado no paciente, é submetido à radiação de um fei...

  17. Trasplante celular y terapia regenerativa con células madre

    OpenAIRE

    Prosper, F. (Felipe)

    2008-01-01

    Uno de los campos de la medicina que más expectativas ha levantado en los últimos años es la terapia celular con células madre. El aislamiento de células embrionarias humanas, la aparente e inesperada potencialidad de las células madre adultas y el desarrollo de la terapia génica nos llevar a imaginar un futuro esperanzador para un importante número de enfermedades actualmente incurables. A lo largo de las siguientes páginas vamos a tratar de dibujar el panorama de la ...

  18. Terapia biológica en enfermedades reumatológicas

    OpenAIRE

    Ugarte-Gil, Manuel F.; Acevedo-Vásquez, Eduardo M; Alarcón, Graciela S.

    2013-01-01

    El advenimiento del uso de terapias biológicas en Reumatología ha modificado significativamente el pronóstico de pacientes portadores de artritis reumatoide (AR), artritis juvenil (AJ), espondilitis anquilosante (EA), entre otras enfermedades. A diferencia de las terapias convencionales estos productos biológicos se dirigen a los llamados blancos terapéuticos ya sea estas una línea celular, un mediador inflamatorio o un receptor de superficie. Estos compuestos son producidos por células vivas...

  19. Terapia dialéctico conductual para el trastorno de personalidad límite

    OpenAIRE

    Irene de la Vega; Sabrina Sánchez Quintero

    2013-01-01

    La terapia dialéctico conductual (TDC) es una terapia psicológica de tercera generación desarrollada por Marsha Linehan (1993a, 1993b) para tratar específicamente los síntomas característicos del trastorno límite de la personalidad: inestabilidad afectiva, trastorno de identidad, impulsividad y dificultades en las relaciones sociales. La TDC parte de un modelo biosocial del trastorno límite y combina técnicas cognitivo conductuales con aproximaciones zen y budistas basadas en la aceptación de...

  20. La estructura de la pareja: implicaciones para la terapia cognitivo conductual

    OpenAIRE

    JOSÉ ANTONIO GARCÍA HIGUERA

    2002-01-01

    La terapia de pareja cognitivo conductual ha mostrado su eficacia de manera empírica (Chambless et al., 1998). Sin embargo, existen limitaciones (Christensen y Heavey 1999) que indican la necesidad de su potenciación. Este artículo repasa la situación de la terapia de pareja, con las aportaciones actuales, enmarcando todo ello en una visión estructural de la pareja, como ente social y relación diádica, que permita una compresión de los avances que se están dando, y aporte indicaciones sobre l...

  1. Terapia fonológica com uso de computador: relato de caso

    Directory of Open Access Journals (Sweden)

    Larissa Llaguno Pereira

    2013-06-01

    Full Text Available O tema desse artigo aborda as mudanças fonológicas a partir da terapia fonológica com o uso de computador em casos de desvio fonológico. Realizou-se estudo de caso de quatro sujeitos (S1, S2, S3 e S4 com idade entre 4:7 e 5:3, de ambos os gêneros, com desvio fonológico. Realizou-se a Avaliação Fonológica da Criança, Exame Articulatório Repetitivo, Avaliação do Sistema Estomatognático, Teste de Figuras para Discriminação Fonêmica, Prova de Estimulabilidade e avaliação audiológica. Os sujeitos foram divididos em duplas de acordo com a semelhança dos sistemas fonológicos, sendo que um sujeito de cada dupla foi tratado com terapia fonológica padrão e outro com uso de computador como principal recurso terapêutico (terapia experimental. Os dados das avaliações dos sujeitos foram analisados e, após, foram comparados os resultados dos submetidos à terapia padrão (S1 e S2, com os pareados submetidos à terapia experimental, com auxílio do computador, (S3 e S4 por meio do teste Exato de Fisher, considerando significância estatística de 5% (p<0,05. Verificou-se que a evolução dos sujeitos S3 e S4 submetidos à terapia experimental foi maior em relação à evolução de S1 e S2 submetidos à terapia padrão, sendo este resultado estatisticamente significante. Os achados da pesquisa demonstram terem sido favoráveis o uso da terapia experimental no tratamento de crianças com desvio fonológico. Contudo, há necessidade de realização de outros estudos com ampliação casuística para confirmação dos achados.

  2. Terapia nutricional en las alteraciones metabólicas en personas viviendo con VIH/Sida

    OpenAIRE

    Marianne Falco; Aline de Cássia Oliveira Castro; Erika Aparecida Silveira

    2012-01-01

    OBJETIVO: Analisar o efeito do tratamento nutricional sobre as alterações metabólicas provocadas pelo uso da terapia antirretroviral em adultos vivendo com HIV/aids. MÉTODOS: Revisão sistemática de literatura no PubMed, Lilacs e Cochrane, entre 1996 e 2010, do tipo ensaio clínico, controlado, randomizado, crossover, adultos, vivendo com HIV/aids em uso de terapia antirretroviral e sem doenças oportunistas. A intervenção de interesse foi suplementação nutricional via oral e/ou mudança de estil...

  3. Trastornos de la alimentación y Terapia Ocupacional: Anorexia nerviosa

    OpenAIRE

    López Domínguez, Esther María

    2016-01-01

    Trabajo Fin de Grado Curso 2015-2016 [ES]Se realizó una revisión bibliográfica sobre la anorexia nerviosa y la terapia ocupacional, intentando analizar la evolución de este trastorno que actualmente está tan en apogeo, entre otros factores como los autores, las palabras de las cuales hacen más uso en sus títulos, el idioma y las revistas que más auge han tenido en dicho tema. Además, justificando la importancia que tiene la intervención desde la terapia ocupacional en los tr...

  4. A simple and efficient procedure for generating stable expression libraries by cDNA cloning in a retroviral vector.

    OpenAIRE

    Rayner, J R; Gonda, T J

    1994-01-01

    cDNA expression cloning is a powerful method for the rescue and identification of genes that are able to confer a readily identifiable phenotype on specific cell types. Retroviral vectors provide several advantages over DNA-mediated gene transfer for the introduction of expression libraries into eukaryotic cells since they can be used to express genes in a wide range of cell types, including those that form important experimental systems such as the hemopoietic system. We describe here a stra...

  5. Quantitative analysis of recombination between YFP and CFP genes of FRET biosensors introduced by lentiviral or retroviral gene transfer.

    Science.gov (United States)

    Komatsubara, Akira T; Matsuda, Michiyuki; Aoki, Kazuhiro

    2015-08-20

    Biosensors based on the principle of Förster (or fluorescence) resonance energy transfer (FRET) have been developed to visualize spatio-temporal dynamics of signalling molecules in living cells. Many of them adopt a backbone of intramolecular FRET biosensor with a cyan fluorescent protein (CFP) and yellow fluorescent protein (YFP) as donor and acceptor, respectively. However, there remains the difficulty of establishing cells stably expressing FRET biosensors with a YFP and CFP pair by lentiviral or retroviral gene transfer, due to the high incidence of recombination between YFP and CFP genes. To address this, we examined the effects of codon-diversification of YFP on the recombination of FRET biosensors introduced by lentivirus or retrovirus. The YFP gene that was fully codon-optimized to E.coli evaded the recombination in lentiviral or retroviral gene transfer, but the partially codon-diversified YFP did not. Further, the length of spacer between YFP and CFP genes clearly affected recombination efficiency, suggesting that the intramolecular template switching occurred in the reverse-transcription process. The simple mathematical model reproduced the experimental data sufficiently, yielding a recombination rate of 0.002-0.005 per base. Together, these results show that the codon-diversified YFP is a useful tool for expressing FRET biosensors by lentiviral or retroviral gene transfer.

  6. Dose of Retroviral Infection Determines Induction of Antiviral NK Cell Responses.

    Science.gov (United States)

    Littwitz-Salomon, Elisabeth; Schimmer, Simone; Dittmer, Ulf

    2017-11-15

    Natural killer (NK) cells are part of the innate immune system and recognize virus-infected cells as well as tumor cells. Conflicting data about the beneficial or even detrimental role of NK cells in different infectious diseases have been described previously. While the type of pathogen strongly influences NK cell functionality, less is known about how the infection dose influences the quality of a NK cell response against retroviruses. In this study, we used the well-established Friend retrovirus (FV) mouse model to investigate the impact of virus dose on the induction of antiviral NK cell functions. High-dose virus inoculation increased initial virus replication compared to that with medium- or low-dose viral challenge and significantly improved NK cell activation. Antiviral NK cell activity, including in vivo cytotoxicity toward infected target cells, was also enhanced by high-dose virus infection. NK cell activation following high-dose viral challenge was likely mediated by activated dendritic cells (DCs) and macrophages and the NK cell-stimulating cytokines interleukin 15 (IL-15) and IL-18. Neutralization of these cytokines decreased NK cell functions and increased viral loads, whereas IL-15 and IL-18 therapy improved NK cell activity. Here we demonstrate that virus dose positively correlates with antiviral NK cell activity and function, which are at least partly driven by IL-15 and IL-18. Our results suggest that NK cell activity may be therapeutically enhanced by administering IL-15 and IL-18 in virus infections that inadequately activate NK cells.IMPORTANCE In infections with retroviruses, like HIV and FV infection of mice, NK cells clearly mediate antiviral activities, but they are usually not sufficient to prevent severe pathology. Here we show that the initial infection dose impacts the induction of an antiviral NK cell response during an acute retroviral infection, which had not investigated before. High-dose infection resulted in a strong NK cell

  7. TERAPIA GÉNICA Y PRINCIPIOS ÉTICOS A TERAPIA GÊNICA E OS PRINCÍPIOS ÉTICOS GEN THERAPY AND ETHICAL PRINCIPLES

    Directory of Open Access Journals (Sweden)

    Eduardo Rodríguez Yunta

    2003-01-01

    Full Text Available La terapia génica constituye una forma de manipulación genética que trata de corregir o disminuir los efectos que ocasionan enfermedades de origen genético. Existen grandes esperanzas en el desarrollo de este tipo de terapia, sobre todo para enfermedades somáticas de origen genético que no tienen curación. Pero hay también numerosas dificultades técnicas que no están del todo resueltas. No se ha demostrado todavía eficacia clínica y se pueden producir daños irreversibles en el organismo. Por una parte, existe la necesidad de regular por medio de protocolos que deben ser rigurosamente analizados por comités de evaluación ética y científica y, por otra, hace falta un diálogo entre países, con el fin de evitar una presentación exitista de la técnica en el mercado sin mencionar sus dificultades inherentes. Una de las preocupaciones mayores es que la aceptación paulatina de este tipo de terapia, y la eliminación de restricciones, permita el uso de la técnica para terapia génica germinal y para terapia génica de mejoría, cuya validez ética es cuestionada. Usar la terapia génica en células germinales conlleva el riesgo de introducir daños genéticos en generaciones posterioresA terapia gênica constitui uma forma de manipulação genética que trata de corrigir ou diminuir os efeitos que ocasionam enfermidades de origem genética. Existem grandes esperanças no desenvolvimento deste tipo de terapia, sobretudo para doenças somáticas de origem genética que não tem cura. Existem, não obstante isso numerosos dificuldades técnicas que não estão totalmente resolvidas. Não se demostrou ainda a eficácia clínica e se pode causar danos irreversíveis no organismo. De um lado, existe a necessidade de regular por meio de protocolos que devem ser rigorosamente analisados por comitês de avaliação ética e científica, por outra, faz falta um diálogo entre países, para se evitar uma apresentação unilateral exitosa da t

  8. Costo-beneficio de la terapia en ambiente húmedo versus terapia tradicional: el caso de un paciente con úlcera en la extremidad inferior

    Directory of Open Access Journals (Sweden)

    Blanca Lilia Reyes-Rocha

    Full Text Available Actualmente, ha cobrado relevancia el uso de la terapia húmeda en la cura de las heridas crónicas; sin embargo, persiste el uso de la terapia tradicional como técnica para lograr la cicatrización de las mismas. El caso que presentamos tiene como propósito determinar el costo-beneficio del empleo de apósitos de cura en ambiente húmedo versus cura tradicional en un paciente con úlcera en la extremidad inferior. Los resultados muestran que el coste es mayor con la terapia en ambiente húmedo; sin embargo, el periodo de cicatrización de la herida es menor en comparación con el tiempo de cicatrización que conlleva la cura tradicional; esto redunda en un beneficio para el paciente al alcanzar su recuperación en un menor tiempo. Estos hallazgos permiten proponer hipótesis para estudios posteriores bajo otro diseño metodológico, a fin de generar evidencia científica que coadyuve en la mejora de los procesos de atención en beneficio de la población con este tipo de padecimiento.

  9. Paciente quirúrgico séptico en terapia intensiva

    Directory of Open Access Journals (Sweden)

    Rubén Bembibre Taboada

    1997-08-01

    Full Text Available Se realizó un estudio anual de 121 pacientes quirúrgicos sépticos ingresados en Terapia Intensiva en el Hospital Provincial Clinicoquirúrgico Docente "Dr. Gustavo Aldereguía Lima" y se aplicaron métodos computadorizados para el procesamiento de datos y aplicación de pruebas de significación estadística. La edad media de la serie fue de 40,4 para vivos y 47,35 para fallecidos; la mayor letalidad correspondió a pancreatitis hemorrágica (80 y cirugía gastroduodenal (45,5. En el 41,32 % el diagnóstico se basó en el examen físico y ultrasonido abdominal. Existió un incremento franco de evolución desfavorable al aumentar el número de intervenciones quirúrgicas. Los gérmenes más frecuentes fueron Klebsiella pneumoniae, E. Coli, Pseudomona aureginosa y Proteus mirabilis. Los anti-bióticos más usados fueron metronidazol, penicilinas, y aminoglucósidos. Se destaca el 8,2 de incidencia para fallo multiórgano (FMO con 100 % de letalidad y un predominio de la evolución favorable en 84 enfermos y 37 que fallecieronA one year-period study of 121 surgical septic patients admitted to the Intensive Care Unit of "Dr. Gustavo Aldereguía Lima" Clinicosurgical Provincial Hospital was carried out by the application of computerized methods for data processing and the application of statistical significance tests. Average age of the series was 40.4 for alive subjects, and 47.35 for deceased subjects; the greatest lethality rate corresponded to haemorrhagic pancreatitis (80 and to gastroduodenal surgery (45.5. In 41.32 % the diagnosis was based on physical examination and abdominal ultrasound. There was a frank increase of unfavourable evolution as the number of surgical procedures increased. Germs most frequently found were Klebsiella pneumonia, E. coli, Pseudomona aeruginosa and Proteus mirabilis. Antibiotics most frequently used were metronidazole, penicillins, and aminoglycosides. An incidence of 8.2 for multiple organ failure is highlithed

  10. Single molecule DNA interaction kinetics of retroviral nucleic acid chaperone proteins

    Science.gov (United States)

    Williams, Mark

    2010-03-01

    Retroviral nucleocapsid (NC) proteins are essential for several viral replication processes including specific genomic RNA packaging and reverse transcription. The nucleic acid chaperone activity of NC facilitates the latter process. In this study, we use single molecule biophysical methods to quantify the DNA interactions of wild type and mutant human immunodeficiency virus type 1 (HIV-1) NC and Gag and human T-cell leukemia virus type 1 (HTLV-1) NC. We find that the nucleic acid interaction properties of these proteins differ significantly, with HIV-1 NC showing rapid protein binding kinetics, significant duplex destabilization, and strong DNA aggregation, all properties that are critical components of nucleic acid chaperone activity. In contrast, HTLV-1 NC exhibits significant destabilization activity but extremely slow DNA interaction kinetics and poor aggregating capability, which explains why HTLV-1 NC is a poor nucleic acid chaperone. To understand these results, we developed a new single molecule method for quantifying protein dissociation kinetics, and applied this method to probe the DNA interactions of wild type and mutant HIV-1 and HTLV-1 NC. We find that mutations to aromatic and charged residues strongly alter the proteins' nucleic acid interaction kinetics. Finally, in contrast to HIV-1 NC, HIV-1 Gag, the nucleic acid packaging protein that contains NC as a domain, exhibits relatively slow binding kinetics, which may negatively impact its ability to act as a nucleic acid chaperone.

  11. Interferon-alpha subtype 11 activates NK cells and enables control of retroviral infection.

    Directory of Open Access Journals (Sweden)

    Kathrin Gibbert

    Full Text Available The innate immune response mediated by cells such as natural killer (NK cells is critical for the rapid containment of virus replication and spread during acute infection. Here, we show that subtype 11 of the type I interferon (IFN family greatly potentiates the antiviral activity of NK cells during retroviral infection. Treatment of mice with IFN-α11 during Friend retrovirus infection (FV significantly reduced viral loads and resulted in long-term protection from virus-induced leukemia. The effect of IFN-α11 on NK cells was direct and signaled through the type I IFN receptor. Furthermore, IFN-α11-mediated activation of NK cells enabled cytolytic killing of FV-infected target cells via the exocytosis pathway. Depletion and adoptive transfer experiments illustrated that NK cells played a major role in successful IFN-α11 therapy. Additional experiments with Mouse Cytomegalovirus infections demonstrated that the therapeutic effect of IFN-α11 is not restricted to retroviruses. The type I IFN subtypes 2 and 5, which bind the same receptor as IFN-α11, did not elicit similar antiviral effects. These results demonstrate a unique and subtype-specific activation of NK cells by IFN-α11.

  12. Maturation of the Gag core decreases the stability of retroviral lipid membranes.

    Science.gov (United States)

    Davidoff, Candice; Payne, Riley J; Willis, Sharon H; Doranz, Benjamin J; Rucker, Joseph B

    2012-11-25

    To better understand how detergents disrupt enveloped viruses, we monitored the biophysical stability of murine leukemia virus (MLV) virus-like particles (VLPs) against a panel of commonly used detergents using real-time biosensor measurements. Although exposure to many detergents, such as Triton X-100 and Empigen, results in lysis of VLP membranes, VLPs appeared resistant to complete membrane lysis by a significant number of detergents, including Tween 20, Tween 80, Lubrol, and Saponin. VLPs maintained their structural integrity after exposure to Tween 20 at concentrations up to 500-fold above its CMC. Remarkably, VLPs containing immature cores composed of unprocessed (uncleaved) Gag polyprotein were significantly more resistant to detergent lysis than VLPs with mature cores. Although the maturity of retroviral Gag is known to influence the stability of the protein core structure itself, our studies suggest that the maturity of the Gag core also influences the stability of the lipid bilayer surrounding the core. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Structural and Functional Comparisons of Retroviral Envelope Protein C-Terminal Domains: Still Much to Learn

    Directory of Open Access Journals (Sweden)

    Jonathan D. Steckbeck

    2014-01-01

    Full Text Available Retroviruses are a family of viruses that cause a broad range of pathologies in animals and humans, from the apparently harmless, long-term genomic insertion of endogenous retroviruses, to tumors induced by the oncogenic retroviruses and acquired immunodeficiency syndrome (AIDS resulting from human immunodeficiency virus infection. Disease can be the result of diverse mechanisms, including tumorigenesis induced by viral oncogenes or immune destruction, leading to the gradual loss of CD4 T-cells. Of the virally encoded proteins common to all retroviruses, the envelope (Env displays perhaps the most diverse functionality. Env is primarily responsible for binding the cellular receptor and for effecting the fusion process, with these functions mediated by protein domains localized to the exterior of the virus. The remaining C-terminal domain may have the most variable functionality of all retroviral proteins. The C-terminal domains from three prototypical retroviruses are discussed, focusing on the different structures and functions, which include fusion activation, tumorigenesis and viral assembly and lifecycle influences. Despite these genetic and functional differences, however, the C-terminal domains of these viruses share a common feature in the modulation of Env ectodomain conformation. Despite their differences, perhaps each system still has information to share with the others.

  14. Integration Site and Clonal Expansion in Human Chronic Retroviral Infection and Gene Therapy

    Science.gov (United States)

    Niederer, Heather A.; Bangham, Charles R. M.

    2014-01-01

    Retroviral vectors have been successfully used therapeutically to restore expression of genes in a range of single-gene diseases, including several primary immunodeficiency disorders. Although clinical trials have shown remarkable results, there have also been a number of severe adverse events involving malignant outgrowth of a transformed clonal population. This clonal expansion is influenced by the integration site profile of the viral integrase, the transgene expressed, and the effect of the viral promoters on the neighbouring host genome. Infection with the pathogenic human retrovirus HTLV-1 also causes clonal expansion of cells containing an integrated HTLV-1 provirus. Although the majority of HTLV-1-infected people remain asymptomatic, up to 5% develop an aggressive T cell malignancy. In this review we discuss recent findings on the role of the genomic integration site in determining the clonality and the potential for malignant transformation of cells carrying integrated HTLV-1 or gene therapy vectors, and how these results have contributed to the understanding of HTLV-1 pathogenesis and to improvements in gene therapy vector safety. PMID:25365582

  15. An Alix fragment potently inhibits HIV-1 budding: characterization of binding to retroviral YPXL late domains.

    Science.gov (United States)

    Munshi, Utpal M; Kim, Jaewon; Nagashima, Kunio; Hurley, James H; Freed, Eric O

    2007-02-09

    The retroviral structural protein, Gag, contains small peptide motifs known as late domains that promote efficient virus release from the infected cell. In addition to the well characterized PTAP late domain, the p6 region of HIV-1 Gag contains a binding site for the host cell protein Alix. To better understand the functional role of the Gag/Alix interaction, we overexpressed an Alix fragment composed of residues 364-716 (Alix 364-716) and examined the effect on release of wild type (WT) and Alix binding site mutant HIV-1. We observed that Alix 364-716 expression significantly inhibited WT virus release and Gag processing and that mutation of the Alix binding site largely relieved this inhibition. Furthermore, Alix 364-716 expression induced a severe defect on WT but not mutant particle morphology. Intriguingly, the impact of Alix 364-716 expression on HIV-1 release and Gag processing was markedly different from that induced by mutation of the Alix binding site in p6. The association of Alix 364-716 with HIV-1 and equine infectious anemia virus late domains was quantitatively evaluated by isothermal titration calorimetry and surface plasmon resonance techniques, and the effects of mutations in these viral sequences on Alix 364-716 binding was determined. This study identifies a novel Alix-derived dominant negative inhibitor of HIV-1 release and Gag processing and provides quantitative information on the interaction between Alix and viral late domains.

  16. Inhibition Profiling of Retroviral Protease Inhibitors Using an HIV-2 Modular System.

    Science.gov (United States)

    Mahdi, Mohamed; Szojka, Zsófia; Mótyán, János András; Tőzsér, József

    2015-11-27

    Retroviral protease inhibitors (PIs) are fundamental pillars in the treatment of HIV infection and acquired immunodeficiency syndrome (AIDS). Currently used PIs are designed against HIV-1, and their effect on HIV-2 is understudied. Using a modular HIV-2 protease cassette system, inhibition profiling assays were carried out for protease inhibitors both in enzymatic and cell culture assays. Moreover, the treatment-associated resistance mutations (I54M, L90M) were introduced into the modular system, and comparative inhibition assays were performed to determine their effect on the susceptibility of the protease. Our results indicate that darunavir, saquinavir, indinavir and lopinavir were very effective HIV-2 protease inhibitors, while tipranavir, nelfinavir and amprenavir showed a decreased efficacy. I54M, L90M double mutation resulted in a significant reduction in the susceptibility to most of the inhibitors with the exception of tipranavir. To our knowledge, this modular system constitutes a novel approach in the field of HIV-2 protease characterization and susceptibility testing.

  17. Avoidance of stimulation improves engraftment of cultured and retrovirally transduced hematopoietic cells in primates

    Science.gov (United States)

    Takatoku, Masaaki; Sellers, Stephanie; Agricola, Brian A.; Metzger, Mark E.; Kato, Ikunoshin; Donahue, Robert E.; Dunbar, Cynthia E.

    2001-01-01

    Recent reports suggest that cells in active cell cycle have an engraftment defect compared with quiescent cells. We used nonhuman primates to investigate this finding, which has direct implications for clinical transplantation and gene therapy applications. Transfer of rhesus CD34+ cells to culture in stem cell factor (SCF) on the CH-296 fibronectin fragment (FN) after 4 days of culture in stimulatory cytokines maintained cell viability but decreased cycling. Using retroviral marking with two different gene transfer vectors, we compared the engraftment potential of cytokine-stimulated cells versus those transferred to nonstimulatory conditions (SCF on FN alone) before reinfusion. In vivo competitive repopulation studies showed that the level of marking originating from the cells continued in culture for 2 days with SCF on FN following a 4-day stimulatory transduction was significantly higher than the level of marking coming from cells transduced for 4 days and reinfused without the 2-day culture under nonstimulatory conditions. We observed stable in vivo overall gene marking levels of up to 29%. This approach may allow more efficient engraftment of transduced or ex vivo expanded cells by avoiding active cell cycling at the time of reinfusion. PMID:11489938

  18. The host cell sulfonation pathway contributes to retroviral infection at a step coincident with provirus establishment.

    Directory of Open Access Journals (Sweden)

    James W Bruce

    2008-11-01

    Full Text Available The early steps of retrovirus replication leading up to provirus establishment are highly dependent on cellular processes and represent a time when the virus is particularly vulnerable to antivirals and host defense mechanisms. However, the roles played by cellular factors are only partially understood. To identify cellular processes that participate in these critical steps, we employed a high volume screening of insertionally mutagenized somatic cells using a murine leukemia virus (MLV vector. This approach identified a role for 3'-phosphoadenosine 5'-phosphosulfate synthase 1 (PAPSS1, one of two enzymes that synthesize PAPS, the high energy sulfate donor used in all sulfonation reactions catalyzed by cellular sulfotransferases. The role of the cellular sulfonation pathway was confirmed using chemical inhibitors of PAPS synthases and cellular sulfotransferases. The requirement for sulfonation was mapped to a stage during or shortly after MLV provirus establishment and influenced subsequent gene expression from the viral long terminal repeat (LTR promoter. Infection of cells by an HIV vector was also shown to be highly dependent on the cellular sulfonation pathway. These studies have uncovered a heretofore unknown regulatory step of retroviral replication, have defined a new biological function for sulfonation in nuclear gene expression, and provide a potentially valuable new target for HIV/AIDS therapy.

  19. Neonatal Gene Therapy With a Gamma Retroviral Vector in Mucopolysaccharidosis VI Cats

    Science.gov (United States)

    Ponder, Katherine P; O'Malley, Thomas M; Wang, Ping; O'Donnell, Patricia A; Traas, Anne M; Knox, Van W; Aguirre, Gustavo A; Ellinwood, N Matthew; Metcalf, Jason A; Wang, Bin; Parkinson-Lawrence, Emma J; Sleeper, Meg M; Brooks, Doug A; Hopwood, John J; Haskins, Mark E

    2012-01-01

    Mucopolysaccharidosis (MPS) VI is due to a deficiency in the activity of N-acetylgalactosamine 4-sulfatase (4S), also known as arylsulfatase B. Previously, retroviral vector (RV)-mediated neonatal gene therapy reduced the clinical manifestations of MPS I and MPS VII in mice and dogs. However, sulfatases require post-translational modification by sulfatase-modifying factors. MPS VI cats were injected intravenously (i.v.) with a gamma RV-expressing feline 4S, resulting in 5 ± 3 copies of RV per 100 cells in liver. Liver and serum 4S activity were 1,450 ± 1,720 U/mg (26-fold normal) and 107 ± 60 U/ml (13-fold normal), respectively, and were directly proportional to the liver 4S protein levels for individual cats. This study suggests that sulfatase-modifying factor (SUMF) activity in liver was sufficient to result in active enzyme despite overexpression of 4S. RV-treated MPS VI cats achieved higher body weights and longer appendicular skeleton lengths, had reduced articular cartilage erosion, and reduced aortic valve thickening and aortic dilatation compared with untreated MPS VI cats, although cervical vertebral bone lengths were not improved. This demonstrates that therapeutic expression of a functional sulfatase protein can be achieved with neonatal gene therapy using a gamma RV, but some aspects of bone disease remain difficult to treat. PMID:22395531

  20. Terapia comportamental cognitiva para pessoas com transtorno bipolar Cognitive behavioral therapy for bipolar disorders

    Directory of Open Access Journals (Sweden)

    Francisco Lotufo Neto

    2004-10-01

    Full Text Available Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  1. Terapia comportamental cognitiva para pessoas com transtorno bipolar Cognitive behavioral therapy for bipolar disorders

    OpenAIRE

    Francisco Lotufo Neto

    2004-01-01

    Descrição dos objetivos e principais técnicas da terapia comportamental cognitiva usadas para a psicoterapia das pessoas com transtorno bipolar.Objectives and main techniques of cognitive behavior therapy for the treatment of bipolar disorder patients are described.

  2. CONTRIBUIÇÕES DA TERAPIA COGNITIVO COMPORTAMENTAL NO TRATAMENTO DA OBESIDADE

    Directory of Open Access Journals (Sweden)

    Ana Raquel Mattoso Chagas Martins

    2016-08-01

    Full Text Available Levando em consideração que o homem é o único animal capaz de modificar seu corpo através do pensamento, a Terapia Cognitivo Comportamental (TCC vem se configurando como um importante aliado no combate à obesidade, proporcionando uma reestruturação cognitiva capaz de modificar não apenas um corpo obeso, mas modificar todo um estilo de vida. A terapia cognitivo-comportamental (TCC tem sido amplamente usada no tratamento da obesidade em associação com outras intervenções, como o acompanhamento nutricional e a prática de atividade física. A TCC é uma terapia de duração breve e com sessões estruturadas nas quais o paciente é solicitado a colaborar ativamente na identificação e na mudança de seus comportamentos e sentimentos que contribuem para a obesidade. O objetivo do presente trabalho é verificar a eficácia do apoio psicoterápico com base na Terapia Cognitivo Comportamental na redução de peso de pacientes obesos. Palavras-chave: Cognitivo; Comportamental; Obesidade.

  3. Atitude de Estudantes de Medicina frente a Terapias Alternativas e Complementares

    Directory of Open Access Journals (Sweden)

    Nayara Mendes Morales

    Full Text Available O uso das Terapias Alternativas e Complementares (TAC vem aumentando ao longo dos anos no Brasil e no mundo com o advento de políticas de saúde favoráveis ao emprego dessas práticas. No entanto, as escolas médicas ainda não oferecem disciplinas curriculares sobre este tema. Com o intuito de descrever as atitudes dos estudantes de Medicina de uma universidade do Sul do Brasil com relação às terapias complementares, foi realizado um estudo observacional transversal descritivo, por meio da aplicação de um questionário. Houve 65,22% de taxa de resposta, e a terapia mais conhecida pelos estudantes foi a Fitoterapia (90,3%. A maioria deles demonstrou atitudes favoráveis com relação às terapias, e 75,26% gostariam de aprender sobre o tema em aulas curriculares.

  4. Uso de kits desechables para optimizar tiempos, movimientos y apego a protocolos de la terapia intravenosa

    Directory of Open Access Journals (Sweden)

    José Juan Escamilla Zamudio

    2017-09-01

    Cómo citar este artículo: Escamilla JJ, Ramírez GI. Uso de kits desechables para optimizar tiempos, movimientos y apego a protocolos de la terapia intravenosa. Rev Cuid. 2017; 8(3: 1749-57. http://dx.doi.org/10.15649/cuidarte.v8i3.412

  5. La Tarea de Auto-consuelo Compasivo en Terapia Focalizada en la Emoción

    National Research Council Canada - National Science Library

    Ciro Caro; Teresa Hornillos

    2015-01-01

    El objetivo de este artículo es poner a disposición de los terapeutas y de los equipos de investigación clínica en psicoterapia, el conocimiento actualizado sobre la Tarea de Auto-consuelo Compasivo de la Terapia Focalizada...

  6. La terapia de la coherencia: un enfoque constructivista apoyado por la neurociencia contemporánea

    OpenAIRE

    Jasiński, Michał; Paz, Clara; Feixas, Guillem

    2016-01-01

    En el presente artículo se describe la terapia de la coherencia (TC). Con el fin de presentar este enfoque se realiza una breve descripción del constructivismo y su influencia tanto en la TC, como en la psicoterapia en general. Se continúa con la expli

  7. Estressores em familiares de pacientes internados na unidade de terapia intensiva

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    Angélica Adam Barth

    Full Text Available RESUMO Objetivo: Identificar e estratificar os principais fatores estressores para os familiares de pacientes internados na unidade de terapia intensiva adulto de um hospital escola. Métodos: Estudo transversal descritivo com familiares de pacientes internados na unidade de terapia intensiva no período de abril a outubro de 2014. Foi utilizado questionário contendo identificação e dados demográficos dos familiares, dados clínicos dos pacientes, bem como 25 fatores estressores adaptados da Escala de Estressores em Unidade de Terapia Intensiva. O grau de estresse de cada fator foi determinado por uma escala de valores pontuando de 1 a 4. Os fatores estressores foram ranqueados conforme média dos pontos obtida. Resultados: A principal causa de admissão na unidade de terapia intensiva foi clínica em 36 (52,2% casos. Os principais fatores estressores foram a presença do estado de coma (3,15 ± 1,23, o paciente não conseguir falar (3,15 ± 1,20 e o motivo da internação (3,00 ± 1,27. Quando retirados da análise os 27 (39,1% pacientes em coma, os fatores de maior estresse para os familiares foram o motivo da internação (2,75 ± 1,354, ver o paciente na unidade de terapia intensiva (2,51 ± 1,227 e o paciente não conseguir falar (2,50 ± 1,269. Conclusão: A dificuldade na comunicação e na relação com o paciente internado na unidade de terapia intensiva foi apontada como os maiores estressores por seus familiares, com destaque para o estado de coma. Por outro lado, o ambiente, as rotinas de trabalho e a relação entre familiar e equipe da unidade de terapia intensiva tiveram menor impacto como fatores estressores.

  8. Terapia sistémica de pareja en la depresión: un estudio de caso único

    OpenAIRE

    Feixas i Viaplana, Guillem; Muñoz Cano, Dámaris; Dada Sánchez, Gloria; Compañ, Victoria; Arroyo Andreu, Susana

    2009-01-01

    En este estudio de caso único se presenta el tratamiento de una mujer diagnosticada de depresión mayor con terapia sistémica de pareja. Esta modalidad de terapia supone la inclusión de la pareja en todas las sesiones de tratamiento, en las que se trabaja con ambos de forma conjunta. A medida que avanza la terapia se van explicitando los significados relacionales de los síntomas y las dificultades de relación, y se trabaja de forma conjunta para remediarlas. El proceso terapéutico se completó ...

  9. A experiência emocional atualizadora em Gestalt-terapia de curta duração

    OpenAIRE

    Ênio Brito Pinto

    2009-01-01

    Apresenta-se e se discute o conceito, de Alexander, de experiência emocional corretiva, sob a ótica da abordagem gestáltica. Propõe-se que em Gestalt-terapia se deva falar em experiência emocional atualizadora. Discute-se a noção de neurose e de psicopatologia em Gestalt-terapia, bem como as implicações desses conceitos no processo de Gestalt-terapia de Curta Duração.

  10. NUEVAS TERAPIAS EN EL MANEJO DE LOS GLIOMAS DE ALTO GRADO

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    Dr. Raúl Valenzuela

    2017-05-01

    Full Text Available El reto de mejorar el tratamiento actual de los gliomas de alto grado ha sido abordado con inmensa creatividad, desarrollándose una gran variedad de estrategias para este fin. El análisis interino de un estudio fase III mostró que el beneficio de la terapia standard mejora al complementarla con terapia de campos eléctricos alternantes (Novo TTF-100 A; dadas las limitaciones de un análisis interino, queda por establecer la real magnitud y relevancia clínica de esta mejoría. El presunto beneficio de usar tratamiento antiviral contra citomegalovirus es muy controvertido y su utilidad no se ha demostrado en forma fehaciente. Las terapias antiangiogénicas han mostrado ser útiles para el manejo de las recurrencias, al menos como tratamiento sintomático, pero no han demostrado mejorar la sobrevida en pacientes de novo. La terapia dirigida contra señales intracelulares de crecimiento, conceptualmente muy atractiva, todavía no ha logrado resultados clínicos exitosos. Hay datos preliminares promisorios respecto al uso clínico de vacunas antitumorales y de inmunomodulación con inhibidores de “checkpoints”; también hay algunos datos preliminares a favor del uso de virus oncolíticos. La terapia genética parece estar en etapas aún muy tempranas de su desarrollo y probablemente demore más tiempo en llegar a demostrar utilidad clínica.

  11. Terapia inmunosupresora en pacientes con Nefropatía Membranosa Idiopática

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    Giovanna Llerena García

    2009-04-01

    Full Text Available Objetivo: Evaluar la respuesta a la terapia combinada según el esquema de Ponticelli en pacientes con Nefropatía Membranosa (NM idiopática, en la tasa de remisión de la proteinuria, la tasa de filtración glomerular (TFG y la frecuencia de complicaciones. Material y métodos: Estudio observacional descriptivo tipo serie de casos en pacientes con NM idiopàtica durante los años 1995 - 2005 que recibieron terapia inmunosupresora, según esquema de Ponticelli. Se determinó la tasa de remisión de la proteinuria y la evolución de la TFG. Resultados: Diez pacientes con NM idiopática cumplieron los criterios de inclusión. La mitad de los casos tuvo remisión parcial (RP al finalizar la terapia; no hubo casos con remisión completa (RC. Al último control, 10% presentó RC y 70% RP. El 80% de los pacientes presentó efectos adversos. Conclusiones: Al finalizar la terapia inmunosupresora según esquema de Ponticelli, se evidencia reducción de la proteinuria (p>0,05, y remisión al último control (p < 0,05, probablemente asociado al uso de bloqueadores del eje renina-angiotensina-aldosterona. Los efectos adversos asociados a la terapia inmunosupresora son frecuentes, sin embargo ningún paciente descontinuó el tratamiento. (Rev Med Hered 2009;20:60-69.

  12. Terapia nutricional no diabetes gestacional Nutritional therapy in gestational diabetes

    Directory of Open Access Journals (Sweden)

    Patricia de Carvalho Padilha

    2010-02-01

    Full Text Available Trata-se de uma revisão da literatura científica sobre a terapia nutricional no Diabetes Mellitus Gestacional, sem restrição de data e com fontes primárias indexadas nas bases de dados SciELO, PubMed, Medline. Os resultados desta revisão apontam a intervenção nutricional como uma importante aliada no controle do Diabetes Mellitus Gestacional, trazendo potenciais benefícios à saúde materno-fetal. Na avaliação do estado nutricional materno devem ser empregados os indicadores antropométricos, dietéticos, bioquímicos, clínicos e funcional. Neste sentido, a avaliação dietética deve ser detalhada, com atenção para o fracionamento e composição das refeições, e grupos de alimentos presentes. No planejamento nutricional a distribuição de macronutrientes em relação ao consumo energético diário deve ser 45-65% de carboidratos, 15-20% de proteínas e 20-35% de lipídeos. Quanto a recomendação dos edulcorantes, são liberados para gestantes acesulfame K, aspartame, neotame, sacarina e sucralose. A atividade física também deve fazer parte da estratégia de tratamento do Diabetes Mellitus Gestacional, embora o impacto do exercício nas complicações neonatais ainda mereça ser rigorosamente testado. Ademais, estudos associam a habilidade de aconselhamento nutricional com a melhorara na adesão ao cuidado nutricional. Diante desses achados, para sucesso no controle do DMG são necessários: a participação da equipe inter e multidisciplinar, o cuidado pré-natal precoce, com assistência nutricional oportuna e a garantia da assistência de qualidade ao longo da gestação.This is a scientific literature review about nutritional therapy in gestational diabetes mellitus, without date restriction and using the SciELO, PubMed and Medline databases. The results of this review show that nutritional intervention is an important tool for managing gestational diabetes mellitus, and potentially benefits the mother's and fetal health

  13. Activation and regulation of endogenous retroviral genes in the human pituitary gland and related endocrine tumours.

    Science.gov (United States)

    Buslei, Rolf; Strissel, Pamela L; Henke, Christine; Schey, Regina; Lang, Nadine; Ruebner, Matthias; Stolt, Claus C; Fabry, Ben; Buchfelder, Michael; Strick, Reiner

    2015-02-01

    Adenohypophysis (AH) hormone-producing cells represent the origin of diverse groups of pituitary adenomas (PA). Deregulation of hypothalamic hormone receptors, growth factors and cAMP signalling have been implicated in the aetiology of PA. Endogenous retroviruses (ERVs) are derived from past exogenous retroviral infections and represent more than 8% of the human genome. Some ERV genes encode open reading frames and produce functional proteins, for example, the ERVW-1 envelope gene Syncytin-1, essential for placentogenesis, but also deregulated in human tumours. Data concerning ERV expression in the AH and related endocrine tumours are missing. Syncytin-1 protein was analysed in normal AH (n = 15) and compared with five PA subtypes (n = 117) by immunohistochemistry. Absolute gene expression of 20 ERV functional envelope genes and ERVW-5 gag was measured. PA tissues were examined for Syncytin-1 and the cAMP signalling marker phospho-CREB-Ser133 using immunohistochemistry. Isolated primary human PA cells were treated with different hormones. Murine embryonic and adult pituitary gland ERV expressions were compared with human AH. Syncytin-1 protein colocalized with corticotropic cells of AH. In contrast, all PA demonstrated significant Syncytin-1 protein overexpression, supporting deregulation. All other ERV genes showed significant up-regulations in different PA subtypes. Phospho-CREB-Ser133 and Syncytin-1 colocalized in PA cells. Cultivated primary PA cells with ACTH or CRH induced their respective receptors and ERV genes. Syncytin-A/-B, murine orthologues to human Syncytin-1/-2, localized to embryonic and adult pituitary glands demonstrating functional mammalian conservation. Deregulated ERV genes may contribute to PA development via cAMP signalling. © 2014 British Neuropathological Society.

  14. Therapeutic potential of antiviral drugs targeting chemorefractory colorectal adenocarcinoma cells overexpressing endogenous retroviral elements.

    Science.gov (United States)

    Díaz-Carballo, David; Acikelli, Ali Haydar; Klein, Jacqueline; Jastrow, Holger; Dammann, Philipp; Wyganowski, Thomas; Guemues, Cihan; Gustmann, Sebastian; Bardenheuer, Walter; Malak, Sascha; Tefett, Nora Sophia; Khosrawipour, Veria; Giger-Pabst, Urs; Tannapfel, Andrea; Strumberg, Dirk

    2015-08-12

    Endoretroviruses account for circa 8 % of all transposable elements found in the genome of humans and other animals. They represent a genetic footprint of ancestral germ-cell infections of exoviruses that is transmittable to the progeny by Mendelian segregation. Traces of human endogenous retroviruses are physiologically expressed in ovarial, testicular and placental tissues as well as in stem cells. In addition, a number of these fossil viral elements have also been related to carcinogenesis. However, a relation between endoretroviruses expression and chemoresistance has not been reported yet. Twenty colorectal carcinoma patient samples were scrutinized for HERV-WE1 and HERV-FRD1 endoretroviruses using immunohistochemical approaches. In order to search for differential expression of these elements in chemotherapy refractory cells, a resistant HCT8 colon carcinoma subline was developed by serial etoposide exposure. Endoretroviral elements were detected by immunocytochemical staining, qPCR and ELISA. IC50-values of antiviral and cytostatic drugs in HCT8 cells were determined by MTT proliferation assay. The antivirals-cytostatics interaction was evaluated by the isobologram method. In this work, we show for the first time that HERV-WE1, HERV-FRD1, HERV-31, and HERV-V1 are a) simultaneously expressed in treatment-naïve colon carcinoma cells and b) upregulated after cytostatic exposure, suggesting that these retroviral elements are intimately related to chemotherapy resistance. We found a number of antiviral drugs to have cytotoxic activity and the ability to force the downregulation of HERV proteins in vitro. We also demonstrate that the use of different antiviral compounds alone or in combination with anticancer agents results in a synergistic antiproliferative effect and downregulation of different endoretroviral elements in highly chemotherapy-resistant colorectal tumor cells. Enhanced HERV-expression is associated with chemoresistance in colon carcinomas which

  15. Foxp3-dependent transformation of human primary CD4+ T lymphocytes by the retroviral protein tax.

    Science.gov (United States)

    Chen, Li; Liu, Dan; Zhang, Yang; Zhang, Huan; Cheng, Hua

    2015-10-23

    The retroviral Tax proteins of human T cell leukemia virus type 1 and 2 (HTLV-1 and -2) are highly homologous viral transactivators. Both viral proteins can immortalize human primary CD4+ memory T cells, but when expressed alone they rarely transform T cells. In the present study, we found that the Tax proteins displayed a differential ability to immortalize human CD4+Foxp3+ T cells with characteristic expression of CTLA-4 and GITR. Because epidermal growth factor receptor (EGFR) was reportedly expressed and activated in a subset of CD4+Foxp3+ T cells, we introduced an activated EGFR into Tax-immortalized CD4+Foxp3+ T cells. We observed that these modified cells were grown independently of exogenous IL-2, correlating with a T cell transformation phenotype. In Tax-immortalized CD4+Foxp3- T cells, ectopic expression of Foxp3 was a prerequisite for Tax transformation of T cells. Accordingly, treatment of the transformed T cells with erlotinib, a selective inhibitor of EGFR, induced degradation of EGFR in lysosome, consequently causing T cell growth inhibition. Further, we identified autophagy as a crucial cellular survival pathway for the transformed T cells. Silencing key autophagy molecules including Beclin1, Atg5 and PI3 kinase class III (PI3KC3) resulted in drastic impairment of T cell growth. Our data, therefore, unveiled a previously unidentified role of Foxp3 in T cell transformation, providing a molecular basis for HTLV-1 transformation of CD4+Foxp3+ T cells. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Onicolisis exudativa y paroniquia bacteriana aguda en relacion con BIBF-1120 y paclitaxel: respuesta a la terapia topica

    National Research Council Canada - National Science Library

    Freites-Martinez, Azael; Martinez-Sanchez, Diego; Puente de Pablo, Nieves; Calderon-Komaromy, Angelica; Cordoba, Susana; Burbujo, Jesus

    2014-01-01

    .... A la semana de iniciar la terapia topica, se observo una paroniquia bacteriana con la perdida de la una del quinto dedo de la mano izquierda, con cultivos positivos para Staphylococcus aureus sensible a meticilina...

  17. Conducta suicida: consideraciones prácticas para la implementación de la terapia cognitiva

    National Research Council Canada - National Science Library

    Ronald Toro

    2013-01-01

    .... Puede tratarse con Terapia Cognitiva (TC), la cual ha demostrado efectividad en esta problematica, basada en la modificacion de cogniciones negativas y estilos disfuncionales de afrontamiento, reduccion de desercion, adherencia a servicios...

  18. Pseudotyping and culture conditions affect efficiency and cytotoxicity of retroviral gene transfer to human corneal endothelial cells.

    Science.gov (United States)

    Valtink, Monika; Stanke, Nicole; Knels, Lilla; Engelmann, Katrin; Funk, Richard H W; Lindemann, Dirk

    2011-08-29

    To evaluate retroviral vectors as a tool to transduce normal human corneal endothelial cells (HCECs) and to optimize transduction to increase gene transfer efficiency. Enhanced green fluorescent protein (EGFP) encoding retroviral vectors based on HIV-1 or murine leukemia virus (MLV), pseudotyped with either vesicular stomatitis virus glycoprotein (VSV-G) or a modified foamy virus envelope protein (FV Env), and prototype foamy virus (PFV) were produced. Transduction was performed in four HCEC culture media that were previously described for specific cultivation of HCECs or organ culture of donor corneas, namely enriched HCEC growth medium F99(HCEC), its unsupplemented basal medium F99, MEM + 2% fetal calf serum (FCS) (MEM), and Human Endothelial-SFM (SFM). Transduction efficiency was evaluated by marker gene transfer assay, and cytotoxic effects of virus infection were evaluated by means of resazurin conversion assay. PFV- and HIV-1-based vectors showed superior transduction efficiency compared with MLV-based vectors. Pseudotyping with a modified FV Env increased transduction efficiency compared with pseudotyping with VSV-G. In medium SFM, transduction efficiency of PFV, HIV-1-/FV Env, and MLV-based vectors was markedly reduced compared with the other culture media. When cells were cultured in F99-based media, cell viability was reduced by retroviral transduction compared with uninfected or mock infected controls, but remained unaffected when cells were cultured in SFM and was even increased when cells were cultured in MEM. HIV-1-based vectors pseudotyped with FV Env can efficiently be used to transduce primary HCECs in vitro. However, transduction efficiency is dependent on culture conditions and impairs metabolic activity and viability of HCECs in vitro.

  19. Aspectos funcionais e psicologicos imediatamente apos alta da Unidade de Terapia Intensiva: coorte prospectiva

    Directory of Open Access Journals (Sweden)

    Patrini Silveira Vesz

    2013-09-01

    Full Text Available OBJETIVO: Avaliar aspectos funcionais e psicológicos dos pacientes imediatamente após alta da unidade de terapia intensiva. MÉTODOS: Coorte prospectiva. Na primeira semana após alta da unidade de terapia intensiva, por meio de uma entrevista estruturada, foram aplicados questionários e escalas referentes à avaliação do grau de dependência e da capacidade funcional (escalas de Barthel modificada e Karnofsky, e aos problemas psíquicos (questionário hospitalar de ansiedade e depressão, além da escala de sonolência de Epworth, em todos os sobreviventes com mais de 72 horas de internação na unidade de terapia intensiva, admitidos de agosto a novembro de 2012. RESULTADOS: Nos 79 pacientes incluídos no estudo, houve aumento do grau de dependência após a alta da unidade de terapia intensiva, quando comparados aos dados pré-hospitalização, por meio da escala de Barthel modificada (57±30 versus 47±36; p40, o prejuízo foi uniforme em todas as categorias da escala de Barthel modificada (p<0,001. Já nos 15 pacientes previamente muito dependentes (Karnofsky <40, o prejuízo ocorreu somente nas categorias de higiene pessoal (p=0,01 e na capacidade de subir escadas (p=0,04. Na avaliação dos distúrbios psicológicos, os transtornos do humor (ansiedade e/ou depressão ocorreram em 31% dos pacientes e os distúrbios do sono em 43,3%. CONCLUSÃO: Em pacientes internados na unidade de terapia intensiva por 72 horas ou mais, observaram-se redução da capacidade funcional e aumento do grau de dependência na primeira semana após alta da unidade de terapia intensiva, bem como elevada incidência de sintomas depressivos, de ansiedade e distúrbios do sono.

  20. Terapia comunitária: relato de uma experiência

    Directory of Open Access Journals (Sweden)

    Ângela Cristina Nogueira

    2017-03-01

    Full Text Available No presente trabalho apresentamos uma experiência de Terapia Comunitária Integrativa, realizada em classes do ensino médio, no Colégio Modelo Luís Eduardo Magalhães, situado em um bairro de periferia da cidade de Salvador, pertencente à rede pública do Estado da Bahia. O objetivo principal do trabalho consistiu em acolher pessoas da comunidade escolar (alunos, pais, mães, avós e/ou responsáveis e da administração do Colégio (direção, coordenadores, professores e funcionários, na tentativa de promover mudanças nas atitudes dessas Instituições, de pessoas outras ligadas ao processo de educação, dos alunos e familiares envolvidos, da comunidade a que pertencem e, consequentemente, da Sociedade como um todo. A metodologia utilizada consistiu, primeiramente em criar espaço necessário, dentro do horário escolar em paralelo com a atividade curricular normal onde foram realizadas rodas de terapia, visando o desenvolvimento do aluno como ser humano e como cidadão. Essas rodas de terapia, cuja característica é ser trabalho grupal aberto, foram desenvolvidas no período de Maio/2010 a Junho/2011, com alunos da primeira, segunda e terceira séries, e com professores dessas classes, nos turnos matutino e vespertino. Depoimentos e questionários aplicados, nesse período, nas rodas de terapia comunitária nos deram subsídios para dados estatísticos que anexaremos ao trabalho. Embora os resultados ainda não tenham sido aferidos no aspecto quantitativo, os depoimentos de professores e alunos e responsáveis atestam o êxito obtido nos resultados das rodas de terapia comunitária, ali realizadas, o que nos leva a concluir que vale a pena continuar investindo e lutando pela inclusão da Terapia Comunitária na Educação.

  1. Quantification of in vitro retroviral replication using a one-tube real-time RT-PCR system incorporating direct RNA preparation.

    Science.gov (United States)

    Bisset, L R; Bosbach, S; Tomasik, Z; Lutz, H; Schüpbach, J; Böni, J

    2001-02-01

    The methodological and logistic benefits gained from assessing in vitro antiretroviral replication using one-tube real-time RT-PCR procedures are currently diminished by a continuing need for prior RNA isolation. We now report a simple and inexpensive modification of a commercially available one-tube RT-PCR assay, consisting of detergent-based virus lysis in the presence of a ribonuclease inhibitor, which can be used to directly quantify retroviral RNA levels in culture supernatant. This approach circumvents the potential loss of RNA inherent to RNA-isolation procedures based on prior extraction and demonstrates a dynamic range of at least 4 logs. Using in vitro culture systems incorporating either HIV-1 or FIV, we show that this ability to isolate retroviral RNA directly during the RT-PCR process can provide an equivalent alternative to one of the more time and resource-consuming steps in quantifying in vitro retroviral RNA levels.

  2. Optimised retroviral infection of human epidermal keratinocytes: long-term expression of transduced integrin gene following grafting on to SCID mice.

    Science.gov (United States)

    Levy, L; Broad, S; Zhu, A J; Carroll, J M; Khazaal, I; Péault, B; Watt, F M

    1998-07-01

    Previous attempts to achieve long-term gene expression in retrovirally transduced human epidermal keratinocytes in vivo have been largely unsuccessful. This has been variously attributed to a failure to target epidermal stem cells, suboptimal grafting conditions or inactivation of the retroviral vector. In an attempt to overcome these problems we expressed the chick beta 1 integrin subunit in primary human epidermal keratinocytes, which allowed us to monitor retroviral gene expression on a cell-by-cell basis. We describe optimised methods for selecting high-titre amphotropic packaging cells and for infecting keratinocytes in culture. When transduced cells were grafted into mice, graft survival was comparable in nude and SCID mice, but it was essential to combine the keratinocytes with a dermal substrate. Using these methods the majority of keratinocytes expressed the chick beta 1 integrin subunit for at least 16 weeks after grafting. We conclude that epidermal keratinocytes are attractive recipient cells for gene therapy.

  3. Beneficios de la terapia con resistómetro inspiratorio en los pacientes con esclerosis multiple frente a terapias respiratorias convencionales

    OpenAIRE

    Martín Sánchez, Carlos

    2016-01-01

    [ES] La Universidad de Salamanca (USAL) a través del programa de Doctorado en Oncología Clínica realiza un estudio con ASPRODES, la Asociación Salmantina de Esclerosis Múltiple (ASDEM) y la Asociación Zamorana de Esclerosis Múltiple (AZDEM) para llevar a cabo un estudio experimental con el fin de analizar las ventajas que la terapia respiratoria con resistómetro inspiratorio puede aportar a los pacientes con Esclerosis Múltiple frente a las técnicas de fisioterapia respiratoria convencional. ...

  4. Foto personali e foto di famiglia come strumento per la terapia. Il “Come, Cosa e Perché” delle tecniche di FotoTerapia

    Directory of Open Access Journals (Sweden)

    Judy Weiser

    2010-12-01

    Full Text Available L’articolo spiega come e perché, l’utilizzo delle foto personali e quelle di famiglia delle persone in terapia durante il loro trattamento (“Tecniche di FotoTerapia” possa aumentare e approfondire tale processo, e migliorare la qualità dei risultati terapeutici. Si descrive come le foto creino un ponte in grado di raggiungere aree profonde del vissuto del cliente dove le parole non possono arrivare – fornendo quindi un eccellente mezzo per esaminare ed esplorare i sentimenti con il minimo dell’interferenza e delle difese cognitive. Basato sul principio che le fotografie presentano accanto ai dettagli visivi un contenuto emotivo, questo articolo mostra come il terapeuta formato nelle Tecniche di FotoTerapia possa usare le foto personali e quelle di famiglia del cliente per evocare ricordi, richiamare sentimenti, riconnettere pensieri, nascondere segreti, e portare alla luce il passato con nuove modalità. Si mostra come le Tecniche di FotoTerapia siano basate sul fatto che tutte le fotografie parlano il linguaggio metaforico e simbolico dell’inconscio, senza usare le parole, e quindi ogni immagine fotografica è in grado, indipendentemente dalla modalità preferita dal terapeuta, di raggiungere informazioni e sentimenti precedentemente bloccati o fortemente difesi. Dopo l’” Introduzione” e le Sezioni relative alle “Arti (e Arte Terapia” e “Fotografie (e Fotografia” che propongono le basi teoriche delle tecniche di FotoTerapia, l’articolo procede da una rassegna generale dell’“Uso delle Fotografie nella Pratica Terapeutica” a una spiegazione più dettagliata della “Cornice di Lavoro delle Tecniche di FotoTerapia”, discutendo i principi e le specifiche applicazioni di ogni tecnica, da usare singolarmente o in combinazione con le altre. È inoltre inclusa una comparazione tra le tecniche di “FotoTerapia” e le analoghe applicazioni sia della “Foto Arte Terapia” che della “Fotografia Terapeutica

  5. A new family of retroviral long terminal repeat elements in the human genome identified by their homologies to an element 5{prime} to the spider monkey haptoglobin gene

    Energy Technology Data Exchange (ETDEWEB)

    Erickson, L.M.; Maeda, N. [Univ. of North Carolina, Chapel Hill, NC (United States)

    1995-06-10

    A new family of retroviral long terminal repeats that we name Spm-LTR has been identified as a result of DNA sequence comparisons between the entire Gen-Bank databank and an element, SPHP, located 5{prime} to the haptoglobin gene of spider monkeys. The 18 human Spm-LTR sequences so identified fall into three subtypes. There is no sequence similarity between Spm-LTR elements and any endogenous retroviral LTR sequences previously reported except for general features that define LTRs. However, a previously described repeated sequence (MER-4) forms a portion of the Spm-LTR sequence. 13 refs., 1 fig., 1 tab.

  6. Terapia de reidratação oral no setor de emergência

    OpenAIRE

    Vieira da Costa, Auxiliadora Damianne P.; Gisélia Alves Pontes da Silva

    2011-01-01

    OBJETIVO: Descrever o manejo da diarreia aguda na emergência, explorando fatores associados à prescrição da terapia de reidratação oral (TRO) versus terapia de reidratação venosa (TRV) para crianças com desidratação não grave. MÉTODOS: Estudo descritivo conduzido de janeiro a maio de 2008 em duas unidades de emergência em Recife (PE), A e B, sendo a emergência B vinculada a um hospital-escola, com observação do manejo de crianças com desidratação não grave por diarreia aguda. As principais va...

  7. Terapia fotodinâmica em carcinoma basocelular periocular: relato de caso

    Directory of Open Access Journals (Sweden)

    Rachel Camargo Carneiro

    2012-12-01

    Full Text Available Os autores descrevem a aplicação de terapia fotodinâmica com cloridrato de aminolevulinato de metila (Metivix® em uma paciente com carcinoma basocelular padrão misto (nodular e infiltrativo em pálpebra inferior de olho direito. Os efeitos colaterais sobre o olho foram avaliados semanalmente. Foi submetida à biòpsia incisional com punch de 2 mm para controle de cura após 12 semanas de tratamento. O anátomopatológico revelou ausência de neoplasia. O tratamento padrão ouro reconhecido mundialmente é a exérese da lesão, porém a terapia fotodinâmica com cloridrato de aminolevulinato de metila (MAL surge como uma opção terapêutica à cirurgia.

  8. Terapias compressivas no tratamento de úlcera venosa: estudo bibliométrico

    Directory of Open Access Journals (Sweden)

    Júlia Teixeira Nicolosi

    2015-01-01

    Full Text Available Introducción: úlceras de origen venosas son lesiones cutáneas que generalmente acometen el tercio inferior de las piernas. El trata - miento de estas heridas es dinámico y depende de la evolución de las fases de la reparación del tejido. Este tratamiento incluye métodos clínicos y quirúrgicos, y la terapia compresiva es el método no quirúrgico más utilizado. Entre las terapias compresivas, se destacan los vendajes inelásticos y elásticos, medias elásticas y presión neumática intermitente. Objetivo: este estudio buscó identificar el perfil de la producción científica nacional e internacional que describiera la terapia compresiva y la úlcera venosa para clasificarla de acuerdo con: cronología de publicación, procedencia, periódicos en que están publicadas, evaluación del “ Qualis ” — coordinación de perfeccionamiento de personal de nivel superior (Capes, distribución del abordaje metodológico, análisis del contenido de las publicaciones y comparar, cuando fuera posible, los datos presentados en esta revisión. Método: estudio bibliométrico realizado en las bases de datos Medline, Lilacs y CINAHL en el que se utilizaron los descriptores “ Varicose Ulcer/therapy ” , “ Compression Bandages ” , “ Wound Healing ” y el opera - dor booleano AND entre los años de 2009 a 2013. Resultados: se seleccionaron 47 artículos; la mayoría de ellos publicados en 2012 (n = 12; 25,53 % , en Estados Unidos (n=14; 29,78 % y Reino Unido (n=14; 29,78 % , en revistas de especialidad vascular (n=19; 40,42 % , con evaluaciones A2 (n=13; 27,65 % y B1 (n=13; 27,65 % . La parte más grande de la metodología utilizada en los estudios seleccionados fue tipo “ estudios clínicos ” (n= 30; 63,82 % . Entre los estudios clínicos y metanálisis, apenas 30 % (n= 14 presentaban como objetivo principal evaluación de la terapia compresiva y estudiaban comparativamente eficacia de vendajes elásticos, inelásticos, medias el

  9. A Gestalt-terapia na universidade: da f(ô)rma à boa forma

    OpenAIRE

    Luciana Loyola Madeira Soares

    2009-01-01

    Este texto apresenta uma discussão sobre as características do trabalho de supervisão em Gestalt-terapia nos Serviços de Psicologia Aplicada dos cursos de graduação em Psicologia. Com uma presença que ainda pode ser considerada recente na universidade, a Gestalt-terapia propõe uma abordagem no estágio em Psicologia Clínica que não se confunde com uma formação de gestalt-terapeutas. Sua estratégia passa pelo desdobramento de possibilidades criativas da relação do supervisor com o estagiário e,...

  10. La estructura de la pareja: implicaciones para la terapia cognitivo conductual

    Directory of Open Access Journals (Sweden)

    JOSÉ ANTONIO GARCÍA HIGUERA

    2002-01-01

    Full Text Available La terapia de pareja cognitivo conductual ha mostrado su eficacia de manera empírica (Chambless et al., 1998. Sin embargo, existen limitaciones (Christensen y Heavey 1999 que indican la necesidad de su potenciación. Este artículo repasa la situación de la terapia de pareja, con las aportaciones actuales, enmarcando todo ello en una visión estructural de la pareja, como ente social y relación diádica, que permita una compresión de los avances que se están dando, y aporte indicaciones sobre los caminos que seguirá en un futuro inmediato.

  11. Terapia complexa descongestiva no tratamento intensivo do linfedema: revisão sistemática

    OpenAIRE

    Paz, Isabel de Almeida; Fréz,Andersom Ricardo; Schiessl, Larissa; Ribeiro, Larissa Gulogurski; Preis, Cássio; Guérios, Lara

    2016-01-01

    RESUMO O linfedema caracteriza-se por acúmulo de proteínas e fluídos no interstício, com alterações físicas e psicológicas. Entre as técnicas fisioterapêuticas utilizadas para redução do linfedema está a terapia complexa descongestiva. O objetivo desta revisão é identificar evidências para a prática da terapia complexa descongestiva no tratamento intensivo do linfedema. Realizou-se uma busca nas bases de dados PubMed, EMBASE e PEDro. Os artigos selecionados foram estudos randomizados e de coo...

  12. Terapia comportamental construtiva: uma outra face da clínica comportamental

    Directory of Open Access Journals (Sweden)

    Luc Vandenberghe

    2007-12-01

    Full Text Available Este artigo apresenta a terapia comportamental construtiva conforme elaborada por Beata Bakker-de Pree. A abordagem, desenvolvida nos Países Baixos, traz uma filosofia do processo terapêutico que é compatível com a de várias terapias comportamentais conhecidas. Acrescenta uma perspectiva valiosa em sua descrição explícita de alguns ingredientes importantes do trabalho clínico, que não estão em destaque nos outros modelos comportamentais, sendo estas a técnica de diferenciação livre e a análise funcional do comportamento saudável do cliente.

  13. Terapia cognitivo-comportamental da depressão Cognitive-behavioral therapy for depression

    Directory of Open Access Journals (Sweden)

    Vania Bitencourt Powell

    2008-10-01

    Full Text Available OBJETIVO: Descrever o uso de técnicas cognitivas e revisar os estudos de eficácia da terapia cognitivo-comportamental no tratamento da depressão. MÉTODO: Revisão não-sistemática proveniente dos estudos originais, complementada por informações provenientes de metanálises e livros-texto especializados. RESULTADOS: Foram descritos os fundamentos da terapia cognitivo-comportamental no tratamento da depressão e revisadas as evidências de eficácia em curto e longo prazo. Discutimos igualmente o uso de tratamento farmacológico concomitante à terapia cognitivo-comportamental. CONCLUSÕES: A terapia cognitivo-comportamental é uma das abordagens que apresentam mais evidências empíricas de eficácia no tratamento da depressão, quer oferecida de forma isolada ou em combinação com farmacoterapia.OBJECTIVE: To describe the use of cognitive techniques and to review studies on the efficacy of CBT in the treatment of depression. METHOD: A non-systematic review of the literature of original studies complemented with data from meta-analyses and specialized textbooks. RESULTS: The fundamentals of cognitive-behavioral therapy in the treatment of depression are described and the evidence of short- and long-term efficacy is reviewed. The use of pharmacological therapy in conjunction with CBT is also discussed. CONCLUSIONS: CBT in the treatment of depression is one of the therapeutic modalities with the highest empirical evidence of efficacy, whether applied alone or in combination with pharmacotherapy.

  14. Terapia EMDR en el trastorno límite de personalidad

    Directory of Open Access Journals (Sweden)

    Dolores Mosquera

    2013-06-01

    Full Text Available Los trastornos de personalidad se han asociado a problemas de apego y trauma temprano, siendo de todos ellos el trastorno límite el que presenta unos porcentajes más elevados. La aplicación de terapias orientadas al trauma como EMDR (Desensibilización y Reprocesamiento por Movimientos Oculares en estos trastornos ofrece interesantes posibilidades para su abordaje.

  15. TERAPIA ELÉCTRICA EN CARDIOLOGÍA Electrical Therapy in cardiology

    Directory of Open Access Journals (Sweden)

    Guillermo Mora Pabón

    2005-01-01

    Full Text Available La terapia eléctrica en cardiología está encaminada a transferir electrones al miocardio, su mayor utilidad está dada en la cardioversión y desfibrilación. La terapia eléctrica cumple las leyes de la electricidad y el mayor factor a vencer es la impedancia o resistencia al flujo de electrones. Para mejorar la efectividad de la terapia eléctrica se han ideado diferentes formas en la onda de choque, en la duración y la polaridad. La terapia eléctrica ha logrado consolidarse como el tratamiento de elección del paro cardiorrespiratorio secundario a fibrilación ventricular y taquicardia ventricular sin pulso. Es igualmente el tratamiento de elección en taquiarritmias con compromiso hemodinámico. Pese a sus grandes ventajas tiene efectos secundarios que se deben conocer adecuadamente para dar un tratamiento oportuno.Electrical shock in cardiology are pursuid transfer of electrons to the myocardium. Its main indications are`s cardioversion and defibrillation. The electrical shock therapy follows laws of electricity laws and consequently, its main difficulty is the impedance or resistance of electrons flow. To make better the effectiveness of this therapy, a number of improvements have been made on the shock wave, its duration, and polarity. The electric shock therapy has become the preferred treatment when dealing with cardiorespiratory arrest secondary, ventricular fibrillation and pulseless ventricular tachycardia. Similarly, it is the preferred treatment for ventricular tachyarrhythmia associated with hemodynamic compromise. Despite its significant advantages, this treatment causes secondary effects, which should adequately be known in order to provide a timely treatment.

  16. Tratamento cirúrgico e terapias adjuvantes na papilomatose respiratória

    Directory of Open Access Journals (Sweden)

    Melissa Ameloti Gomes Avelino

    2013-10-01

    Full Text Available Papilomatose respiratória recorrente ou papilomatose laríngea recorrente é uma doença da laringe, causada pelo papiloma vírus humano, caracterizada por lesões epiteliais verrucosas e, geralmente, recorrentes. Na literatura são descritos diversos tipos de tratamento, como cirurgia a frio, a laser e/ou uso de microdebridador, além das terapias adjuvantes; todas no sentindo de diminuir possíveis sequelas permanentes da doença. OBJETIVO: Realizar uma revisão de literatura a respeito desta doença com ênfase nas técnicas cirúrgicas e terapias adjuvantes mais utilizadas atualmente. MÉTODO: Utilizou-se a metodologia de revisão bibliográfica, por meio de levantamentos em base de dados eletrônicos de domínio público, entre 1992-2012, utilizando-se as palavras-chave: papiloma, infecções por papillomavírus, laringe, terapêutica, vacinas contra papillomavírus. RESULTADOS: Foram levantados 357 artigos, dos quais 49 foram usados como base para esta revisão. Os trabalhos científicos apontam para a redução de recidiva na maioria das terapêuticas adjuvantes. Entretanto, o levantamento demonstrou metodologias e amostras diferentes, o que não permitiu comparar os tipos de tratamento e de terapias adjuvantes. CONCLUSÃO: A escolha da técnica cirúrgica varia entre os autores, porém, há uma tendência atual ao uso do microdebridador. As terapias adjuvantes recentes, como cidofovir, vacina tetravalente contra o papiloma vírus humano e bevacizumab, necessitam de estudos mais amplos.

  17. Asistencia ventricular izquierda para terapia de destino: primera experiencia en septuagenarios

    OpenAIRE

    Sebastian V. Rojas; Murat Avsar; Jasmin S. Hanke; Aitor Uribarri; Sara Rojas-Hernandez; Pedro L. Sanchez; José M. González-Santos; Axel Haverich; Jan D. Schmitto

    2016-01-01

    Objetivos: Durante los últimos años el número de pacientes de avanzada edad que presentan insuficiencia cardíaca congestiva se ha incrementado de manera dramática. En el contexto del estancamiento global del trasplante cardíaco nace la necesidad de una terapia definitiva alternativa para estos pacientes. Recientemente, los dispositivos de asistencia ventricular izquierda (DAVI) han experimentado un auge, sobrepasando incluso el número de pacientes trasplantados mundialmente. El desarrollo tec...

  18. Habilidades Clínicas en la Terapia Conductual Tercera Generación

    Directory of Open Access Journals (Sweden)

    Jorge Barraca Mairal

    2009-01-01

    Full Text Available En este artículo se repasan las técnicas de tres de las terapias de tercera generación conductual (Terapia de Aceptación y Compromiso, Psicoterapia Analítico Funcional y Terapia Conductual Dialéctica para reflexionar sobre el tipo de destrezas que el terapeuta debe desarrollar si pretende lograr una actuación competente al practicarlas. Este examen lleva a distinguir entre: (1 habilidades de escucha y discriminación de respuesta; (2 habilidades de fluidez, repertorio y competencia verbal; (3 habilidades de ejecución motora; (4 habilidades de imaginación-creatividad; (5 habilidades de conexión-empatía; y (6 otras habilidades (trabajo en grupo entre terapeutas, meditación, atención plena, etc.. Un análisis de estas destrezas permite concluir que los nuevos desarrollos parten de las tradicionales habilidades del terapeuta cognitivo-conductual pero replanteadas y con formas decididamente más elaboradas. Por otro lado, se revela que las competencias habitualmente entrenadas en la licenciatura, así como las que pueden derivarse exclusivamente de la lectura de los textos en que se divulgan estas terapias, resultan limitadas para un trabajo eficaz dentro de estos nuevos modelos. En conclusión, se propone la implementación de una formación práctica o procedimental a través de talleres, materiales audio-visuales y supervisión de casos.

  19. Lack of evidence for retroviral infections formerly related to chronic fatigue in Spanish fibromyalgia patients.

    Science.gov (United States)

    Oltra, Elisa; García-Escudero, María; Mena-Durán, Armando Vicente; Monsalve, Vicente; Cerdá-Olmedo, Germán

    2013-11-11

    types of retroviral infection formerly associated to chronic fatigue does not rule out the possibility that other viruses are involved in inciting or maintaining fibromyalgia and/or chronic fatigue conditions.

  20. Analysis of Prototype Foamy Virus particle-host cell interaction with autofluorescent retroviral particles

    Directory of Open Access Journals (Sweden)

    Schwille Petra

    2010-05-01

    succeeded for the first time in identifying two cell lines resistant to Prototype Foamy Virus Env-mediated gene transfer. Interestingly, both cell lines still displayed FV Env-dependent attachment of fluorescent retroviral particles, implying a post-binding block potentially due to lack of putative FV entry cofactors. These cell lines might ultimately lead to the identification of the currently unknown ubiquitous cellular entry receptor(s of FVs.

  1. Analysis of prototype foamy virus particle-host cell interaction with autofluorescent retroviral particles.

    Science.gov (United States)

    Stirnnagel, Kristin; Lüftenegger, Daniel; Stange, Annett; Swiersy, Anka; Müllers, Erik; Reh, Juliane; Stanke, Nicole; Grosse, Arend; Chiantia, Salvatore; Keller, Heiko; Schwille, Petra; Hanenberg, Helmut; Zentgraf, Hanswalter; Lindemann, Dirk

    2010-05-17

    resistant to Prototype Foamy Virus Env-mediated gene transfer. Interestingly, both cell lines still displayed FV Env-dependent attachment of fluorescent retroviral particles, implying a post-binding block potentially due to lack of putative FV entry cofactors. These cell lines might ultimately lead to the identification of the currently unknown ubiquitous cellular entry receptor(s) of FVs.

  2. Retroviral insertional mutagenesis identifies Zeb2 activation as a novel leukemogenic collaborating event in CALM-AF10 transgenic mice.

    Science.gov (United States)

    Caudell, David; Harper, David P; Novak, Rachel L; Pierce, Rachel M; Slape, Christopher; Wolff, Linda; Aplan, Peter D

    2010-02-11

    The t(10;11) translocation results in a CALM-AF10 fusion gene in a subset of leukemia patients. Expression of a CALM-AF10 transgene results in leukemia, with prolonged latency and incomplete penetrance, suggesting that additional events are necessary for leukemic transformation. CALM-AF10 mice infected with the MOL4070LTR retrovirus developed acute leukemia, and ligation-mediated polymerase chain reaction was used to identify retroviral insertions at 19 common insertion sites, including Zeb2, Nf1, Mn1, Evi1, Ift57, Mpl, Plag1, Kras, Erg, Vav1, and Gata1. A total of 26% (11 of 42) of the mice had retroviral integrations near Zeb2, a transcriptional corepressor leading to overexpression of the Zeb2-transcript. A total of 91% (10 of 11) of mice with Zeb2 insertions developed B-lineage acute lymphoblastic leukemia, suggesting that Zeb2 activation promotes the transformation of CALM-AF10 hematopoietic precursors toward B-lineage leukemias. More than half of the mice with Zeb2 integrations also had Nf1 integrations, suggesting cooperativity among CALM-AF10, Zeb2, and Ras pathway mutations. We searched for Nras, Kras, and Ptpn11 point mutations in the CALM-AF10 leukemic mice. Three mutations were identified, all of which occurred in mice with Zeb2 integrations, consistent with the hypothesis that Zeb2 and Ras pathway activation promotes B-lineage leukemic transformation in concert with CALM-AF10.

  3. Comprehensive profiling of retroviral integration sites using target enrichment methods from historical koala samples without an assembled reference genome

    Directory of Open Access Journals (Sweden)

    Pin Cui

    2016-03-01

    Full Text Available Background. Retroviral integration into the host germline results in permanent viral colonization of vertebrate genomes. The koala retrovirus (KoRV is currently invading the germline of the koala (Phascolarctos cinereus and provides a unique opportunity for studying retroviral endogenization. Previous analysis of KoRV integration patterns in modern koalas demonstrate that they share integration sites primarily if they are related, indicating that the process is currently driven by vertical transmission rather than infection. However, due to methodological challenges, KoRV integrations have not been comprehensively characterized. Results. To overcome these challenges, we applied and compared three target enrichment techniques coupled with next generation sequencing (NGS and a newly customized sequence-clustering based computational pipeline to determine the integration sites for 10 museum Queensland and New South Wales (NSW koala samples collected between the 1870s and late 1980s. A secondary aim of this study sought to identify common integration sites across modern and historical specimens by comparing our dataset to previously published studies. Several million sequences were processed, and the KoRV integration sites in each koala were characterized. Conclusions. Although the three enrichment methods each exhibited bias in integration site retrieval, a combination of two methods, Primer Extension Capture and hybridization capture is recommended for future studies on historical samples. Moreover, identification of integration sites shows that the proportion of integration sites shared between any two koalas is quite small.

  4. Terapias cognitivo conductuales para el tratamiento de los trastornos de personalidad

    Directory of Open Access Journals (Sweden)

    Manuela Navarro-Leis

    2013-06-01

    Full Text Available Se han propuesto muchos tratamientos psicológicos para el abordaje de los trastornos de personalidad, realizándose gran variedad de estudios para comprobar la eficacia de los mismos. Y aunque hasta la fecha no se ha podido demostrar empíricamente que exista ningún tratamiento establecido como eficaz, si se ha demostrado que los tratamientos cognitivo conductuales y conductuales resultan probablemente eficaces para el tratamiento de estos trastornos, en concreto y de forma más específica para el Trastorno Límite de Personalidad. El objetivo de este trabajo es ofrecer una revisión a nivel teórico y empírico de los tres modelos de tratamiento considerados actualmente de mayor eficacia: Terapia Dialéctica Conductual, Terapia de Aceptación y Compromiso y Psicoterapia Analítico Funcional, incluidas dentro de las llamadas Terapias de conducta de tercera generación.

  5. Estilos de cuidar de enfermeiras na Terapia Intensiva mediados pela tecnologia

    Directory of Open Access Journals (Sweden)

    Rafael Celestino da Silva

    2014-04-01

    Full Text Available Objetivou-se analisar as representações sociais de enfermeiras de terapia intensiva sobre as práticas de cuidado, face à tecnologia. Realizou-se entrevistas com vinte e uma enfermeiras de um centro de terapia intensiva, em hospital público do Rio de Janeiro. Aplicouse análise lexical, com uso do Alceste 2010. Os resultados se organizaram em duas categorias, cada qual com três classes lexicais. A primeira trouxe o sentido da tecnologia na terapia intensiva e a organização dos estilos de cuidar; a segunda mostrou a condição do cliente e suas repercussões na prática de cuidar das enfermeiras. Concluiu-se que a tecnologia organiza os estilos de cuidar das enfermeiras, que se constroem na assistência ao cliente no contexto do trabalho. Estes conduzem as enfermeiras a atribuírem sentidos às suas práticas, levando-os a elaboração de modos de atuar em face das tecnologias.

  6. Tres casos interesantes de uso de terapia de vacío en neonatos

    Directory of Open Access Journals (Sweden)

    Ignacio Capdevila

    Full Text Available Antecedentes y Objetivos. La terapia de vacío es una herramienta adicional en el arsenal terapéutico actual del cirujano plástico y se aplica frecuentemente en el tratamiento de heridas complejas como paso intermedio hasta el tratamiento definitivo de las mismas, y como medida de disminución del tiempo que transcurre hasta su cierre. En el caso de los neonatos, es especialmente crítico conseguir disminuir este tiempo hasta el cierre definitivo de las heridas; sin embargo, la bibliografía al respecto no aporta suficiente información sobre el uso de esta modalidad terapéutica en épocas tempranas de la vida. Pretendemos por tanto compartir la experiencia clínica en este tema de nuestra Unidad de Cirugía Plástica Pediátrica. Material y Método. Describimos 3 casos en los que el uso de terapia de vacío permitió un tratamiento adecuado y definitivo de heridas de diferente etiología y diferentes localizaciones en pacientes neonatos. Conclusiones. Consideramos que la terapia de vacío constituye una excelente herramienta para la preparación de heridas complejas como paso previo al tratamiento definitivo y como una medida terapéutica segura también en neonatos.

  7. Terapia con anticuerpos monoclonales en Cardiología y Medicina Interna

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    Christian David Adams-Sánchez

    2016-07-01

    Full Text Available La terapia biológica basada en anticuerpos monoclonales, constituyen una nueva herramienta terapéutica, que de la mano del desarrollo de la biología molecular permiten intervenir puntos claves en la etiopatogenia de la enfermedad, permitiendo una terapia personalizada. Se han desarrollado nuevos anticuerpos monoclonales que intervienen en las enfermedades cardiovasculares, por lo que el entendimiento de los principios terapéuticos, los tipos y el mecanismo de acción de estos fármacos es esencial para un uso adecuado. En este artículo se discutirá el perfil de los anticuerpos monoclonales en la enfermedad cardiovascular, como los inhibidores de la PCSK-9 y el antídoto del Dabigatran, pasando por las moléculas ya conocidas como el abciximab, el antídoto de la digoxina y la terapia inmunomoduladora en el trasplante cardiaco. Del mismo modo, se evalúa una posible aplicación de los anticuerpos monoclonales usados en reumatología que podrían tener un papel importante en el manejo de las enfermedades cardiovasculares.

  8. Queratinocitos derivados de piel humana modificados por el vector retroviral FOCH 29-NeoR

    Directory of Open Access Journals (Sweden)

    Luz Marina Restrepo

    2000-02-01

    Full Text Available

    En este protocolo se evaluará la eficiencia de la transducción mediada por el vector retroviral FOCH 29-NeoR derivado del virus de Friend; éste ha mostrado una alta eficiencia en la transducción, tanto de células madres hematopoyéticas como de otras líneas celulares. Se medirá su eficiencia de transducción en cultivos primarios de queratinocitos, derivados de biopsias de piel humana o de sobrantes de procedimientos quirúrgicos como circuncisiones, mastectomías y cirugía cosmética de pacientes que consultan el Hospital Universitario San Vicente de Paul, Hospital la María, la Clínica del Rosario y la Clínica León XIII.

    Las muestras de piel se procesarán en un lapso no superior a 12 horas, se eliminará el exceso de dermis y tejido conectivo por digestión con dispasa (0.6-2.4 U/ml a 37°C durante 1 hora. Las muestras serán lavadas con PBS, antibiótico (penicilina + estreptomicina y se cortarán en fragmentos de 1-2 mm; después de 2-3 horas de digestión con tripsina-EDTA (0.25% las células serán resuspendidas en KGM (Medio de crecimiento para queratinocitos y se sembrarán a una concentración de 105 - 3x105 células por plato de 100 mm; se incubarán a 37°C, 5% CO2 con cambios de medio 2-3 veces por semana. Se harán subcultivos con el fin de expandirlos y congelar una parte de las

  9. Use of bicistronic retroviral vectors encoding the LacZ gene together with a gene of interest: a method to select producer cells and follow transduced target cells

    NARCIS (Netherlands)

    Staal, F. J.; Bakker, A. Q.; Verkuijlen, M.; van Oort, E.; Spits, H.

    1996-01-01

    The coordinate expression of a marker gene and a therapeutic gene in one retroviral vector has considerable advantages. High-titer producer lines can potentially be selected on the basis of marker gene expression, and the expression of transduced genes in target cells can readily be followed.

  10. Cholesterol Supplementation During Production Increases the Infectivity of Retroviral and Lentiviral Vectors Pseudotyped with the Vesicular Stomatitis Virus Glycoprotein (VSV-G).

    Science.gov (United States)

    Chen, Yong; Ott, Christopher J; Townsend, Kay; Subbaiah, Papasani; Aiyar, Ashok; Miller, William M

    2009-05-15

    Cholesterol, a major component of plasma membrane lipid rafts, is important for assembly and budding of enveloped viruses, including influenza and HIV-1. Cholesterol depletion impairs virus assembly and infectivity. This study examined the effects of exogenous cholesterol addition (delivered as a complex with methyl beta cyclodextrin) on the production of Molony murine leukemia virus retroviral vector and HIV-1-based lentiviral vector pseudotyped with the vesicular stomatitis virus glycoprotein (VSV-G). Cholesterol supplementation before and during vector production enhanced the infectivity of retroviral and lentiviral vectors up to 4-fold and 6-fold, respectively. In contrast, the amount of retroviral vector produced was unchanged, and that of lentiviral vector was increased less than two-fold. Both free cholesterol and cholesterol ester content in 293-gag-pol producer cells increased with cholesterol addition. In contrast, the phospholipids headgroup composition was essentially unchanged by cholesterol supplementation in 293-gag-pol packaging cells. Based on these results, it is proposed that cholesterol supplementation increases the infectivity of VSV-G-pseudotyped retroviral and lentiviral vectors, possibly by altering the composition of the producer cell membrane where the viral vectors are assembled and bud, and/or by changing the lipid composition of the viral vectors.

  11. Inhibition of histone deacetylation in 293GPG packaging cell line improves the production of self-inactivating MLV-derived retroviral vectors

    Directory of Open Access Journals (Sweden)

    Crosato Milena

    2006-04-01

    Full Text Available Abstract Background Self-inactivating retroviral vectors (SIN are often associated with very low titers. Promoter elements embedded within SIN designs may suppress transcription of packageable retroviral RNA which in turn results in titer reduction. We tested whether this dominant-negative effect involves histone acetylation state. We designed an MLV-derived SIN vector using the cytomegalovirus immediate early enhancer-promoter (CMVIE as an embedded internal promoter (SINCMV and transfected the pantropic 293GPG packaging cell line. Results The SINCMV retroviral producer had uniformly very low titers (~10,000 infectious retroparticles per ml. Northern blot showed low levels of expression of retroviral mRNA in producer cells in particular that of packageable RNA transcript. Treatment of the producers with the histone deacetylase (HDAC inhibitors sodium butyrate and trichostatin A reversed transcriptional suppression and resulted in an average 106.3 ± 4.6 – fold (P = 0.002 and 15.5 ± 1.3 – fold increase in titer (P = 0.008, respectively. A histone gel assay confirmed increased histone acetylation in treated producer cells. Conclusion These results show that SIN retrovectors incorporating strong internal promoters such as CMVIE, are susceptible to transcriptional silencing and that treatment of the producer cells with HDAC inhibitors can overcome this blockade suggesting that histone deacetylation is implicated in the mechanism of transcriptional suppression.

  12. HEMO, an ancestral endogenous retroviral envelope protein shed in the blood of pregnant women and expressed in pluripotent stem cells and tumors.

    Science.gov (United States)

    Heidmann, Odile; Béguin, Anthony; Paternina, Janio; Berthier, Raphaël; Deloger, Marc; Bawa, Olivia; Heidmann, Thierry

    2017-08-08

    Capture of retroviral envelope genes is likely to have played a role in the emergence of placental mammals, with evidence for multiple, reiterated, and independent capture events occurring in mammals, and be responsible for the diversity of present day placental structures. Here, we uncover a full-length endogenous retrovirus envelope protein, dubbed HEMO [human endogenous MER34 (medium-reiteration-frequency-family-34) ORF], with unprecedented characteristics, because it is actively shed in the blood circulation in humans via specific cleavage of the precursor envelope protein upstream of the transmembrane domain. At variance with previously identified retroviral envelope genes, its encoding gene is found to be transcribed from a unique CpG-rich promoter not related to a retroviral LTR, with sites of expression including the placenta as well as other tissues and rather unexpectedly, stem cells as well as reprogrammed induced pluripotent stem cells (iPSCs), where the protein can also be detected. We provide evidence that the associated retroviral capture event most probably occurred >100 Mya before the split of Laurasiatheria and Euarchontoglires, with the identified retroviral envelope gene encoding a full-length protein in all simians under purifying selection and with similar shedding capacity. Finally, a comprehensive screen of the expression of the gene discloses high transcript levels in several tumor tissues, such as germ cell, breast, and ovarian tumors, with in the latter case, evidence for a histotype dependence and specific protein expression in clear-cell carcinoma. Altogether, the identified protein could constitute a "stemness marker" of the normal cell and a possible target for immunotherapeutic approaches in tumors.

  13. An Efficient Large-Scale Retroviral Transduction Method Involving Preloading the Vector into a RetroNectin-Coated Bag with Low-Temperature Shaking

    Science.gov (United States)

    Dodo, Katsuyuki; Chono, Hideto; Saito, Naoki; Tanaka, Yoshinori; Tahara, Kenichi; Nukaya, Ikuei; Mineno, Junichi

    2014-01-01

    In retroviral vector-mediated gene transfer, transduction efficiency can be hampered by inhibitory molecules derived from the culture fluid of virus producer cell lines. To remove these inhibitory molecules to enable better gene transduction, we had previously developed a transduction method using a fibronectin fragment-coated vessel (i.e., the RetroNectin-bound virus transduction method). In the present study, we developed a method that combined RetroNectin-bound virus transduction with low-temperature shaking and applied this method in manufacturing autologous retroviral-engineered T cells for adoptive transfer gene therapy in a large-scale closed system. Retroviral vector was preloaded into a RetroNectin-coated bag and incubated at 4°C for 16 h on a reciprocating shaker at 50 rounds per minute. After the supernatant was removed, activated T cells were added to the bag. The bag transduction method has the advantage of increasing transduction efficiency, as simply flipping over the bag during gene transduction facilitates more efficient utilization of the retroviral vector adsorbed on the top and bottom surfaces of the bag. Finally, we performed validation runs of endoribonuclease MazF-modified CD4+ T cell manufacturing for HIV-1 gene therapy and T cell receptor-modified T cell manufacturing for MAGE-A4 antigen-expressing cancer gene therapy and achieved over 200-fold (≥1010) and 100-fold (≥5×109) expansion, respectively. In conclusion, we demonstrated that the large-scale closed transduction system is highly efficient for retroviral vector-based T cell manufacturing for adoptive transfer gene therapy, and this technology is expected to be amenable to automation and improve current clinical gene therapy protocols. PMID:24454964

  14. HIV-1 subtypes and mutations associated to antiretroviral drug resistance in human isolates from Central Brazil Subtipos e mutações associadas à resistência aos anti-retrovirais em isolados de HIV-1 do Distrito Federal

    Directory of Open Access Journals (Sweden)

    Daniela Marreco Cerqueira

    2004-09-01

    Full Text Available The detection of polymorphisms associated to HIV-1 drug-resistance and genetic subtypes is important for the control and treatment of HIV-1 disease. Drug pressure selects resistant variants that carry mutations in the viral reverse transcriptase (RT and protease (PR genes. For a contribution to the public health authorities in planning the availability of therapeutic treatment, we therefore described the genetic variability, the prevalence of mutations associated to drug resistance and the antiretroviral resistance profile in HIV-1 isolates from infected individuals in Central Brazil. Nineteen HIV-1 RNA samples from a Public Health Laboratory of the Federal District were reversely transcribed and cDNAs were amplified by nested PCR. One fragment of 297 bp coding the entire protease gene, and another of 647 bp, corresponding to the partial RT gene (codons 19-234, were obtained. Automated sequencing and BLAST analysis revealed the presence of 17 B and 2 F1 HIV-1 subtypes. The amino acid sequences were analyzed for the presence of resistance-associated mutations. A total of 6 PR mutations, 2 major and 4 accessory, and 8 RT mutations related to drug resistance were found. Our data suggest a high prevalence of HIV-1 B subtype in the studied population of Federal District as well as the presence of genetically-resistant strains in individuals failing treatment.A detecção de polimorfismos do HIV-1 que estejam associados à resistência às drogas anti-retrovirais e aos subtipos genéticos é importante para o controle e tratamento da infecção pelo HIV-1. A pressão exercida pela terapia anti-retroviral seleciona variantes resistentes com mutações nos genes virais da transcriptase reversa (RT e da protease (PR. Assim, visando contribuir com as autoridades de saúde pública na perspectiva de planejar a disponibilidade de um tratamento terapêutico, nós descrevemos a variabilidade genética e a prevalência de mutações associadas à resist

  15. 207. Terapia de resincronización cardíaca en la práctica clínica diaria. seguimiento a medio plazo

    Directory of Open Access Journals (Sweden)

    N. Miranda

    2012-04-01

    Conclusiones: La TRC es una terapia eficaz en el tratamiento de los pacientes con insuficiencia cardíaca refractaria al tratamiento convencional en nuestro medio. Es fundamental una correcta selección de los pacientes que van a ser sometidos a dicha terapia con vistas a mejorar la efectividad de ésta.

  16. La discrepancia entre la investigación y la práctica clínica de la terapia de conducta

    OpenAIRE

    Becoña Iglesias, Elisardo

    1999-01-01

    La terapia y modificación de conducta se ha consolidado como la terapia psicológica de mayor relevancia y eficacia en sus 40 años de existencia. Sin embargo cada vez más se hace evidente el surgimiento de discrepancias entre la investigación que sust

  17. An Optimized GD2-Targeting Retroviral Cassette for More Potent and Safer Cellular Therapy of Neuroblastoma and Other Cancers.

    Directory of Open Access Journals (Sweden)

    Simon Thomas

    Full Text Available Neuroblastoma is the commonest extra cranial solid cancer of childhood. Despite escalation of treatment regimens, a significant minority of patients die of their disease. Disialoganglioside (GD2 is consistently expressed at high-levels in neuroblastoma tumors, which have been targeted with some success using therapeutic monoclonal antibodies. GD2 is also expressed in a range of other cancer but with the exception of some peripheral nerves is largely absent from non-transformed tissues. Chimeric Antigen Receptors (CARs are artificial type I proteins which graft the specificity of a monoclonal antibody onto a T-cell. Clinical data with early CAR designs directed against GD2 have shown some promise in Neuroblastoma. Here, we describe a GD2-targeting CAR retroviral cassette, which has been optimized for CAR T-cell persistence, efficacy and safety.

  18. Target-cell-derived tRNA-like primers for reverse transcription support retroviral infection at low efficiency

    DEFF Research Database (Denmark)

    Schmitz, Alexander; Lund, Anders H; Hansen, Anette C

    2002-01-01

    Reverse transcription of a retroviral genome takes place in the cytoplasm of an infected cell by a process primed by a producer-cell-derived tRNA annealed to an 18-nucleotide primer-binding site (PBS). By an assay involving primer complementation of PBS-mutated vectors we analyzed whether tRNA...... primers derived from the target cell can sustain reverse transcription during murine leukemia virus (MLV) infection. Transduction efficiencies were 4-5 orders of magnitude below those of comparable producer-cell complementations. However, successful usage of a target-cell-derived tRNA primer was proven...... by cases of correction of single mismatches between Akv-MLV vectors and complementary tRNA primers toward the primer sequence in the integrated vector. Thus, target-cell-derived tRNA-like primers are able to initiate first-strand cDNA synthesis and plus-strand transfer leading to a complete provirus...

  19. Genome-wide retroviral insertional tagging of genes involved in cancer in Cdkn2a-deficient mice

    DEFF Research Database (Denmark)

    Lund, Anders H; Turner, Geoffrey; Trubetskoy, Alla

    2002-01-01

    We have used large-scale insertional mutagenesis to identify functional landmarks relevant to cancer in the recently completed mouse genome sequence. We infected Cdkn2a(-/-) mice with Moloney murine leukemia virus (MoMuLV) to screen for loci that can participate in tumorigenesis in collaboration...... retroviral integration sites and mapped them against the mouse genome sequence databases from Celera and Ensembl. In addition to 17 insertions targeting gene loci known to be cancer-related, we identified a total of 37 new common insertion sites (CISs), of which 8 encode components of signaling pathways...... that are involved in cancer. The effectiveness of large-scale insertional mutagenesis in a sensitized genetic background is demonstrated by the preference for activation of MAP kinase signaling, collaborating with Cdkn2a loss in generating the lymphoid and myeloid tumors. Collectively, our results show that large...

  20. Distinct roles of CD4+ T cell subpopulations in retroviral immunity: lessons from the Friend virus mouse model

    Directory of Open Access Journals (Sweden)

    Kassiotis George

    2011-09-01

    Full Text Available Abstract It is well established that CD4+ T cells play an important role in immunity to infections with retroviruses such as HIV. However, in recent years CD4+ T cells have been subdivided into several distinct populations that are differentially regulated and perform widely varying functions. Thus, it is important to delineate the separate roles of these subsets, which range from direct antiviral activities to potent immunosuppression. In this review, we discuss contributions from the major CD4+ T cell subpopulations to retroviral immunity. Fundamental concepts obtained from studies on numerous viral infections are presented along with a more detailed analysis of studies on murine Friend virus. The relevance of these studies to HIV immunology and immunotherapy is reviewed.

  1. FLT3 ligand preserves the uncommitted CD34+CD38- progenitor cells during cytokine prestimulation for retroviral transduction

    DEFF Research Database (Denmark)

    Nielsen, S D; Husemoen, L L; Sørensen, T U

    2000-01-01

    in a higher percentage of cells than the EGFP gene, but there seemed to be a positive correlation between expression of the two genes. The effect of cytokine prestimulation was therefore monitored using EGFP as marker for transduction. When SCF was compared to SCF in combination with more potent cytokines......Before stem cell gene therapy can be considered for clinical applications, problems regarding cytokine prestimulation remain to be solved. In this study, a retroviral vector carrying the genes for the enhanced version of green fluorescent protein (EGFP) and neomycin resistance (neo(r)) was used...... for transduction of CD34+ cells. The effect of cytokine prestimulation on transduction efficiency and the population of uncommitted CD34+CD38- cells was determined. CD34+ cells harvested from umbilical cord blood were kept in suspension cultures and stimulated with combinations of the cytokines stem cell factor...

  2. Identifying activated T cells in reconstituted RAG deficient mice using retrovirally transduced Pax5 deficient pro-B cells.

    Directory of Open Access Journals (Sweden)

    Nadesan Gajendran

    Full Text Available Various methods have been used to identify activated T cells such as binding of MHC tetramers and expression of cell surface markers in addition to cytokine-based assays. In contrast to these published methods, we here describe a strategy to identify T cells that respond to any antigen and track the fate of these activated T cells. We constructed a retroviral double-reporter construct with enhanced green fluorescence protein (EGFP and a far-red fluorescent protein from Heteractis crispa (HcRed. LTR-driven EGFP expression was used to enrich and identify transduced cells, while HcRed expression is driven by the CD40Ligand (CD40L promoter, which is inducible and enables the identification and cell fate tracing of T cells that have responded to infection/inflammation. Pax5 deficient pro-B cells that can give rise to different hematopoietic cells like T cells, were retrovirally transduced with this double-reporter cassette and were used to reconstitute the T cell pool in RAG1 deficient mice that lack T and B cells. By using flow cytometry and histology, we identified activated T cells that had developed from Pax5 deficient pro-B cells and responded to infection with the bacterial pathogen Listeria monocytogenes. Microscopic examination of organ sections allowed visual identification of HcRed-expressing cells. To further characterize the immune response to a given stimuli, this strategy can be easily adapted to identify other cells of the hematopoietic system that respond to infection/inflammation. This can be achieved by using an inducible reporter, choosing the appropriate promoter, and reconstituting mice lacking cells of interest by injecting gene-modified Pax5 deficient pro-B cells.

  3. Ancestral capture of syncytin-Car1, a fusogenic endogenous retroviral envelope gene involved in placentation and conserved in Carnivora.

    Science.gov (United States)

    Cornelis, Guillaume; Heidmann, Odile; Bernard-Stoecklin, Sibylle; Reynaud, Karine; Véron, Géraldine; Mulot, Baptiste; Dupressoir, Anne; Heidmann, Thierry

    2012-02-14

    Syncytins are envelope protein genes of retroviral origin that have been captured for a function in placentation. Two such genes have already been identified in simians, two distinct, unrelated genes have been identified in Muridae, and a fifth gene has been identified in the rabbit. Here, we searched for similar genes in the Laurasiatheria clade, which diverged from Euarchontoglires--primates, rodents, and lagomorphs--shortly after mammalian radiation (100 Mya). In silico search for envelope protein genes with full-coding capacity within the dog and cat genomes identified several candidate genes, with one common to both species that displayed placenta-specific expression, which was revealed by RT-PCR analysis of a large panel of tissues. This gene belongs to a degenerate endogenous retroviral element, with precise proviral integration at a site common to dog and cat. Cloning of the gene for an ex vivo pseudotype assay showed fusogenicity on both dog and cat cells. In situ hybridization on placenta sections from both species showed specific expression at the level of the invasive fetal villi within the placental junctional zone, where trophoblast cells fuse into a syncytiotrophoblast layer to form the maternofetal interface. Finally, we show that the gene is conserved among a series of 26 Carnivora representatives, with evidence for purifying selection and conservation of fusogenic activity. The gene is not found in the Pholidota order and, therefore, it was captured before Carnivora radiation, between 60 and 85 Mya. This gene is the oldest syncytin gene identified to date, and it is the first in a new major clade of eutherian mammals.

  4. Cuanta más psicología, mejor: eficacia para dejar de fumar. De la terapia cognitiva conductual intensiva y de los parches de nicotina combinados con terapia cognitiva conductual intensiva y menos intensiva

    OpenAIRE

    Ignacio Gabino Fernández Arias; María Paz García-Vera; Jesús Sanz

    2014-01-01

    Para comparar la eficacia para dejar de fumar de la terapia cognitiva conductual intensiva (TCC/I), la TCC/I con parches de nicotina (TCC/I+PN) y la terapia cognitiva conductual no intensiva con parches de nicotina (TCC/NI+PN) se realizó un estudio experimental de medidas repetidas con 235 fumadores adultos asignados aleatoriamente a uno de esos tres tratamientos. Entre los pacientes que completaron el tratamiento (n = 152) la TCC/I+PN mostró tasas de abstinencia a los 6 meses y al año, mayor...

  5. Relación empírica entre la Terapia Racional Emotivo-Conductual (TREC) de Ellis y la Terapia Cognitiva (TC) de Beck en una muestra costarricense

    OpenAIRE

    Cabezas Pizarro, Hannia; Lega, Leonor I.

    2012-01-01

    En este estudio se explora una posible relación empírica entre la terapia racional emotivoconductual (TREC) de Ellis y la terapia cognitiva (TC) de Beck, dos de los modelos más conspicuos en el campo de la psicoterapia cognitiva actual. Si bien este modelo utiliza el término “cognitivo” en forma tal que se encuentra asociado con el afecto, la fisiología y la conducta (Dobson, 1986), sostiene que las perturbaciones emocionales, en esencia, son causadas por el proceso cognitivo del individuo. E...

  6. Terapia fibrinolítica sistêmica no tromboembolismo pulmonar

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    José Manuel Ceresetto

    2017-05-01

    Full Text Available Resumo O tromboembolismo pulmonar permanece como um grande desafio terapêutico para os médicos especialistas, pois, apesar de todo investimento e desenvolvimento em seu diagnóstico, profilaxia e tratamento, essa condição continua sendo a principal causa de morte evitável em ambiente hospitalar. Ainda restam muitas dúvidas em relação a qual perfil de paciente vai se beneficiar de fato da terapia fibrinolítica sistêmica, sem ficar exposto a um grande risco de sangramento. A estratificação de risco e a avaliação do prognóstico do evento, através de escores clínicos de insuficiência ventricular direita, marcadores de dilatação e disfunção do ventrículo direito e avaliação da massa trombótica, associados ou de forma isolada, são ferramentas que podem auxiliar na identificação do paciente que irá se beneficiar dessa terapia. Os únicos consensos em relação à terapia fibrinolítica no tratamento do tromboembolismo pulmonar são: não deve ser indicada de forma rotineira; nenhum dos escores ou marcadores, isoladamente, devem justificar seu uso; e os pacientes com instabilidade hemodinâmica são os mais beneficiados. Além disto, deve-se avaliar cada caso em relação ao risco de sangramento, especialmente no sistema nervoso central.

  7. Terapia trombolítica en pacientes con infarto agudo de miocardio en Cienfuegos

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    Lázaro Abilio Hernández Rodríguez

    2014-03-01

    Full Text Available Fundamento: el tratamiento trombolítico practicado a menos de dos horas, tras el inicio del infarto tiene resultados similares a la reperfusión mecánica. Objetivo: describir aspectos relevantes de la terapia trombolítica en pacientes con infarto agudo de miocardio con elevación del segmento ST en Cienfuegos. Métodos: estudio descriptivo, prospectivo, en 225 pacientes egresados (vivos y fallecidos desde el 1o de abril de 2012 al 31 marzo de 2013, de la Unidad de Cuidados Integrales del Corazón y la Unidad de Cuidados Intensivos Polivalentes, del Hospital Dr. Gustavo Aldereguía Lima. Las variables estudiadas se obtuvieron de la revisión de las historias clínicas e incluyeron: variables demográficas y clínicas, tiempos de demora, sitio, motivo de exclusión y nivel de prioridad para la trombolisis. Resultados: la media de edad superó los 60 años. Predominaron los hombres, hipertensos y de alto riesgo según la escala GRACE. El 29,7 % de los pacientes no recibió terapia trombolítica, debido mayormente al factor tiempo y la mayoría (82,3 % se trató en el Hospital. Las medianas de los tiempos de demora: síntomas-puerta, puerta-droga y síntomas-droga fueron 90, 35 y 140 minutos respectivamente. Conclusiones: la trombolisis extrahospitalaria acorta el tiempo total de isquemia, pero pocos pacientes se beneficiaron de ella. Los retrasos para la terapia trombolítica en Cienfuegos continúan por encima de los estándares requeridos.

  8. A atuação do profissional fisioterapeuta em unidades de terapia intensiva neonatal

    Directory of Open Access Journals (Sweden)

    Rita Casciane Simão Reis Theis

    2016-06-01

    Full Text Available Objetivo: revisar na literatura atual, a atuação do profissional fisioterapeuta em unidades de terapia intensiva neonatal. Método: como estratégia, foi realizada busca nas bases de dados MEDLINE (via PubMed, Cochrane CENTRAL, Lilacs e PEDro, publicado nos últimos dez anos. Além de busca manual em referências de estudos já publicados sobre o assunto. Foram encontrados 20 artigos. A busca compreendeu os seguintes descritores "Fisioterapia motora”, “Unidade de terapia intensiva neonatal”, “técnicas fisioterapêuticas”, “Motor Physiotherapy”, “neonatal intensive care unit”, “physiotherapeutic techniques. Resultados: a fisioterapia é parte da assistência multiprofissional proporcionada nas unidades de terapia intensiva (UTIs. O contínuo desenvolvimento do tratamento fisioterapêutico nas UTIs neonatais levou às melhores técnicas e recursos para essa população. A fisioterapia motora está entre os procedimentos utilizados com a preocupação de diminuir atraso no desenvolvimento neuropsicomotor dos recém-nascidos (RNs. Conclusões: a função do fisioterapeuta no atendimento em UTIs neonatais é identificar o melhor tratamento, a fim de intervir precocemente nas possíveis disfunções motoras advindas do tempo de internação prolongado dos RNs. Cada vez mais, a inserção do profissional fisioterapeuta se faz necessário na assistência multidisciplinar ao recém-nascido pré-termo. Em geral, constatou-se que a fisioterapia desempenha um papel importante dentro das UTIs neonatais, promovendo resultados importantes na qualidade de vida desses recém-nascidos e seus familiares.

  9. Diferentes terapias na osteoartrite induzida por papaína em joelhos de ratos

    OpenAIRE

    Rosseto, Laryssa Petrocini [UNESP

    2016-01-01

    Devido ao aumento da expectativa de vida dos animais e o crescente número de pessoas, a osteoartrite (OA), também conhecida como artrose, surge como uma das afecções mais relevantes na medicina veterinária e humana. Diversos tratamentos são utilizados e propostos, porém não há ainda consenso sobre a melhor terapia. Objetivou-se investigar e comparar a eficácia do Laser de baixa intensidade e o ultrassom terapêutico em conjunto com plasma rico em plaquetas (PRP), no tratamento da o...

  10. Terapia cognitivo-comportamental da fobia social Cognitive-behavioral therapy in social phobia

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    Lígia M Ito

    2008-10-01

    Full Text Available OBJETIVO: Este artigo revisa aspectos relevantes da fobia social e os estágios de tratamento através da terapia cognitivo-comportamental em crianças, adolescentes e adultos. MÉTODO: A partir do banco de dados Medline, realizou-se revisão da literatura publicada a respeito do tratamento da fobia social por meio da terapia cognitivo-comportamental. RESULTADOS: Revisão da literatura sugere que a fobia social é uma condição prevalente e crônica, caracterizada por inibição social e timidez excessiva. Tanto o diagnóstico como o tratamento desse transtorno são comumente determinados pelo nível de incômodo e pelo prejuízo funcional. Estudos populacionais indicam taxas de prevalência ao longo da vida para a fobia social entre 2,5 e 13,3%. As principais técnicas utilizadas na terapia cognitivo-comportamental para a fobia social são descritas e exemplificadas em um relato de caso. CONCLUSÕES: Há consenso geral na literatura de que a terapia cognitivo-comportamental é eficaz tanto para o tratamento de jovens como de adultos com fobia social. Uma vez que a fobia social com freqüência tem início precoce, a identificação de crianças com risco acentuado para o desenvolvimento de fobia social deve ser priorizada em investigações futuras.OBJECTIVE: This article reviews relevant aspects of social phobia and the stages of treatment within cognitive-behavioral therapy in children and adolescents, as well as in adults. METHOD: A review of the literature published on the treatment of social phobia using cognitive-behavioral treatments was performed using the Medline database. RESULTS: A review of the literature suggests that social phobia is a chronic and prevalent condition, characterized by social inhibition and excessive shyness. Diagnosis and treatment of the disorder are usually determined by distress level and functional impairment. Population studies indicate that lifetime prevalence rates for social phobia range from 2.5 to 13

  11. Familiares de pacientes com AVC em unidade de terapia intensiva: impactos do adoecimento

    OpenAIRE

    Joana Galdieri Torres

    2011-01-01

    Este estudo tem como objetivo principal, conhecer o impacto do adoecimento para os familiares de pacientes vítimas de AVC, que se encontram internados em unidade de terapia intensiva. Habitualmente, a literatura tem mostrado trabalhos realizados com familiares de pacientes em situação crônica de adoecimento; estudos que contemplem os familiares no momento inicial do adoecimento ainda são escassos. Os instantes iniciais de internamento em uma UTI configuram-se como um desafio a ser enfrentado ...

  12. Efecto de la terapia manual en el síndrome del latigazo cervical

    OpenAIRE

    Olombrada de Santos, María

    2016-01-01

    Introducción: El síndrome del latigazo cervical es una patología muy común altamente relacionada con los accidentes de tráfico. Puede presentarse de varias formas, cuyos signos y síntomas son distintos en cada caso, por ello no existe un solo tipo de tratamiento. El tratamiento fisioterápico, que incluyen las terapias manuales, es fundamental para la mejoría de estos pacientes. Objetivo: El objetivo de este trabajo es conocer la utilidad de las diferentes técnicas manuales, utilizadas por fis...

  13. Terapia génica neuroprotectora a largo plazo en un modelo de envejecimiento experimental

    OpenAIRE

    Schwerdt, J. I.; Hereñú, Claudia Beatriz; Camihort, Gisela; Luna, Georgina; Spinedi, Eduardo; Goya, Rodolfo Gustavo; Cónsole-Avegliano, Gloria Miriam

    2015-01-01

    El envejecimiento se asocia a una mayor incidencia de enfermedades neurodegenerativas (Parkinson, Alzheimer) que abren la posibilidad de aplicar terapia génica con factores neurotróficos. Los pacientes portadores de enfermedad de Parkinson presentan alteraciones funcionales en el eje hipotálamolactotropo. En la rata hembra, el envejecimiento trae aparejada una progresiva degeneración y pérdida de neuronas hipotalámicas tubero-infundibulares dopaminérgicas (TIDA) que ejercen un control tóni...

  14. Impacto nutricional de la terapia biológica en pacientes oncológicos

    OpenAIRE

    Salazar González, Marta

    2015-01-01

    La malnutrición es un factor determinante en pacientes oncológicos, siendo considerado como factor pronóstico de la enfermedad. La desnutrición no es causada solo por el tumor, sino que también por los tratamientos recibidos para su cura. Uno de esos tratamientos es la terapia biológica, también denominada inmunoterapia, la cual no ha sido muy estudiada para determinar el impacto nutricional que conlleva a estos tipos de pacientes. Debido a la poca información disponible sobre el impa...

  15. Laser terapia no controle da mucosite oral: um estudo de metanálise

    OpenAIRE

    Figueiredo, André Luiz Peixoto; Lins, Liliane; Cattony, Ana Carolina; Falcão, Antônio Fernando Pereira

    2013-01-01

    OBJETIVO: Realizar uma metanálise da eficácia da laser terapia (LT) na prevenção damucosite oral (MO) em pacientes submetidos à oncoterapia. MÉTODOS: Foi realizada uma busca nas bases de dados MEDLINE, LILACS e Cochrane, utilizando as palavras-chave "laser therapy" e "oral mucositis". Os estudos de caso-controle incluídos foram submetidos à análise do odds ratio (OR), cujo ponto de corte para a estatística foi MO grau > 3. Os cálculos foram realizados com o programa BioEstat 5.0, utilizando a...

  16. PATOLOGIA ENDOMETRIAL EN MUJERES CON SANGRADO ANORMAL DURANTE TERAPIA DE REEMPLAZO HORMONAL

    OpenAIRE

    Bianchi P,Marcelo; Berrios C.,Cecilia; Villaseca D.,Paulina; Arteaga U,Eugenio

    2003-01-01

    Se presenta un estudio para analizar la incidencia de patología endometrial en mujeres sanas posmenopáusicas que reciben terapia de reemplazo hormonal (TRH) y que presentan sangrado uterino anormal. Se estudiaron 188 mujeres posmenopáusicas que presentaron flujo rojo uterino anormal (irregular o excesivo) durante TRH con estrógenos y progesterona en diferentes esquemas (49% secuencial continuo; 39% combinado continuo; 12% secuencial discontinuo. Al 100% de las pacientes se les realizó en form...

  17. TERAPIA GESTÁLTICA DE FRIEDRICH SOLOMON PERLS FUNDAMENTACIÓN FENOMENOLÓGICA-EXISTENCIAL

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    Luis Fernando Velásquez

    2001-01-01

    Full Text Available La primera parte de este documento se ocupa de la vida de Fritz Perls, quien ha sido considerado uno de los principales representantes del Enfoque Humanista en Psicología. En segunda instancia se analiza, de manera clara y precisa, la estrecha relación que existe entre la filosofía existencial, la fenomenología y la Terapia Gestalt propuesta por Perls. Así mismo, el autor revisa los elementos teóricos y prácticos de diversas teorías y escuelas de pensamiento que convergen de manera apropiada en el modelo psicoterapéutico de Perls.

  18. Acidosis láctica secundaria a terapia antirretroviral en pacientes con VIH/sida

    OpenAIRE

    Benhard Hasbum-Fernández; José Rojas-Solano; Luis Gutiérrez-Jaikel; María Paz León-Bratti

    2006-01-01

    La acidosis láctica es una complicación infrecuente de la terapia antirretroviral para VIH. Su aparición se ha relacionado con la administración de análogos nucleósidos de la transcriptasa inversa, en especial estavudina y didanosina. Se presentan los 2 casos que se manejaron en el año 2005 en el Servicio de Medicina del Hospital México. En ambos el desenlace fue fatal, aún cuando se utilizaron todas las medidas terapéuticas recomendadas.Lactic acidosis is a rare complication of antiretrovira...

  19. Fenomenologia do onírico: a gestalt-terapia e a daseinsanálise

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    Ívena Pérola do Amaral Santos

    Full Text Available O texto apresenta a gestalt-terapia e a daseinsanálise enquanto abordagens representativas no trabalho clínico com o sonhar humano, tendo como base o método fenomenológico. Traz os conceitos teóricos e as aplicações práticas propostas por ambas. Por fim, traz uma análise das convergências e divergências entre as duas teorias, estabelecendo-se suas distinções e contribuições.

  20. Tratamiento psicológico, según la terapia racional emotiva

    OpenAIRE

    Víctor Amorós Terán

    2013-01-01

    En este artículo el autor presenta el caso de un paciente de 30 años, de sexo masculino, soltero, quien sufre de ansiedad, depresión e incapacidad para enfrentar el trabajo. Se describen los datos más importantes de la historia y el motivo de consulta y se relatan algunas sesiones de terapia racional emotiva. The author presents the study of a 30 year old patient, a single male, who suffers from anxiety, depression and difficulties to cope with his work. The most important aspects of the pati...