Response to direct-acting antiviral agents in chronic hepatitis C patients with end-stage renal disease: a clinical experience

SUMMARY OBJECTIVE The recent development of direct-acting antiviral agents (DAAs) has dramatically changed the treatment of chronic hepatitis C, and interferon-based regimes have become a poor treatment choice in clinical practice. Today DAAs offer shorter, well-tolerated, highly effective curative therapies. This study aimed to evaluate the effectiveness and safety of DAAs in patients with end-stage renal disease and HCV genotype 1 infection in real clinical practice. METHODS Thirty-six patients who attended our clinic, were diagnosed with chronic hepatitis C (CHC), undergoing hemodialysis, and fulfilled the criteria of age >18 years, genotype 1 infection, with a detectable HCV RNA level were considered for the study. Patients with GT1a infection received OBV/PTV/r plus DSV plus RBV for 12 weeks; GT1b infected patients received this regimen without RBV for 12 weeks. RESULTS The study was conducted on 33 patients. The mean age was 52.30 ±13.77 years, and 70 % of them were male. By the fourth week of treatment, HCV RNA levels decreased below 15 IU/ml in all patients. Sustained virologic response (SVR) 12 rate was 100%. Nine patients had side effects during treatment. Of the patients with side effects, 89.9% were in group 1a and 11.1% in group 1b. CONCLUSION In this study, treatment with OBV/PTV/r and DSV with or without RBV resulted in high rates of sustained virologic response in HCV GT1-infected patients with end-stage renal disease (ESRD). SVR was achieved in all patients with few side effects.

RESUMO O recente desenvolvimento de agentes antivirais de ação direta (DAAs) mudou drasticamente o tratamento da hepatite C crônica, e os regimes livres de interferon tornaram-se pobres escolhas para tratamento na prática clínica. Hoje os DAAs oferecem terapias curativas mais curtas, bem toleradas e altamente eficazes. O objetivo deste estudo foi avaliar a eficácia e segurança dos DAAs em pacientes com doença renal em estágio terminal e infecção pelo genótipo 1 do HCV na prática clínica real. MÉTODOS Trinta e seis pacientes, que se inscreveram em nossa clínica com diagnóstico de hepatite C crônica (CHC), inclusive no programa de hemodiálise, e preencheram os critérios de idade >18 anos, foram considerados para infecção pelo genótipo 1 com nível detectável de RNA do HCV. Os pacientes com infecção por GT1a receberam OBV/PTV/r mais DSV mais RBV por 12 semanas. Os pacientes infectados com GT1b receberam este regime sem RBV por 12 semanas. RESULTADOS O estudo foi realizado em 33 pacientes. A idade média foi de 52,30±13,77 anos e 70% deles eram do sexo masculino. Na semana 4 do tratamento, os níveis de ARN do VHC diminuíram para menos de 15 UI/ml em todos os pacientes. A taxa de resposta virológica sustentada (RVS) 12 foi de 100%. Nove pacientes apresentaram efeitos colaterais durante o tratamento. Dos pacientes com efeitos colaterais, 89,9% estavam no grupo 1a e 11,1% no grupo 1b. CONCLUSÃO Neste estudo, o tratamento com OBV/PTV/r e DSV com ou sem RBV resultou em altas taxas de resposta virológica sustentada em pacientes infectados pelo VGC GT1 com doença renal em estágio final (ESRD). A RVS foi alcançada em todos os pacientes com poucos efeitos colaterais.

Dung removal by dung beetles (Coleoptera: Scarabaeidae) and macrocyclic lactone use on cattle ranches of Yucatan, Mexico / Remoción de estiércol por escarabajos estercoleros (Coleoptera: Scarabaeinae) y uso de lactonas macrocíclicas en ranchos ganaderos de Yucatán, México

Abstract:The expanded use of macrocyclic lactones (ML) to treat endo- and ectoparasites in cattle in tropical regions, can reduce dung beetle populations, and thus interrupt the dung removal process in cattle pasture ecosystems. During the reproductive period (the rainy season) of two functional groups of dung beetles (paracoprid and telocoprid Scarabaeinae), we compared dung removal amount in ranches where ML are and are not used in Yucatan, Mexico, through exclusion traps baited with 500 g of ML-free cow dung. On each ranch, two transects (separated by 500 m) with six traps each, were set up for 24 hours. After this time, all the dung remnants in each trap were obtained and weighed in order to record the dung removal. Results showed that dung removal amounts were similar in ranches with and without ML use. Dung beetles removed 40.1 % of all cow dung weighed. Paracoprids removed 87.46 % and telocoprids 12.54 % of all the dung that was removed. Our results indicated that the ecological function of dung beetles in the pastures studied, does not seem to be affected by the ML use, and that paracoprid species removed most of the dung. For both types of ranch, further studies that take into account the population dynamics and movement of the most important dung beetle species in the region are required, coupled with laboratory studies evaluating the effect of ML on their reproductive success. This could give some light on the effect of ML on the ecological function of this important insect group in the sustainability of cattle production systems. Rev. Biol. Trop. 64 (3): 945-954. Epub 2016 September 01.

ResumenLa expansión en el uso de lactonas macrocíclicas (LM) para el tratamiento de endo y ectoparásitos del ganado en las regiones tropicales puede reducir las poblaciones de escarabajos del estiércol, interrumpiendo así el proceso de eliminación de estiércol de ganado en los pastizales. Durante el período reproductivo (época de lluvias) de dos grupos funcionales de escarabajos coprófagos (paracópridos y telecópridos), se comparó la cantidad removida de estiércol usando trampas de exclusión cebadas con 500 g de estiércol de vaca libre de LM en dos ranchos donde se usan y en dos donde no se usan LM, en la península de Yucatán, México. En cada rancho se establecieron dos transectos (separados por 500 m) con seis trampas cada uno, las cuales estuvieron activas durante 24 horas. Después de este tiempo, todos los restos de estiércol en cada trampa se pesaron para registrar la remoción. Los resultados mostraron que las cantidades de remoción fueron similares en ranchos con y sin uso de LM. Los escarabajos estercoleros removieron 40.1 % del peso total del excremento. Los paracópridos removieron 87.46 % y los telecópridos 12.54 % del total de excremento removido. Los resultados indican que la función ecológica de los escarabajos estercoleros en los potreros estudiados no parece verse afectada por el uso de LM y que las especies paracórpidas remueven la mayor parte del excremento. Se requiere hacer más estudios en ambos tipos de ranchos, en los que se tome en cuenta la dinámica poblacional y el movimiento de las especies más importantes de la región, acoplados a estudios de laboratorio que evalúen el efecto de las LM sobre el éxito reproductivo, y de esta manera esclarecer el efecto de las LM sobre la función ecológica de este grupo de insectos tan importante para la sustentabilidad de los sistemas ganaderos.

Tumor size and prognosis in patients with Wilms tumor / Tamanho tumoral e prognóstico em pacientes portadores de tumor de Wilms

OBJECTIVE: Investigate the relationship of the tumor volume after preoperative chemotherapy (TVAPQ) and before preoperative chemotherapy (TVBPQ) with overall survival at two and at five years, and lifetime. METHODS: Our sample consisted of consecutive patients evaluated in the period from 1989 to 2009 in an Onco-Hematology Service. Clinical, histological and volumetric data were collected from the medical records. For analysis, chi-square, Kaplan-Meier, log-rank and Cox regression tests were used. RESULTS: The sample consisted of 32 patients, 53.1% were male with a median age at diagnosis of 43 months. There was a significant association between TVAPQ>500mL and the difference between the TVBPQ and TVAPQ (p=0.015) and histologic types of risk (p=0.008). It was also verified an association between the difference between the TVBPQ and TVAPQ and the predominant stromal tumor (p=0.037). When assessing the TVAPQ of all patients, without a cutoff, there was an association of the variable with lifetime (p=0.013), i.e., for each increase of 10mL in TVAPQ there was an average increase of 2% in the risk of death. CONCLUSIONS: Although our results indicate that the TVAPQ could be considered alone as a predictor of poor prognosis regardless of the cutoff suggested in the literature, more studies are needed to replace the histology and staging by tumor size as best prognostic variable. .

OBJETIVO: Investigar a relação entre o volume do tumor após a quimioterapia pré-operatória (VTPOS) e antes da quimioterapia pré-operatória (VTPRE) com sobrevida geral aos dois e cinco anos e tempo de vida. MÉTODOS: A amostra foi composta por pacientes consecutivos avaliados de 1989 a 2009, em um serviço de onco-hematologia. Os dados clínicos, histológicos e volumétricos foram coletados a partir dos registros médicos. Para análise, usaram-se os testes qui-quadrado, Kaplan-Meier, log-rank e regressão de Cox. RESULTADOS: A amostra foi composta de 32 pacientes, 53,1% do sexo masculino, com mediana de idade ao diagnóstico de 43 meses. Houve associação significativa entre VTPOS >500 mL e a diferença entre o VTPRE e VTPOS (p=0,015) e os tipos histológicos de risco (p=0,008). Verificou-se também uma associação entre a diferença entre o VTPRE e VTPOS e o tumor de predomínio estromal (p=0,037). Quando se avaliou o VTPOS de todos os pacientes, sem um ponto de corte definido, observou-se associação dessa variável com o tempo de vida (p=0,013), isto é, para cada aumento de 10 mL no VTPOS houve um aumento médio de 2% no risco de morte. CONCLUSÕES: Embora os resultados indiquem que o VTPOS poderia ser considerado um preditor isolado de mau prognóstico, independentemente do ponto de corte sugerido na literatura, mais estudos são necessários para substituir a histologia e estadiamento pelo tamanho do tumor como melhor variável prognóstica. .

Research progress of the drug delivery system of antitumor platinum drugs with macrocyclic compounds / 药学学报

Platinum-based anticancer drugs have been becoming one of the most effective drugs for clinical treatment of malignant tumors for its unique mechanism of action and broad range of anticancer spectrum. But, there are still several problems such as side effects, drug resistance/cross resistance and no-specific targeting, becoming obstacles to restrict its expanding of clinical application. In recent years, supramolecular chemistry drug delivery systems have been gradually concerned for their favorable safety and low toxicity. Supramolecular macrocycles-platinum complexes increased the water solubility, stability and safety of traditional platinum drugs, and have become hot focus of developing novel platinum-based anticancer drugs because of its potential targeting of tumor tissues/organs. This article concentrates in the research progress of the new drug delivery system between platinum-based anticancer drugs with three generations of macrocycles: crown ether, cyclodextrin, cucurbituril and calixarene.

Studies on macrocyclic jatrophane diterpenes of Euphorbia kansui / 中国中药杂志

<p><b>OBJECTIVE</b>To study macrocyclic jatrophane diterpenes of Euphorbia kansui.</p><p><b>METHOD</b>The compounds were isolated and purified by various column chromatographic methods. Structures were elucidated by spectroscopic analyses.</p><p><b>RESULT</b>Three macrocyclic jatrophane diterpenes were isolated from E. kansui and were characterized as kansuinin D1 (1), kansuinin D (2), kansuinin A (3).</p><p><b>CONCLUSION</b>Kansuinin D1 (1) was a new compound.</p>