Abes Mahmed Amed

Prevalence of sexual dysfunction during pregnancy

OBJECTIVEnThis study aims to evaluate the sexual function and to determine the prevalence of sexual dysfunction among teenagers and adult women during pregnancy using the Female Sexual Function Index (FSFI).nnnMETHODSnA cohort study was conducted with 271 healthy pregnant women presenting a stable relationship with their partners. These women contributed to the survey since the laboratory diagnosis of their present pregnancy. Anonymous questionnaires evaluated aspects of sexual activity and female sexual function. This last item was assessed through the FSFI questionnaire.nnnRESULTSnThe women sexual function showed a similar pattern during the first and second trimesters; however, it presented a significantly clear decrease in the third trimester. There was a significant difference in the scores of all FSFI domains when comparing the second and third trimesters. The sexual dysfunction among pregnant teenagers was rated 40.8% in the first trimester, 31.2% in the second and 63.2% in the third. For pregnant adults, the dysfunction was rated, respectively, 46.6%, 34.2% and 73.3%.nnnCONCLUSIONnThe sexual function is affected during pregnancy with a significant decrease in all FSFI domains in the third trimester considering both pregnant teenagers and adults. Prevalence of sexual dysfunction is high during pregnancy and reaches higher levels in the third trimester in both age groups; however, teenagers presented better sexual function ratings.

HIV-infected pregnant women have greater adherence with antiretroviral drugs than non-pregnant women

The objective of the study was to evaluate the influence of pregnancy on the level of adherence with antiretroviral (ARV) drugs, in a prospective cohort of 72 pregnant women and 79 non-pregnant women. Adherence was measured by pill counting and self-reporting. Women were deemed adherent if 95% or more of all ARV had been taken as prescribed, in two occasions. According to pill counting, 43.1 and 17.7% of pregnant and non-pregnant women, respectively, met the criteria of adherence (P = 0.001); in the postpartum, adherence declined to 20.6% (P = 0.002). In both groups, adherence rates by self-reporting were significantly higher as compared with pill counting (P = 0.001). In multivariate regression analysis, age >29 years (odds ratio [OR] 3.58, confidence interval [CI] 95% 0.10–0.75, P = 0.011), mean number of pills/day <6 (OR 2.53, CI 95% 1.07–6.01, P = 0.035), and being pregnant (OR 3.33, CI 95% 1.36–8.13, P = 0.008) were independently associated to greater adherence.

Stavudine effects on rat pregnancy outcome

Objective: Stavudine is an inhibitor of HIV reverse transcriptase and acts as a chain terminator during DNA synthesis. The aim of the study presented here was to evaluate the effects of stavudine during rat pregnancy.

Foscarnet Effects on the Rat Pregnancy Outcome

Foscarnet es un inhibidor de la transcriptasis reversa del HIV que actua en la sintesis del DNA. En este trabajo evaluamos los efectos cronicos del foscarnet durante la prenez de la rata albina. Ratas prenadas fueron distribuidas aleatoriamente en cuatro grupos (n = 10 para cada grupo): uno control (C), tratadas con agua bidestilada, y tres experimentales (E1, E2 y E3), tratadas con 180, 360 o 720 mg/Kg al dia de foscarnet. El farmaco y el vehiculo (siempre 1 ml) fueron administrados una vez al dia desde el dia 0 hasta el dia 20 de la gestacion. Las ratas fueron pesadas semanalmente y sacrificadas al termino de la prenez. No se observaron alteraciones significativas en cuanto al incremento de peso corporal entre los grupos. Sin embargo, las ratas tratadas con foscarnet (especialmente las de los grupos E2 y E3) presentaron reducciones del peso promedio de los fetos y de las respectivas placentas. La incidencia de reabsorciones y malformaciones (acortamiento de miembros) fue significativa en el grupo E3. Se concluye que la administracion de foscarnet durante toda la prenez de la rata puede producir efectos toxicos definidos, especialmente en los compartimientos placentario y fetal

Efeitos do uso crônico do amprenavir sobre a prenhez da rata albina

OBJECTIVE: to evaluate the chronic effects of amprenavir on implantations, reabsorptions, fetuses, placentae, and maternal and fetal mortality in the albino rat. METHODS: five groups of EPM-1 Wistar pregnant rats were used: two controls: Contr1 (control of stress) and Contr2 (drug vehicle control), and 3 experimental groups that were treated once a day throughout gestation with 46mg/kg (Exper1), 138mg/kg (Exper2) and 414mg/kg (Exper3) of oral solution of amprenavir. The drug and the vehicle (propyleneglycol) were administered by gavage. The evaluations included maternal body weight gain, number of implantations, reabsorptions, fetuses, placentae and of intrauterine deaths as well as fetal and placental mean weight and major malformations. Fragments of lungs, kidneys, liver and intestines were collected and prepared for histopathological evaluation. RESULTS: Exper3 group tended to show lesser maternal body weight gain during gestation (P = 0.07), but amprenavir did not affect the intrauterine contents. The cytotoxic effect of the drug was observed with regard to the histopathological analyses of pregnant rat viscerae and to the maternal mortality rate: 50% in Exper1 and Exper2 groups, and 70% in Exper3 group. CONCLUSION: amprenavir exerted adverse side effects on maternal lung, gut, kidney and liver, and significantly increased maternal mortality rates in all administered doses and especially at 414 mg/kg.

Morbidade febril puerperal em pacientes infectadas pelo HIV

PURPOSE: the morbidity in HIV-positive patients due to puerperal fever was studied and correlated to the method and duration of labor, the duration of premature rupture of the membranes, CD4+ cell count and the viral load (VL) at peridelivery. METHODS: a total of 207 HIV-positive women with prenatal examinations and deliveries between May 1997 and December 2001 were enrolled. Of these, 32 had natural childbirth and 175 had a cesarean section. Of the total of enrolled patients, 62.8% were submitted to elective cesarean section. The average age of the group was 27.4 years, and 25.6% were nulliparous and 26% were primiparous. At the moment of the delivery the average gestational age was 37.8 weeks. At the end of pregnancy the average of the CD4+ cell count was approximately 481 cells/mm3 and the viral load 49,100 copies/mL. RESULTS: puerperal morbidity occurred in 34 patients, with 33 after cesarean section and one after natural childbirth. The most usual intercurrent post-cesarean infection was that of the surgical wound (13% of the infection cases). Analyzed factors, such as delivery duration, duration of rupture of the membranes, number of CD4+ cells or the viral load at peridelivery, did not interfere in puerperal morbidity. CONCLUSIONS: puerperal morbidity was 16.8% and occurred more frequently after cesarean sections (18.9%) than after vaginal deliveries (3.1%). The other factors did not present a significant effect on puerperal morbidity.

Qualidade de vida de gestantes infectadas pelo vírus da imunodeficiência humana (HIV) na cidade de São Paulo

PURPOSE: It was to assess the quality of life (QOL) of HIV-infected pregnant women using the HIV/AIDS - Targeted Quality of Life (HAT-QoL) questionnaire.METHODS:A descriptive study of 60 pregnant women attended at the Multidisciplinary Nucleus of Infectious Diseases During Pregnancy (NUPAIG) - UNIFESP/EPM and in the referral network of the Municipal Office of Sao Paulo, conducted from February 2011 to October 2012. Sociodemographic and clinical variables were collected from 60 HIV-infected pregnant women who answered the HAT-QoL questionnaire, which included 34 questions about quality of life.RESULTS:The average age was 30 years and the average period of HIV infection was 5.7 years. Only 8.3% of patients had a CD4 cell score of ≤200 cells/mm³ and 45% showed undetectable viral load. The average domain scores ranged from 47.5 to 83.7. The domains with the lowest scores were financial concerns and concerns about secrecy. The domains with the highest scores and lower impact on quality of life were concerns about medication and confidence in the professional.CONCLUSION: In this initial study with 60 pregnant women, we concluded that the HAT-QOL can contribute to the assessment of quality of life in the population of HIV-infected pregnant women in Brazil.

Efeitos do uso crônico do nelfinavir sobre a prenhez da rata albina: ensaio biológico

OBJETIVO: avaliar o efeito do uso cronico do nelfinavir sobre o peso de ratas albinas prenhes e seus conceptos, bem como o numero de implantacoes, fetos, placentas, reabsorcoes e mortalidade materna e fetal. METODOS: 50 ratas albinas EPM-1 Wistar, prenhes, foram aleatoriamente divididas em cinco grupos: 2 controles, Contr1 (controle do estresse) e Contr2 (controle do veiculo), e tres experimentais, Exp40, Exp120 e Exp360, que receberam, respectivamente, 40, 120 e 360 mg/kg por dia de nelfinavir por via oral. A droga e o veiculo (agua destilada) foram administrados por gavagem em duas tomadas diarias (12/12 horas), desde o primeiro dia ate o dia 20 da prenhez. No ultimo dia do experimento, todos os animais foram anestesiados e sacrificados. Foram avaliados a evolucao do peso, numero de implantacoes, reabsorcoes, fetos, placentas, obitos intra-uterinos, o peso dos fetos e das placentas e malformacoes maiores. A analise estatistica foi realizada pela analise de variância (ANOVA) completada pelo teste de Kruskal-Wallis. RESULTADOS: em relacao ao ganho de peso das ratas, houve ganho normal em todos os grupos, nao sendo constatadas diferencas significantes entre eles. ANOVA mostrou ausencia de diferencas significativas entre os grupos quanto aos parâmetros estudados. As medias do numero de fetos foram: controles = 9,7±0,50; grupos tratados com nelfinavir = 9,7±0,81. Para as medias de numeros de placentas e implantacoes, controles = 9,7±0,50; grupos tratados com nelfinavir = 9,7±0,78. Quanto as medias de pesos fetais, controles = 4,04±0,50; grupos tratados com nelfinavir = 3,91±0,33 g. Finalmente, para as medias de pesos de placentas, controles = 0,64±0,02; grupos tratados com nelfinavir = 0,67±0,02 g. Alem disto, nao foram observadas reabsorcoes, mortalidade das matrizes, obitos e malformacoes fetais. CONCLUSOES: o nelfinavir, em todas as doses administradas, nao influiu no ganho de peso das ratas prenhes e nao mostrou efeitos deleterios sobre os conceptos.

HIV infected pregnant women and STD: Prevalence and correlation between clinical and laboratorial exams

delivery in 5% of the patients. The global index of transmission was 15.9% (221138). Elective cesarean delivery was associated with a lower transmission rate than emergent cesarean or vaginal delivery: 12.1% (4/33), 15.4% (2113) and 17.4% (16192) respectively. Antiretroviral therapy used was: ACTG076 (zidovudine alone) complete (69/138), ACTG076 incomplete (19/138), combined therapy with analogues nucleosides with or without protease inhibitor (291138) and no treatment (211138). The transmission rates were: 7.2%, 26.3%, 0% and 57.1% respectively. The highest transmission rate was observed in patients with vaginal delivery that did not receive treatment (58.8%), while the lowest transmission rate was in the combined therapy group despite of the mode of delivery used. Conclusions: These data confirm that perinatal transmission decreases with appropriate treatment during pregnancy. Our results suggest that combined therapy is more effective than zidovudine alone to prevent HIV perinatal transmission.