Valdelias Xavier Pereira

An experience of vascular access for hemodialysis in Brazil

Background The analysis of hemodialysis services is relevant for the quality of life of patient. In this study we investigated the profile of vascular access used for hemodialysis patients in our Unit. Methods We evaluated 219 patients of both genders aged over 18 years old who have undergone implant or manufacture of vascular hemodialysis access. We excluded patients on renal replacement therapy by peritoneal dialysis. Results Associated diseases were hypertension and diabetes mellitus. 161 had arteriovenous fistula, with 153 held by the same dialysis and nine of them were still maturing. 27 patients on dialysis used central venous catheter. 148 were indigenous and five were made using polytetrafluoroethylene prosthesis (PTFE). Among the 27 patients with central venous catheters, ten used short-term catheter and 17 used long-term catheter. The most frequent type of fistula use was on the radio distal cephalic, in 85 patients (52.5%), followed by radio cephalic proximal in 26 patients (16%). The number of fistulas in dialysis patients conducted by this kind of therapy ranged from one to ten and in 64 patients (41.83%) fistula was the first and only to be made. Among the fistula for dialysis patients, the highest prevalence was radio cephalic fistula in 111 patients (72.5%) and mean duration of use was 48.1 months, ranging from two months to 17 years. Conclusion Our Unit of hemodialysis is above the limits established by international norms.

Oral Sensorimotor System in Patients with Facial Lipoatrophy Living with AIDS

Introduction: Lipodystrophy Syndrome in people living with AIDS is characterized by body fat redistribution and metabolic abnormalities and is associated with the use of antiretroviral therapy (ART). It is socially and psychologically impacting once it reduces the quality of life of those who develop it. The prevalence varies from 6% to 69%.Objective: Characterize the Oral Sensorimotor System in patients with Facial Lipoatrophy living with AIDS.Methods: Cross-sectional convenience sample study. Sixty-four patients living with AIDS treated in the Lipodystrophy Clinic were clinically evaluated by the infectious disease physician and by the speech language pathologist. The Oral Sensorimotor System structures were evaluated through the Orofacial Assessment Protoco.Results: Changes in tone and mobility are associated with loss of subcutaneous fat.Conclusions: Changes presented in the morphology and function of the Oral Sensoriomotor System are associated with facial Lipoatrophy in patients living with AIDS.

Cardiovascular Risk in HIV/AIDS and Lipodystrophy Syndrome Patients

Background: The treatment of people living with AIDS , known a highly active antiretroviral therapy (HAART), has increased considerably, and the disease has therefore acquired chronic features. Several changes have been observed, especially in cardiovascular disease risk. Objective: To assess cardiovascular risk in HIV/AIDS patients treated with HAART and compare this with Lipodystrophy Syndrome (LS) carriers. Methods: This is a descriptive cross-sectional study. 192 patients were recruited from a lipodystrophy outpatient centre, using Framingham risk scores. Results: After criteria inclusion/exclusion, the final sample consisted of 81 patients divided into two groups (HIV/AIDS - without lipodystrophy and HIV/LS - with lipodystrophy). The mean age of HIV/AIDS was 46.5 years, and of the HIV/LS patients was 52 years. In accordance with Framingham scores the cardiovascular risk in HIV/AIDS was 46.59% and 14.29% in HIV/LS. Conclusion: The risk of cardiovascular disease over 10 years is significantly higher in patients with lipodystrophy syndrome.