bluuebunny/crossref_metadata_2025 huggingface dataset:
Reduction of the HIV-1 reservoir in resting CD4+ T-lymphocytes by high dosage intravenous immunoglobulin treatment: a proof-of-concept study
Authors: Lindkvist Annica , Edén Arvid , Norström Melissa M , Gonzalez Veronica D , Nilsson Staffan , Svennerholm Bo , Karlsson Annika C , Sandberg Johan K , Sönnerborg Anders , Gisslén Magnus
Published: July 2009

Background

The latency of HIV-1 in resting CD4+T-lymphocytes constitutes a major obstacle for the eradication of virus in patients on antiretroviral therapy (ART). As yet, no approach to reduce this viral reservoir has proven effective.

Methods

Nine subjects on effective ART were included in the study and treated with high dosage intravenous immunoglobulin (IVIG) for five consecutive days. Seven of those had detectable levels of replication-competent virus in the latent reservoir and were thus possible to evaluate. Highly purified resting memory CD4+T-cells were activated and cells containing replication-competent HIV-1 were quantified. HIV-1 from plasma and activated memory CD4+T-cells were compared with single genome sequencing (SGS) of thegagregion. T-lymphocyte activation markers and serum interleukins were measured.

Results

The latent HIV-1 pool decreased with in median 68% after IVIG was added to effective ART. The reservoir decreased in five, whereas no decrease was found in two subjects with detectable virus. Plasma HIV-1 RNA ≥ 2 copies/mL was detected in five of seven subjects at baseline, but in only one at follow-up after 8–12 weeks. The decrease of the latent HIV-1 pool and the residual plasma viremia was preceded by a transitory low-level increase in plasma HIV-1 RNA and serum interleukin 7 (IL-7) levels, and followed by an expansion of T regulatory cells. The magnitude of the viral increase in plasma correlated to the size of the latent HIV-1 pool and SGS of thegagregion showed that viral clones from plasma clustered together with virus from activated memory T-cells, pointing to the latent reservoir as the source of HIV-1 RNA in plasma.

Conclusion

The findings from this uncontrolled proof-of-concept study suggest that the reservoir became accessible by IVIG treatment through activation of HIV-1 gene expression in latently-infected resting CD4+T-cells. We propose that IVIG should be further evaluated as an adjuvant to effective ART.
Resveratrol exhibits a strong cytotoxic activity in cultured cells and has an antiviral action against polyomavirus: potential clinical use
Authors: Berardi Valerio , Ricci Francesca , Castelli Mauro , Galati Gaspare , Risuleo Gianfranco
Published: July 2009

Background

Resveratrol is a non flavonoid polyphenol compound present in many plants and fruits and, at especially high concentrations, in the grape berries of Vitis vinifera. This compound has a strong bioactivity and its cytoprotective action has been demonstrated, however at high concentrations the drug exhibits also an effective anti-proliferative action. We recently showed its ability to abolish the effects of oxidative stress in cultured cells. In this work we assayed the bioactivity of resveratrol as antiproliferative and antiviral drug in cultured fibroblasts. Studies by other Authors showed that this natural compound inhibits the proliferation of different viruses such as herpes simplex, varicella-zoster and influenza A. The results presented here show an evident toxic activity of the drug at high concentrations, on the other hand at sub-cytotoxic concentrations, resveratrol can effectively inhibit the synthesis of polyomavirus DNA. A possible interpretation is that, due to the damage caused by resveratrol to the plasma membrane, the transfer of the virus from the endoplasmic reticulum to the nucleus, may be hindered thus inhibiting the production of viral DNA.

Methods

The mouse fibroblast line 3T6 and the human tumor line HL60 were used throughout the work. Cell viability and vital cell count were assessed respectively, by the MTT assay and Trypan Blue staining. Cytotoxic properties and evaluation of viral DNA production by agarose gel electrophoresis were performed according to standard protocols.

Results

Our results show a clear dose dependent both cytotoxic and antiviral effect of resveratrol respectively at high and low concentrations. The cytotoxic action is exerted towards a stabilized cell-line (3T6) as well as a tumor-line (HL60). Furthermore the antiviral action is evident after the phase of virion entry, therefore data suggest that the drug acts during the synthesis of the viral progeny DNA.

Conclusion

Resveratrol is cytotoxic and inhibits, in a dose dependent fashion, the synthesis of polyomavirus DNA in the infected cell. Furthermore, this inhibition is observed at non cytotoxic concentrations of the drug. Our data imply that cyto-toxicity may be attributed to the membrane damage caused by the drug and that the transfer of polyomavirus from the endoplasmic reticulum to the cytoplasm may be hindered. In conclusion, the cytotoxic and antiviral properties of resveratrol make it a potential candidate for the clinical control of proliferative as well as viral pathologies.
Differences in resistance mutations among HIV‐1 non‐subtype B infections: a systematic review of evidence (1996–2008)
Authors: Martinez‐Cajas Jorge L , Pai Nitika P , Klein Marina B , Wainberg Mark A
Published: July 2009

Ninety percent of HIV‐1‐infected people worldwide harbour non‐subtype B variants of HIV‐1. Yet knowledge of resistance mutations in non‐B HIV‐1 and their clinical relevance is limited. Although a few reviews, editorials and perspectives have been published alluding to this lack of data among non‐B subtypes, no systematic review has been performed to date.

With this in mind, we conducted a systematic review (1996–2008) of all published studies performed on the basis of non‐subtype B HIV‐1 infections treated with antiretroviral drugs that reported genotype resistance tests. Using an established search string, 50 studies were deemed relevant for this review.

These studies reported genotyping data from non‐B HIV‐1 infections that had been treated with either reverse transcriptase inhibitors or protease inhibitors. While most major resistance mutations in subtype B were also found in non‐B subtypes, a few novel mutations in non‐B subtypes were recognized. The main differences are reflected in the discoveries that: (i) the non‐nucleoside reverse transcriptase inhibitor resistance mutation, V106M, has been seen in subtype C and CRF01_AE, but not in subtype B, (ii) the protease inhibitor mutations L89I/V have been reported in C, F and G subtypes, but not in B, (iii) a nelfinavir selected non‐D30N containing pathway predominated in CRF01_AE and CRF02_AG, while the emergence of D30N is favoured in subtypes B and D, (iv) studies on thymidine analog‐treated subtype C infections from South Africa, Botswana and Malawi have reported a higher frequency of the K65R resistance mutation than that typically seen with subtype B.

Additionally, some substitutions that seem to impact non‐B viruses differentially are: reverse transcriptase mutations G196E, A98G/S, and V75M; and protease mutations M89I/V and I93L.

Polymorphisms that were common in non‐B subtypes and that may contribute to resistance tended to persist or become more frequent after drug exposure. Some, but not all, are recognized as minor resistance mutations in B subtypes. These observed differences in resistance pathways may impact cross‐resistance and the selection of second‐line regimens with protease inhibitors. Attention to newer drug combinations, as well as baseline genotyping of non‐B isolates, in well‐designed longitudinal studies with long duration of follow up are needed.
Broad-range PCR, cloning and sequencing of the full 16S rRNA gene for detection of bacterial DNA in synovial fluid samples of Tunisian patients with reactive and undifferentiated arthritis
Authors: Siala Mariam , Gdoura Radhouane , Fourati Hela , Rihl Markus , Jaulhac Benoit , Younes Mohamed , Sibilia Jean , Baklouti Sofien , Bargaoui Naceur , Sellami Slaheddine , Sghir Abdelghani , Hammami Adnane
Published: July 2009

Introduction

Broad-range rDNA PCR provides an alternative, cultivation-independent approach for identifying bacterial DNA in reactive and other form of arthritis. The aim of this study was to use broad-range rDNA PCR targeting the 16S rRNA gene in patients with reactive and other forms of arthritis and to screen for the presence of DNA from any given bacterial species in synovial fluid (SF) samples.

Methods

We examined the SF samples from a total of 27 patients consisting of patients with reactive arthritis (ReA) (n = 5), undifferentiated arthritis (UA) (n = 9), rheumatoid arthritis (n = 7), and osteoarthritis (n = 6) of which the latter two were used as controls. Using broad-range bacterial PCR amplifying a 1400 bp fragment from the 16S rRNA gene, we identified and sequenced at least 24 clones from each SF sample. To identify the corresponding bacteria, DNA sequences were compared to the EMBL (European Molecular Biology Laboratory) database.

Results

Bacterial DNA was identified in 20 of the 27 SF samples (74, 10%). Analysis of a large number of sequences revealed the presence of DNA from more than one single bacterial species in the SF of all patients studied. The nearly complete sequences of the 1400 bp were obtained for most of the detected species. DNA of bacterial species including Shigella species, Escherichia species, and other coli-form bacteria as well as opportunistic pathogens such as Stenotrophomonas maltophilia and Achromobacter xylosoxidans were shared in all arthritis patients. Among pathogens described to trigger ReA, DNA from Shigella sonnei was found in ReA and UA patients. We also detected DNA from rarely occurring human pathogens such as Aranicola species and Pantoea ananatis. We also found DNA from bacteria so far not described in human infections such as Bacillus niacini, Paenibacillus humicus, Diaphorobacter species and uncultured bacterium genera incertae sedis OP10.

Conclusions

Broad-range PCR followed by cloning and sequencing the entire 16S rDNA, allowed the identification of the bacterial DNA environment in the SF samples of arthritic patients. We found a wide spectrum of bacteria including those known to be involved in ReA and others not previously associated with arthritis.
Motifs and cis-regulatory modules mediating the expression of genes co-expressed in presynaptic neurons
Authors: Liu Rui , Hannenhalli Sridhar , Bucan Maja
Published: July 2009

Background

Hundreds of proteins modulate neurotransmitter release and synaptic plasticity during neuronal development and in response to synaptic activity. The expression of genes in the pre- and post-synaptic neurons is under stringent spatio-temporal control, but the mechanism underlying the neuronal expression of these genes remains largely unknown.

Results

Using unbiased in vivo and in vitro screens, we characterized the cis elements regulating the Rab3A gene, which is expressed abundantly in presynaptic neurons. A set of identified regulatory elements of the Rab3A gene corresponded to the defined Rab3A multi-species conserved elements. In order to identify clusters of enriched transcription factor binding sites, for example, cis-regulatory modules, we analyzed intergenic multi-species conserved elements in the vicinity of nine presynaptic genes, including Rab3A, that are highly and specifically expressed in brain regions. Sixteen transcription factor binding motifs were over-represented in these multi-species conserved elements. Based on a combined occurrence for these enriched motifs, multi-species conserved elements in the vicinity of 107 previously identified presynaptic genes were scored and ranked. We then experimentally validated the scoring strategy by showing that 12 of 16 (75%) high-scoring multi-species conserved elements functioned as neuronal enhancers in a cell-based assay.

Conclusions

This work introduces an integrative strategy of comparative genomics, experimental, and computational approaches to reveal aspects of a regulatory network controlling neuronal-specific expression of genes in presynaptic neurons.
Prenatal risk factors for autism: comprehensive meta-analysis
Authors: Gardener Hannah , Spiegelman Donna , Buka Stephen L.
Published: July 2009

Background

The aetiology of autism is unknown, although prenatal exposures have been the focus of epidemiological research for over 40 years.

Aims

To provide the first quantitative review and meta-analysis of the association between maternal pregnancy complications and pregnancy-related factors and risk of autism.

Method

PubMed, Embase and PsycINFO databases were searched for epidemiological studies that examined the association between pregnancy-related factors and autism. Forty studies were eligible for inclusion in the meta-analysis. Summary effect estimates were calculated for factors examined in multiple studies.

Results

Over 50 prenatal factors have been examined. The factors associated with autism risk in the meta-analysis were advanced parental age at birth, maternal prenatal medication use, bleeding, gestational diabetes, being first born v. third or later, and having a mother born abroad. The factors with the strongest evidence against a role in autism risk included previous fetal loss and maternal hypertension, proteinuria, pre-eclampsia and swelling.

Conclusions

There is insufficient evidence to implicate any one prenatal factor in autism aetiology, although there is some evidence to suggest that exposure to pregnancy complications may increase the risk.
Effect of feedback of treatment outcome in specialist mental
healthcare: meta-analysis
Authors: Knaup Carina , Koesters Markus , Schoefer Dorothea , Becker Thomas , Puschner Bernd
Published: July 2009

Background

Feedback of treatment outcome during the course of therapy (outcome
management) is increasingly considered to be beneficial for improving the
quality of mental healthcare.

Aims

To review the impact of feedback of outcome to practitioners and/or
patients in specialist mental health services.

Method

A systematic search and meta-analysis of controlled trials using outcome
management in mental health services published in English or German
language.

Results

Twelve studies met inclusion criteria. Feeding back outcome showed a
small, but significant (d = 0.10; 95% CI 0.01–0.19) positive short-term
effect on the mental health of individuals that did not prevail in the
long run. Subgroup analysis revealed no significant differences regarding
feedback modalities. Outcome management did not contribute to a reduction
of treatment duration.

Conclusions

Evidence on the effects of outcome management in mental healthcare is
promising. More targeted research is needed in order to identify the
effective ingredients of outcome feedback and to assess its
cost-effectiveness.
Clinical effectiveness of online computerised
cognitive–behavioural therapy without support for depression in primary
care: randomised trial
Authors: de Graaf L. E. , Gerhards S. A. H. , Arntz A. , Riper H. , Metsemakers J. F. M. , Evers S. M. A. A. , Severens J. L. , Widdershoven G. , Huibers M. J. H.
Published: July 2009

Background

Computerised cognitive–behavioural therapy (CCBT) might offer a solution
to the current undertreatment of depression.

Aims

To determine the clinical effectiveness of online, unsupported CCBT for
depression in primary care.

Method

Three hundred and three people with depression were randomly allocated to
one of three groups: Colour Your Life; treatment as usual (TAU) by a
general practitioner; or Colour Your Life and TAU combined. Colour Your
Life is an online, multimedia, interactive CCBT programme. No assistance
was offered. We had a 6-month follow-up period.

Results

No significant differences in outcome between the three interventions
were found in the intention-to-treat and per protocol analyses.

Conclusions

Online, unsupported CCBT did not outperform usual care, and the
combination of both did not have additional effects. Decrease in
depressive symptoms in people with moderate to severe depression was
moderate in all three interventions. Online CCBT without support is not
beneficial for all individuals with depression.
Shooting the messenger: the science and politics of ethnicity
research
Authors: Singh Swaran P.
Published: July 2009

Scientific arguments showing ‘how the world is’ are fundamentally different
from political assertions about ‘how the world should be’. Ideologically
motivated political attacks can hamper our understanding of mental disorders
by preventing academics from pursuing research in contentious areas.
Evidence should be countered by better evidence, not by shooting the
messenger.
Genetic utility of broadly defined bipolar schizoaffective disorder as a diagnostic concept
Authors: Hamshere M. L. , Green E. K. , Jones I. R. , Jones L. , Moskvina V. , Kirov G. , Grozeva D. , Nikolov I. , Vukcevic D. , Caesar S. , Gordon-Smith K. , Fraser C. , Russell E. , Breen G. , Clair D. St , Collier D. A. , Young A. H. , Ferrier I. N. , Farmer A. , McGuffin P. , Holmans P. A. , Owen M. J. , O'Donovan M. C. , Craddock N. ,   Wellcome Trust Case Control Consortium
Published: July 2009

Background

Psychiatric phenotypes are currently defined according to sets of descriptive criteria. Although many of these phenotypes are heritable, it would be useful to know whether any of the various diagnostic categories in current use identify cases that are particularly helpful for biological–genetic research.

Aims

To use genome-wide genetic association data to explore the relative genetic utility of seven different descriptive operational diagnostic categories relevant to bipolar illness within a large UK case–control bipolar disorder sample.

Method

We analysed our previously published Wellcome Trust Case Control Consortium (WTCCC) bipolar disorder genome-wide association data-set, comprising 1868 individuals with bipolar disorder and 2938 controls genotyped for 276 122 single nucleotide polymorphisms (SNPs) that met stringent criteria for genotype quality. For each SNP we performed a test of association (bipolar disorder group v. control group) and used the number of associated independent SNPs statistically significant atP<0.00001 as a metric for the overall genetic signal in the sample. We next compared this metric with that obtained using each of seven diagnostic subsets of the group with bipolar disorder: Research Diagnostic Criteria (RDC): bipolar I disorder; manic disorder; bipolar II disorder; schizoaffective disorder, bipolar type; DSM–IV: bipolar I disorder; bipolar II disorder; schizoaffective disorder, bipolar type.

Results

The RDC schizoaffective disorder, bipolar type (v. controls) stood out from the other diagnostic subsets as having a significant excess of independent association signals (P<0.003) compared with that expected in samples of the same size selected randomly from the total bipolar disorder group data-set. The strongest association in this subset of participants with bipolar disorder was at rs4818065 (P= 2.42 × 10–7). Biological systems implicated included gamma amniobutyric acid (GABA)Areceptors. Genes having at least one associated polymorphism atP<10–4includedB3GALTS, A2BP1, GABRB1, AUTS2, BSN, PTPRG, GIRK2andCDH12.

Conclusions

Our findings show that individuals with broadly defined bipolar schizoaffective features have either a particularly strong genetic contribution or that, as a group, are genetically more homogeneous than the other phenotypes tested. The results point to the importance of using diagnostic approaches that recognise this group of individuals. Our approach can be applied to similar data-sets for other psychiatric and non-psychiatric phenotypes.
The rise and fall of the biopsychosocial model
Authors: Ghaemi S. Nassir
Published: July 2009

The biopsychosocial model is the conceptual status quo of contemporary psychiatry. Although it has played an important role in combatting psychiatric dogmatism, it has devolved into mere eclecticism. Other non-reductionistic approaches to medicine and psychiatry such as William Osler's medical humanism or Karl Jaspers' method-based psychiatry should be reconsidered.
Effects of Growth Hormone and Free Fatty Acids on Insulin Sensitivity in Patients with Type 1 Diabetes
Authors: Salgin Burak , Marcovecchio Maria L. , Williams Rachel M. , Jackson Sarah J. , Bluck Leslie J. , Humphreys Sandy M. , Acerini Carlo L. , Dunger David B.
Published: July 2009

Context: Because GH stimulates lipolysis, an increase in circulating free fatty acid levels, as opposed to a direct effect of high GH levels, could underlie the development of insulin resistance in type 1 diabetes (T1D). Our aim was to explore the relative contributions of GH and free fatty acids to the development of insulin resistance in patients with T1D.

Patients: Seven (four females, three males) nonobese patients with T1D aged 21–30 yr were studied on four occasions in random order. On each visit, overnight endogenous GH production was suppressed by octreotide. Three 1-h pulses of recombinant human GH (rhGH) or placebo were administered on two visits each. Acipimox, an antilipolytic drug, or a placebo were ingested every 4 h on two visits each. Stable glucose and glycerol isotopes were used to assess glucose and glycerol turnover. The overnight protocol was concluded by a two-step hyperinsulinemic euglycemic clamp on each visit.

Main Outcome: rhGH administration led to increases in the insulin infusion rate required to maintain euglycemia overnight (P = 0.008), elevated basal endogenous glucose production (P = 0.007), decreased basal peripheral glucose uptake (P = 0.03), and reduced glucose uptake during step 1 of the clamp (P < 0.0001). Coadministration of rhGH and acipimox reversed these effects and suppression of lipolysis in the absence of GH replacement led to further increases in insulin sensitivity.

Results: GH pulses were associated with an increase in endogenous glucose production and decreased rates of peripheral glucose uptake, which was entirely reversed by acipimox. Therefore, GH-driven decreases in insulin sensitivity are mainly determined by the effect of GH on lipolysis.

Growth hormone decreases insulin sensitivity through increases in free fatty acid levels.
An update on nuclear calcium signalling
Authors: Bootman Martin D. , Fearnley Claire , Smyrnias Ioannis , MacDonald Fraser , Roderick H. Llewelyn
Published: July 2009

Over the past 15 years or so, numerous studies have sought to characterise how nuclear calcium (Ca2+) signals are generated and reversed, and to understand how events that occur in the nucleoplasm influence cellular Ca2+ activity, and vice versa. In this Commentary, we describe mechanisms of nuclear Ca2+ signalling and discuss what is known about the origin and physiological significance of nuclear Ca2+ transients. In particular, we focus on the idea that the nucleus has an autonomous Ca2+ signalling system that can generate its own Ca2+ transients that modulate processes such as gene transcription. We also discuss the role of nuclear pores and the nuclear envelope in controlling ion flux into the nucleoplasm.
How peroxisomes multiply
Authors: Hettema Ewald H. , Motley Alison M.
Published: July 2009

With every cell division, peroxisomes duplicate and are segregated between progeny cells. Here, we discuss the different modes of peroxisome multiplication and the machinery that is involved in each case. Peroxisomes have been considered by many to be peripheral to mainstream cell biology. However, this is changing in response to the recent finding that peroxisomes obtain membrane constituents from the endoplasmic reticulum, making them the latest branch of the endomembrane system to be identified. Furthermore, the observations that peroxisome and mitochondrial biogenesis can occur in a coordinated manner, and that these organelles share factors for their multiplication, demonstrate previously unanticipated aspects of cellular organisation.
Comparative analysis of ESCRT-I, ESCRT-II and ESCRT-III function inDrosophilaby efficient isolation of ESCRT mutants
Authors: Vaccari Thomas , Rusten Tor Erik , Menut Laurent , Nezis Ioannis P. , Brech Andreas , Stenmark Harald , Bilder David
Published: July 2009

ESCRT proteins were initially isolated in yeast as a single functional set of conserved components controlling endosomal cargo sorting and multivesicular body (MVB) biogenesis. Recent work has suggested that metazoan ESCRT proteins might have more functionally diverse roles, but the limited availability of ESCRT mutants in species other than yeast has hampered a thorough analysis. Here, we used a genetic screening strategy based on both cell-autonomous and non-autonomous growth-promotion phenotypes to isolate null mutations in nearly half of the ESCRT-encoding genes of Drosophila, including components of ESCRT-I, ESCRT-II and ESCRT-III complexes. All ESCRT components are required for trafficking of ubiquitylated proteins and are required to prevent excess Notch and EGFR signaling. However, cells lacking certain ESCRT-III components accumulate fewer ubiquitylated molecules in endosomes and display reduced degrees of cell proliferation compared with those lacking components of ESCRT-I and ESCRT-II. Moreover, although we find by ultrastructural analysis that MVB formation is impaired in ESCRT-I and ESCRT-II mutant cells, MVB biogenesis still occurs to some degree in ESCRT-III mutant cells. This work highlights the multiple cell biological and developmental roles of ESCRT proteins in Drosophila, suggests that the metazoan ESCRT-I, ESCRT-II and ESCRT-III complexes do not serve identical functions, and provides the basis for an extensive analysis of metazoan ESCRT function.
Crumbs stabilises epithelial polarity during tissue remodelling
Authors: Campbell Kyra , Knust Elisabeth , Skaer Helen
Published: July 2009

The apicobasal polarity of epithelia depends on the integrated activity of apical and basolateral proteins, and is essential for tissue integrity and body homeostasis. Yet these tissues are frequently on the move as they are sculpted by active morphogenetic cell rearrangements. How does cell polarity survive these stresses? We analyse this question in the renal tubules of Drosophila, a tissue that undergoes dramatic morphogenetic change as it develops. Here we show that, whereas the Bazooka and Scribble protein groups are required for the establishment of tubule cell polarity, the key apical determinant, Crumbs, is required for cell polarity in the tubules only from the time when morphogenetic movements start. Strikingly, if these movements are stalled, polarity persists in the absence of Crumbs. Similar rescue of the ectodermal phenotype of the crumbs mutant when germ-band extension is reduced suggests that Crumbs has a specific, conserved function in stabilising cell polarity during tissue remodelling rather than in its initial stabilisation. We also identify a requirement for the exocyst component Exo84 during tissue morphogenesis, which suggests that Crumbs-dependent stability of epithelial polarity is correlated with a requirement for membrane recycling and targeted vesicle delivery.
Prevalence of Sodium Bicarbonate–Induced Alkalemia in Cardiopulmonary Arrest Patients
Authors: Geraci Matthew J , Klipa Dusko , Heckman Michael G , Persoff Jason
Published: July 2009

Background:

Intravenous sodium bicarbonate (SB) administration during cardiopulmonary arrest (CPA) is intended to counteract lactic acidosis due to hypoxia, poor perfusion, and anaerobic metabolism. Despite a lack of documented efficacy and a level III recommendation from the American Heart Association, SB is widely used during resuscitation events. SB has both theoretical and measurable adverse effects. Excess or poorly timed administration during a CPA may elevate a patient's pH, inducing alkalemia. Despite decades of controversy surrounding use of this drug, the prevalence of SB-induced alkalemia has not been previously documented.

Objective:

To estimate the prevalence of SB-induced alkalemia in inpatients after CPA and to investigate the pattern of SB administration.

Methods:

Medical records were retrospectively reviewed with attention to SB administration and arterial blood gas (ABG) data. After application of inclusion and exclusion criteria to 264 CPA patients, the study group comprised 88 patients. When measured, il PCO2 and pH were above normal limits after SB administration, we concluded that SB contributed to the alkalemia.

Results:

Twenty-seven (31 %) patients received SB without any ABG data, and 70 (79%) patients received at least one empiric SB dose. Of the 61 patients with ABG data, alkalemia occurred in 10, a prevalence of 16%. Administration of SB increased pH in only 9 (15%) other CPA patients and had no effect in the 42 (69%) remaining patients.

Conclusions:

Administration of SB during CPA was causally linked with inducing alkalemia in 16% of patients. Early collection of ABG samples may assist in optimizing pH during CPA and thus reduce unwarranted empiric use of SB.
Sertraline-Induced Rhabdomyolysis in an Elderly Patient with Dementia and Comorbidities
Authors: Gareri Pietro , Segura-Garcia Cristina , Fazio Pasquale De , Fazio Salvatore De , Sarro Giovambattista De
Published: July 2009

Objective:

To describe a case of sertraline-induced rhabdomyolysis in an elderly patient with dementia and comorbidities.

Case Summary:

A 71-year-old woman visited a psychiatrist in September 2007 for her depressed mood. Her medical history included vascular dementia accompanied by depression, arterial hypertension, and heart failure, as well as cardiac pacemaker implantation several years earlier for severe bradyarrythmia. She had begun taking amisulpride 50 mg/day and diazepam 2 mg at bedtime 6 months prior to the psychiatrist appointment, with poor relief of her depressed mood. Her drug therapy also included nicergoline 30 mg/day, amlodipine 5 mg/day, aspirin 100 mg/day, candesartan 16 mg/day, and atenolol 25 mg/day. At this psychiatrist visit, sertraline 50 mg/day was added for her depression, and was continued after a geriatrician visit in October. Her mood improved significantly. On December 18, 2007, she was admitted to the cardiology unit to undergo a pacemaker replacement. Laboratory tests revealed creatine kinase (CK) 7952 IU/L, lactate dehydrogenase 1021 IU/L, myoglobin 2322 U/L, and aspartate aminotransferase 362 IU/L, resulting in a diagnosis of iatrogenic rhabdomyolysis. Amisulpride and sertraline were discontinued. On December 24, serum CK was 839 IU/L and myoglobin was 91 U/L and the patient was discharged. On January 22, laboratory tests showed normal values of CK, CK-MB, and myoglobin. Sertraline 50 mg/day was again prescribed for the patient's persistent depressed mood. Fifteen days later, blood tests showed CK 1327 IU/L and myoglobin 324 U/L; therefore, the drug was discontinued. CK and myoglobin levels normalized a week later. On April 2, escitalopram was started. At time of writing, there was no evidence of any increase in CK, myoglobin, or other markers of rhabdomyolysis.

Discussion:

The Naranjo probability scale indicated a probable relationship between sertraline treatment and the onset of rhabdomyolysis. No relationship between amisulpride and rhabdomyolysis was found. Furthermore, rechallenge with sertraline caused CK and myoglobin to again increase, which was reversed following a discontinuation of sertraline. The patient's other comorbidities and medications have not been suggested as possible interactions with sertraline that can cause rhabdomyolysis. Genetic defects of sertraline demethylation and/or P-glycoprotein binding or concurrent circumstances may explain the onset of rhabdomyolysis in this particular patient.

Conclusions:

This patient's rhabdomyolysis was probably induced by sertraline therapy.
Core Concepts
Authors: Warren Jamie B. , Anderson JoDee M.
Published: July 2009

Respiratory distress syndrome (RDS) is seen primarily in the preterm neonate and is due mostly to pulmonary surfactant deficiency. Lung atelectasis leads to ventilation-perfusion mismatching, hypoxia, and eventual respiratory failure in the untreated infant who has RDS. RDS is diagnosed by physical findings consistent with respiratory distress and characteristic radiographic findings. Treatment of RDS begins antenatally with the administration of maternal steroids to women at risk of preterm delivery between 24 and 34 weeks’ gestation. The use of repeat doses of antenatal steroids is under investigation but is currently not recommended outside of randomized, controlled trials. SRT has been approved for use since 1990 and has been successful in decreasing rates of RDS. Natural surfactant is currently recommended for use, but synthetic surfactant that contains proteins to mimic surfactant proteins is being investigated. In general, prophylactic use of surfactant is recommended over rescue treatment in infants at high risk for developing RDS, but the determination of which infants are at high risk for developing RDS remains a clinical one. The push toward use of less invasive ventilation strategies in the treatment of RDS has led to several trials of nasal continuous positive airway pressure (nCPAP). Results of the SUPPORT trial are pending, but the COIN trial has concluded that nCPAP use in infants who have RDS is not detrimental. Inhaled nitric oxide for RDS still requires investigation on safety and efficacy. Several other treatments have been studied, but as of yet, only inositol administration shows promise in the treatment of RDS. Several complications of the recommended treatments for RDS have been identified, but the benefits far outweigh the risks. Finally, there remains a need for long-term follow-up studies on preterm infants treated for RDS to assess neurodevelopmental outcomes.
Curso de imersão em diabetes como técnica educativa para profissionais médicos
Authors: Zanoni Patrícia H. , Parisi Maria Cândida Ribeiro , Admoni Sharon N. , Queiroz Márcia S. , Nery Marcia
Published: July 2009

Este estudo avaliou a eficácia do método de ensino teórico e prático sobre diabetes e a atitude de profissionais médicos quanto à realização de controle glicêmico intensivo. Participaram de um curso de imersão em diabetes, com dois dias de duração, 48 médicos-residentes de clínica médica ou endocrinologia. Os participantes receberam treinamento de monitorização de glicemia capilar, técnicas de aplicação de insulina e contagem de carboidratos, sendo orientados a se portarem como diabéticos e a seguir prescrição médica individual. Foram avaliados através de questionários. No questionário de conhecimentos, observou-se um aumento significante de 12% no índice de acertos entre o início e o final do curso (61,2% e 73,2%, respectivamente, com p < 0,0001). Antes do curso, 70,8% dos participantes diziam ter dificuldades na contagem de carboidratos e 89,6%, na automonitorização glicêmica. Após a experiência prática, 82,9% dos participantes encontraram dificuldades na realização de contagem de carboidratos e 80,8%, na automonitorização; 40,4% fizeram uso de todas as medicações prescritas e 36,1% monitorizaram todas as glicemias. Os resultados deste estudo mostram que esse tipo de curso é eficaz para a aquisição de conhecimentos e contribui com a sensibilização do profissional médico quanto às dificuldades cotidianas enfrentadas pelo portador de diabetes melito na aderência às recomendações.
Study of some parameters affecting the in vitro cultivation of Plasmodium falciparum within saimiri sciureus red blood cells
Authors: Fandeur T. , Dedet J. P.
Published: July 2009

The in vitro growth and multiplication of the erythrocytic stages of Plasmodium falciparum within Saimiri sciureus (squirrel monkey) red blood cells have been studied. Various parameters, such as the origin of the red blood cells and serum supplement, nature of the buffer, influence of the final pH of the medium, role of proteose peptone and glucose addition, were investigated. The selection of the best culture conditions led to the obtention of a reproducible in vitro growth of two parasite cycles in Saimiri erythrocytes, which is an useful achievement for in vitro studies. Our failure to establish a continuous culture line for longer than 19 days, could be explained by a dramatic increasing of osmotic fragility of the Saimiri red blood cells related to their small size.
Alterações biomorfogênicas causadas pela aplicação de precoceno II em ninfas de Triatoma infestans (Klug, 1834) (Hemiptera, reduviidae, triatominae)
Authors: Jurberg José , Costa Jane Margaret , Gonçalves Teresa Cristina M. , Garcia Eloi , Azambuja Patrícia de
Published: July 2009

O precoceno II aplicado topicamente em ninfas de 4ª estádio, nas dosagens de 200, 300 e 400 micron-grama/1 micron-litro de acetona, proporcionou o aparecimento de adultóides, em diferentes percentagens com as seguintes características: tegumento alterado, aparelho bucal deformado, asas braquípteras, tarsos trímeros, ocelos, evidentes e genitália externa com estruturas desenvolvidas e deformadas; genitália interna em estágio intermediário entre ninfas de 4§ e 5§ estádios. Os adultóides apresentaram um período de sobrevivência inversamente proporcional à dosagem aplicada, variando de 3 a 22 dias, não tendo se alimentado devido as alterações.
Tripomastigota muito largo como padrão morfológico de cepas do Trypanosoma cruzi do extremo Sul do Brasil?
Authors: Schlemper Junior Bruno R. , Ishida Maria Márcia I. , Steindel Mário , Gargioni Rogério
Published: July 2009

Foi estudado, em camundongos, o padrão morfológico-evolutivo de tripomastigotas sanguíneos de cinco cepas silvestres de Trypanosoma cruzi de Santa Catarina. Os resultados mostraram predomínio da forma muito larga ( > 70%) ao longo de toda a fase aguda de infecção em quatro cepas de média virulência. Com uma cepa de elevada virulência, a forma delgada foi prevalente no período inicial de infecção seguido de maior ocorrência da muito larga. Tendo em vista que a maioria das cepas de T. cruzi que possuem predomínio da forma muito larga foram isoladas no sul do Brasil (Rio Grande do Sul e Santa Catarina) e que existem evidências de diferentes comportamentos biológicos entre estes parasitas sangüíneos, os autores sugerem a investigação de possíveis correlações dos padrões morfológicos com os aspectos epidemiológicos e clínicos da doença de Chagas.
Orientation of the snail Biomphalaria straminea (Dunker, 1848) in response to light in a situation of selection
Authors: Schall Virginia T. , Jurberg Pedro , Rozemberg Brani
Published: July 2009

The behavioral response of Biomphalaria straminea to light was evaluted in terms of location of the snail in a Y-shaped aquarium in a situation of selection and of the rate (cm/hour) and direction of locomotion under homogeneous 9vertical) or differential (horizontal) lighting upon only one arm of the aquarium. The light source consisted of daylight fluorescent lamps with a spectrum close to that of natural light, with illumination varying from 28 to 350 lux. Analysis of the data showed that all animals, whether in groups or isolated, were attracted to light, although the time needed to approach the light source was 50% shorter for the former than for the latter. The rate of locomotion of B. straminea was 35% higher than observed in B. glabrata and 51% higher than that observed in B. tenagophila studied under similar conditions. The results are discussed in terms of social factors and geographical distribution of the three species.
Psychodopygus Leonidasdeanei a new species of sand fly (Diptera: Psychodidae) from Pará State, Brazil
Authors: Fraiha Habib , Ryan Lee , Ward Richard D. , Lainson Ralph , Shaw Jeffrey
Published: July 2009

The male and female of Psychodopygus leonidasdeanei n.sp., (Diptera : Psychodidae) are described and illustrated from specimens collected in Shannon traps near Santarém, Pará State, Brazil. This species is a member of the squamiventris series and information is given on the distribution of the members of this series in Pará. A pictorial guide to separate the males and some females from others in the series is given.
Henneguya intracornea n.sp. (Myxozoa: Myxosporea) parasita do olho do lambari, Astyanax Scabripinnis (Jenyns, 1842) (Osteichthyes, Characidae)
Authors: Gioia Ismael , Cordeiro Nelson da Silva , Artigas Paulo de Toledo
Published: July 2009

Descreve-se um novo mixosporídeo - Henneguya intracornea n.sp - parasita da córnea de peixe de água doce, Astyanax scabripinnis (Jenyns, 1842) da região de Campinas, Sp. As sucessivas fases evolutivas são descritas. Assinalam-se os caracteres morfológicos e biológicos que distinguem H. intracornea n.sp. das demais espécies do gênero. Destaca-se o parasitismo exclusivo da córnea do peixe parasitado e suas características morfológicas, com ênfase para sua típica cápsula polar, com a forma de garrafa e para os dois processos caudais, desiguais no comprimento.
Biologia de Lutzomyia intermedia Lutz & Neiva, 1912 e Lutzomyia longypalpis Lutz & Neiva, 1912 (Diptera, Phychodidae), em condições experimentais. I. aspectos da alimentação de larvas e adultos
Authors: Rangel Elizabeth F. , Souza Nataly A. , Wermelinger Eduardo D. , Barbosa André F. , Andrade Claudia A.
Published: July 2009

Objetivando ampliar o conhecimento da biologia de flebótomos em cativeiro, que propicie condições para mantê-los regularmente, estabelecemos colônias autônomas de Lutzomyia intermedia e Lutzomyia longipalpis, apresentando aqui dados referentes às observações sobre a alimentaçãodas larvas e adultos. A ração comercializada para peixes é bem aceita pelas larvas das duas espécies, em todos os estádios; é de fácil aquisição e de baixo custo, não favorecendo a proliferação de fungos. As larvas de L. intermedia e de L. longipalpis, em todos os estádios, aceitam rações alimentares de origem vegetal e de origem mista; porém as de 1º e 2º estádios de L. intermedia têm certa preferência pela ração de base vegetal, enquanto que as de 3º e 4º estádios de L. longipalpis ainda que discretamente, preferem ração de origem mista. A prévia alimentação com solução açucarada não é fator indispensável ao hematofagismo nas duas espécies. Ambas se alimentam bem em homem, cão, pinto ou hamster, mas a fonte de alimento sanguíneo mais adequada é o hamster, analisando-se aceitação da isca, desova, duração do ciclo e produtividade a partir do número de ovos postos. As fêmeas de L. longipalpis mostraram maior resistência ao jejum de sangue que as l. intermedia, embora ambas possam resistir, em mais de 70% até o 7º dia, apenas com alimentação de solução açucarada.
Nasal secretions of Neisseria lactamica carriers have an inhibitory effect on Neisseria meningitidis attachment to human oroepithelial cells
Authors: Andrade João Ramos Costa , Marques Margareth da Cunha , Santa Rosa Milden Rodrigues de
Published: July 2009

Nasal secretions of volunteers colonized by N. lactamica impaired the attachment of N. lactamica and of meningococci of groups A and B to oroepithelial cells. Bacterial adherence was found to be mediated by nonpiliated adhesins with antigen(s) which probably are shared by the strains tested. Although a strong attachment-inhibiting activity arises in their nasal secretions, volunteers remained colonized by N. lactamica. This evidence suggest that the eradication of Neisseria carriage is a multifactorial event.
Sorotipos de Salmonella isolados de processos entéricos humanos em Recife-Pernambuco, durante o triênio 1978-1980
Authors: Leal Nilma Cintra , Sá Agenor Tavares de , Solari Claude André , Silva Sebastião Januário da , Hofer Ernesto
Published: July 2009

De 13.196 coproculturas realizadas durante o triênio 1978-1980 em Recife, Pernambuco, foram isoladas 1.720 salmonelas, das quais 1.387 foram caracterizadas sorologicamente. O estudo global possibilitou o reconhecimento de 63 sorotipos concentrados em primeiro plano no grupo sorológico B (73,18%) e identificando-se como tipos mais incidentes: S. typhimurium, S. saint-paul, S. poona, S. derby, S. agona, S. newport, S. oranienburg, S. infantis, S. tshiongwe e S. ndolo, que representaram 1.231 amostras ou 88,75% do total de isolamentos. Algumas considerações de ordem epidemiológica e bacteriológica são discutidas em relação aos quatros sorotipos mais freqüentes.
Fatores que podem afetar a criação e manutenção de caramujos infectados e a produção de cercárias de Schistosoma masoni
Authors: Souza Cecília Pereira de , Araújo Neusa , Jannotti Liana Konovaloff , Gazzinelli Giovanni
Published: July 2009

Foram estudados fatores que afetam a produção em massa de cercárias do Schistosoma mansoni. Rotíferos e ostracodos causaram diminuição de produção em nossa colônia. Os rotíferos foram erradicados facilmente lavando-se os aquários e a alface com ácido acético diluído. Já o ostracodo foi de difícil erradicação, produzindo mortalidade nos caramujos infectados, que alcançou níveis de 50-60% por mês. Moluscos infectados mantidos na incubadora a temperatura constante e em total escuridão apresentaram maior eliminação quando iluminados, a aproximadamente 30ºC. A eliminação de cercárias foi praticamente a mesma entre os pHs 5-7. Traços de metais pesados adicionados à água destilada afetaram negativamente a eliminação. Finalmente, a manutenção em incubadora, embora apresenta-se maior mortalidade de moluscos, foi mais simples e eficiente para a produção em massa de cercárias que o sistema convencional com água corrente.
Ecology of sandflies (Diptera: Psychodidae) in a restricted focus of cutaneous leishmaniasis in Northern Venezuela: II. Species composition in relation to habitat, catching method and hour of catching
Authors: Feliciangeli M. Dora
Published: July 2009

The ecology of phlebotomine sandflies in an endemic focus of cutaneous leishmaniasis in Northern Venezuela (San Esteban, Carabobo State) was investigated through a year-term study. Three different habitats: viz. a house, a pridomestic area and a sylvatic area, were covered and the species composition, the abundance and occurrence of each species were analyzed in relation to the habitats, catching methods and hour of catching. L. panamensis, L. gomezi and L. ovallesi are the species which bite man, although almost exclusively at night. All of them hide by day and are common in the sylvatic area. Moreover, L. panamensis and L. gomezi successfully approach the house and seem to settle in the peridomestic area. L. shannoni and L. olmeca bicolor also approach and accidentally bite man. L. trinidadensis, L. atroclavata and L. cayennensis are the common non-antrhopophilic species in the area.
Efeito da quimioterapia sobre os ovos do Schistosoma mansoni
Authors: Reis Mitermayer Galvão dos , Andrade Zilton A.
Published: July 2009

A administração de praziquantel a camundongos infectados pelo Schistosoma mansoni (50 cercarias/8 semanas) causou necrose de coagulação e/ou lítica, e por vezes calcificação dos miracídios nos tecidos a partir do 4º dia do início do tratamento. A administração conjugada de oxamniquine/hycanthone, embora muito efetiva para eliminar os vermes adultos, não teve ação sobre os miracídios no interior dos granulomas, tendo os testes de eclosão sido positivos até o 15º dia após o tratamento curativo. A ação do praziquantel sobre os ovos do S. mansoni pode ter repercussão sorológica ou patogênica, facilitando uma mais rápida reabsorção dos granulomas pelos tecidos do hospedeiro.
Ecology of sandflies (Diptera: Psychodidae) in a restricted focus of cutaneous leishmaniasis in Northern Venezuela: III. Seasonal fluctuation
Authors: Feliciangeli M. Dora
Published: July 2009

A one year-long study (March 1979-March 1980) was carried out at San Esteban, an endemic focus of cutaneous leishmaniasis in Northern Venezuela, with the aim of observing the seasonal fluctuation of the local phlebotomine sandflies species. The influence of climatic factors (temperature, relative humidity and rainfall) on population dynamics was analyzed in three collecting sites - a house, a peridomestic area and a sylvatic region. Among anthropophilic species, L. panamensis behaved as a wetseason species, the mean minimum relative humidity being the critical factor influencing the total number of individuals. When the population density of this fly decreased, it was successfully replaced by L. ovallesi, a dry-season species. On the other hand, seasonal variations of L. gomezi were more strongly affected by the temperature.