1,721,102 research outputs found
Terapia HIV, sindrome metabolica e rischio cardiovascolare
No full textI soggetti con infezione da HIV1+ presentano anomalie metaboliche che possono determinare Sindrome Metabolica (SM) (presenza di tre o più dei seguenti parametri: obesità addominale, ipertrigliceridemia, basso livello di colesterolo HDL, elevata pressione sanguigna ed insulino-resistenza, secondo la definizione del U.S. National Cholesterol Education Program Adult Treatment Panel III), riconosciuta come predittiva di aumento del rischio di Malattia CardioVascolare (MCV).
In particolare, l’utilizzo della terapia antiretrovirale altamente attiva (HAART) sembra essere associata ad un aumento di prevalenza di SM e di MCV.
In questo studio sono stati valutati gli effetti dell’utilizzo degli inibitori delle proteasi (PI) e della terapia NNRTI (inibitori non nucleosidici della trascrittasi inversa) dopo 1 anno (t1) e 2 anni (t2) di trattamento sulla SM e sull’aumento del rischio cardiovascolare (determinato con l’algoritmo di Framingham).
Sono stati valutati 99 pazienti HIV1+, di cui 58 in terapia con PI (38,5±9,7anni) e 41 con NNRTI (37,0±8,5anni).
Entrambi i tipi di terapia hanno determinato un aumento del numero medio di CD4+ (PI: t0:232±134, t1:320±140, t2:481±210; NNRTI: t0:257±120, t1:381±181, t2:532±185) ed una riduzione dei livelli plasmatici di HIV-RNA (PI: t0:49088±21610, t1:654±2313, t2:57±126; NNRTI: t0:46004±25946, t1:863±4683, t2:137±618).
La prevalenza di SM rilevata in entrambe le tipologie di trattamento con PI e NNRTI ad 1 e 2 anni è risultata rispettivamente pari a 3,4% e 41,4% e 12,2% e 17,1% (ORt1: 0,26; IC 95%: 0,02-1,70 e ORt2: 3,43; IC 95%: 1,21-10,60).
Il rischio cardiovascolare osservato nei pazienti sottoposti a terapia con PI (basale=1,74% vs 2 aa=3,72%) è risultato più elevato rispetto ai soggetti trattati con NNRTI (basale=1,13% vs 2 aa=1,88%).
La terapia antiretrovirale con PI e NNRTI in pazienti con CD4+ normalizzati e con soppressione della replicazione virale sembra determinare un’induzione della SM ed un aumento del rischio cardiovascolare con valori più elevati nei pazienti in terapia con PI
Correlazione tra distribuzione del tessuto adiposo perineale, spessore dell'intima-media carotidea e indice di resistenza arteriosa intrarenale in pazienti con infezione da HIV-1+.
No full textL’infezione da virus di immunodeficienza umana (HIV1+) e l'uso di terapia antiretrovirale altamente attiva può determinare un’accelerazione del processo aterosclerotico ed un aumento del rischio di malattie cardiovascolari. Obiettivo primario del nostro studio è stato quello di valutare se la distribuzione del tessuto adiposo peri-renale, un parametro di obesità viscerale, è correlata all’indice di resistenza arteriosa intrarenale e allo spessore dell’intima-media carotidea, indici di aterosclerosi in pazienti infetti da HIV1+. Sono stati arruolati 68 pazienti HIV1+ in uno studio trasversale. La distribuzione del tessuto adiposo peri-renale e lo spessore dell’intima-media carotidea sono stati misurati mediante ecografia con sonda rispettivamente di 3,75 MHz e 15 MHz. L’ecocolordoppler è stato utilizzato per il calcolo dell’indice di resistenza delle arterie intrarenali.
La distribuzione del tessuto adiposo peri-renale è risultata correlata direttamente con l’indice di resistenza delle arterie intrarenali (r=0.41, p=0.0006) e con lo spessore dell’intima-media carotidea (r=0.46, p=0.0001). Si è, inoltre, evidenziata una correlazione diretta (r=0.38, p=0.001) tra la distribuzione del tessuto adiposo peri-renale ed il rischio cardiovascolare misurato mediante l’algoritmo di Framingham.
I nostri dati dimostrano che la valutazione ecografica del tessuto adiposo peri-renale può essere un potenziale indicatore di un aumentato rischio cardiovascolare in pazienti con infezione da HIV1+
Interleukin-17 regulates visceral obesity in HIV-1-infected patients.
Full text linkObjective
The aim of the study was to evaluate the interleukin-17 (IL-17) plasma level in HIV-1-infected patients and its relation to central obesity.
Methods
Eighty-four HIV-1-infected patients [42 with visceral obesity (group A) and 42 without visceral obesity (group B)] and 46 HIV-negative subjects [23 with visceral obesity (group C) and 23 without visceral obesity (group D)] were enrolled in the study. Sonographic measurements of perirenal fat diameter/body mass index (PRFD/BMI) were used to assess visceral adipose tissue thickness.
Results
HIV-1-infected patients had higher plasma levels of IL-17 than HIV-negative subjects [837.8 ± 260 pg/mL (mean ± standard deviation) vs. 395.3 ± 138.6 pg/mL, respectively; P < 0.001]. Furthermore, HIV-1-infected patients with a diagnosis of visceral obesity had lower levels of IL-17 than HIV-infected lean patients (756.9 ± 282.9 pg/mLvs. 918.7 ± 208.4 pg/mL, respectively; P < 0.01). IL-17 (r = −0.21; P = 0.03) and waist circumference (r = 0.48; P < 0.001) were significantly associated with visceral adipose tissue thickness. A negative correlation of IL-17 (r = −0.23; P < 0.001) with PRFD/BMI was found.
Conclusions
This study suggests a linear negative association between IL-17 and visceral adipose tissue thickness
Association of visceral adiposity with increased intrarenal artery resistive index in HIV-1-infected patients receiving highly active antiretroviral therapy.
Full text linkPurpose: The aim of our study was to evaluate whether perirenal fat thickness (PRFT), a parameter of central obesity, is related to kidney function and intrarenal artery resistive index (IARI) in human immunodeficiency virus (HIV)-1-infected patients. Materials and Methods: We enrolled 102 consecutive HIV-1-infected patients receiving highly active antiretroviral therapy for more than 12 months in a prospective cohort study. Echographically, the PRFT and IARI were measured and the serum metabolic parameters were evaluated. PRFT and IARI were measured using a 3.75 MHz convex linear probe. Results: The mean of PRFT and IARI in HIV-1-infected patients with visceral obesity was considerably higher than that in patients without it (P <0.001 and <0.01, respectively). Using the average IARI as the dependent variable, age (odds ratio, 1.07; 95% confidence interval [CI], 1.01–1.14; P < 0.5) and PRFT (odds ratio, 1.28; 95% CI, 1.08–1.51; P<0.01) were independent factors associated with IARI. Conclusion: Our data indicate that ultrasonographic assessment of PRFT may have a potential to be a marker of increased endothelial damage with specific involvement of the renal vascular district in HIV-1-infected patients
Sonographically measured perirenal fat thickness: an early predictor of atherosclerosis in HIV-1-infected patients receiving highly active antiretroviral therapy?
Full text linkABSTRACT
Purpose. The aim of our study was to evaluate whether perirenal fat thickness (PRFT), a pa- rameter of central obesity, is related to carotid intima- media thickness (IMT), an index of atherosclerosis in human immunodeficiency virus (HIV)-1-infected patients.
Methods. We enrolled 70 consecutive HIV-1- infected patients receiving highly active antiretroviral therapy for more than 12 months, in a prospective cohort study. Sonographically measured PRFT and carotid IMT, as well as serum metabolic parameters, were evaluated. PRFT and IMT were measured using 3.75-MHz convex and 7.5-MHz linear probes, respec- tively.
Results. The mean PRFT and IMT in HIV-1-infected patients with visceral obesity was significantly greater than those in patients without it (p < 0.0001 and p < 0.01, respectively). Using the average IMT as the dependent variable in regression analysis, PRFT was an independent factor associated with ca- rotid IMT (p < 0.05). A PRFT of 6.4 mm was the most discriminatory value for predicting an IMT ! 0.9 mm (sensitivity 83.3%, specificity 83.9%). Sub- jects with visceral obesity had a progressively increasing carotid IMT on the 12-month measure- ment (p < 0.05).
Conclusion. Our data demonstrated that PRFT mea- surement could be used as an early predictor of IMT increase in HIV-1-infected patients receiving highly active antiretroviral therapy
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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