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Ximenes, Ricardo Arraes de Alencar
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Id: biblio-1089327
Autor: Azevedo, Larissa Negromonte; Ximenes, Ricardo Arraes de Alencar; Monteiro, Polyana; Montarroyos, Ulisses Ramos; Miranda-Filho, Demócrito de Barros.
Título: Factors associated to modification of first-line antiretroviral therapy due to adverse events in people living with HIV/AIDS
Fonte: Braz. j. infect. dis;24(1):65-72, Feb. 2020. tab, graf.
Idioma: en.
Projeto: Brasil (CAPES).
Resumo: ABSTRACT Antiretroviral therapy (ART) has modified the outcome of patients with HIV infection, providing virological control and reducing mortality. However, there are several reasons as to why patients may discontinue their antiretroviral therapy, with adverse events being one of the main reasons reported in the literature. This is a case-control nested in a cohort of people living with HIV/AIDS, conducted to identify the incidence of ART modification due to adverse events and the associated factors, in two referral services in Recife, Brazil, between 2011 and 2014. Of the modifications occurred in the first year of ART, 25.7% were driven by adverse events. The median time elapsed between initiating ART and the first modification due to adverse events was 70.5 days (95% CI: 26-161 days). The main adverse events were dermatological, neuropsychiatric and gastrointestinal. Dermatological events were the earliest to appear after initiating ART. Efavirenz was the most prescribed and most modified drug during the study period. The group of participants who used zidovudine, lamivudine, and efavirenz had a 2-fold greater chance (adjusted OR: 2.16 95% CI: 1.28-3.65) of switching ART due to adverse events when compared to the group that used tenofovir with lamivudine and efavirenz.
Descritores: Síndrome de Imunodeficiência Adquirida/tratamento farmacológico
Fármacos Anti-HIV/efeitos adversos
-Fatores de Tempo
Brasil
Zidovudina/efeitos adversos
Modelos Logísticos
Fatores de Risco
Síndrome de Imunodeficiência Adquirida/mortalidade
Ritonavir/efeitos adversos
Lamivudina/efeitos adversos
Terapia Antirretroviral de Alta Atividade/efeitos adversos
Benzoxazinas/efeitos adversos
Combinação de Medicamentos
Estimativa de Kaplan-Meier
Lopinavir/efeitos adversos
Tenofovir/efeitos adversos
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Pessoa de Meia-Idade
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-886661
Autor: MÜLLER, TALISE E; ELLWANGER, JOEL H; MICHITA, RAFAEL T; MATTE, MARIA CRISTINA C; RENNER, JANE D P.
Título: CYP2B6 516 G>T polymorphism and side effects of the central nervous system in HIV-positive individuals under Efavirenz treatment: Study of a sample from southern Brazil
Fonte: An. acad. bras. ciênc;89(1,supl):497-504, May. 2017. tab.
Idioma: en.
Resumo: ABSTRACT This study aimed to identify the 516 G>T polymorphism of the CYP2B6 gene and evaluate its influence on central nervous system (CNS) side effect development in HIV-positive individuals undergoing Efavirenz (EFV) treatment in a population from southern Brazil. Additionally, we performed a survey on the clinical and epidemiological characteristics of our sample. In addition to medical records evaluation, whole blood of 89 individuals was analyzed for viral load, T lymphocyte count (CD4+ and CD8+), and the polymorphism. Considering the side effects of the CNS reported by individuals but without considering the genetic variables, no statistically significant association was noted between the adverse effects and the antiretroviral treatment (including or not EFV). In addition, no statistically significant difference was noted for the influence of genotype on the viral load or the number of T lymphocytes (CD4+ and CD8+) among individuals undergoing EFV treatment. This is the first study that investigated the impact of the 516 G>T polymorphism of the CYP2B6 gene among HIV-positive individuals from southern Brazil. Its clinical significance indicates the need for prospective studies in this population.
Descritores: Polimorfismo Genético/genética
Infecções por HIV/genética
Infecções por HIV/tratamento farmacológico
Sistema Nervoso Central/efeitos dos fármacos
Inibidores da Transcriptase Reversa/efeitos adversos
Benzoxazinas/efeitos adversos
Citocromo P-450 CYP2B6/genética
-Estudos Prospectivos
Relação CD4-CD8
Inibidores da Transcriptase Reversa/uso terapêutico
Carga Viral
Benzoxazinas/uso terapêutico
Genótipo
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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ARAUJO, M
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Id: lil-433166
Autor: Eira, M; Araujo, M; Seguro, A. C.
Título: Urinary NO3 excretion and renal failure in indinavir-treated patients
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;39(8):1065-1070, Aug. 2006. tab.
Idioma: en.
Conferência: Apresentado em: International Conference on Infectious Diseases, 11, Cancun, 2004.
Resumo: Treatment with indinavir (IDV), a protease inhibitor, is frequently associated with renal abnormalities. We determined the incidence of renal failure (creatinine clearance <80 mL min-1 1.73 (m²)-1) in HIV patients treated with highly active antiretroviral therapy, including IDV, and investigated the possible mechanisms and risk factors of IDV nephrotoxicity. Thirty-six patients receiving IDV were followed for 3 years. All were assessed for age, body weight, duration of infection, duration of IDV treatment, sulfur-derivative use, total cholesterol, triglycerides, magnesium, sodium, potassium, creatinine, and urinalysis. We also determined renal function in terms of creatinine clearance, urine osmolality and fractional excretion of sodium, potassium, and water. Urinary nitrate (NO3) excretion was measured in 18 IDV-treated patients and compared with that of 8 patients treated with efavirenz, a drug without renal side effects. Sterile leukocyturia occurred in 80.5 percent of the IDV-treated patients. Creatinine clearance <80 mL min-1 1.73 (m²)-1 was observed in 22 patients (61 percent) and was associated with low body weight and the use of sulfur-derivatives. These patients also had lower osmolality, lower urine volume and a higher fractional excretion of water compared to the normal renal function group. Urinary NO3 excretion was significantly lower in IDV-treated patients (809 ± 181 æM NO3-/mg creatinine) than in efavirenz-treated patients (2247 ± 648 æM NO3-/mg creatinine, P < 0.01). The lower NO3 excretion suggests that IDV decreases nitric oxide production.
Descritores: Insuficiência Renal
Inibidores da Protease de HIV/efeitos adversos
Indinavir/efeitos adversos
Nitratos/urina
Nitritos/urina
-Insuficiência Renal
Terapia Antirretroviral de Alta Atividade
Benzoxazinas
Biomarcadores/urina
Creatinina/sangue
Taxa de Filtração Glomerular
Infecções por HIV/tratamento farmacológico
Inibidores da Protease de HIV/uso terapêutico
Indinavir/uso terapêutico
Testes de Função Renal
Oxazinas/uso terapêutico
Estudos Prospectivos
Inibidores da Transcriptase Reversa/uso terapêutico
Fatores de Risco
Limites: Adulto
Feminino
Humanos
Masculino
Pessoa de Meia-Idade
Responsável: BR1.1 - BIREME


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Texto completo SciELO Chile
Texto completo
Id: lil-742561
Autor: Gallardo C, Natalia; Valenzuela L, Omar; Ibáñez V, Sebastián.
Título: Neumomediastino y necrosis cutánea en asociación a dermatomiositis: presentación de un caso clínico y revisión de la literatura / Pneumomediastinum and cutaneous necrosis in dermatomyositis: Report of one case
Fonte: Rev. méd. Chile;143(1):120-123, ene. 2015. ilus.
Idioma: es.
Resumo: We report a 37 years old male with a dermatomyositis treated with oral cyclophosphamide. He was admitted to the hospital due to a zone of skin necrosis with purulent exudate, located in the second left toe. A complete blood count showed a leukocyte count of 2,600 cells/mm³. A Chest CAT scan showed a pneumomediastinum with emphysema of adjacent soft tissue. Cyclophosphamide was discontinued and leukocyte count improved. The affected toe was amputated and a chest CAT scan showed a partial resolution of the pneumomediastinum. We discuss and review the pathogenesis, clinical presentation and management of pneumomediastinum and cutaneous necrosis in association with dermatomyositis.
Descritores: Benzoxazinas/uso terapêutico
Canabinoides/agonistas
Encefalomielite Autoimune Experimental/tratamento farmacológico
Encefalomielite Autoimune Experimental/patologia
Morfolinas/uso terapêutico
Naftalenos/uso terapêutico
Neurônios/efeitos dos fármacos
Oligodendroglia/efeitos dos fármacos
-Análise de Variância
Precursor de Proteína beta-Amiloide/metabolismo
Caspase 9/metabolismo
/metabolismo
CASPASE ABATTOIRS/metabolismo
Contagem de Células/métodos
Sistema Nervoso Central/patologia
Citocinas/genética
Citocinas/metabolismo
Modelos Animais de Doenças
Encefalomielite Autoimune Experimental/complicações
Macrófagos/efeitos dos fármacos
Exame Neurológico
Degeneração Neural/etiologia
Degeneração Neural/prevenção & controle
Poli(ADP-Ribose) Polimerases/metabolismo
Medula Espinal/efeitos dos fármacos
Medula Espinal/patologia
Linfócitos T/efeitos dos fármacos
Fatores de Tempo
Limites: Animais
Feminino
Ratos
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: CL1.1 - Biblioteca Central


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Id: lil-665514
Autor: Adjene, J. O; Igbigbi, P. S.
Título: Effects of chronic administration of efavirenz on the chromatophilic substance of the intracranial auditory relay centres of adult Wistar rats / Efectos de la administración crónica de efavirenz sobre la sustancia cromatofílica de los centros de relevo auditivos intracraneales de ratas Wistar adultas
Fonte: Int. j. morphol;30(3):993-998, Sept. 2012. ilus.
Idioma: en.
Resumo: The effects of chronic administration of efavirenz commonly used as part of highly active antiretroviral therapy (HAART) for the treatment of Human Immunodeficiency Virus (HIV) type-1 therapy on the chromatophilic substance of the intracranial auditory relay centre namely the inferior colliculus and medial geniculate body of adult wistar rats were carefully studied. The rats of both sexes (n=20), with an average weight of 200g were randomly assigned into treatment (n=10) and control (n=10) groups. The rats in the treatment group received 600 mg/70kg body weight of efavirenz dissolved in distilled water daily for 30 days through the orogastric tube. The control group received equal volume of distilled water daily for 30 days through the same route. The rats were fed with grower's mash obtained from Edo Feeds and Flour Mill Limited, Ewu, Edo state, Nigeria and given water liberally. The rats were sacrificed by cervical dislocation method on the thirty-first day of the experiment. The inferior colliculus and medial geniculate body were carefully dissected out and quickly fixed in 10 percent formal saline for histological study. The histological findings indicated that the treated sections of the inferior colliculus and medial geniculate body showed that the chromatophilics substances were less intensely stained as compared to the control. The parenchyme was vacuolated and with evidence of hypertrophy and more spaces between the axonal mesh around the sparsely distributed neurons as compared to the control group. The treated section of the inferior colliculus showed neurons with faintly stained chromatophilics substances in large, medium and small sized neurons while that of the medial geniculate body showed less intense and enlarge chromatophilics substances with some vacuolations. Chronic administration of efavirenz may therefore have an adverse effect on the chromatophilics substances of the inferior colliculus and medial geniculate body of adult wistar rats...

Fueron estudiados los efectos de la administración crónica del efavirenz, comúnmente utilizado como parte del tratamiento antirretroviral de gran actividad para el VIH tipo 1, sobre la sustancia cromatofílica del centro de relevo auditivo intracraneal, el colículo inferior y cuerpo geniculado medial, en ratas Wistar adultas. Ratas de ambos sexos (n = 20), con un peso promedio de 200g fueron asignadas aleatoriamente a tratamiento (n = 10) y control (n = 10). Las ratas del grupo tratado recibieron 600mg/70kg peso corporal de efavirenz disuelto en agua destilada durante 30 días a través de sonda orogástrica. El grupo de control recibió un volumen igual de agua destilada durante 30 días por la misma vía. Las ratas fueron alimentadas con puré agricultor obtenido de Edo Feeds and Flour Mill Limited, Ewu, estado de Edo, Nigeria y agua ad-libitum. Las ratas se sacrificaron por dislocación cervical el día 31. El colículo inferior y el cuerpo geniculado medial fueron disecados cuidadosamente y se fijaron en solución de formalina salina al 10 por ciento. Los hallazgos histológicos indicaron que en las secciones tratadas del colículo inferior y el cuerpo geniculado medial la sustancia cromatofílica fue menos intensamente teñidas en comparación con el control. El parénquima se vacuoló, con evidencia de hipertrofia y más espacios entre la red axonal alrededor de neuronas escasamente distribuidas en comparación con el grupo control. La sección tratada del colículo inferior mostró neuronas con sustancia cromatofílica débilmente teñida en las neuronas de tamaño grande, mediano y pequeño, mientras que las del cuerpo geniculado medial mostraron sustancia cromatofílica menos intensa, con algunas vacuolaciones amplias. La administración crónica de efavirenz puede tener un efecto adverso sobre las sustancias cromatofílica del colículo inferior y del cuerpo geniculado medial de ratas Wistar adultas. Se recomienda realizar estudios adicionales...
Descritores: Benzoxazinas/farmacologia
Colículos Inferiores
Colículos Inferiores/patologia
Corpos Geniculados
Corpos Geniculados/patologia
-Benzoxazinas/efeitos adversos
Ratos Wistar
Limites: Animais
Ratos
Responsável: CL1.1 - Biblioteca Central


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Brigido, Luís Fernando de Macedo
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Id: lil-612812
Autor: Lanca, Andre Minhoto; Collares, Jeova Keny Baima; Ferreira, João Leandro de Paula; Lima, Danielle Malta; Brigido, Luis Fernando de Macedo; Rodrigues, Rosangela; Fonseca, Benedito Antonio Lopes da.
Título: HIV-1 tropism and CD4 T lymphocyte recovery in a prospective cohort of patients initiating HAART in Ribeirão Preto, Brazil
Fonte: Mem. Inst. Oswaldo Cruz;107(1):96-101, Feb. 2012. graf.
Idioma: en.
Projeto: FAPESP; . CNPq.
Resumo: While human immunodeficiency virus (HIV)-1 chemokine co-receptors 5 tropism and the GWGR motif in the envelope third variable region (V3 loop) have been associated with a slower disease progression, their influence on antiretroviral response remains unclear. The impact of baseline V3 characteristics on treatment response was evaluated in a randomised, double blind, prospective cohort study with patients initiating highly active antiretroviral therapy with lopinavir or efavirenz plus azithothymidine/3TC (1:1) over 48 weeks. Similar virological and immunological responses were observed for both treatment regimens. The 43 individuals had a mean baseline CD4 T cell count of 119 cells/mm³ [standard deviation (SD) = 99] and a mean viral load of 5.09 log10 copies/mL (SD = 0.49). The GWGR motif was not associated with a CD4 T cell response, but predicted R5 tropism by the geno2pheno[clinical20 percent] algorithm correlated with higher CD4 T cell levels at all monitoring points (p < 0.05). Moreover, higher false-positive rates (FPR) values from this analysis revealed a strong correlation with CD4 T cell recovery (p < 0.0001). Transmitted drug resistance mutations, documented in 3/41 (7.3 percent) cases, were unrelated to the assigned antiretroviral regimen and had no impact on patient outcomes. In conclusion, naÏve HIV-1 R5 infected patients exhibited higher CD4 T cell counts at baseline; this difference was sustained throughout therapy. The geno2pheno[clinical] option FPR positively correlated with CD4 T cell gain and may be useful in predicting CD4 T cell recovery.
Descritores: Terapia Antirretroviral de Alta Atividade
Fármacos Anti-HIV/uso terapêutico
Infecções por HIV/tratamento farmacológico
HIV-1
Tropismo Viral/efeitos dos fármacos
-Benzoxazinas/uso terapêutico
CDABBREVIATIONS AS TOPIC LYMPHOCYTE COUNT
Estudos de Coortes
Método Duplo-Cego
Infecções por HIV/imunologia
Infecções por HIV/virologia
HIV-1
Lopinavir/uso terapêutico
Estudos Prospectivos
Resultado do Tratamento
Carga Viral
Limites: Adulto
Feminino
Humanos
Masculino
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME


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Id: lil-608546
Autor: Casotti, Janaina Aparecida Schineider; Passos, Luciana Neves; Oliveira, Fabiano José Pereira de; Cerutti Júnior, Crispim.
Título: Prevalence of discordant immunologic and virologic responses in patients with AIDS under antiretroviral therapy in a specialized care center in Brazil / Prevalência da resposta imunológica e virológica discordante em pacientes com AIDS sob terapêutica antirretroviral em ambulatório de centro de cuidados especializados no Brasil
Fonte: Rev. Inst. Med. Trop. Säo Paulo;53(6):301-307, Nov.-Dec. 2011. tab.
Idioma: en.
Resumo: Some patients under antiretroviral therapy (ART) do not reach immune recovery when the viral load becomes undetectable. This is called discordant immunologic and virologic responses. Its prevalence varies between 8 percent and 24 percent. This study describes its prevalence and the characteristics of the affected subjects in the outpatient clinic of a Brazilian specialized-care center. Of 934 patients on ART, 536 had undetectable viral loads. Prevalence was 51/536 or 9 percent (95 percent confidence interval: 6.6 percent to 11.4 percent). Median age at the beginning of ART was 37 years (interquartile range - IQR: 31 to 45). Male gender and mixed race predominated (76.5 percent and 47.1 percent respectively). AIDS-defining illnesses were absent at the beginning of ART in 60.8 percent. Fifty-one percent were taking protease inhibitors, 43.2 percent Efavirenz and 5.8 percent both. Median time on ART was 36 months (IQR: 17-81 months). Irregular treatment was recorded for 21.6 percent. ART had been modified for 63 percent prior to the study, and 15.7 percent had used monotherapy or double therapy. Median CD4 count was 255 cells/mm³ (IQR: 200-284). Median viral load before ART was 4.7 log10 copies/mL (IQR: 4.5-5.2). Discordant responders were not different from AIDS patients in general, but there was a high frequency of multiple schedules of treatment.

Alguns pacientes sob terapêutica antirretroviral (TARV) não obtêm recuperação imune quando a carga viral se torna indetectável. Isto é chamado resposta imunológica e virológica discordante. A prevalência varia entre 8 por cento e 24 por cento. Este estudo descreve sua prevalência e características dos afetados em ambulatório de um centro de cuidados especializados brasileiro. De 934 pacientes sob TARV, 536 tinham carga viral indetectável. A prevalência foi 51/536, ou 9 por cento (Intervalo de Confiança de 95 por cento de 6,6 por cento a 11,4 por cento). Idade mediana no início da TARV foi 37 anos (distância interquartílica - DQ: 31 a 45). Gênero masculino e cor parda predominaram (76,5 por cento e 47,1 por cento, respectivamente). Doenças definidoras de Aids estavam ausentes no início da TARV em 60,8 por cento. Cinquenta e um por cento recebiam inibidores da Protease, 43,2 por cento Efavirenz e 5,8 por cento ambos. Tempo mediano de TARV foi 36 meses (DQ: 17-81). Tratamento irregular foi registrado em 21,6 por cento. TARV havia sido anteriormente modificado em 63 por cento e 15,7 por cento haviam usado mono ou dupla terapêutica. A contagem mediana de CD4 foi 255 células/mm³ (DQ: 200-284). O logaritmo mediano da carga viral antes do TARV foi 4,7 (DQ: 4,5-5,2). Aqueles com resposta discordante não eram diferentes dos pacientes com AIDS em geral, mas houve alta frequência de múltiplos esquemas terapêuticos.
Descritores: Fármacos Anti-HIV/uso terapêutico
Benzoxazinas/uso terapêutico
Infecções por HIV/tratamento farmacológico
Inibidores da Protease de HIV/uso terapêutico
Ritonavir/uso terapêutico
-CDABBREVIATIONS AS TOPIC LYMPHOCYTE COUNT
Estudos Transversais
Quimioterapia Combinada
Infecções por HIV/imunologia
Infecções por HIV/virologia
Carga Viral/imunologia
Limites: Adulto
Humanos
Masculino
Responsável: BR1.1 - BIREME


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Id: lil-566780
Autor: Quiroga, Patricia N; Mirson, Daniel J. E; Ridolfi, Adriana S; Fuentes, Silvia; De Cristófano, María de los Ángeles; Navoni, Julio; Villaamil Lepori, Edda C.
Título: Metabolitos del efavirenz como probable causa de falsos-positivos en test inmunológico para benzodiacepinas en orina / False-positive immunoassay results for urine benzodiacepines probably caused by efavirenz metabolites
Fonte: Acta toxicol. argent;15(2):44-50, dic. 2007.
Idioma: es.
Resumo: En el tratamiento del síndrome de inmunodeficiencia adquirida (SIDA) una de las drogas antirretrovirales usadas es el efavirenz (EFV). Existe una asociación entre el consumo de drogas de abuso y la probabilidad de adquirir el SIDA, razón por la cual se solicita su investigación en orina. Como método de screening para detectar el consumo de estas drogas se utilizan habitualmente los ensayos inmunológicos. Una característica especial de estos métodos son las reacciones cruzadas que pueden presentarse con sustancias estructuralmente relacionadas dando origen a resultados falsos positivos.Al analizar 18 muestras de orina de pacientes con SIDA, se observó un 78% de resultados falsos positivos para benzodiacepinas (BZD) cuando fueron analizados mediante el ensayo inmunológico Triage® (Ascend Multi Immune Assay). El estudio confirmatorio por cromatografía gaseosa acoplada a espectrometría de masa (GC-MS) reveló la ausencia de BZD en todos los casos y el 100% de los resultados falsos positivos observados correspondieron a las muestras de los pacientes tratados con EFV. Con el propósito de dilucidar el origen de esta reacción cruzada fueron aislados el EFV y sus metabolitos de las muestras de orina, mediante extracción en fase sólida (SPE) y cromatografía en capa delgada de alta resolución (HPTLC), e identificados por cromatografía gaseosa- espectrometría de masa (GC-MS y GC-MS/MS/MS).Los resultados obtenidos en este estudio indicarían que los metabolitos del EFV (8-OH-EFV y/o 7-OH-EFV) y no el EFV podrían ser los responsables de la reacción cruzada observada en el ensayo inmunológico.

Efavirenz (EFV) is an antiretroviraldrug used in the acquired immunodeficiency syndrome (AIDS) treatment. Immunoassay techniques have been widely used for abuse drug screening test. The presence of structurally related substances in urine samples can interfere by cross reactionscausing false positive results. High percentage of false positive results (78%) for benzodiazepines (BDZ) had been established for 18 urine samples assayed by immunoassay test Triage® (Ascend Multi Immune Assay). Gas chromatography-mass spectrometry(GC-MS) evaluation was negative for BDZ for all cases. One hundred percent (100%) of the positive results came from patients treated with EFV. With the aim to determine the cause of this cross- reaction, EFV and its metabolites were isolated by solid phase extraction(SPE) and high performance thin-layer chromatography (HPTLC) and then, identified by gas chromatography mass spectrometry (GC-MS and GC-MS/MS/MS). GC-MS/MS/MS analysis showed that EFV metabolites (8-OH-EFV and/or 7-OH-EFV) could probably be responsible for the cross reaction observed in the immunologic assays.
Descritores: Benzoxazinas
Benzodiazepinas/urina
Testes Imunológicos
-Terapia Antirretroviral de Alta Atividade
Reações Falso-Positivas
Drogas Ilícitas
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico
Transtornos Relacionados ao Uso de Substâncias/complicações
Limites: Humanos
Responsável: AR1.1 - Biblioteca Rafael Herrera Vegas


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Texto completo SciELO Saúde Pública
Texto completo
Id: lil-536497
Autor: Rodrigues, William C. V; Soler, Orenzio.
Título: Licença compulsória do efavirenz no Brasil em 2007: contextualização / Compulsory licensing of efavirenz in Brazil in 2007: contextualization
Fonte: Rev. panam. salud pública = Pan am. j. public health;26(6):553-559, dic. 2009.
Idioma: pt.
Resumo: The present article aims at contextualizing the first Brazilian experience with compulsory licensing, which functions as a defense mechanism to prevent excessive pricing by holders of patents. According to this mechanism, a government can authorize a third party to explore the patented object (in this case a drug) without previous consent from the patent holder. On May 4, 2007, Brazil officially issued compulsory licensing of the antiretroviral drug efavirenz for public, non-commercial use. Initially, generic versions of the drug were purchased from laboratories in India. The next step was the manufacture of efavirenz by Farmanguinhos, official pharmaceutical laboratory (Fundação Osvaldo Cruz). It is concluded that the decision made by the Brazilian government to issue compulsory licensing of efavirenz nwas correct, taking into account the projected savings of US$ 236.8 until 2012 and the guarantee of availability of efavirenz, the most usual free antiretroviral treatment provided in Brazil.
Descritores: Fármacos Anti-HIV
Benzoxazinas
Patentes como Assunto
-Brasil
Responsável: BR1.1 - BIREME


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Texto completo SciELO Brasil
Texto completo
Id: lil-493670
Autor: Pittoggi, Carmine; Martis, Gianni; Mastrangeli, Giorgia; Mastrangeli, Bruno; Spadafora, Corrado.
Título: In vitro evidence for a new therapeutic approach in renal cell carcinoma
Fonte: Int. braz. j. urol;34(4):492-502, July-Aug. 2008. ilus, graf.
Idioma: en.
Resumo: PURPOSE: Renal cell carcinoma (RCC) is the most lethal among the common urologic malignancies, comprising 3 percent of all human neoplasias; approximately 40 percent of patients eventually die of cancer progression. One third of patients who present with metastatic disease and up to 40 percent treated for localized disease generally experience recurrence. RCCs are characterized by high resistance to chemo-, radio- and immunotherapy. We recently discovered an endogenous enzymatic activity, which is particularly expressed in tumorigenic cell, endogenous non-telomerase reverse transcriptase (RT) of retrotrasposon / retroviral origin, as a specific target to induce proliferation arrest in a number of human carcinogenesis in vitro culture cell lines. METHODS: To address this possibility, we have employed RCC primary cell culture testing pharmacological inhibition, in vitro, by two characterized non nucleosidic RT inhibitors, nevirapine and efavirenz; next, we assessed morphological effects and analyzed putative modulation on gene expression profile. RESULTS: Both treatments reduced cell proliferation rate and induced morphological differentiation and gene expression reprogramming in different RCC analyzed tumor biomarkers. CONCLUSION: In this study we describe a new potential therapeutic approach to obtain considerable future benefits in renal carcinoma cure and attempt to establish a new possible pharmacological therapy based on oral drugs administration in renal RCC treatment.
Descritores: Antineoplásicos/uso terapêutico
Benzoxazinas/uso terapêutico
Carcinoma de Células Renais/tratamento farmacológico
Neoplasias Renais/tratamento farmacológico
Nevirapina/uso terapêutico
Inibidores da Transcriptase Reversa/uso terapêutico
-Carcinoma de Células Renais/genética
Carcinoma de Células Renais/patologia
Proliferação de Células/efeitos dos fármacos
Ensaios de Seleção de Medicamentos Antitumorais/métodos
Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos
Neoplasias Renais/genética
Neoplasias Renais/patologia
Reação em Cadeia da Polimerase Via Transcriptase Reversa
RNA
Células Tumorais Cultivadas
Limites: Humanos
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME



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