BACKGROUND Iron homeostasis contribute for the human immunodeficiency virus (HIV) pathogenesis. OBJECTIVES We assessed the iron intake pattern in antiretroviral naïve Brazilian men living with HIV correlating with clinical and nutritional parameters. METHODSThe iron consumption mean was estimated according to a food frequency questionnaire (FFQ), and a 3-day food record (3dFR) submitted to the patients. HIV viral load, CD4 + T cell counts, serum iron, haematological and anthropometrics parameters were recorded.FINDINGS Fifty-one HIV-infected adult men naïve for antiretroviral therapy (ART) were enrolled. The mean age of participants was 35 (SEM ± 1.28) years old, with mean time of HIV-1 infection of 1.78 (0-16.36, min-max) years. Majority (41.18%) had complete secondary, and 21.57% had tertiary educational level. The income was around 1x (54.90%) to 2x (41.18%) minimum wage. Fifty-four percent showed normal weight, while 40% were overweight. The patients showed normal mean values of haematological parameters, and mean serum iron was 14.40 µM (SEM ± 0.83). The FFQ showed moderate correlation with the 3dFR (ρ = 0.5436, p = 0.0009), and the mean values of iron intake were 10.55(± 0.92) mg/day, recorded by FFQ, and 15.75(± 1.51) mg/day, recorded by 3dFR. The iron intake, recorded by FFQ, negatively correlated with serum iron (ρ = -0.3448, p = 0.0132), and did not have influence in the CD4 + T cell counts [e.B 0.99 (0.97-1.01, 95% confidence interval (CI), p = 0.2]. However, the iron intake showed a positive effect in HIV viral load [e.B 1.12 (1.02-1.25, 95%CI), p < 0.01].MAIN CONCLUSIONS This study draws attention for the importance of iron intake nutritional counseling in people living with HIV. However, more studies are required to clarify the association between high iron intake and HIV infection and outcome.
Lung cancer is the second most common malignancy worldwide, accounting for the highest number of cancer deaths. Advanced lung cancer may infrequently appear as skin metastasis and this may be the first sign of the disease. In these cases, survival is low and prognosis is poor. The aim of this study is to report a case of adenocarcinoma of the lung where the earliest manifestations were skin metastases to the face, cervical region, and chest. A 67-year-old male, former smoker, and alcoholic was referred to the oncology center for investigation of a primary tumor site, presenting with skin lesions suggestive of metastasis to the face, cervical region, and chest. Computed tomography (CT) scan of the chest, cholangioresonance, breast ultrasonography, colonoscopy, upper GI endoscopy, and magnetic resonance imaging of the brain were performed. Imaging studies revealed disseminated cancer with a potential primary site in the right lung. Positron emission tomography (PET)-CT scan demonstrated secondary implants and was consistent with primary right lung cancer. The patient underwent a right lung biopsy of the skin and breast and axillary lymph nodes. A solid subtype of adenocarcinoma with metastases to the skin and axillary nodes was confirmed. Due to widespread metastatic disease, the case was conducted using strategies including chemotherapy and palliative radiotherapy for symptomatic control. At about 6 months of follow-up care, the patient died. In the elderly, periodical cancer screening is important, especially in patients with major risk factors (e.g., history of smoking). Some cancers may be virtually silent and manifest themselves only at advanced stages beyond treatment possibilities.
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