Thesis (Ph. D.)--University of Wisconsin--Madison, 1962. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1954. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Master of Science in Epidemiology in the field of Epidemiology and Biostatistics June, 2017 / Background Hepatitis B and ART have been established to cause liver damage. We compared the changes in the levels of Alanine amino Transferase (ALT) in HBV/HIV co-infected and HIV infected women on ART to determine liver disease among women on ART in Lilongwe Malawi using Data from the BAN study. Methods We conducted a secondary data analysis from The BAN study to investigate the changes in the levels of ALT among HIV/HBV co-infected and HIV mono-infected women who were randomised into the maternal ART arm. In brief The BAN study assessed the benefit of nutritional supplementation given to women during breastfeeding, the benefit and safety of antiretroviral medications given either to infants or to their mothers to prevent HIV transmission during breastfeeding and the feasibility of exclusive breastfeeding followed by early, rapid breastfeeding cessation. ALT was monitored up to 48 weeks with an average of 12 follow-ups per individual. Continuous variables i.e. Age, ALT and CD4 count were compared between HIV/HBV co-infected women and HIV mono-infected women using the Wilcoxon rank sum test. Multiple regression analyses were performed using longitudinal data Generalised Linear mixed models to evaluate the relationship between ALT and HIV/HBV co-infection, among HIV-infected women, controlling for ART regimen, CD4 count and visit. All individuals were included in the analysis regardless of the different numbers of follow-up visits. To show the change of ALT levels longitudinal line graphs were used. Predictions of ALT levels per visit were also plotted using margin plots. Results The study subjects comprised of 544 women of whom 5.6% were HIV/HBV co-infected. The age range of the study population was 16-45 years. Median age at enrolment was 26(IQR: 22-29). The median ALT enzyme level of HIV/HBV co-infected individuals was slightly higher at baseline (13 UI/L (10-16) vs 14 UI/L (11-18, p=0.10) and at the last follow-up (17UI/L (14-22) vs 19 UI/L (16-26, p=0.04) compared to HIV mono-infected counterparts. HIV/HBV co-infection women were 3.28 times (1.43-9.03 p= 0.01) more likely to have abnormal ALT, compared to their mono-HIV infected counterparts. Individuals that were initiated on Nelfinavar as first line ART were 3.22 times (1.85-5.59 p=0.001) more likely to have elevated ALT compared to those that were initiated on LPV/r based regimen. Moderately immune suppressed women (CD4 count of between 200 to 500 cells/dl) were 0.38 times less likely to have elevated ALT(0.15-1.00) while women who were severely immune suppressed had 3.51 times more likely to have abnormal ALT . Overall there was an increase in the level of ALT per each subsequent visit. Conclusion Individuals co-infected with HIV/HBV generally had higher levels of ALT compared to HIV mono-Infected individuals and this increased over time. The current study suggests that monitoring of ALT in patients co-infected with HIV/ HBV on ART should be performed regularly, and the caution should be taken when prescribing first line ART. / MT2017

Thesis (Ph. D.)--University of Wisconsin, 1951. / Typescript. Photographic illustrations laid in. eContent provider-neutral record in process. Description based on print version record. Includes bibliographies.

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-11-29T18:54:35Z No. of bitstreams: 1 Helder Jacobina Santos As y-glutamil... 2005.pdf: 33243351 bytes, checksum: 707639696a2cd425ea90f9fb81248893 (MD5) / Made available in DSpace on 2012-11-29T18:54:35Z (GMT). No. of bitstreams: 1 Helder Jacobina Santos As y-glutamil... 2005.pdf: 33243351 bytes, checksum: 707639696a2cd425ea90f9fb81248893 (MD5) Previous issue date: 2005 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / A carbamazepina é a droga de eleição usada no tratamento de pacientes com epilepsia secundariamente generalizada. Além disso, a carbamazepina tem sido implicada no aumento sérico de algumas enzimas. Alguns autores encontraram prevalência de 13% e os outros, 22% e até 53% de alterações para as fosfatases alcalinas. Objetivo; As metas deste trabalho são determinar a proporção de alterações amostrais nas atividades das gama-glutamil transferase (GGT), fosfatases alcalinas totais (FA), transaminases (AST e ALT) e as concentrações séricas da carbamazepina em pacientes de ambulatórios de epilepsia. Metodologia: 0 desenho do estudo é descritivo, aprovado pelo Comitê de Ética local, no qual uma amostra de conveniência de 52 pacientes epilépticos de acompanhamento ambulatorial foi organizada por faixa etária de 12 a 30 e de 31 a 90 anos e, subdivididos por tempo de uso. As atividades séricas das GGT, FA, AST e ALT foram determinadas, assim como, as concentrações séricas da carbamazepina. As proporções de alterações por variáveis foram descritas. Resultados: 52% dos pacientes apresentaram alteração em pelo menos uma enzima, 42% com alterações nas FA, 18%, nas GGT, 12% nas AST e 2%, nas ALT. A faixa etária de 12 a 30 anos apresentou 56% de alterações nas FA enquanto que aquela de 31 a 90 anos, apenas 18%. Conclusão: a faixa etária pode colaborar com o aumento de prevalência das fosfatases alcalinas alteradas nestes pacientes. Quanto aos baixos valores para GGT e transamin / Carbamazepine is the drug utilized in the treatment of patients who bear epilepsy with secondary generalization. Furthermore, carbamazepine has been implicated with the serum increase of certain enzymes. Some authors have found a prevalence of 13% while others have found 22%, or even 53% of alterations for alkaline phosphatases. Objective: the goals of this study are to determine the ratio of alterations of the serum activities of the enzymes gamma-glutamil transferase (GGT), alkaline phosphatases (AF) and transaminases (AST, aspartate aminotransferase; and ALT, alanine aminotransferase) were determined as well as the serum concentrations of carbamazepine in samples taken from the metropolitan region of Salvador, Bahia. Methodology: the design of this study is descriptive and it has been approved by the local Ethics Committee. A convenience sample of 52 epileptic ward patients was distributed according to age groups of 12 to 30 and 31 to 90 years-old, and was also subdivided according to the period of usage. The serum activities of the enzymes GGT, AF, AST, and ALT were determined as well as the serum concentrations of carbamazepine. The proportions of alterations per variables were described. Results: 52% of the patients showed alteration in at least one enzyme, 42% with alterations in the AF, 18% in the GGT, 2% in the ALT, and 12% in the AST. The age group of 12 to 30 years-old showed 56% of the alterations in AF while the group of 31 to 90 year olds showed only 18% alterations. Conclusion: age group may contribute to the increase of prevalence of altered alkaline phosphatases in these patients. In regard to the low values 70 altered alkaline phosphatases In these patients. In regard to the low values of GGT and transaminases, futher studies would be necessary for better understanding of those variations.

Orientadores: Hiroshi Aoyama, Marcio Andre Miranda / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-09T01:06:42Z (GMT). No. of bitstreams: 1 Camargo_CamiladeAndrade_M.pdf: 1153945 bytes, checksum: d090e6ed4e436a5029c6e36de7786df1 (MD5) Previous issue date: 2007 / Resumo: Os flavonóides são fitocompostos polifenólicos, caracterizados quimicamente como heterosídeos flavônicos. Apresentam diversas atividades biológicas devido às suas propriedades antioxidantes e habilidades em modular a atividade de diversas enzimas ou receptores celulares, tornando-os responsáveis pelo efeito protetor contra doenças relacionadas ao sistema cardiovascular; certas formas de câncer e doenças de fotossensibilidade e envelhecimento. As fosfatases ácidas, enzimas que hidrolisam ésteres fosfatos em meio ácido, encontram-se amplamente distribuídas no organismo. Estas enzimas são importantes no catabolismo de diversas substâncias, acreditando-se que a alteração da atividade destas enzimas esteja relacionada com modificações induzidas por drogas e por várias doenças. As transaminases são enzimas hepáticas cujo nível aumenta quando há lesão das células hepáticas (hepatócitos) provocada por qualquer tipo de agressão, como vírus, consumo excessivo de álcool ou drogas. O acetaminofeno é uma droga frequentemente usada como analgésico e antipirético. O dano hepático causado pelo uso frequente ou exagerado do acetaminofeno é comum hoje em dia. A manutenção correta dos sistemas metabólicos hepáticos é de grande importância para a manutenção da saúde. Desta forma, o estudo do flavonóide quercetina como possível protetor dos efeitos hepatotóxicos provocados pelo acetaminofeno pode ser muito promissor. O objetivo do presente trabalho foi estudar os efeitos preventivos e terapêuticos, in vivo, do flavonóide quercetina sobre as atividades de fosfatases ácidas (total, tartarato-resistente e de baixa massa molecular relativa) e de transaminases glutâmica oxalacética (TGO) e glutâmica pirúvica (TGP) no fígado de camundongos, tratados ou não com acetaminofeno. Para o desenvolvimento deste trabalho foi realizado um tratamento agudo (24 horas), de camundongos machos da linhagem Swiss, com quercetina e acetaminofeno, utilizando-se óleo de milho ou nujol como veículo para o flavonóide. A dosagem da TGO e da TGP confirmou que o acetaminofeno pode realmente ser considerado hepatotóxico, quando administrado ou ingerido em grandes concentrações no organismo. A quercetina, dissolvida em óleo mineral, reverteu a hepatotoxicidade induzida pelo acetaminofeno, nos tratamento terapêutico e, em conjunto com acetaminofeno. A quercetina dissolvida em óleo de milho, no tratamento preventivo, pode não ser a única responsável pela reversão da hepatotoxicidade causada pela administração do acetaminofeno, uma vez que quando se substituiu o veículo utilizado, óleo de milho pelo óleo mineral, este efeito não foi mais observado. Comparando-se os resultados obtidos entre fosfatases e transaminases pode-se observar que a atividade da FATR, no tratamento com nujol, demosntra uma semelhança muito grande com os resultados observados nos gráficos das atividades das transaminases e provavelmente pode se considerada uma marcadora de dano hepático. O alfa-tocoferol, presente no óleo de milho, pode ter exercido um efeito antioxidante, e mascarado o efeito protetor da quercetina e a hepatotoxicidade do acetaminofeno. Este estudo foi importante para mostrar que a atividade dos flavonóides no organismo vivo pode ser influenciada por diversos fatores, como: a natureza do veículo utilizado na sua administração, ordem de administração e o tempo de permanecia no organismo / Abstract: Flavonoids are polyphenolic phytocompounds chemically characterized as flavonic heterosides. These compounds present several biological activities due to their antioxidant properties and hability to modulate the activities of enzymes or cellular receptors, making them responsible for the protector effect against diseases related to the cardiovascular system, certain forms of cancer, photosensibility diseases and aging. Acid phosphatases, enzymes that hydrolyze phosphate esters at acid medium, are largely distributed in the organisms. These enzymes are important in the catabolism of several compounds and could be related to the modifications induced by drugs and diseases. Transaminases are hepatic enzymes which levels increase in consequence of hepatic cells (hepatocytes) lesions provoked by agressions such as virus and excessive alcohol and drug consumption. Acetaminophen is a drug frequently used as analgesic and antipyretic. It is common the hepatic damage caused by the frequent or exaggerated use of acetaminophen. The correct maintenance of the hepatic metabolic systems is of great importance for the health. In this way, the study of the flavonoid quercetin as a possible protector of the hepatotoxic effects provoked by acetaminophen seems to be promising. The objectif of the present work was to study the in vivo effects of the flavonoid quercetin on the activities of acid phosphatases (total, tartrate-resistant and relative low molecular weight) and of transaminases glutamic oxalacetic (GOT) and glutamic pyruvic (GPT) in mice livers treated with acetaminophen. To develop this work, it was performed an acute treatment (24 hours) of Swiss male mice, with quercetin and acetaminophen, using corn oil or nujol as a vehicle for the flavonoid. The determination of GOT and GPT activities confirmed that acetaminophen can be considered hepatotoxic, when administered or ingested in great amount. In the therapeutic treatments, when applied with acetaminophen, quercetin, solubilized in mineral oil, reverted the acetaminophen-induced hepatotoxicity. In the preventive treatment, quercetin, solubilized in corn oil, might not be the only responsible for the reversibility, since this effect was no more observed when the vegetal oil was replaced by the mineral oil. The results with FATR, in the treatment with nujol, showed great similarity with the results obtained with transaminases, suggesting that this class of phosphatases could be considered as markers of hepatic damage. The alphatocopherol, present in the corn oil, could be exerting an antioxidant effect, masking the protector effect of quercetin and the acetaminophen hepatotoxicity. The importance of the present study was to stress that the in vivo flavonoids activities can be influenced by several factors, such as, the nature of the vehicle used in the administration, the order of administration and the retention time in the organism / Mestrado / Bioquimica / Mestre em Biologia Funcional e Molecular

Biocatalysis is considered a green and environmentally friendly technology. Therefore, novel enzymes and enzymatic systems, together with cascades and protein engineering approaches, are in high demand. Here, three very different biocatalytic approaches have been studied. First, the richness of enzymes in the Red Sea brine pools has been assessed, and the discovery and characterization of a novel halophilic γ-carbonic anhydrase is described, together with the protein engineering approach, which boosted the initial catalytic activity of the γ- carbonic anhydrase. The understanding of polyextremophilicity principles from enzymes from the Red Sea brine pool, contributes to the bioengineering effort of turning mesophilic enzymes into more stable variants. Next, focus is given to the use of amine-transaminases in cascades for chiral amine synthesis. This resulted in the development of a self-sufficient sustainable cascade for chiral and non-chiral amine synthesis. This cascade was achieved by combining a lysine decarboxylase with an amine-transaminase to generate a cheap amino donor source for a more sustainable reaction economy. Finally, gas vesicle nanoparticles are functionalized by various engineering principles to create floating platforms for the immobilization of enzymes. The proof-of-concept was achieved by anchoring a phytase via anchoring peptides on the gas vesicle nanoparticles surface. These bioengineering approaches contributed to the effort of generating first principles for protein engineering.

Aim: To evaluate the association between elevated serum transaminase levels and insulin resistance (IR) in a population of healthy individuals. Methods: We define IR with a cut-off point of homeostatic model assessment (HOMA-IR) ≥ 3.8. For aspartate aminotransferase (AST), we consider elevated values >30 U/L in women and values >36 U/L in men. For alanine aminotransferase (ALT), we consider elevated values >30 U/L in women and values >40 U/L in men. We performed a crude and adjusted generalized linear model from Poisson family with robust variance, in order to evaluate the association between elevated serum transaminase levels and IR. The associations were presented as prevalence ratio (PR) with their respective 95% confidence intervals (95% CI). Results: We included 261 participants in the study. The median age was 39 years (31–45) and 23.7% of the participants were men. The prevalence of elevated serum transaminase for AST and ALT were, 13.8% and 26.1%, respectively. The prevalence of IR was 34.1%. In the crude analysis we found statistical significance between elevated AST and ALT with IR (PR = 3.18; 95% CI: 2.33–4.34 and PR = 2.44; 95% CI: 1.88–3.30; respectively). However, in the multivariate analysis, the association only remained statistically significance with ALT, but lost its significance with AST, PR = 1.90; CI 95%: 1.31–2.77 and a PR = 1.23; CI 95%: 0.93–1.61; respectively. Conclusion: Elevated serum levels of ALT were associated with insulin resistance. ALT could be used in clinical practice as an additional tool to assess IR in apparently healthy people. / Dirección de Gestión de la Investigación, Universidad de Antofagasta / Revisión por pares

INTRODUÇÃO: Pacientes com coinfecção HIV e hepatite C, em geral, apresentam rápida progressão da fibrose hepática. No entanto, a maior parte dos estudos, que avaliam essa questão, caracteriza a progressão da fibrose de forma indireta, utilizando para isso uma única biópsia hepática e tendo como base de cálculo o tempo estimado de infecção pelo vírus da hepatite C. OBJETIVO: Os objetivos do presente trabalho são: 1-Estimar a taxa de progressão da fibrose hepática de forma direta, através da análise de biópsias pareadas em pacientes coinfectados HIVhepatite C, não submetidos a tratamento prévio para hepatite C; 2- Avaliar a possível associação dessa progressão a determinadas variáveis clínicas. MÉTODOS: Trinta pacientes coinfectados com HIV e hepatite C, sem antecedente de tratamento prévio da hepatite C, submetidos a duas biópsias hepáticas pareadas foram avaliados. Calculou-se a taxa de progressão de fibrose direta e foram feitas determinações de progressão, estabilização e regressão da fibrose. Procedeu-se então à análise estatística, testando-se a associação entre progressão de fibrose e algumas variáveis clínicas e demográficas. RESULTADOS: A taxa de progressão média foi de 0,13 UF/ano, com 36,7% dos pacientes configurando-se como progressores. Em análise univariada, a progressão de fibrose hepática esteve associada a níveis de alanina aminotransferase (p<0,001) e aspartato aminotransferase (p<0,0340) acima de 3 vezes o limite superior da normalidade à época da primeira biópsia. Verificou-se também associação entre níveis de alanina aminotransferase (p=0,049) e aspartato aminotransferase (p=0,013) acima da normalidade e atividade necroinflamatória à primeira biópsia. CONCLUSÕES: Elevações de alanina aminotransferase e aspartato aminotransferase parecem estar associadas a uma maior atividade necroinflamatória em pacientes co-infectados pelo HIV e hepatite C e também a uma progressão mais acelerada da fibrose hepática nesse grupo de pacientes / INTRODUCTION: HIV and hepatitis C virus co-infected patients usually exhibit rapid liver fibrosis progression. However, most studies evaluating this issue indirectly characterize fibrosis progression via single liver biopsy, further using this as basis for calculating the estimated duration of hepatitis C infection. OBJECTIVE: Objectives of this study include: 1- Estimate the annual rate of direct liver fibrosis progression, using analyses of paired biopsy samples from HIVhepatitis C co-infected patients without prior treatment for hepatitis C; 2- Assess the possible association of fibrosis progression with certain clinical variables. METHODS: We evaluated 30 HIV-hepatitis C co-infected patients, with no history of prior treatment for hepatitis C, who underwent two paired liver biopsies. We calculated the annual rate of direct fibrosis progression and determined fibrosis progression, stabilization, and regression. We then performed statistical analysis, testing the association between fibrosis progression and several clinical and demographic variables. RESULTS: The average annual progression rate was 0.13 FU/year, with 36.7% of patients defined as progressors. In univariate analysis, liver fibrosis progression was associated with alanine aminotransferase (p<0.001) and aspartate aminotransferase (p<0.0340) levels over three times the upper limit of normal present at first biopsy. There was also an association between above-normal alanine aminotransferase (p=0.049) and aspartate aminotransferase (p=0.013) levels and necroinflammatory activity at first biopsy. CONCLUSION: Elevated alanine aminotransferase and aspartate aminotransferase levels appear to be associated with higher necroinflammatory activity and more accelerated liver fibrosis progression among HIV-hepatitis C co-infected patients

INTRODUÇÃO: Pacientes com coinfecção HIV e hepatite C, em geral, apresentam rápida progressão da fibrose hepática. No entanto, a maior parte dos estudos, que avaliam essa questão, caracteriza a progressão da fibrose de forma indireta, utilizando para isso uma única biópsia hepática e tendo como base de cálculo o tempo estimado de infecção pelo vírus da hepatite C. OBJETIVO: Os objetivos do presente trabalho são: 1-Estimar a taxa de progressão da fibrose hepática de forma direta, através da análise de biópsias pareadas em pacientes coinfectados HIVhepatite C, não submetidos a tratamento prévio para hepatite C; 2- Avaliar a possível associação dessa progressão a determinadas variáveis clínicas. MÉTODOS: Trinta pacientes coinfectados com HIV e hepatite C, sem antecedente de tratamento prévio da hepatite C, submetidos a duas biópsias hepáticas pareadas foram avaliados. Calculou-se a taxa de progressão de fibrose direta e foram feitas determinações de progressão, estabilização e regressão da fibrose. Procedeu-se então à análise estatística, testando-se a associação entre progressão de fibrose e algumas variáveis clínicas e demográficas. RESULTADOS: A taxa de progressão média foi de 0,13 UF/ano, com 36,7% dos pacientes configurando-se como progressores. Em análise univariada, a progressão de fibrose hepática esteve associada a níveis de alanina aminotransferase (p<0,001) e aspartato aminotransferase (p<0,0340) acima de 3 vezes o limite superior da normalidade à época da primeira biópsia. Verificou-se também associação entre níveis de alanina aminotransferase (p=0,049) e aspartato aminotransferase (p=0,013) acima da normalidade e atividade necroinflamatória à primeira biópsia. CONCLUSÕES: Elevações de alanina aminotransferase e aspartato aminotransferase parecem estar associadas a uma maior atividade necroinflamatória em pacientes co-infectados pelo HIV e hepatite C e também a uma progressão mais acelerada da fibrose hepática nesse grupo de pacientes / INTRODUCTION: HIV and hepatitis C virus co-infected patients usually exhibit rapid liver fibrosis progression. However, most studies evaluating this issue indirectly characterize fibrosis progression via single liver biopsy, further using this as basis for calculating the estimated duration of hepatitis C infection. OBJECTIVE: Objectives of this study include: 1- Estimate the annual rate of direct liver fibrosis progression, using analyses of paired biopsy samples from HIVhepatitis C co-infected patients without prior treatment for hepatitis C; 2- Assess the possible association of fibrosis progression with certain clinical variables. METHODS: We evaluated 30 HIV-hepatitis C co-infected patients, with no history of prior treatment for hepatitis C, who underwent two paired liver biopsies. We calculated the annual rate of direct fibrosis progression and determined fibrosis progression, stabilization, and regression. We then performed statistical analysis, testing the association between fibrosis progression and several clinical and demographic variables. RESULTS: The average annual progression rate was 0.13 FU/year, with 36.7% of patients defined as progressors. In univariate analysis, liver fibrosis progression was associated with alanine aminotransferase (p<0.001) and aspartate aminotransferase (p<0.0340) levels over three times the upper limit of normal present at first biopsy. There was also an association between above-normal alanine aminotransferase (p=0.049) and aspartate aminotransferase (p=0.013) levels and necroinflammatory activity at first biopsy. CONCLUSION: Elevated alanine aminotransferase and aspartate aminotransferase levels appear to be associated with higher necroinflammatory activity and more accelerated liver fibrosis progression among HIV-hepatitis C co-infected patients