SummaryThe objective of this study was to describe the adherence to antiretroviral therapy (ART) among adolescents followed-up in Rio de Janeiro. This cross-sectional study included all adolescents (aged 10-19 years) followed at Instituto de Puericultura e Pediatria Martaga~ o Gesteira and Hospital Universita' rio Clementino Fraga Filho. Adherence was determined by self-report (number of missed ART doses in three days prior to the interview). Adherence was categorized as taking _95% of the ARTs (adherent), or ,95% (non-adherent). Variables related to demographics and treatment were evaluated and if P value _0.15, they were selected for a logistic regression analysis. One hundred and one adolescents were interviewed. The mean time on ART was 91 months and the mean adherence was 94% of this, 21 were non-adherent, and 80 adherent. The risk factors associated with non-adherence were: if the patient was not concerned about ART, odds ratio (OR) ¼ 3.47 (95% confidence interval [CI] ¼ 1.13-10.68); if they do not carry an extra dose of ART, OR ¼ 6.63 (95% CI ¼ 1.73-25.47); if a health-care worker taught them how to take ART, OR ¼ 0.27 (95% CI ¼ 0.08-0.93). Adherence among adolescents was higher than expected. Factors associated with lack of adherence were: interviewees being unaware of ARTs and lack of commitment to the treatment. Interventions involving these factors must be evaluated.
The aim of present study was to describe the frequency of lipodystrophy syndrome associated with HIV (LSHIV) and factors associated with dyslipidemia in Brazilian HIV infected children. HIV infected children on antiretroviral treatment were evaluated (nutritional assessment, physical examination, and laboratory tests) in this cross-sectional study. Univariate analysis was performed using Mann-Whitney test or Fisher's exact test followed by logistic regression analysis. Presence of dyslipidemia (fasting cholesterol >200mg/dl or triglycerides >130mg/dl) was the dependent variable. 90 children were enrolled. The mean age was 10.6 years (3-16 years), and 52 (58%) were female. LSHIV was detected in 46 children (51%). Factors independently associated with dyslipidemia were: low intake of vegetables/fruits (OR=3.47, 95%CI=1.04-11.55), current use of lopinavir/ritonavir (OR=2.91, 95%CI=1.11-7.67). In conclusion, LSHIV was frequently observed; inadequate dietary intake of sugars and fats, as well as current use of lopinavir/ritonavir was associated with dyslipidemia.
There are only scarce data on HIV progression in vertically infected children in developing countries. The aim of this study is to describe factors from neonatal period associated with long term non-progression (LTNP), in a Brazilian cohort. A cohort study, with data systematically collected from the "Peixe" Cohort (cohort study of children conducted at the main HIV Pediatric Center in Rio de Janeiro, from 1996 to 2005). The study included children who were vertically infected and started follow up at 5 years of age or younger. LTNP, defined as not reaching category C or severe immunosuppression before 5 years of age. Neonatal and demographic factors were studied. Variables with p-value<0.15 were included in a logistic regression model. 213 patients were included, of whom 42% (89/213) were classified as LTNP. Variables independently associated with LTNP were: baseline (at study entry) CD4+ cells (per %) (OR= 1.06, 95%CI=1.01-1.12); age of initiating follow-up, per month (OR= 1.03, 95%CI=1.01-1.06); ZDV use duriing newborn period (OR= 3.31, 95%CI=0.86-12.71); use of antiretroviral (ART) before classification C or severe immunosuppression (OR= 5.89, 95%CI=2.03-17.10). Adjusting for age at the beginning of follow-up, antiretroviral that was unsuccessfully used to prevent maternal-to-child transmission (ZDV use in neonatal period) was associated with better prognosis. ARTs initiation before category C or severe immunosuppression was also associated with LTNP. Key-Words: HIV, antiretroviral therapy, long term non-progressors, children, Brazil.It is estimated that 20-40% of HIV-1-infected children present with rapid disease progression and develop AIDS within the first years of life [1][2][3][4]. On the other hand, 60-80% of infected children manifest less severe symptoms and many survive through adolescence [3][4][5][6]. In developed countries, advanced maternal disease, high maternal viral load, and maternal and infant immune suppression were associated with rapid HIV progression in children [7]. In developing countries, where the majority of perinatal infections occur, there are only scarce data on HIV progression and risk factors. Meanwhile, in some developed countries, all HIV infected children are treated with highly active antiretroviral therapy (HAART) in early infancy. [8]. Brazilian guidelines [9] recommend that HIV infected infants should be treated only if they present any stage B or C symptoms and/or are in immune categories 2 or 3 (CDC) [10]. Although there is some evidence that infants benefit from treatment started in their first year of life, with early HIV replication control and preservation of the immune system [3,4,11], aspects associated with HAART adverse events, adherence and emergence to drug resistant virus must also be considered [5]. Another important issue is the possibility that almost 50% [1-4] of these infants would be long-term nonprogressors (LTNP), and would not benefit from HAART until five years of age or older. It is important to identify early life events that might be associated...
Objective: To evaluate the correlation between perception of dyspnea during a mild to moderate asthma attack using the Modified Borg Scale (MBS) and peak expiratory flow rate (PEFR).Methods: This was a cross-sectional study conducted with children and adolescents who sought a pediatric emergency service due to an asthma attack. Data were collected from July 2005 to June 2006. Demographic data were recorded. Patients and those in charge of them were requested to grade, individually, the patient's dyspnea using the MBS; afterwards, the PEFR was measured.Results: 181 asthmatic patients were evaluated, with a mean age of 7.2 (± 2.4) years (range, 4-12). The mother sought medical aid in 83.4% of the cases (151/181). Patient symptoms included coughing in 68.5% (124/181), dyspnea in 47.0% (85/181), and wheezing in 12.7% (23/181). Thirty-six percent (65/181) had a mild attack, and 64.1% (116/181) a moderate one. A significant negative correlation was found between the patients' and accompanying adults' perceptions of patient's dyspnea and the PEFR (% predicted; r s = -0.240 and r s = -0.385, respectively). Conclusion:Both the patients and those looking after them had a poor perception of the severity of the patient's dyspnea. This emphasizes the need to monitor objective measures such as the PEFR and to develop better ways of evaluating dyspnea.J Pediatr (Rio J). 2011;87(6):541-6: Perception, asthma and dyspnea. ResumoObjetivo: Avaliar a correlação entre a percepção da dispneia durante uma crise de asma leve a moderada, por meio da escala modificada de Borg, com a medida do pico de fluxo expiratório (PFE). Métodos IntroduçãoA percepção pode ser definida como sensação consciente de um problema fisiológico apreciada pelo paciente. É o resultado final de uma série de processos: ativação de terminações aferentes por estímulos fisiopatológicos, transmissão e processamento de informações pelas vias neuronais, interpretação no córtex cerebral e reconhecimento pelo paciente.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.