Orientadores: Aarão Mendes Pinto-Neto / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T00:48:47Z (GMT). No. of bitstreams: 1 Ferreira_CarlosEduardo_D.pdf: 174307 bytes, checksum: 7f97e64fdd4bd155a5e6a13566a145d2 (MD5) Previous issue date: 2006 / Resumo: Objetivo: o objetivo deste estudo foi avaliar as características sócio-demográficas, a prevalência de sintomas da menopausa na mulher HIV positiva e fatores associados a tais sintomas comparando com grupo controle. Foram analisados: características dessa população (idade, raça, escolaridade, autopercepção de saúde, status menopausal, estado civil, paridade, tabagismo, uso de drogas, uso de antiretrovirais, índices de CD4, índice de massa corpórea, aposentadoria e comportamento de risco para DST), a prevalência de sintomas da menopausa (Vasomotores, psicológicos, sexuais, genito-urinários, palpitações, artralgias e insônia) e fatores associados com tais sintomas. Foi realizado um estudo corte transversal de mulheres no climatério divididas em 96 mulheres HIV positivas e 155 mulheres HIV negativas. Os critérios de inclusão foram: ter 40 anos ou mais e ser brasileira. O critério de exclusão usado foi o uso de Terapia de Reposição Hormonal há menos de seis meses. A prevalência dos sintomas foi estudada nas variáveis de controle e nas demais variáveis dependentes através do teste de qui-quadrado. A prevalência de um ou mais sintomas foi avaliada multivariadamente através de medidas repetidas pela técnica de GEE - estimação de equação generalizada e calculado o valor do Odds Ratio ajustado pelas variáveis de controle. O nível de significância assumido foi de 5% e o software utilizado para análise foi o SAS versão 9.01. Resultados: A média de idade das mulheres com HIV e sem HIV foi de 48,9 ± 7,4 e de 51 ± 8,7 anos, respectivamente. Os sintomas psicológicos foram as queixas mais comuns seguido de vasomotor. Mulheres com idade entre 45 e 54 anos (OR:1,51;IC95%:1,19-2,75), rebendo aposentadoria (OR:1,94;IC95%:1,29-2,93), com HIV (OR:2,24; IC95%:1,36-3,68), com três ou mais filhos (OR:2,24; IC95%:1,17-4,27) e que referiram auto-percepção do estado de saúde como não muito boa/péssima (OR: 2,03;IC95%: 1,34-3,08) apresentaram maior chance de referir sintomas. Entre mulheres com HIV, a chance de referir sintomas foi menor para aquelas com idade maior ou igual a 55 anos (OR:0,10;IC95%:0,01-0,67). Receber aposentadoria aumentou a chance de referir sintomas (OR:2,43;IC95¨:1,07-5,52). Conclusão: A prevalência de sintomas menopausais foi elevada em mulheres com HIV. A idade, receber aposentadoria, infecção pelo HIV, escolaridade, paridade, IMC, auto-percepção do estado de saúde foram associados ao risco de referir sintomas nas mulheres em geral. Entre as HIV positivas, a idade e recebimento de aposentadoria se associaram a tais sintomas / Abstract: Objective: the aim of this study was to evaluate sociodemographic characteristics, the prevalence of menopause symptoms and its associated factors in HIV-infected women, in comparison to a control group. The following factors were analyzed: population characteristics (age, race, school education, self-perception of health, menopausal status, marital status, parity, smoking, drug use, antiretroviral use, CD4 indexes, body mass index, receipt of public benefits and risk behavior for STD), the prevalence of menopause symptoms (vasomotor, psychological, sexual, genitourinary, palpitations, arthralgias and insomnia) and factors associated with these symptoms. A cross-sectional study of climacteric women was conducted, divided into 96 HIV-positive and 155 HIV-negative women. Inclusion criteria were: age 40 years or older and being Brazilian. Exclusion criteria were: Hormone Replacement Therapy within the past six months. The prevalence of symptoms in the control variables and in the remaining dependent variables was studied by the chi-square test. The prevalence of one or more symptoms was multivariately assessed by repeated measures using the GEE technique¿generalized estimating equation models¿and calculation of the adjusted Odds Ratio value by the control variables. The assumed significance level was 5% and SAS version 9.01 was the software used for analysis was. Results: the mean age of HIV-infected and HIV-uninfected women was 48.9 ± 7.4 and 51 ± 8.7 years, respectively. Psychological symptoms were the most common complaints followed by vasomotor symptoms. The odds of reporting symptoms were higher in women aged between 45 and 54 years (OR: 1.51; 95%CI: 1.19-2.75) who received public benefits (OR: 1.94; 95%CI:1.29-2.93), had HIV (OR: 2.24; 95%CI: 1.36-3.68), had three or more children (OR: 2.24; 95%CI: 1.17-4.27) and had a fair/poor perception of their physical health(OR: 2.03; 95%CI:1.34-3.08). Among HIV-infected women, the odds of reporting symptoms were lower for those aged 55 or older (OR: 0.10; 95%CI: 0.01-0.67) and for those with two or more partners in the past year (OR: 0.32; 95%CI: 0.11-1.00). Receipt of public benefits increased the odds of reporting symptoms (OR: 2.43; 95%CI: 1.07-5.52). Conclusion: The prevalence of menopause symptoms was high in HIV-infected women. Age, receipt of public benefits, HIV infection, school education, parity and self-perception of health status were associated with the risk of reporting symptoms in women in general. Among the HIV-positive women, age, number of sexual partners in the past year and receipt of public benefits were associated with such symptoms / Doutorado / Doutor em Tocoginecologia

Orientador: Helaine Maria Besteli Pires Milanez / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-14T07:08:24Z (GMT). No. of bitstreams: 1 Delicio_AdrianeMaira.pdf: 1826833 bytes, checksum: bc3f2dce3447c00fccb97f45337d0f78 (MD5) Previous issue date: 2009 / Resumo: Objetivo: avaliar a transmissão vertical (TV) do HIV e fatores associados em gestantes soropositivas acompanhadas em um serviço universitário brasileiro (CAISM/UNICAMP) entre 2000 e 2009. Sujeitos e Métodos: coorte histórica de 452 gestações e seus recém-nascidos. Os dados foram coletados dos prontuários e registrados em fichas específicas. Crianças sem seguimento foram convocadas para definição diagnóstica. Análise dos dados: análise descritiva através de distribuição percentual e de médias; teste de X², exato de Fisher, t de Student, Mann-Whitney e ANOVA, razão de risco e intervalo de confiança. Resultados: A TV foi de 3,6%. A idade média das gestantes foi 27 anos; principal categoria de exposição foi a sexual (86,5%); 55% já apresentava o diagnóstico prévio à gravidez. Sessenta e dois por cento não estavam em uso de TARV ao engravidar. CD4 médio inicial foi de 474 células/ml e 70.3% apresentaram carga viral indetectável no terceiro trimestre. Como TARV, 55% usaram esquemas com IP e 35% com nevirapina. Monoterapia com AZT foi utilizada em 5,5%. Idade gestacional média no parto foi de 37,2 semanas e em 92% a via foi cesárea; 97,2% receberam AZT endovenoso. Os fatores associados à TV foram: baixa contagem de CD4, elevada carga viral, tempo reduzido de TARV, presença de alterações gestacionais (anemia, RCF, oligoâmnio), coinfecções durante o pré-natal (CMV e toxoplasmose) e presença de trabalho de parto. Uso de TARV potente, parto por cesárea e uso do AZT pelo RN foram fatores protetores. Má adesão ao tratamento esteve presente em 13 dos 15 casos infectados; em sete houve presença de coinfecção neonatal (CMV e toxoplasmose). Conclusão: Fatores de risco para TV foram comprometimento do estado imunológico da gestante, menor tempo de terapia, coinfecções (CMV e toxoplasmose) e presença de trabalho de parto. O uso de TARV potente e a realização de cesárea foram fatores protetores para a TV do HIV. / Abstract: Objectives: to evaluate mother-to-child transmission (MTCT) rates and related factors in HIV-infected pregnant women from CAISM/UNICAMP between 2000 and 2009. Subjects and methods: cohort of 452 HIV-infected pregnant women and their newborns. Data was collected from recorded files and undiagnosed children were enrolled for investigation. Statistical analysis: qui-square test, Fisher exact test, Student t test, Mann-Whitney test, ANOVA, risk ratio and confidence intervals. Results: MTCT occurred in 3.6%. The study population displayed a mean age of 27 years; 86.5% were found to have acquired HIV through sexual contact; 55% were aware of the diagnosis prior to the pregnancy; 62% were not using HAART. Mean CD4 cell-count was 474 cells/ml and 70.3% had undetectable viral loads in the third trimester. HAART included nevirapine in 35% of cases and protease inhibitors in 55%; Zidovudine monotherapy was used in 5.5%. Mean gestational age at delivery was 37.2 weeks and in 92% by caesarian section; 97.2% received intravenous zidovudine. Implicated factors related to MTCT were: low CD4 cell counts, elevated viral loads, maternal aids, shorter periods receiving HAART, maternal concurring illnesses (anemia, IUGR, oligodydramnium), coinfections (CMV and toxoplasmosis) and the occurrence of labor. Use of HAART for longer periods, caesarian delivery and oral zidovudine for the newborns were associated with a decreased risk. Poor adhesion to treatment was present in 13 of the 15 cases of transmission; in 7, co-infections were diagnosed (CMV and toxoplasmosis). Conclusion: Use of HAART and caesarian delivery are protective factors in mother-to-child transmission of HIV. Maternal coinfecctions and maternal concurring illnesses were risk factors for MTCT. / Universidade Estadual de Campi / Ciencias Biomedicas / Mestre em Tocoginecologia

Doctorat en Sciences / info:eu-repo/semantics/nonPublished

M.Tech. / RNA interference (RNAi) is a gene silencing mechanism that uses short RNA duplexes to block gene expression. This mechanism has been widely explored to determine functions of genes. Furthermore, this phenomenon has been used to silence unwanted genes such as viral genes. RNAi has been successfully employed in non-mammalian organisms such as plants, where long dsRNAs (more than 30 bp) have been used without inducing non-specific effects. However, in mammalian cells, cytoplasmic dsRNAs of more than 30 bp trigger non-specific induction of many genes, which may result from the activation of dsRNA-dependent protein kinase (PKR) and 2’,5’-oligoadenylate synthetase (2’,5’-OAS), via the interferon response pathway. In this study, we describe a novel and simple strategy to overcome nonspecific effects induced by longer RNA duplexes. This strategy uses sodium bisulphite which is a mutagen that deaminates cytosine residue to uracil residues in order to introduce mutations in the sense strand of the duplex. Introduction of these mutations results in the formation of G:U pairings between the sense and antisense strands of the long hairpin RNA. RNA duplexes with mismatches have been shown to be able to prevent interferon induction in mammalian cells. According to the obtained results, long hairpins RNA with and without mismatches were unable to inhibit the expression of the target region, which was the U5 region of the HIV-1 subtype C LTR. The U5 region of the LTR is actively involved in the reverse transcription of HIV-1. Therefore silencing of this region would have led to the inhibition or reverse transcription blockage. Furthermore, data showed that the interferon response was induced when using these long hairpin RNA duplexes. Due to the sensitivity of mammalian cells, the action of sodium bisulphite could have stimulated certain genes of the interferon pathway. Even though hairpins constructed in this study were unable to prevent the induction of the interferon response pathway and also could not silence the target, this strategy of using sodium bisulphite has a great potential as shown by its ability to induce changes in cytosine residues and leaving other nucleotides unchanged.

Masters in Public Administration - MPA / HIV/AIDS is a deadly disease that needs to be addressed with immediate effect before serious damage can occur. Because the government has a responsibility over the health of its citizens, everybody expects the government to take a lead in the fight against this epidemic and from the look of things the government's strategies are not making the desired impact on the epidemic. The author attempted to highlight that the South African government has not played a satisfactory role in the fight against this pandemic, which threatens to alter history to a degree not seen in the world. / South Africa

Magister Artium - MA / This study focuses on the impact of HIV/AIDS on women in Namibia. Namibia, with a population of only 1.7 million people, is ranked as the seventh highest country in the world in terms of HIV/AIDS infections. The percentage of women living with HIV/AIDS in Namibia accounts for 54% of the total of 68 196 people in the country living with the virus. Women are also diagnosed with the disease at a younger age (30) in comparison to their male counterparts (35 years). Desoite their needs, women living with HIV/AIDS bear a triple burden of caring for those living with HIV/AIDS, caring for themselves and coping with the responses to their infection. There are few focused intervention strategies to support and care for women living with HIV/AIDS in Namibia. / South Africa

Magister Scientiae - MSc / Over the past two decades of HIV research, effective vaccine candidates have been elusive. Traditionally viral research has been characterized by a gene -by-gene approach, but in the light of the availability of complete genome sequences and the tractable size of the HIV genome, a genomic approach may improve insight into the biology and epidemiology of this virus. A genomic approach to finding HIV vaccine candidates can be facilitated by the use of genome sequence visualization. Genome browsers have been used extensively by various groups to shed light on the biology and evolution of several organisms including human, mouse, rat, Drosophila and C.elegans. Application of a genome browser to HIV genomes and related annotations can yield insight into forces that drive evolution, identify highly conserved regions as well as regions that yields a strong immune response in patients, and track mutations that appear over the course of infection. Access to graphical representations of such information is bound to support the search for effective HIV vaccine candidates. This study aimed to answer the question of whether a tool or application exists that can be modified to be used as a platform for development of an HIV visualization application and to assess the viability of such an implementation. Existing applications can only be assessed for their suitability as a basis for development of an HIV genome browser once a well-defined set of assessment criteria has been compiled. / South Africa

Magister Artium - MA / This study aimed to explore the gender imbalances that exist in access to education and participation in schooling of the female orphans and vulnerable children, and also how this relates to the continuing feminisation of the HIV and AIDS pandemic in Zambia. The study was based on the premise that the girl child is disadvantaged in this area, and the HIV and AIDS pandemic in worsening the situation for female orphans and vulnerable children. / South Africa

Magister Public Health - MPH / The aim of this quasi-experimental study was to examine the impact of a health education intervention on knowledge about HIV/Hepatitis B transmission, attitudes, beliefs and intentions towards condom use. Research has shown tht small group discussion, single sex groups, age proximity of health educators, and HIV prevention integrated in the broader sexual health context, increased the effectiveness of health education with regard to safer sexual practices. / South Africa

Magister Educationis - MEd / In many countries, the scale of poverty, and the alarming number of children now being orphaned by HIV and AIDS, has increased the roles and responsibilities of grandparents as caregivers in their grandchildren's lives. Not only do grandparents have to care for their grandchildren on a daily basis but they also carry the burden of seeing them through school, possibly with the fear that they might not be able to see them achieve all their dreams. This study examined the complex issues surrounding school attendance for orphaned children in Mbekweni, a township in the Western Province, in South Africa. The study explored the relationship between the attitudes of orphaned learners and their caregivers towards education and schooling itself, uncovering the struggles and the strengths of caregivers and orphaned children that directly relate to success or faiolure in school. / South Africa