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In the original publication [...].
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Recent studies have shown the effects of vitamin D on host response to infectious diseases. Some studies detected a high prevalence of hypovitaminosis D in HIV-infected patients, but scarce information exists for HTLV-1 infection. We conducted a cross-sectional study to evaluate the frequency of hypovitaminosis D in HTLV-1 patients and its relationship with their immune response in HTLV-infected patients and in age- and gender-matched controls at a Brazilian rehabilitation hospital. We compared vitamin D, interleukin-6 (IL-6), tumoral necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ) levels across groups. Logistic regression was utilized to assess the association between hypovitaminosis D and cytokine levels. We enrolled 161 HTLV-infected subjects (129 HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients, 32 asymptomatic HTLV carriers) and equal number of HTLV-negative controls. We observed a significantly higher prevalence of hypovitaminosis D in patients with HAM/TSP than in HTLV asymptomatic carriers (p < 0.001), or controls (p < 0.001). HAM/TSP patients also had higher levels of IL-6 and IFN-γ than asymptomatic carriers. Patients with HAM/TSP and hypovitaminosis D had higher levels of TNF-α than asymptomatic HTLV carriers. These findings suggest hypovitaminosis D plays a role in HAM/TSP pathogenesis, and it needs to be evaluated in further studies.
Assuntos
Citocinas/sangue , Paraparesia Espástica Tropical/imunologia , Deficiência de Vitamina D/imunologia , Adulto , Idoso , Brasil/epidemiologia , Portador Sadio/epidemiologia , Portador Sadio/imunologia , Estudos Transversais , Feminino , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/imunologia , Vírus Linfotrópico T Tipo 1 Humano/patogenicidade , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Paraparesia Espástica Tropical/epidemiologia , Prevalência , Vitamina D/sangue , Deficiência de Vitamina D/epidemiologiaRESUMO
BACKGROUND: Individuals with Parkinson's disease (PD) may exhibit some degree of change in swallowing dynamics during the course of the disease. These changes can affect their physical, functional and emotional quality of life. AIMS: To develop a quality of life and swallowing questionnaire for individuals with PD. METHODS & PROCEDURES: The first version of the questionnaire comprised 29 items taken from the accounts of 50 patients treated over a 2-month period at Sarah Hospital in Salvador, Bahia, Brazil. A committee of 10 experts in the field analyzed the content and reduced the questionnaire to 28 questions. The questionnaire was then administered to 140 PD patients and 47 healthy individuals. A factor analysis of the items guided the drafting of the final questionnaire, which consisted of 19 items grouped into four factors, encompassing physical, functional and emotional aspects. A test-retest assessment was conducted with 44 individuals with PD. OUTCOMES & RESULTS: The internal consistency, estimated by the mean of Cronbach's alpha coefficient, varied between 0.71 (domain 3) and 0.94 (domain 1) in the test and between 0.69 (domain 3) and 0.95 (domain 1) in the retest. The correlation coefficient in the test/retest comparison was high and significant, demonstrating that the measurement was stable. A significant difference was observed between the PD group and the comparison group. CONCLUSIONS & IMPLICATIONS: The questionnaire developed is a valid, statistically appropriate and clinically effective self-administered instrument for individuals with PD.