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Id: biblio-1289530
Autor: Rojas Rondón, Irene; Vigoa Aranguren, Lázaro; García Vega, Yanelda; Bello Rivero, Iraldo; Duncan Roberts, Yaquelín.
Título: Seguridad del HeberFERON( en pacientes con carcinoma basal palpebral / Safety of HeberFERON in patients with basal cell eyelid carcinoma
Fonte: Rev. cuba. oftalmol;34(1):e1131, 2021. tab.
Idioma: es.
Resumo: Objetivo: Evaluar la seguridad del HeberFERON( en el tratamiento del carcinoma basal palpebral. Métodos: Se realizó un estudio descriptivo en pacientes con carcinoma basal palpebral, a quienes se les aplicó HeberFERON( perilesional, de enero del año 2013 a enero de 2018. La muestra quedó constituida por 20 pacientes que cumplieron los criterios de inclusión. La dosis protocolizada fue de 3,5 x 106 UI, perilesional, dos veces a la semana por 5 semanas consecutivas. Las variables del estudio fueron: edad, sexo, color de la piel, localización del tumor, así como tipo y grado de evento adverso. Para todas las variables del estudio fueron calculadas las frecuencias absolutas y relativas. Resultados: La población estudiada con carcinoma basal palpebral mostró mayor frecuencia entre los 60 y 79 años de edad (80 por ciento) y las lesiones se presentaron fundamentalmente en el párpado inferior (60 (). El eritema palpebral y el dolor en el sitio de la inyección constituyeron los eventos adversos oculares más frecuentes (95,0 y 70,0 por ciento respectivamente) y se presentaron en el 95 por ciento de los pacientes investigados. Los eventos adversos sistémicos (fiebre, artralgia y la cefalea) prevalecieron en el 100 por ciento de los casos, en quienes el grado de severidad fue leve. Conclusiones: El HeberFERON( en el tratamiento del carcinoma basal palpebral es una buena alternativa no quirúrgica; es seguro y bien tolerado(AU)

Objective: Evaluate the safety of HeberFERON in the treatment of basal cell eyelid carcinoma. Methods: A descriptive study was conducted of patients with basal cell eyelid carcinoma undergoing perilesional HeberFERON therapy from January 2013 to January 2018. The sample was composed of 20 patients meeting the inclusion criteria. The protocol dose was 3.5 x 106 UI perilesional twice a week for five consecutive weeks. The variables analyzed were age, sex, skin color and tumor location, as well as adverse event type and degree. Absolute and relative frequencies were estimated for all the study variables. Results: The prevailing age group in the study basal cell eyelid carcinoma population was 60-79 years (80 percent). The most common lesion site was the lower eyelid (60 percent). Eyelid erythema and injection site pain were the most frequent ocular adverse events (95.0 percent and 70.0 percent, respectively), presenting in 95 percent of the study subjects. Systemic adverse events (fever, arthralgia and headache) prevailed in 100 percent of the cases studied, among whom the degree of severity was mild. Conclusions: HeberFERON is a good non-surgical alternative for basal cell eyelid carcinoma. It is safe and well tolerated(AU)
Descritores: Carcinoma Basocelular/tratamento farmacológico
Interferons/uso terapêutico
Neoplasias Palpebrais/terapia
-Epidemiologia Descritiva
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
Limites: Humanos
Pessoa de Meia-Idade
Idoso
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1289532
Autor: Rojas Rondón, Irene; Vigoa Aranguren, Lázaro; Garcìa Vega, Yanelda; Bello Rivero, Iraldo; Duncan Roberts, Yaquelin.
Título: Respuesta clínica del tratamiento con HerberFERON( en pacientes con carcinoma basal palpebral / Clinical response to treatment with HerberFERON® in patients with basal palpebral carcinoma
Fonte: Rev. cuba. oftalmol;34(1):e1139, 2021. tab.
Idioma: es.
Resumo: Objetivo: Determinar la respuesta clínica en pacientes con carcinoma basal palpebral tratados con HeberFERON. Métodos: Se realizó un estudio descriptivo en pacientes con carcinoma basal palpebral, a quienes se les aplicó HeberFERON( perilesional en el Instituto Cubano de Oftalmología "Ramón Pando Ferer", de enero del año 2013 a enero de 2015. La muestra quedó constituida por 10 pacientes que cumplieron con los criterios de inclusión. Las variables del estudio fueron: edad, sexo, color de la piel, forma clínica, diámetro tumoral, subtipo histológico del tumor, así como la respuesta clínica después del tratamiento de los casos estudiados. Para todas las variables del estudio fueron calculadas las frecuencias absolutas y relativas. Resultados: Predominaron el género masculino y los sujetos de piel blanca. En los pacientes estudiados se presentaron la forma clínica nódulo ulcerativo, el subtipo histológico tumoral poco diferenciado y la respuesta clínica objetiva. Conclusiones: En la mayoría de los pacientes se logró una buena respuesta clínica al tratamiento con HeberFERON(, por lo que este tratamiento se convierte una nueva alternativa no quirúrgica(AU)

Objective: To determine the clinical response in patients with basal palpebral carcinoma treated with HeberFERON(. Methods: A descriptive study was carried out in patients with eyelid cell basal carcinoma tried with HeberFERON in the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" from January 2013 to January 2015. The sample consisted of 10 patients who fulfilled the inclusion criteria. The study variables were: age, sex, skin color, clinical form, tumor diameter, histological subtype of the tumor, as well as the clinical response after treatment of the cases studied. In all the variables, absolute and relative frequencies were calculated. Results: Male gender and white-skinned subjects predominated. The clinical form ulcerative nodule, poorly differentiated histological tumor subtype, and objective clinical response were present in the patients studied. Conclusions: In most of the patients a good clinical answer was achieved to the treatment with HeberFERON, which becomes a new non surgical alternative(AU)
Descritores: Carcinoma Basocelular/terapia
Interferons/uso terapêutico
Neoplasias Palpebrais/terapia
-Epidemiologia Descritiva
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: lil-708878
Autor: Hernández, Mario Andrés; Ruiz, José Ricardo; Lizarazo, Diego Vicente.
Título: Fenómeno de Raynaud secundario y vasculitis cutánea asociados al uso de interferón / Secondary Raynaud's phenomenon and cutaneous vasculitis associated with the use of interferon
Fonte: Acta méd. colomb;39(1):81-84, ene.-mar. 2014. ilus.
Idioma: es.
Resumo: Resumen Se presenta el caso de un hombre adulto con fenómeno de Raynaud secundario y refractario al manejo médico asociado a vasculitis cutánea, que previamente venía recibiendo interferón beta para tratamiento de esclerosis múltiple. La agresividad del proceso requiere la interrupción de la medicación,la utilización de vasodilatadores, inhibidores de endotelina 1, simpatectomía bilateral por videotoracoscópia, aplicación de toxina botulínica periarterial interdigital en manos y terapia inmunosupresora con corticoide a altas dosis y ciclofosfamida obteniendo detención del proceso isquémico, pero con pérdida anatómica asociada. (Acta Med Colomb 2014; 39: 81-84).

Abstract The case of an adult male with secondary Raynaud's phenomenon refractory to medical management and associated with cutaneous vasculitis who previously had been receiving interferon beta for multiple sclerosis treatment, is presented. The aggressiveness of the process required the interruption of the medication, the use of vasodilators, inhibitors of endothelin-1, bilateral thoracoscopic sympathectomy by video, peri-arterial interdigital botulinum toxin application in hands and immunosuppressive therapy with high dose corticosteroids and cyclophosphamide, obtaining arrest of the ischemic process, but with associated anatomical loss. (Acta Med Colomb 2014; 39: 81-84).
Descritores: Doença de Raynaud
-Autoimunidade
Interferons
Vasculite Leucocitoclástica Cutânea
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: CO70 - Asociación Colombiana de Medicina Interna


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Id: biblio-1287517
Autor: Stefanello, Simone; Amaral, Carolina S; Zappe, Igor G; Mujica, Lady K. S; Emanuelli, Mauren P; Portela, Valério M; Ramos, Adriano T; Antoniazzi, Alfredo Q.
Título: Evaluation of interferon-stimulated gene 15 (ISG15) expression in blood neutrophils in beef cattle poisoned by Senecio spp / Avaliação da expressão do gene estimulado por interferon 15 (ISG15) em neutrófilos sanguíneos em bovinos de corte intoxicados por Senecio spp
Fonte: Pesqui. vet. bras = Braz. j. vet. res;41:e06880, 2021. tab, graf.
Idioma: en.
Resumo: This study aimed to assess liver damage and interferon-stimulated gene 15 (ISG15) blood expression as a consequence of embryonic signaling on maternal recognition of pregnancy in beef cattle presenting natural ingestion of Senecio spp. Epidemiological aspects, as the presence of the plant, associated to gamma glutamyl transferase (GGT) activity can be used as Senecio spp. poisoning diagnosis. Maternal recognition of pregnancy period occurs when the embryo secretes interferon tau (IFNT) to signal its presence to the mother and eventually extend corpus luteum (CL) lifespan. In our study, liver damage was determined by concentration serum GGT, cytological and histopathological examinations. Reproductive status was evaluated by concentration of progesterone, CL diameter and ISG15 mRNA expression on Day 19 following fixed-time artificial insemination (FTAI). Cows were categorized into two groups based on concentration of GGT: Group 1 (GGT<30U/L) and 2 (GGT>31U/L). No difference on body condition scores was observed. All the cows presented liver damage based on cytology and histopathological exams. Cows from the Group 1 had higher pregnancy rate, presenting larger CL diameter and greater concentration of progesterone. Interestingly, ISG15 mRNA expression had no difference between Groups 1 and 2, even presenting difference in pregnancy status. These findings suggest embryonic loss beyond Day 19. It suggests late embryonic mortality may be associated to liver insufficiency. In conclusion, liver injury and/or concentration of GGT does not alter ISG15 expression on blood neutrophils, however cows presenting lower concentration of GGT (<30U/L) had increased pregnancy status. Therefore, the concentration of GGT allow us to screen liver status and foresee a successful pregnancy in beef cattle.(AU)

O objetivo deste estudo foi avaliar a lesão hepática e a expressão sanguínea do gene estimulado por interferon 15 (ISG15) durante a sinalização embrionária, no reconhecimento materno da gestação, em bovinos de corte apresentando ingestão natural de Senecio spp. Fatores epidemiológicos, como a presença da planta, associados à atividade da gama glutamil transferase (GGT) podem ser utilizados como diagnóstico da intoxicação por Senecio spp. O reconhecimento materno da gestação ocorre quando o embrião secreta interferon tau (IFNT) para sinalizar sua presença à mãe. Em nosso estudo, a lesão hepática foi determinada pela concentração sérica de GGT, pelos exames citológicos e histopatológicos. O estado reprodutivo foi avaliado pela concentração de progesterona, diâmetro de corpo lúteo (CL) e expressão de mRNA ISG15 no Dia 19 após a inseminação artificial em tempo fixo (IATF). As vacas foram separadas em dois grupos com base na concentração de GGT sanguíneo: Grupo 1 (GGT<30U/L) e Grupo 2 (GGT>31U/L). Não foi observada nenhuma diferença no escore de condição corporal entre os grupos. Na citologia e nos exames histopatológicos todas as vacas apresentaram lesão hepática. As vacas do Grupo 1 apresentaram maior taxa de prenhez, maior diâmetro do CL e maior concentração de progesterona. Diferente do esperado, a expressão do mRNA ISG15 não foi diferente entre os Grupos 1 e 2, mesmo apresentando diferença na taxa de prenhez. Esses achados sugerem perda embrionária após o Ddia 19. Isso demonstra que a mortalidade embrionária tardia pode estar associada à insuficiência hepática. Dessa forma, conclui-se que a lesão hepática e/ou concentração de GGT não altera a expressão de ISG15 nos neutrófilos sanguíneos, porém vacas com menor concentração de GGT (<30U/L) apresentaram maiores taxas de prenhez. Assim, a concentração de GGT nos permite avaliar a saúde hepática e prever uma gestação bem-sucedida em bovinos de corte.(AU)
Descritores: Plantas
Envenenamento
Progesterona
Senécio
Bovinos/sangue
Inseminação Artificial
Expressão Gênica
Interferons
Neutrófilos
-Mortalidade
Corpo Lúteo
Limites: Animais
Bovinos
Responsável: BR68.1 - Biblioteca Virginie Buff D'Ápice


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Id: biblio-1156437
Autor: Garrote Santana, Heidys.
Título: Anemia diseritropoyética congénita tipo I: una mirada actualizada de sus bases moleculares, diagnóstico y tratamiento / Congenital dyserythropoietic anemia type I: an updated review about its molecular bases, diagnosis and treatment
Fonte: Rev. cuba. hematol. inmunol. hemoter;36(3):e1218, jul.-set. 2020.
Idioma: es.
Resumo: Introducción: Las anemias diseritropoyéticas congénitas constituyen un grupo de trastornos hereditarios caracterizados por anemia refractaria, eritropoyesis ineficaz y alteraciones morfológicas de los eritroblastos. La anemia diseritropoyética congénita tipo I es la más frecuente, no obstante, constituye una rara enfermedad con particularidades morfológicas y moleculares. Objetivo: Analizar los aspectos más novedosos en cuanto a la patogenia molecular, el diagnóstico genético y el tratamiento de la anemia diseritropoyética congénita tipo I. Métodos: Se realizó una revisión de la literatura, en inglés y español. Se utilizaron motores de búsqueda como Google académico y Pubmed que permitió el acceso a artículos actualizados del tema. Se hizo un análisis y resumen de la bibliografía revisada. Análisis y síntesis de la información: La anemia diseritropoyética congénita tipo I es una enfermedad hereditaria autosómica recesiva. Se caracteriza por anemia de grado variable, reticulocitopenia, alteraciones morfológicas de la serie roja en la lámina periférica y un número elevado de eritroblastos binucleados conectados por puentes internucleares en el aspirado de médula ósea. Se han identificado múltiples alteraciones moleculares que involucran fundamentalmente a los genes CDAN1 y C15orf41. Las proteínas codificadas por estos genes participan en proceso vitales como el ciclo celular, la reparación del ADN y la transcripción de ARN. Conclusiones: El estudio de las bases moleculares de la anemia diseritropoyética congénita tipo I ha cambiado la perspectiva en el diagnóstico de esta enfermedad. Los protocolos de tratamiento son similares a otras anemias hemolíticas hereditarias aunque se destaca el uso del Interferón-α(AU)

Introduction: Congenital dyserythropoietic anemias belong to a group of hereditary disorders characterized by refractory anemia, ineffective erythropoiesis and morphological alterations of erythroblasts. Congenital dyserythropoietic anemia type I is the most frequent; however, it is a rare disease with morphological and molecular characteristics. Objective: To analyze the most updated aspects regarding molecular pathogenesis, genetic diagnosis and treatment of congenital dyserythropoietic anemia type I. Methods: A review of the literature in English and Spanish was carried out. Search engines such as Google Scholar and Pubmed were used, which allowed access to updated articles on the subject. An analysis and summary of the revised bibliography was carried out. Information analysis and synthesis: Congenital dyserythropoietic anemia type I is an autosomal recessive hereditary disease. It is characterized by anemia of variable degree, reticulocytopenia, morphological alterations of the red series in the peripheral lamina, and high number of binucleated erythroblasts connected by internuclear bridges in the bone marrow aspirate. Multiple molecular alterations have been identified, mainly involving the CDAN1 and C15orf41 genes. The proteins encoded by these genes participate in vital processes, such as the cell cycle, DNA repair, and RNA transcription. Conclusions: The study of the molecular bases of congenital dyserythropoietic anemia type I has changed the perspective concerning the diagnosis of this disease. Treatment protocols are similar to other hereditary hemolytic anemias, although the use of Interferon-α stands out(AU)
Descritores: Patogênese Homeopática/métodos
Interferons/uso terapêutico
Doenças Genéticas Inatas/epidemiologia
Anemia Diseritropoética Congênita/diagnóstico
-Anemia Diseritropoética Congênita/terapia
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-961467
Autor: Brahm, Javier; Urzúa, Alvaro; Poniachik, Jaime; Cáceres, Dante D; Carreño, Laura; Venegas, Mauricio.
Título: El polimorfismo rs12979860 C> T en el gen Interferón lambda 4 no está asociado a riesgo de fibrosis hepática en pacientes chilenos con hepatitis crónica por virus C / Interferon Lambda 4 RS12979860 C> T polymorphism is not associated with liver fibrosis in patients with hepatitis C
Fonte: Rev. méd. Chile;146(7):823-829, jul. 2018. tab.
Idioma: es.
Projeto: OAIC.
Resumo: Background. Host genetic predispositions may be important determinants of liver fibrosis in patients with chronic hepatitis C (CHC). The association between Interferon-L 4 (IFNL4) rs12979860 C>T polymorphism and risk of liver fibrosis in CHC is contradictory. Aim: To evaluate the impact of IFNL4 rs12979860 polymorphism on the risk of fibrosis in patients with CHC. Material and Methods: One hundred fifty patients with CHC aged 50 ± 11 years (89 females) were genotyped for IFNL4 rs12979860 using real time PCR. Fibrosis present in liver biopsies was assessed using the METAVIR score, comparing patients with either no fibrosis, mild fibrosis, or intermediate fibrosis (F0+F1+F2, n = 96), with patients with severe fibrosis or cirrhosis (F3+F4, n = 54). Results: In F0-F2 patients the distribution of rs12979860 genotypes was 22 CC, 57 CT and 17 TT, whereas in patients F3-F4 the distribution was 10, 29 and 15, respectively. No association between IFNL4 rs12979860 genotype and risk of fibrosis was observed in uni or multivariate analyses. Conclusions: IFNL4 rs12979860 C>T polymorphism is not associated with risk of liver fibrosis in this group of patients with CHC.
Descritores: Interleucinas/genética
Hepatite C Crônica/genética
Cirrose Hepática/genética
-Antivirais/uso terapêutico
Chile
Estudos Retrospectivos
Fatores de Risco
Interferons/uso terapêutico
Hepatite C Crônica/tratamento farmacológico
Hepatite C Crônica/sangue
Polimorfismo de Nucleotídeo Único
Genótipo
Cirrose Hepática/sangue
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1042812
Autor: Ledezma-Morales, Mónica; Restrepo G, Juan Carlos; Amariles, Pedro; Trillos A, María Camila; Vargas R, Rubén Darío.
Título: Caracterización de pacientes con hepatitis C crónica tratados en un hospital de alta complejidad de Medellín / Characterization of patients with chronic hepatitis C treated in a high complexity hospital in Medellin
Fonte: Rev. colomb. gastroenterol;34(3):249-260, jul.-set. 2019. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: la hepatitis C (HepC) representa un problema de salud pública a nivel mundial. Se estima que en Colombia la prevalencia de virus de la hepatitis C (VHC) está entre el 0,5-1 %, y asciende al 2,1 % en pacientes mayores de 50 años. La Unidad de Hepatología del Hospital Pablo Tobón Uribe (HPTU) ha sido un referente en el manejo de la HepC en Medellín y Colombia durante años. Objetivo: describir las características sociodemográficas/clínicas y los resultados en salud de los pacientes con HepC crónica atendidos en el HPTU entre 2013 y 2018. Materiales y métodos: estudio observacional, descriptivo, retrospectivo de pacientes con HepC crónica atendidos entre el 1 de enero de 2013 y el 31 de marzo de 2018. Resultados: se analizaron 108 pacientes. La edad promedio fue de 55,8 años (desviación estándar [DE] 13,7), 51,9 % eran hombres, y 78,7 % pertenecían al régimen contributivo. El mecanismo de transmisión más frecuente fue la hemotransfusión; el genotipo 1 predominó en el grupo de pacientes analizados. La efectividad de los esquemas con interferón fue del 46,9 % y de los antivirales de acción directa (AAD) del 94,6 %. La presencia de reacciones adversas a medicamentos (RAM) fue del 68,2 % en pacientes con esquemas con interferón/ribavirina y del 25,9 % en pacientes con AAD. Conclusiones: se realiza la caracterización de los pacientes atendidos en el HPTU, en quienes los AAD han mostrado mayor efectividad y seguridad en comparación con esquemas con interferón/ribavirina.

Abstract Introduction: Throughout the world hepatitis C (HepC) is a public health problem. Estimates for its prevalence in Colombia range from 0.5% to 1% but 2.1 % for patients over 50 years of age. The Hepatology Unit at the Hospital Pablo Tobón Uribe (HPTU) has been a benchmark for management of HepC in Medellín and Colombia for years. Objective: To describe sociodemographic and clinical characteristics together with health outcomes of patients with chronic HepC who were treated at the HPTU between 2013 and 2018. Materials and methods: This is an observational, descriptive and retrospective study of patients with chronic HepC, treated between January 1, 2013 and March 31, 2018. Results: One hundred and eight patients were analyzed. The average age was 55.8 years (SD 13.7), 51.9% were men, and 78.7% belonged to the contributory health care scheme. Most frequently, the disease was transmitted by blood, and genotype 1 predominated in the group of patients analyzed. The effectiveness of interferon schemes was 46.9% while that of Direct-Acting Antivirals (DAA) was 94.6%. Adverse drug reactions were found in 68.2% of patients treated with interferon/ribavirin schemes but in only 25.9% of the patients treated with DAA. Conclusions: In this group of patients treated at HPTU, DAA were safer and more effective than interferon/ribavirin schemes.
Descritores: Pacientes
Estudos Retrospectivos
Hepatite C Crônica
-Antivirais
Interferons
Atenção à Saúde
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
Limites: Humanos
Masculino
Feminino
Tipo de Publ: Estudo Observacional
Responsável: CO354 - Sociedad Colombiana de Gastroenterología


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Id: biblio-897004
Autor: Avanzi, Valéria Miranda; Vicente, Bianca Arão; Beloto, Nayara Carvalho Polido; Gomes-da-Silva, Monica Maria; Ribeiro, Clea Elisa Lopes; Tuon, Felipe Francisco; Vidal, Luine Rosele Renaud; Nogueira, Meri Bordignon; Raboni, Sonia Mara.
Título: Profile of HIV subtypes in HIV/HBV- and HIV/HCV-coinfected patients in Southern Brazil
Fonte: Rev. Soc. Bras. Med. Trop;50(4):470-477, July-Aug. 2017. tab, graf.
Idioma: en.
Projeto: Conselho Nacional de Desenvolvimento Científico e Tecnológico.
Resumo: Abstract INTRODUCTION: HIV and viral hepatitis infections are major causes of chronic disease worldwide and have some similarities with regard to routes of transmission, epidemiology, front barriers faced during access of treatment, and strategies for a global public health response. The objective was to describe the HIV-1 subtypes, viral tropism and single-nucleotide polymorphisms (SNPs) of interleukin 28B (IL28B) from a case series of HIV/viral hepatitis coinfected patients from southern Brazil. METHODS: Clinical and epidemiological data were evaluated by a review of medical records. Periodic blood draws were taken to determine the viral and host characteristics. RESULTS: This study included 38 patients with HIV/HBV or HIV/HCV coinfection; the median age was 49 years. Thirty-seven (97.4%) were on antiretroviral therapy, 32 (84.2%) had an undetectable viral load, a median CD4+ T-cell count of 452 cells/mm3. HIV-1 subtyping showed 47.4 and 31.6% of patients with subtypes C and B, respectively. Analysis of viral co-receptor usage showed a predominance of the R5 variant (64.7%), with no significant difference between the subtypes. Twenty patients with HIV/HCV coinfection were eligible to receive HCV therapy with pegylated-interferon-alpha plus ribavirin, and 10/20 (50%) of them achieved sustained virological response. SNPs of IL28B were evaluated in 93.3% of patients with HIV/HCV coinfection, and 17 (60.7%) presented the CC genotype. CONCLUSIONS: In the present case series, a higher frequency of HIV subtype C was found in coinfected patients. However such findings need to be prospectively evaluated with the inclusion of data from regional multicenter analyses.
Descritores: Variação Genética
Infecções por HIV/virologia
Interleucinas/genética
Hepatite C Crônica/complicações
Polimorfismo de Nucleotídeo Único
Hepatite B/complicações
-Infecções por HIV/complicações
Estudos Transversais
Interferons
Tropismo Viral
Coinfecção/virologia
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Responsável: BR1.1 - BIREME


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Souto, Francisco José Dutra
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Id: biblio-897052
Autor: Lobato, Cirley Maria de Oliveira; Balassiano, Natalia; Hyppolito, Elodie Bomfim; Sanchez-Lermen, Rafaela Liz Pellegrim; Signorelli, Izabelle Venturini; Nicacio, Miguel Yasuo Tomita; Firmino Filho, Alberto Pereira; Andrade, Thais Guaraná de; Lima, José Milton de Castro; Arruda, Talita Amorim de; Coutinho, Fernanda Schwanz; Araujo, Everton Felipe do Vale; Esmeraldo, Ticiana Mota; Cortez, Erlon; Capeli, Rafaela Lorenzon Aragão; Matos, Melquior Brunno Mateus de; Pessoa, Francisco Sérgio Rangel; Oliveira, Hélder Cássio de; Arruda, Érico Antônio Gomes de; Gonçalves, Patrícia Lofêgo; Araújo Filho, Antônio Haroldo; Esberard, Eliane Bordalo Cathalá; Souto, Francisco José Dutra.
Título: Effectiveness of first-wave protease inhibitors in hepatitis C virus genotype 1 infection: a multicenter study in Brazil
Fonte: Rev. Soc. Bras. Med. Trop;51(1):14-20, Jan.-Feb. 2018. tab.
Idioma: en.
Resumo: Abstract INTRODUCTION: In 2013, combination therapy using peginterferon, ribavirin, and boceprevir or telaprevir was introduced to treat hepatitis C virus genotype 1 infection in Brazil. The effectiveness of this therapy in four Brazilian regions was evaluated. METHODS: Clinical and virological data were obtained from patients of public health institutions in five cities, including sustained virological response (SVR) and side effects. Patients with advanced fibrosis (F3/4), moderate fibrosis (F2) for > 3 years, or extra-hepatic manifestations were treated according to Ministry of Health protocol. Treatment effectiveness was verified by using bivariate and multivariate analysis; p-values of < 0.05 were considered significant. RESULTS: Of 275 patients (64.7% men; average age, 57 years old), most (61.8%) were treatment-experienced; 53.9% had subgenotype 1a infection, 85.1% had advanced fibrosis, and 85.5% were treated with telaprevir. SVR was observed in 54.2%. Rapid virological response (RVR) was observed in 54.6% of patients (data available for 251 patients). Overall, 87.5% reported side effects and 42.5% did not complete treatment. Skin rash, severe infection, and death occurred in 17.8%, 2.5%, and death in 1.4% of cases, respectively. SVR was associated with treatment completion, RVR, and anemia. CONCLUSIONS: The effectiveness of hepatitis C virus triple therapy was lower than that reported in phase III clinical trials, possibly owing to the prioritized treatment of patients with advanced liver fibrosis. The high frequency of side effects and treatment interruptions observed supported the decision of the Brazilian authorities to suspend its use when safer and more effective drugs became available in 2015.
Descritores: Inibidores de Proteases/administração & dosagem
Hepacivirus/genética
Hepatite C Crônica/tratamento farmacológico
-Oligopeptídeos/administração & dosagem
Ribavirina/administração & dosagem
Prolina/administração & dosagem
Prolina/análogos & derivados
Protocolos Clínicos
Interferons/administração & dosagem
Resultado do Tratamento
Hepatite C Crônica/virologia
Quimioterapia Combinada
Resposta Viral Sustentada
Genótipo
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Feminino
Adulto
Idoso
Tipo de Publ: Estudo Multicêntrico
Ensaio Clínico Fase III
Responsável: BR1.1 - BIREME


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Id: biblio-1103663
Autor: Cañás, Martin; Urtasun, Martin A.
Título: La evidencia en tiempos de coronavirus (COVID-19) / Evidence in times of coronavirus (COVID-19)
Fonte: Evid. actual. práct. ambul;23(2):e002057, 2020.
Idioma: es.
Resumo: La pandemia de COVID-19 está generando información epidemiológica y clínica en una escala sin precedentes para una enfermedad de reciente aparición. Aunque ya se han iniciado numerosos ensayos clínicos de fármacos antiguos y nuevos como potenciales antivirales específicos, la mayor parte de la información publicada hasta ahora carece de los controles básicos para la evaluación de la eficacia de un medicamento. Los medios de comunicación amplifican estos resultados preliminares y suman presión a los médicos asistenciales y a los decisores de políticas públicas. Este artículo revisa las pruebas disponibles sobre los cuatro tratamientos antivirales específicos más prometedores: hidroxicloroquina, lopinavir/ritonavir, remdesvir e interferones alfa y beta. Se comprueba en todos ellos que no hay demostración suficiente de eficacia como para recomendar su uso fuera de una investigación experimental adecuadamente controlada. En el uso individual de un medicamento no hay forma de saber si está beneficiando o perjudicando al paciente. Es erróneo asumir que la eventual curación se debe al fármaco y un mal desenlace debe atribuirse a la enfermedad. Sólo la comparación entre grupos de pacientes asignados al tratamiento experimental o a un control adecuado permite conocer la eficacia y seguridad de las intervenciones. El desafío es conciliar la urgencia de actuar con la generación de nuevos conocimientos.Aunque no resulta sencillo organizar ensayos clínicos en este contexto, las instituciones pueden sumarse a los proyectos en marcha a nivel nacional e internacional. El uso de estos fármacos debe considerarse experimental, por lo que es necesario obtener el consentimiento informado del paciente. (AU)

The COVID-19 pandemic is generating epidemiological and clinical information on an unprecedented scale for a newly emerging disease. Although numerous clinical trials of old and new drugs as potential specific antivirals have already been started, most of the information published so far lacks basic controls for evaluating drug efficacy. The media amplify these preliminary results and add pressure to doctors and policymakers. This article reviews the available evidence for the four most promising specific antiviral treatments: hydroxychloroquine, lopinavir / ritonavir, remdesvir, and alpha and beta interferons. The findings show that none of them has sufficient demonstration of efficacy to recommend its use outside ofthe adequately controlled experimental study. In the individual use of a drug there is no way of knowing if it is benefiting orharming the patient. It is wrong to assume that the eventual cure is due to the drug and a poor outcome must be attributed to the disease. Only the comparison between groups of patients assigned to the experimental treatment or to an adequate control can establish the efficacy and safety of the interventions. The challenge is to reconcile the urgency to act with the generation of new knowledge. Although it is not easy to organize clinical trials in this context, the institutions can join theongoing projects at the national and international levels. The use of these drugs should be considered experimental, so it is necessary to obtain the informed consent of the patient. (AU)
Descritores: Antivirais/farmacologia
Pneumonia Viral/tratamento farmacológico
Interferons/farmacologia
Infecções por Coronavirus/tratamento farmacológico
Ritonavir/farmacologia
Lopinavir/farmacologia
Hidroxicloroquina/farmacologia
-Antivirais/efeitos adversos
Resultado do Tratamento
Azitromicina/farmacologia
Medição de Risco
Ritonavir/administração & dosagem
Ritonavir/efeitos adversos
Medicina Baseada em Evidências/tendências
Disseminação de Informação
Uso Off-Label
Comunicação em Saúde
Pandemias
Lopinavir/administração & dosagem
Lopinavir/efeitos adversos
Hidroxicloroquina/administração & dosagem
Hidroxicloroquina/efeitos adversos
Consentimento Livre e Esclarecido
Limites: Humanos
Tipo de Publ: Editorial
Responsável: AR2.1 - Biblioteca Central



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