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Leite-Silva PR, Pinheiro RS, Barbosa-Ferreira JMB, Balieiro A, Sabidó M, Lacerda MVG, Chaves YO, Nogueira PA, Benzaken AS. Bone mass, fracture risk, and associated factors in postmenopausal women living with HIV. Menopause 2024; 31:46-51. [PMID: 38113435 DOI: 10.1097/gme.0000000000002293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVE The aim of this study was to assess the prevalence of low bone mass (osteopenia/osteoporosis), the factors associated with low bone mass, and the risk of fractures in Brazilian postmenopausal women living with HIV (WLH) in the Amazon region. METHODS This is a cohort study with a cross-sectional assessment at baseline conducted between March 2021 to August 2022 with 100 postmenopausal WLH undergoing antiretroviral therapy (ART) between 45 and 60 years of age and 100 age-matched HIV-negative women. Data on bone mineral density in the lumbar spine (LS) and femoral neck (FN) were collected using dual x-ray absorptiometry and the 10-year risk of hip and major osteoporotic fractures was assessed using the Fracture Risk Assessment tool (FRAX). RESULTS The age of menopause onset occurred earlier in WLH ( P < 0.001). No differences in prevalence of osteoporosis and osteopenia in LS and FN were observed except for a lower T score in FN in WLH ( P = 0.039). The FRAX for major osteoporotic fracture and hip fracture were low in both groups, despite the mean of both FRAX scores was higher in WLH ( P < 0.001). Multivariate analysis showed that years since menopause onset, higher body mass index and higher FRAX major osteoporotic fracture were associated with the WLH group, while a higher frequency of physical activity was registered in the HIV-negative group. Multivariate analysis also showed that in WLH, a lower T score in FN was associated with years since menopause onset and body mass index and that the number of years since menopause onset was associated with a lower T score in the LS and a higher score in the FRAX hip fracture. CONCLUSIONS Our findings show a high prevalence of low bone mass (osteopenia/osteoporosis) in Brazilian postmenopausal women from the Amazon region. Women living with HIV have higher FRAX scores than HIV-negative women and a lower T score in the FN.
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Affiliation(s)
| | - Rebeca S Pinheiro
- Pós-graduação em Imunologia Básica e Aplicada, Universidade Federal doAmazonas, Manaus, Brazil
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Costa AG, Chaves YO, Teixeira-Carvalho A, Ramasawmy R, Antonelli LRV, Barbosa L, Balieiro A, Monteiro WM, Mourão MP, Lacerda MVG, Martins-Filho OA, Costa FTM, Malheiro A, Nogueira PA. Increased platelet distribution width and reduced IL-2 and IL-12 are associated with thrombocytopenia in Plasmodium vivax malaria. Mem Inst Oswaldo Cruz 2020; 115:e200080. [PMID: 32696915 PMCID: PMC7367212 DOI: 10.1590/0074-02760200080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/26/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Thrombocytopenia in malaria involves platelet destruction and consumption; however, the cellular response underlying this phenomenon has still not been elucidated. OBJECTIVE To find associations between platelet indices and unbalanced Th1/Th2/Th17 cytokines as a response to thrombocytopenia in Plasmodium vivax infected (Pv-MAL) patients. METHODS Platelet counts and quantification of Th1/Th2/Th17 cytokine levels were compared in 77 patients with uncomplicated P. vivax malaria and 37 healthy donors from the same area (endemic control group - ENCG). FINDINGS Thrombocytopenia was the main manifestation in 55 patients, but was not associated with parasitaemia. The Pv-MAL patients showed increases in the mean platelet volume (MPV), which may be consistent with larger or megaplatelets. Contrary to the findings regarding the endemic control group, MPV and platelet distribution width (PDW) did not show an inverse correlation, due the increase in the heterogeneity of platelet width. In addition, the Pv-MAL patients presented increased IL-1β and reduced IL-12p70 and IL-2 serum concentrations. Furthermore, the reduction of these cytokines was associated with PDW values. MAIN CONCLUSIONS Our data demonstrate that an increase in MPV and the association between reductions of IL-2 and IL-12 and PDW values may be an immune response to thrombocytopenia in uncomplicated P. vivax malaria.
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Affiliation(s)
- Allyson Guimarães Costa
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil.,Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Diretoria de Ensino e Pesquisa, Manaus, AM, Brasil.,Universidade do Estado do Amazonas, Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil
| | - Yury Oliveira Chaves
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Biologia Parasitária, Rio de Janeiro, RJ, Brasil
| | - Andréa Teixeira-Carvalho
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brasil
| | - Rajendranath Ramasawmy
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil.,Universidade Nilton Lins, Faculdade de Medicina, Manaus, AM, Brasil
| | - Lis Ribeiro Valle Antonelli
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Laboratório de Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Lucas Barbosa
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | - Antonio Balieiro
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | - Wuelton Marcelo Monteiro
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil
| | - Maria Paula Mourão
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil
| | - Marcus Vinicius Guimarães Lacerda
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil.,Universidade do Estado do Amazonas, Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Manaus, AM, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | - Olindo Assis Martins-Filho
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Diretoria de Ensino e Pesquisa, Manaus, AM, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brasil
| | | | - Adriana Malheiro
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Diretoria de Ensino e Pesquisa, Manaus, AM, Brasil.,Universidade do Estado do Amazonas, Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil
| | - Paulo Afonso Nogueira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil
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Magalhães MJTL, Pontes G, Serra PT, Balieiro A, Castro D, Pieri FA, Crainey JL, Nogueira PA, Orlandi PP. Multidrug resistant Pseudomonas aeruginosa survey in a stream receiving effluents from ineffective wastewater hospital plants. BMC Microbiol 2016; 16:193. [PMID: 27558582 PMCID: PMC4995675 DOI: 10.1186/s12866-016-0798-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 08/03/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Multi-drug resistant forms of Pseudomonas aeruginosa (MDRPA) are a major source of nosocomial infections and when discharged into streams and rivers from hospital wastewater treatment plants (HWWTP) they are known to be able to persist for extended periods. In the city of Manaus (Western Brazilian Amazon), the effluent of three HWWTPs feed into the urban Mindu stream which crosses the city from its rainforest source before draining into the Rio Negro. The stream is routinely used by Manaus residents for bathing and cleaning (of clothes as well as domestic utensils) and, during periods of flooding, can contaminate wells used for drinking water. RESULTS 16S rRNA metagenomic sequence analysis of 293 cloned PCR fragments, detected an abundance of Pseudomonas aeruginosa (P. aeruginosa) at the stream's Rio Negro drainage site, but failed to detect it at the stream's source. An array of antimicrobial resistance profiles and resistance to all 14 tested antimicrobials was detected among P. aeruginosa cultures prepared from wastewater samples taken from water entering and being discharged from a Manaus HWWTP. Just one P. aeruginosa antimicrobial resistance profile, however, was detected from cultures made from Mindu stream isolates. Comparisons made between P. aeruginosa isolates' genomic DNA restriction enzyme digest fingerprints, failed to determine if any of the P. aeruginosa found in the Mindu stream were of HWWTP origin, but suggested that Mindu stream P. aeruginosa are from diverse origins. Culturing experiments also showed that P. aeruginosa biofilm formation and the extent of biofilm formation produced were both significantly higher in multi drug resistant forms of P. aeruginosa. CONCLUSIONS Our results show that a diverse range of MDRPA are being discharged in an urban stream from a HWWTP in Manaus and that P. aeruginosa strains with ampicillin and amikacin can persist well within it.
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Affiliation(s)
| | - Gemilson Pontes
- Instituto Nacional de Pesquisa da Amazônia - INPA, 2936 André Araújo Av, 69060-001, Manaus, AM, Brazil
| | - Paula Takita Serra
- Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil
| | - Antonio Balieiro
- Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil
| | - Diogo Castro
- Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil
| | - Fabio Alessandro Pieri
- Departamento Básico - Área de Saúde; Campus Governador Valadares, Universidade Federal de Juiz de Fora, Rua Israel Pinheiro, 2000, Bairro Universitário, Governador Valadares, MG, Brazil
| | - James Lee Crainey
- Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil
| | - Paulo Afonso Nogueira
- Programa de Pós-Graduação Sociedade e Endemias na Amazônia, ILMD, 476, Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.,Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil
| | - Patricia Puccinelli Orlandi
- Programa de Pós-Graduação Sociedade e Endemias na Amazônia, ILMD, 476, Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil. .,Instituto de Pesquisa Leônidas e Maria Deane - FIOCRUZ AMAZONIA, 476 Teresina St, Adrianópolis, 69057-070, Manaus, AM, Brazil.
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