Hugo Ribeiro Zanetti

Cardiovascular Complications of HIV

With the advent of the antiretroviral therapy (ART), people infected with HIV are experiencing a significant increase in life expectancy. However, as this population ages, the morbidity and mortality due to events not related to HIV infection and/or treatment become increasingly clear. Cardiovascular diseases are among the major causes of death, and, thus, understanding the factors that trigger this situation is necessary. This review article will assess how the intrinsic and extrinsic factors related to HIV, ART and the associated risk factors can aid the epidemiological transition of mortality in this population. Moreover, we will present the studies on the epidemiology and pathogenesis of each clinical condition related to HIV-infected individuals, in addition to introducing the major markers of cardiovascular disease in this population. Finally, we will point the main issues to be addressed by health professionals for an adequate prognosis.

Efficacy and safety of pharmacological interventions in metabolic syndrome: protocol for systematic review and network meta-analysis

Introduction: The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades. MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia and an increased risk of cardiovascular events.This study aims to fill this gap of research by conducting a Bayesian network meta-analysis to compare major drugs to treat MetS. Methods and analysis: We will search the PubMed, EMBASE, Cochrane Library, Web of Science, Embase, google scholar, clinical trials registry (ClinicalTrials. gov) for unpublished or undergoing research listed in registry platforms. Randomized controlled trials (RCTs) on the drug therapy of MetS with outcome measures including diagnostic criteria of MetS will be included. The quality of included RTCs will be evaluated according to the Cochrane Collaboration’s risk of bias tool. Traditional pairwise meta-analysis and Bayesian network meta-analysis will be conducted to compare the efficacies of antidiabetic drugs. Sensitivity analysis on the sample size of RCTs, meta-regression analysis on the follow-up periods, dosages and baselines of outcome measure, contradiction analysis between pairwise and network meta-analyses, and publication bias analysis, will be performed. Randomized controlled trials (RCTs) on the drug therapy of MetS with outcome measures criteria of MetS diagnostic will be included. The quality of included RTCs will be evaluated according to the Cochrane Collaboration’s risk of bias tool. Traditional pairwise meta-analysis and Bayesian network meta-analysis will be conducted to compare the efficacies of drugs. Sensitivity analysis on the sample size of RCTs, meta-regression analysis on the follow-up periods, dosages and baselines of outcome measure, contradiction analysis between pairwise and network meta-analyses, and publication bias analysis, will be performed. Ethics and dissemination Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. Trial registration number: PROSPERO (CRD42018083468). *Correspondence to: Leonardo Roever, MHS, Federal University of Uberlândia, Department of Clinical Research, Brazil, Email: leonardoroever@hotmail.com

Triad of the Ischemic Cardiovascular Disease in People Living with HIV? Association Between Risk Factors, HIV Infection, and Use of Antiretroviral Therapy

Purpose of ReviewThis review is focused on cardiovascular risk factors in HIV-infected people.Recent FindingsAntiretroviral therapy (ART) has significantly increased the life expectancy of HIV-infected people. Thus, this population has experienced non-HIV-related diseases, mainly cardiovascular diseases. Thus, in our review, we intend to understand the cardiovascular risk factors that trigger this situation.SummaryWe have demonstrated that both ART and traditional cardiovascular risk factors contribute to the development of cardiovascular disease in HIV-infected people. Thus, it becomes important to stratify the risk factors to reduce this scenario.

Human Immunodeficiency Virus Infection, Antiretroviral Therapy, and Statin: a Clinical Update

Purpose of ReviewThis clinical update is intended to focus in relationship between HIV infection and use of antiretroviral therapy (ART) and statin.Recent FindingsThough ART significantly changed the course of HIV infection, it is related to numerous side effects principally to the lipid profile. In this way, statins became one of the most used lipid-lowering therapies in this population. In our clinical update, we evaluated studies that demonstrate the relationship and molecular mechanisms that HIV infection and ART use trigger dyslipidemia and also the use of statin to reduce this condition.SummaryWe have demonstrated that use of statin can be used in dyslipidemic HIV-infected people as long as there is no drug interaction with ART. Recently, studies using rosuvastatin have shown greater effects when compared to the other statins.

TENDÊNCIA TEMPORAL DE TABAGISMO E INTERNAÇÕES POR DOENÇAS DO APARELHO RESPIRATÓRIO NAS CAPITAIS DA REGIÃO SUDESTE DO BRASIL: 2008-2013

This study aim to describe the prevalence of smoking and hospitalizations due to respiratory diseases inadults of capital cities of southeastern, Brazil. It is a quantitative research data were obtained from asystematic search of computerized databases made available by the Ministry of Health of Brazil, namely theRisk and Protective Factors for Chronic Diseases Surveillance through telephone (VIGITEL) and the SingleSystem Database Health (DATASUS), focalizing changes in the percentage of smokers and number ofhospitalizations due to respiratory diseases between the period from 2008 to 2013. Over the yearsanalyzed there was a decline in the percentage of smokers and stabilizing the number of hospitalizationsfor respiratory diseases. The tendency of decline the percentage of smokers indicates the effectiveness ofsmoke-free policies in the country and possibly having positive impact on the prevention of respiratorydiseases. Descriptors : Smoking; Respiratory systems; Public Health; Uses of Epidemiology.

Resistance training improves quality of life in people with HIV: a randomized clinical trial

The study aimed to evaluate the effect of periodized resistance training on the quality of life of people infected with HIV. Thirty HIV-infected people, sedentary and receiving antiretroviral therapy, were randomly divided into two groups. The resistance training group (RT) participated in a 12-week periodized exercise program while the control group (CON) was asked to maintain daily habits. Before and after the twelve weeks, all volunteers answered a quality of life questionnaire (Patient-Reported Outcomes Quality of Life-HIV) in the Portuguese language version, containing eight domains: 1) physical health and symptoms (PHS); 2) body change (BC); 3) social relationships (SR); 4) intimate relationships (IR); 5) stigma (ST); 6) emotional distress (ED); 7) health concerns (HC); and 8) treatment impact (TI). A mixed-design analysis of variance for repeated measures was used to analyze the effects of time, treatment and interaction, having significant value when p <0.05. Interactions were found for the following domains: PHS (p <0.0001), BD (p <0.0001), SR (p <0.0001), IR (p<0.002), ST (p <0.0001), ED (p <0.0001), HC (P <0.0001) and TI (p <0.0001). RT improves quality of life in HIV-infected individuals and points to the need for its implementation in health care services targeted at this population.

Effects of a Six-Week Daily Undulating Resistance Training Program on Anthropometric Characteristics, Biochemical Profile and Muscular Strength in an HIV-Seropositive Woman with Lipodystrophy: A Case Study

To investigate the effects of daily undulating periodization resistance training (DUPRT) program on anthropometric and biochemical profile and muscular strength in an HIV-infected woman with lipodystrophy. Case report: A 50 year old woman participated in a 6 week DUPRT program. Anthropometric and glycemic profile as well as blood lipid profile pre- and post-DUPRT. Results: After six weeks, the participant showed increased body lean mass, circumference of arms, thighs and calf, HDL-c, and muscle strength. She also exhibited reduction in fat percentage and fat mass, circumference of neck, chest, waist, abdomen and hip, and levels of fasting glucose, triglyceride, total cholesterol, LDL-c and HBA1C. Conclusion: Six weeks of DUPRT improved all evaluated profiles in an HIV-infected patient with lipodystrophy.

Cardiovascular risk factors in patients with fibromyalgia

Objetivo: Verificar os fatores de risco cardiovasculares em pacientes com fibromialgia (FM). Metodos: O estudo foi composto por 40 mulheres diagnosticadas com FM e encaminhadas para o setor de Reabilitacao Fisica do Hospital de Clinicas de Uberlândia. Foi aplicado um questionario do American College of Sports Medicine contendo perguntas sobre historico familiar; tabagismo; hipertensao; dislipidemia; glicose de jejum alterada; obesidade; sedentarismo e etilismo. Resultados: O sedentarismo teve prevalencia de 92,5%, hereditariedade 52,5%, obesidade 50%, hipertensao arterial 45%, dislipidemia 37,5%, tabagismo 25%, etilismo 8% e diabetes 7,5%. Alem disso, 60% da amostra apresentou tres ou mais fatores de risco, 30% apresentou 2 fatores e 10% apresentou apenas um fator de risco. Conclusao: Pacientes com FM apresentam varios fatores de risco cardiovasculares, desse modo, deve-se orientar tais pacientes a mudanca do estilo de vida, a fim de reduzir tais fatores e consequentemente eventos cardiacos futuros, e proporciona melhora do quadro de dor.