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OBJECTIVES: To assess the effect of protease inhibitor (PI)-based dual therapy on CD4/CD8 ratio during the first year of therapy in antiretroviral therapy (ART)-naïve patients using data from randomized controlled clinical trials. METHODS: We pooled data from the GARDEL and ANDES studies, both randomized controlled clinical trials that recruited ART-naïve people living with HIV and randomly assigned them to receive PI-based dual therapy (DT) or triple therapy (TT) aiming to compare viral efficacy. We compared median CD4/CD8 ratios and the proportion of patients with CD4/CD8 ratio > 1 at 48 weeks after ART initiation in both treatment arms using the Mann-Whitney U-test and the χ2 test. We performed subgroup analysis for patients > 50 years old, with baseline CD4 counts ≤ 200 cells/µL, viral load > 100 000 HIV RNA copies/mL, and ritonavir-boosted lopinavir-based therapy. RESULTS: We analysed data from 571 patients: 292 on DT and 279 on TT. No differences were observed in CD4/CD8 ratio (0.632 vs. 0.617, P = 0.729) or in the proportion of patients with CD4/CD8 ratio > 1 (17.9% vs. 19.3%, P = 0.678) 48 weeks after ART initiation. Subgroup analysis showed no further differences. CONCLUSION: The impact of PI-based DT regimens on the CD4/CD8 ratio during the first year of treatment for ART-naïve patients is similar to that of TT.
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Fármacos Anti-VIH , Infecciones por VIH , Inhibidores de la Proteasa del VIH , VIH-1 , Recuento de Linfocito CD4 , Linfocitos T CD8-positivos , Infecciones por VIH/tratamiento farmacológico , Humanos , Lamivudine/uso terapéutico , Persona de Mediana Edad , Inhibidores de la Transcriptasa Inversa , Ritonavir/farmacología , Ritonavir/uso terapéutico , Carga ViralRESUMEN
In this work, a two-dimensional coordination polymer was synthesized and the structure was determined by single-crystal X-ray diffraction. The crystal structure belongs to the space group Pna21 and was characterized by Raman and FT-infrared spectroscopy, powder X-ray diffraction and Brunauer-Emmett-Teller surface area analysis. Catalyst activities were evaluated through the synthesis of glycerol carbonate from glycerol and urea using a batch reactor. After the optimization of both reaction and reaction conditions, the activity results showed that the coordination polymer used as a heterogeneous catalyst has good values of conversions and selectivity for the manufacturing of glycerol carbonate in a fine-chemical process. The analysis of powder X-ray diffraction and spectroscopy for the coordination polymer employed, before and after the reaction, shows that some changes have taken place in the crystal structure during the process, in spite of a recovery at the end of the reaction. The advantages and limitations of the coordination polymer were discussed and compared with those of the previous heterogeneous catalysts in the literature.
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We aimed to quantify the proportion of people receiving care for HIV-infection that are 50 years or older (older HIV patients) in Latin America and the Caribbean between 2000 and 2015 and to estimate the contribution to the growth of this population of people enrolled before (<50yo) and after 50 years old (yo) (⩾50yo). We used a series of repeated, cross-sectional measurements over time in the Caribbean, Central and South American network (CCASAnet) cohort. We estimated the percentage of patients retained in care each year that were older HIV patients. For every calendar year, we divided patients into two groups: those who enrolled before age 50 and after age 50. We used logistic regression models to estimate the change in the proportion of older HIV patients between 2000 and 2015. The percentage of CCASAnet HIV patients over 50 years had a threefold increase (8% to 24%) between 2000 and 2015. Most of the growth of this population can be explained by the increasing proportion of people that enrolled before 50 years and aged in care. These changes will impact needs of care for people living with HIV, due to multiple comorbidities and high risk of disability associated with aging.
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Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Adulto , Distribución por Edad , Región del Caribe , Demografía/tendencias , Femenino , Humanos , América Latina , Masculino , Persona de Mediana EdadRESUMEN
The United States organic poultry industry is currently facing a limitation on dietary inclusion of synthetic methionine (Met). This study investigated Brazil nut protein powder (BNPP), spray-dried egg white (SDEW), and spray-dried egg blend (70:30 albumen: yolk) (SDEB) as alternatives to synthetic Met in organic laying hen diets. A total of 270 Hy-Line Brown laying hens was fed 5 diets from 22 to 38 wk of age, with 6 replicates of 3 adjacent cages per diet and 3 hens per cage. Diets included a commercial control (COM) (non-organic with standard CP and synthetic Met), an organic control (ORG) (with no synthetic Met, but higher CP to meet Met requirements), and 3 organic treatment diets with no synthetic Met, but including BNPP, SDEW, or SDEB at levels to meet Met requirements. Egg production and quality, body weight (BW), feed intake, and manure nutrients and ammonia were assessed. Data were analyzed using the PROC MIXED procedure of SAS, with Tukey's test used for multiple mean comparisons, and P ≤ 0.05 was deemed statistically significant. Body weight was greatest for the COM diet, and feed conversion improved for hens fed egg-based diets compared to controls. Egg weight and production did not differ between COM and treatment diets. The SDEW diet had greater albumen height and Haugh units compared to ORG and BNPP diets and greater percent albumen compared to COM and BNPP diets. Specific gravity was greatest for BNPP fed hens. Manure DM and potash were highest from COM and BNPP diets, respectively. Both egg-based diets increased ammonia flux relative to the COM diet. The BNPP and egg-based diets were lower in cost for $/metric tonne, $/dozen eggs, and $/kg of eggs compared to the ORG diet. The ingredients assessed herein could, therefore, cost-effectively replace synthetic Met in organic hen diets without negatively impacting egg production.
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Bertholletia/química , Pollos/metabolismo , Dieta/veterinaria , Proteínas en la Dieta/metabolismo , Metionina/metabolismo , Óvulo/química , Amoníaco/análisis , Alimentación Animal/análisis , Fenómenos Fisiológicos Nutricionales de los Animales/efectos de los fármacos , Animales , Heces/química , Femenino , Nitrógeno/análisis , Polvos/químicaRESUMEN
Direct infusion electrospray ionisation mass spectrometry in the negative ion mode [ESI(-)-MS] was employed to evaluate the authenticity of aged cachaças, a traditional and valuable Brazilian alcoholic beverage prepared from the distillation of brewed sugarcane juice and aged in barrels made of common woods. Counterfeit samples were prepared by adding dyes, sawdust or essences to a freshly-distiled, much less valuable sample (white cachaça) to simulate the 1-2years long natural ageing in wooden barrels. A simple visual inspection revealed remarkable differences between the ESI(-)-MS of the authentic samples (aged in oak or amburana casks) and the artificially-aged counterfeit samples. A set of diagnostic ions were detectable in the ESI(-)-MS of the authentic samples aged in oak (m/z 197, 241, 301 and 307) and amburana (m/z 271 and 377/379). This fast and direct methodology seems useful as a routine procedure to monitor this highly profitable and common counterfeit practice.
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Bebidas Alcohólicas/análisis , Saccharum/química , Espectrometría de Masa por Ionización de Electrospray/métodos , Brasil , Control de CalidadRESUMEN
A unique bistable copper-metallacyclic complex is used as an elegant molecular switch for the reversible formation of emulsions by simple pH variation. This switch may have several exciting applications in biphasic processes such as catalysis and separation science technologies.
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Comprehensive two-dimensional gas chromatography (GCxGC) was applied to the study of cachaça production. Effects of bidistillation, and the use of charcoal filtration in the production of artisan cachaça, as well as the effects of multi-distillation on volatile products in commercial cachaça were investigated. Volatile compounds were collected and concentrated onto a polyacrylate solid-phase microextraction fibre, and analyzed using GCxGC on a non-polar (BPX5)-polar (BP20) column set. More than 100 compounds, comprising various homologous series were tentatively identified using MS library matching and comparison with retention indices. Phthalate organic contamination following the use of ion exchange resin for removal of copper ion was evident. Charcoal successfully removes this contamination product. Prediction of compounds within particular homologous series aids component identification.
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Bebidas Alcohólicas/análisis , Cromatografía de Gases y Espectrometría de Masas/métodos , Compuestos Orgánicos Volátiles/análisis , Carbón Orgánico/química , Filtración/métodos , Microextracción en Fase SólidaRESUMEN
SUMMARY: A 41-year-old pregnant woman with multiple virological failures started darunavir, enfuvirtide, zidovudine and lamivudine at week 28 of pregnancy. During week 38, the patient had a viral load <400 copies/mL and a CD4 count of 180 cells/mm(3) (13%). The child was found to be in good health, with negative HIV-polymerase chain reactions at birth, at two and at six months.
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Terapia Antirretroviral Altamente Activa , Proteína gp41 de Envoltorio del VIH/uso terapéutico , Inhibidores de Fusión de VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/uso terapéutico , Fragmentos de Péptidos/uso terapéutico , Sulfonamidas/uso terapéutico , Adulto , Recuento de Linfocito CD4 , Darunavir , Farmacorresistencia Viral Múltiple , Quimioterapia Combinada , Enfuvirtida , Femenino , Proteína gp41 de Envoltorio del VIH/administración & dosificación , Inhibidores de Fusión de VIH/administración & dosificación , Infecciones por VIH/virología , Inhibidores de la Proteasa del VIH/administración & dosificación , VIH-1/efectos de los fármacos , Humanos , Recién Nacido , Fragmentos de Péptidos/administración & dosificación , Embarazo , Resultado del Embarazo , Sulfonamidas/administración & dosificación , Resultado del Tratamiento , Carga ViralRESUMEN
Rum and cachaça are sugarcane distillates produced on large scales and of similar composition, and their differentiation is currently a subject of commercial dispute and a challenging analytical task. We have investigated the ability of direct-infusion electrospray ionization mass spectrometry in the negative ion mode, i.e. ESI(-)-MS, to distinguish between samples of these distillates. ESI(-)-MS fingerprints were collected for some samples of Brazilian artisan cachaça, aged in two types of wooden casks, i. e. amburana (Amburana cearensis) and jequitibá (Cariniana estrellensis), and of commercial rum. The mass spectra were found to be very distinctive, showing sets of diagnostic ions for each type of sample, i. e. (1) cachaça aged in amburana (m/z 271, 313, 377) and jequitibá (m/z 171, 255, 455) casks; and (2) commercial rum (m/z 89, 97, 179, 255, 283). When applied to the ESI(-)-MS data, principal component analysis and hierarchical cluster analysis split rum and cachaça samples into well-defined groups. Moreover, the two types of cachaça samples aged in wooden casks of amburana or jequitibá were also split into two distinct groups. Direct-infusion ESI(-)-MS can therefore be potentially applied to the rapid, simple, and accurate differentiation of these commercially important sugarcane distillates.
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We have investigated the capability of direct infusion electrospray ionization mass spectrometry in the negative ion mode, ESI(-)-MS, to differentiate representative samples of artisan cachaça, a Brazilian sugar cane distillate of large production, aged in four different types of wood casks: amburana (Amburana cearensis), jequitibA (Cariniana estrellensis), balm (Myroxylon peruiferum), and oak (Quercus rubra). The ESI(-)-MS were found to be very characteristic, showing sets of diagnostic ions for each of the four types of samples: amburana (m/z 271, 313, 377), jequitibA (m/z 143, 171, 255), balm (m/z 137, 269, 283, 297), and oak (m/z 197, 301, 307). Furthermore, principal component (PCA) and hierarchical cluster analysis (HCA), applied to the ESI(-)-MS data, divided these samples into four definite categories. The influence of the aging time on the ESI(-)-MS fingerprints of the cachaça samples stored in oak casks was also established. An inversion in the relative intensity of the diagnostic ions of m/z 307 and 301 is detected in the ESI(-)-MS as the aging time increased from 1 to 2 years. The chemical structures of the major cachaça components were proposed on the basis of the following: (a) the comparison of the ESI(-)-MS/MS of the diagnostic anions with those of the authentic anions or (b) the interpretation of the fragmentation patterns of the previously unknown diagnostic anions. Hence, direct infusion ESI(-)-MS allows not only a rapid, simple, and accurate way to distinguish among cachaça samples stored in different wood casks but also monitoring changes in their chemical composition according to the aging time.
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Bebidas Alcohólicas/análisis , Bebidas Alcohólicas/clasificación , Espectrometría de Masa por Ionización de Electrospray , Madera , Análisis de Varianza , Fermentación , Manipulación de Alimentos/métodos , Factores de TiempoRESUMEN
UNLABELLED: A variety of exfoliative cheilitis has been observed in reactive HIV-1 patients subjected to high activity antiretroviral therapy (HAART). The lesions exhibit exfoliation, crater formation, fissuring, erosions and/or the formation of papules, vesicles and blisters associated to erythema and edema. The condition is not included in the 1993 EEC Clearinghouse classification (1) of oral lesions associated with HIV infection. In an earlier series of 1899 patients (2), we failed to observe this pathology and have only found one similar case described in the literature to date (3). OBJECTIVE: We present a series of 6 patients with HIV infection and morpho-histological alterations of the labial semimucosa, subjected to HAART. MATERIALS AND METHODS: The 6 patients were selected from among 20 HIV-positive individuals treated in our Infectious Diseases Unit with a combination of nucleoside and non-nucleoside reverse transcriptase inhibitors and protease inhibitors requiring stomatological care for painful lesions of the lips and oral cavity. The study was conducted over a 6-month period between May and October 1998. An analysis was made of the case histories, CD4-positive cell counts and viral load. The stomatological explorations were completed with biopsies, hematoxylin-eosin staining and immunohistochemical studies involving AE1 and AE3 monoclonal antibodies, vimentin, protein S-100, carcinoembryonic antigen (CEA), laminin, CD8, HLA-DR, BM-1 and CD31 markers. At the time of detection of the oral lesions, the patients had received different combinations of the following antiretroviral treatments: stavudine (D4T), zalcitabine (DDC), didanosine (DDI), zidovudine (AZT), lamivudine (3TC), nelfinavir (NFV), saquinavir (SQV), ritonavir (RTV), hydroxyurea (HU), indinavir (IDN) and efavirenz (EFV). RESULTS: There were four males and two females (age range 31-42 years). The CD4-positive and viral load ranges were 70-330 cells/mm3 and 200-500,200 copies, respectively. Stomatologic manifestations: The oral clinical manifestations consisted of desquamation, cracks, fissures, scabs, ulcerations, edema, erythema, multiple punctate xanthomas (1 case), dryness and labial semimucosal thickening. Microscopic study: Microscopically, the lesions consisted of ulcerations with adjacent hyperkeratosis and suprabasal vacuolization accompanied by a dense lymphocyte infiltrate within the chorion. Inmunohistochemistry: The immunohistochemical study in turn revealed surface epithelial alterations with AE1-AE3 monoclonal antibody labeling. Membrane glycoprotein activation (laminin) was detected, along with the presence of cytotoxic lymphocytes (CD8) and activated lymphocytes (BM-1). CD31 labeling in turn indicated endothelial activation.