Navegando por Palavras-chave "lipodystrophy"
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- ItemAcesso aberto (Open Access)Composição corporal e densidade mineral óssea em crianças e adolescentes pré-puberes infectados pelo HIV(Universidade Federal de São Paulo (UNIFESP), 2014) Palchetti, Cecília Zanin [UNIFESP]; Oliveira, Fernanda Luisa Ceragioli [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: Avaliar prospectivamente as alteracoes ocorridas na composicao corporal de pacientes infectados pelo HIV e identificar as variaveis determinantes de lipodistrofia ao longo do tempo. Metodos: Estudo de coorte prospectivo, avaliado em periodo de dois anos e meio, incluindo 35 pre-puberes infectados pelo HIV, ambos os sexos, entre 7 a 12 anos atendidos em centro de referencia. Os pacientes foram distribuidos em dois grupos: sem lipodistrofia (SL) e com lipodistrofia (CL). Compararam-se dados clinicos, antropometricos, de composicao corporal e bioquimicos alem da determinacao dos fatores preditores de lipodistrofia no tempo 1 (T1) e tempo 2 (T2). Resultados: A media (DP) de idade foi de 9,6(1,1) e 11,6 (1,2) anos, no T1 e T2, respectivamente. No T2, 16 (45,7%) criancas continuavam pre-puberes. O grupo CL (n=8) apresentou maior prevalencia de baixa estatura (p =0,008) no T1, maiores valores de insulina (p=0,010) e HOMA-IR (p=0,013) e reducao da dobra cutanea tricipital (p=0,026) no T2 comparado ao grupo SL (n=27). Nos dois tempos, observou-se menores concentracoes de HDLc (p=0,027), maiores valores de relacao tronco/braco (p=0,002;p=0,001) e menores valores da relacao braco+perna/tronco (p=0,001) no grupo CL. No T1, os fatores preditores independentes de lipodistrofia foram baixa estatura (OR= 46,198; p= 0,019) e relacao braco+perna/tronco (OR=0,00009; p= 0,011); no T2 foram circunferencia abdominal (OR= 1,199; p = 0,025) e HDLc (OR = 0,835; p = 0,015). Conclusao: Em periodo curto de tempo, o grupo CL apresentou significativa redistribuicao de gordura corporal com adiposidade central e alteracoes bioquimicas compativeis com a sindrome lipodistrofica que aumenta o risco cardiovascular desses pacientes
- ItemSomente MetadadadosThe impact of facial lipoatrophy treatment with polymethyl methacrylate in AIDS patients as measured by four quality-of-life questionnaires(Royal Soc Medicine Press Ltd, 2011-10-01) Warde Filho, Mario Jorge [UNIFESP]; Gragnani, A. [UNIFESP]; Gomes, H. [UNIFESP]; Hochman, Bernardo [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Life-expectancy increased in patients infected with HIV/AIDS with the advent of highly active antiretroviral therapy (ART). Facial lipoatrophy is a common complication in these patients, eventually leading to stigma, segregation and a negative impact in quality of life (QOL). We measured the impact of the treatment of facial lipoatrophy with polymethyl methacrylate (PMMA) in the QOL of patients with HIV/AIDS by using four questionnaires that address QOL. Forty consecutive patients on ART referred for facial lipoatrophy treatment were enrolled in this study. the first 20 were allocated to the intervention group and were treated with tissue augmentation with PMMA. the other 20 were allocated to the control group, which received treatment only after six months. At baseline, four questionnaires were applied to all patients in both groups and again after six months. the variation in scores within the control group for all domains of all four instruments was significantly better when compared with that within the control group. We detected improvement in the QOL of patients with HIV/AIDS and facial lipoatrophy when they were treated with PMMA.
- ItemAcesso aberto (Open Access)Lipodistrofia em crianças e adolescentes com síndrome da imunodeficiência adquirida e sua relação com a terapia antirretroviral empregada(Sociedade Brasileira de Pediatria, 2009-08-01) Sarni, Roseli Oselka Saccardo [UNIFESP]; Souza, Fabíola Isabel Suano de [UNIFESP]; Battistini, Tânia Regina Beraldo; Pitta, Tassiana Sacchi; Fernandes, Ana Paula; Tardini, Priscila Chemiotti; Fonseca, Fernando Luiz Affonso [UNIFESP]; Santos, Valter Pinho dos [UNIFESP]; Lopez, Fábio Ancona [UNIFESP]; Faculdade de Medicina do ABC Departamento de Pediatria Serviço de Nutrologia; Universidade Federal de São Paulo (UNIFESP); FMABC Departamento de Pediatria Serviço de Nutrologia; FMABC Serviço de Nutrologia, Departamento de Pediatria; FMABC; Universidade de São Paulo (USP); FMABC Departamento de PediatriaOBJECTIVE: To evaluate the presence of clinical lipodystrophy in children with the acquired immunodeficiency syndrome and to relate it to the antiretroviral regimen employed, to changes in lipid profile and to insulin resistance. METHODS: This was a cross-sectional study that evaluated 30 children and adolescents (median age = 9.1 years) with the acquired immunodeficiency syndrome during 2004 and 2005. The following clinical and laboratory evaluations were performed: classification of HIV infection, anthropometric measurements (weight and height), serum glycemia, serum insulin and lipid profile (LDL-c, HDL-c, triglycerides). Lipodystrophy was diagnosed using clinical parameters. The chi-square test was used for statistical analysis. RESULTS: All of the patients were taking antiretroviral therapy regularly (median duration of 28.4 months); 80% were on three drugs in combination (highly active therapy) and 30% were on protease inhibitors. Lipodystrophy and dyslipidemia were observed in 53.3 and 60% of the patients, respectively. Children on a highly active therapy regimen with protease inhibitors exhibited a higher percentage of mixed lipodystrophy; the difference between these children and the group on highly active therapy without protease inhibitors and the group not on a highly active therapy was statistically significant (44.4 vs. 16.7%; p = 0.004). There was no statistically significant association between the presence of lipodystrophy and sex, age (> 10 years), changes to the lipid profile or insulin resistance. CONCLUSIONS: The elevated prevalence of dyslipidemia and lipodystrophy observed among children with acquired immunodeficiency syndrome, which exhibited a relationship with the antiretroviral regimen employed, may represent an increased risk for future complications, in particular cardiovascular problems.