Literature analysis of adverse drug reactions induced by sintilimab / 中国药房

OBJEC TIVE To investigate the status and clinical characteristics of adverse drug reactions （ADRs）induced by sintilimab in order to provide references for clinical rational drug use. METHODS The cases of ADR induced by sintilimab were retrieved from the databases of PubMed ，Embase，CNKI，VIP and Wanfang. RESULTS A total of 32 literature were included ， involving 33 patients among which there were 25 males（75.76％）and 8 females（24.24％）. The incidence of ADRs was higher in patients aged over 40 years（81.82％）. The dose of sintilimab was the drug instructions recommended dose （200 mg）for 30 patients and 100 mg for a patient. The earliest ADR occurred 1 h after the first medication ，the latest ADR occurred after 14 cycles of sintilimab. The 27 cases suffered from ADR cases （81.82％）within 4 months after medication ，and no reports of ADR occurred after 12 months of medication. The major manifestations of ADR were myocarditis ，diabetes mellitus ，checkpoint inhibitor pneumonitis（CIP），cytokine release syndrome （CRS）and hypothyroid myopathy （HM），etc. CRS and HM belonged to ADRs not recorded in the drug instructions. The 29 cases of recovery and 4 deaths occurred after symptomatic treatment. CONCLUSIONS ADR caused by sintilimab often occurs within 4 months after treatment ，and it is high in males and patients over 40 years old. In clinical application of sintilimab ，attention should be paid to the occurrence of myocarditis ，diabetes mellitus ，CIP，as well as CRS and HM not recorded in the drug instructions.

Recursos educativos abiertos para la comunidad virtual de enfermería / Open educational resources for the virtual nursing community

El presente trabajo tiene el objetivo de mostrar las potencialidades que tienen los Recursos Educativos Abiertos obtenidos de las actividades realizadas en el marco del proyecto de Telenfermería, en la modalidad de teleconferencias, con el propósito de ser reutilizados, para fines académicos, en la formación de los procesos en enfermería. Se realizó una revisión bibliográfica y documental de las actividades realizadas, desde diciembre del 2011 hasta julio del 2014, a través de las salas virtuales de la Red de Enfermería Informática, evidenciadas en las grabaciones de estas sesiones de trabajo que se encuentran enlazadas en el sitio web de la REDENFI, en el Aula Virtual de la ENSAP y el Repositorio del Campus Virtual de la Salud Pública, además se valoró el registro de participantes en la base de datos diseñada para este fin. Se trasmitieron a través de las plataformas de Elluminate y BlackBoard 1 taller, 8 entrenamientos, 8 reuniones virtuales y 15 teleconferencias. Las teleconferencias y los entrenamientos están disponibles para ser reutilizados como Recursos Educativos Abiertos, según las necesidades de los profesores, estudiantes y comunidad virtual de enfermería en general, esto ha permitido que progresivamente el personal de enfermería identifique la potencialidad y el alcance que tiene esta herramienta, para el intercambio científico y las actividades académicas en la formación de enfermeira.

The present paper was aimed at showing the potentialities of Open Educational Resources obtained from activities of telenursing project, teleconference modality, which can be reused for academic purposes in the processes of nursing formation. A literature and documentary review of these activities performed from December 2011 until July 2014 through virtual classrooms of the informatic nursing network and shown in the recording of these working sessions that are linked in REDENFI website, in the virtual classroom of ENSAP (National School of Public Health) and in the Repository of the Virtual Public Health Campus. The registration of participants in the database created for this purpose was also assessed. Elluminate and BlackBoard platforms allowed broadcasting one workshop, 8 training courses, 8 virtual meetings and 15 teleconferences. Teleconferences and training courses are available for reuse as Open Educational Resources according to the requirements of professors, students and the virtual nursing community in general. All this has made it possible that the nursing staff gradually realize the potentialities and the scope of this tool for the scientific exchange and the academic activities in the nursing formation.

Application of IS1311 locus 2 PCR-REA assay for the specific detection of ‘Bison type’ Mycobacterium avium subspecies paratuberculosis isolates of Indian origin.

Background & objectives: Of the three major genotypes of Mycobacterium avium subspecies paratuberculosis (MAP), ‘Bison type’ is most prevalent genotype in the domestic livestock species of the country, and has also been recovered from patients suffering from Crohn’s disease. Recently, a new assay based on IS1311 locus 2 PCR- restriction endonuclease analysis (REA) was designed to distinguish between ‘Indian Bison type’ and non-Indian genotypes. The present study investigated discriminatory potential of this new assay while screening of a panel of MAP isolates of diverse genotypes and from different geographical regions. Methods: A total of 53 mycobacterial isolates (41 MAP and 12 mycobacterium other than MAP), three MAP genomic DNA and 36 MAP positive faecal DNA samples from different livestock species (cattle, buffaloes, goat, sheep and bison) and geographical regions (India, Canada, USA, Spain and Portugal) were included in the study. The extracted DNA samples (n=92) were analyzed for the presence of MAP specific sequences (IS900, ISMav 2 and HspX) using PCR. DNA samples were further subjected to genotype differentiation using IS1311 PCR-REA and IS1311 L2 PCR-REA methods. Results: All the DNA samples (except DNA from non-MAP mycobacterial isolates) were positive for all the three MAP specific sequences based PCRs. IS1311 PCR-REA showed that MAP DNA samples of Indian origin belonged to ‘Bison type’. Whereas, of the total 19 non-Indian MAP DNA samples, 2, 15 and 2 were genotyped as ‘Bison type’, ‘Cattle type’ and ‘Sheep type’, respectively. IS1311 L2 PCR-REA method showed different restriction profiles of ‘Bison type’ genotype as compared to non-Indian DNA samples. Interpretation & conclusions: IS1311 L2 PCR-REA method successfully discriminated ‘Indian Bison type’ from other non-Indian genotypes and showed potential to be future epidemiological tool and for genotyping of MAP isolates.

First identification of Mycobacterium avium paratuberculosis sheep strain in Argentina

We here identified for the first time the presence of Mycobacterium avium paratuberculosis (MAP) sheep (S) strain in Argentina. IS900 polymerase chain reaction (PCR) was positive. The S strain was compared with MAP cattle (C) strains by using IS1311 PCR-restriction endonuclease analysis (PCR-REA), multiplex PCR and restriction fragment length polymorphism (RFLP) analysis.

Estudos QSAR e Ancoragem Molecular de Inibidores da Atividade Biológica do Fator de Inibição da Migração dos Macrófagos (MIF) / QSAR Modeling and Molecular Docking Study of Inhibitors of Macrophage Migration Inhibitory Factor (MIF)

Cumarina e 4-Cromonas são promissores inibidores de fator inibição da migração de macrófagos (MIF), uma proteína envolvida em doenças inflamatórias, como artrite reumatóide e outras patologias. Estudos teóricos de QSAR e ancoragem molecular de um conjunto de compostos mostraram correlação com estudos experimentais. Os descritores doadores de ligação hidrogênio e momento dipolo total foram capazes de prever atividade inibitória de compostos contra o MIF (MIFi). Paralelamente, estudos de ancoragem molecular também foram capazes de identificar ligações hidrogênio e hidrofóbicas entre os ligantes e o MIF. Como resultado, ambas as metodologias mostraram as contribuições de ligação de hidrogênio e interações hidrofóbicas para explicar a atividade de compostos inibidores de MIF, descrevendo os grupos farmacofóricos destes compostos. Adicionalmente, um conjunto de cumarinas naturais e sintéticas foi submetido aos modelos QSAR e de ancoragem molecular a fim de que as suas atividades contra MIF fossem preditas. Ambas as metodologias de modelagem molecular puderam estimar as interações intermoleculares entre inibidores e a enzima, os quais foram muito similares a compostos descritos previamente. Estes resultados podem ser úteis para o desenho de novos compostos contra doenças inflamatórias como artrite reumatóide.

Coumarin and Chromen-4-one are promising inhibitors of Macrophage Migration Inhibitory Factor (MIF), a protein involved in rheumatoid arthritis and other inflammatory diseases. Quantum structure-activity relationship (QSAR) and docking theoretical studies were undertaken on a set of compounds of known activity and showed agreement with previous experimental studies. Two descriptors, hydrogen donor sites and the total dipole, were able to predict MIF inhibitory activity (MIFi). The docking studies corroborated the QSAR studies. As a result, both methods indicated contributions of hydrogen bonds and hydrophobic interactions that explain the activity of the MIF inhibitors, describing the pharmacophore groups these molecules. Additionally, a set of natural and synthetic coumarins was subjected to the QSAR and docking models in order to predict their possible MIF inhibitory activity. Both molecular modeling methods were able to estimate the intermolecular interactions between inhibitors and enzyme, which were very similar to those of previously described compounds. These results could be useful to design new compounds against inflammatory diseases such as rheumatoid arthritis.

Occurrence of bovine herpesvirus type 4 DNA in Argentinean Holstein cattle from Santiago del Estero, Argentina / Ocorrência de DNA de herpesvírus bovino tipo 4 em gado Holstein argentino de Santiago del stero, Argentina

and from cattle with a variety of clinical signs. The pathogenic role of BoHV-4 remains unclear and it is unknown whether the virus acts as a primary pathogen or whether it facilitates secondary infections After natural or experimental infections, BoHV-4 can establish latency, mainly in cells of the monocyte/macrophage linage. Latent virus can be reactivated after glucocorticoid treatment or by stress factors. In 2007, BoHV-4 was isolated for the first time in Argentina, from samples of bovine abortions. In the present study, we used viral isolation, nested PCR and restriction endonuclease analysis (REA) to investigate the presence of BoHV-4 in bovine leukocytes from a single herd of dairy cattle with reproductive problems. In this work, we demonstrated that BoHV-4 genome is present in the leukocytes of a high proportion (63.4%) of animals, probably in a latent or persistent state. BoHV-4 was isolated from one out of eleven peripheral blood leukocyte (PBL) samples. By REA we demonstrated the existence of genomic variation among the strains circulating in this particular herd. Furthermore, all PBL samples evaluated in this study differed from the American prototype strain, DN 599. Overall, this work demonstrated that BoHV-4 is present in the leukocyte fraction of dairy cattle and that viral strains present in this herd are genetically divergent. Although BoHV-4 was detected in a herd with a background of reproductive disorders, it is not possible to conclude that the virus is the primary responsible for these conditions.

O herpesvírus bovino tipo 4 (BoHV-4) é um gama-herpesvírus que foi isolado de animais aparentemente saudáveis e de gado com uma variedade de sinais clínicos. O papel patogênico do BoHV-4 ainda não está claro e não se sabe se o vírus age como um patógeno primário ou se facilita infecções secundárias. Depois de infecções naturais ou experimentais, BoHV-4 pode estabelecer latência, principalmente nas células dos linhagens de monócitos/macrófagos. O vírus latente pode ser reativado após o uso de glicocorticóides ou por fatores de estresse. Em 2007, o BoHV-4 foi isolado pela primeira vez na Argentina, a partir de amostras de abortos bovinos. No presente estudo, utilizou-se o isolamento viral, nested PCR e análise com endonucleases de restrição (REA) para investigar a presença de BoHV4 em leucócitos de bovinos provenientes de um único rebanho de gado leiteiro com problemas reprodutivos. Neste trabalho, demonstramos que o genoma do BoHV-4 está presente nos leucócitos em uma elevada proporção (63,4%) dos animais, provavelmente em um estado latente ou persistente. BoHV-4 foi isolado de uma de cada onze amostras de leucócitos no sangue periférico (PBL). Por REA nós demonstramos a existência de variações genômicas entre as estirpes circulantes deste rebanho particular. Além disso, todas as amostras de PBL avaliados neste estudo diferiram da estirpe protótipo Americano, DN 599. Em geral, este estudo demonstrou que o BoHV-4 está presente na fração leucocitária do gado leiteiro e que as estirpes virais presentes neste rebanho são geneticamente divergentes. Embora que BoHV-4 foi detectado em um rebanho com história de distúrbios reprodutivos, não é possível concluir que o vírus é o principal responsável por estas condições.

Antimicrobial resistance and investigation of the molecular epidemiology of Listeria monocytogenes in dairy products / A resistência antimicrobiana e investigação de epidemiologia molecular de Listeria monocytogenes em produtos lácteos

INTRODUCTION: Listeria monocytogenes is a ubiquitous microorganism in nature and is responsible for listeriosis, an infectious disease caused by consumption of contaminated food. METHODS: Molecular characterization was performed on 19 strains of Listeria monocytogenes (serovars 1/2a, 1/2b, 4b and 4c), isolated from dairy products in Rio Grande do Sul, Brazil. The molecular techniques applied were random amplification of polymorphic DNA and restriction enzyme analysis. In addition to the molecular analysis, the antimicrobial resistance profile was determined. RESULTS: The strains studied showed a low degree of diversity. In relation to the antimicrobial resistance profile of those microorganisms from the samples analyzed, all of them were susceptible to the antimicrobials tested. CONCLUSIONS: The molecular techniques that were used presented good discriminatory power for the strains studied. Furthermore, all of the samples that were analyzed were susceptible to the antimicrobials tested.

INTRODUÇÃO: Listeria monocytogenes é um microrganismo que se encontra disseminado na natureza, sendo responsável por causar listeriose, uma doença infecciosa causada pelo consumo de alimentos contaminados. MÉTODOS: A análise molecular de 19 linhagens de Listeria monocytogenes, sorovares 1/2a, 1/2b, 4b, 4c, isoladas de produtos lácteos do Rio Grande do Sul, Brasil. As técnicas moleculares aplicadas foram: Amplificação Randômica do DNA Polimórfico e Análise por Enzimas de Restrição. Além da análise molecular foi realizado o perfil de resistência antimicrobiana. RESULTADOS: As linhagens estudadas mostraram baixo grau de diversidade, em relação ao perfil de resistência antimicrobiana desses microrganismos das amostras analisadas todas foram susceptíveis aos antimicrobianos testados. CONCLUSÕES: As técnicas moleculares estudadas apresentaram um bom poder de discriminação para as linhagens estudadas. Além disso, todas as amostras analisadas foram susceptíveis aos antimicrobianos analisados.

Detecção do grupo mycoplasma mycoides por imunoperoxidase indireta (IPI) e PCR-REA em conduto auditivo de bovinos / Detection of mycoplasma mycoides cluster by indirect immunoperoxidase (IPI) and PCR-REA in the ear canal of bovines

O Grupo Mycoplasma mycoides (GMM) foi diagnosticado por PCR-REA e imunoperoxidase indireta (IPI) em amostras de lavados de conduto auditivo de bovinos no Estado do Rio de Janeiro, Brasil. 60 bovinos foram selecionados aleatoriamente. As lavagens foram feitas com uso de seringas estéreis contendo um volume de 60 mL de solução salina tamponada (PBS pH 7.2). As amostras obtidas foram estocadas em glicerol (1:2) e congeladas a 20ºC até uso. Estas amostras foram diluídas até 10-5 e repicadas em meio Hayflick modificado, sólido e líquido, sendo incubados a 37ºC por 48-72 horas. As placas foram mantidas em microaerofilia e observadas diariamente, para visualização das colônias típicas em ôovo-fritoõ. Das 60 amostras cultivadas, 48 (80,00 por cento) foram positivas para Mycoplasma spp. A prevalência obtida para o GMM na IPI foi de 20,0 por cento (12/60) enquanto na PCR-REA foi de 41,7 por cento (25/60). Das cepas tipificadas pela IPI 58,3 por cento (7/12) foram M. mycoides subsp. mycoides LC e 41,7 por cento (5/12) foram M. capricolum. Na PCR-REA o grupo M. mycoides foi confirmado pela visualização de um amplicon de 785bp, compatível com este grupo. O valor encontrado no teste Kappa para associação entre estes testes foi de 0,14 (P>0,05. Na clivagem do produto da PCR com a enzima de restrição AluI, de cepas de referências e dos isolados de ouvido os fragmentos obtidos foram de 81, 98, 186 e 236pb, mas não de 370pb, que é específica para o agente da Pleuropneumonia Contagiosa Bovina. A presença de espécies de micoplasmas no conduto auditivo de bovinos assintomáticos representa um risco para propagação de Mycoplasma spp. entre rebanhos bovinos no Brasil.

Mycoplasma mycoides cluster (MMC) was diagnosed by polimerase chain reaction-restriction endonuclease analysis (PCR-REA) and indirect immunoperoxidase (IPI), both, carried out in flushing from external ear canal, collected from bovine at slaughter time in the State of Rio de Janeiro, southeastern, Brazil. A total of 60 bovines were randomly selected. Sterile syringes (60mL) loaded with buffer solution (PBS, pH 7.2) were used for the ear canal flushing. The obtained samples were stored in glycerol (1:2) and frozen at -20ºC until use. These specimens were diluted up to 10-5, inoculated in liquid and solid modified Hayflickïs media and incubated at 37ºC for 2-3 days. The plates were kept in a microaerophilia condition and examined every two days under a stereomicroscope for the presence of typical colonies ôfried-eggõ. In this study, 35 strains selected in agreement with their biochemistry and physiologic proprieties, were used. From the 60 cultivated samples, 48 (80.00 percent) were positive for Mycoplasma spp. Under IPI the prevalence obtained for MMC was 20.0 percent (12/60) while by PCR-REA it was 41.7 percent (25/60). The IPI typing of these isolates resulted in 58.3 percent (7/12) for M.mycoides mycoides LC and 41.7 percent (5/12) for M. capricolum. PCR-REA for MMC was confirmed by the amplicon size of 785bp, compatible with this group. The Kappa value for the association between these two tests was 0.14 (p>0.05). After restriction analysis with AluI in all MMC strains the fragments size obtained were of 81, 98, 186 and 236bp, but not of 370bp that is compatible with Mycoides mycoides mycoides SC of bovine type. The presence of mycoplasmas species in the ear canal of asymptomatic bovines represent a risk of subsequent propagation of Mycoplasma spp. among bovine herds in Brazil.

An improved method for characterization of the mutation associated to porcine stress syndrome by PCR amplification followed by restriction analysis / Um método melhorado para caracterização da mutação associada à síndrome do estresse suíno por amplificação por PCR seguido de análise de restrição

A mutation in the gene coding for the ryanodine receptor 1 (RYR1), also known as halothane (hal) gene or swine stress gene, is associated to the porcine stress syndrome (PSS). Detection of the mutation is normally accomplished by PCR amplification of an 81bp fragment of the hal gene, followed by digestion with the HhaI restriction endonuclease. Wild-type allele (N) is cut in two fragments, whereas the mutant allele (n) is not digested by the restriction enzyme. Electrophoresis of the digested DNA on agarose gel and ethidium bromide staining allows the reading of the result. The correct interpretation is difficult due to the small size of the DNA fragments. In this study we designed a new set of primers for amplification of a 144bp fragment that facilitates the reading of the result. In addition, we optimized the PCR reaction to allow amplification from a single hair bulb, added directly into the PCR mix without previous treatment. This improved method was used to genotype 165 sows and boars used in a breeding program. Forty-nine percent of the animals had the NN genotype, whereas 50% were Nn and only 1% was nn.

Uma mutação no gene que codifica o receptor ryanodine 1 (RYR1), também conhecido como gene do halotano (hal) ou gene do estresse suíno, está associada à Síndrome do Estresse Suíno (PSS). A mutação é geralmente detectada por PCR, a partir da amplificação de um fragmento de 81pb do gene hal, seguida por digestão com a endonuclease de restrição HhaI. O alelo normal (N) é cortado em dois fragmentos, enquanto que o alelo mutado (n) não é digerido pela enzima de restrição. A eletroforese do DNA digerido em gel de agarose corado com brometo de etídio permite a leitura do resultado. A interpretação correta é difícil devido ao pequeno tamanho dos fragmentos. Neste estudo, foi projetado um novo par de iniciadores para a amplificação de um fragmento de 144pb, o que facilita a leitura do resultado. Adicionalmente, foi otimizada a reação de PCR para permitir a amplificação a partir de um único bulbo capilar, acrescentado diretamente na mistura de PCR, sem tratamento prévio. Esse método foi usado para genotipar 165 reprodutores utilizados em granjas produtoras de matrizes. Quarenta e nove porcento dos animais apresentaram genótipo NN, 50% Nn e apenas 1% nn.

Medical negligence - majesty of law - Doctors

In a land mark historical judgment the Hon,ble Supreme Court has ruled that doctors should not be held criminally responsible unless there is prime facie evidence before the Court in the form of a credible opinion from another competent doctor, preferably a Government doctor in the same field of medicine supporting the charges of a rash and negligent act. It is a laudable judgment in the light of criminal procedures filed against the medical professionals in trivial cases under Section 304-A and even 304 IPC where prima-facie there seems to be no neglect in these medical treatments.

Preliminary report on 86 cases treated with isonicotinic acid hydrazid and the neohydrazide-rea (cyanacetic acid hydrazide)

Isonicotinic Acid Hydazid undoubtedly exerts some beneficial effects on pulmonary tuberculosis, miliary tuberculosis, and other manifestations of the diseaseThese beneficial effects are manifested by amelioration of symptoms, lowering of the temperature to normal, increase of appetite, diminution of cough and expectoration, gain of weight, sensation of well-being, etcThe clinical improvements are accompanied by radiological changes-return to normal of the sedimentation rate, and reduction of TB bacilli until the disease becomes negative; The use of the drug does not exclude the classical therapy of the disease-bed rest, nutritional diet, and other control measures against the disease. (Conclusion)