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1.
Article in English | MEDLINE | ID: mdl-31405866

ABSTRACT

Emerging malaria parasite sulfadoxine-pyrimethamine (SP) resistance has prompted assessment of alternatives for intermittent preventive treatment in pregnancy (IPTp). The objective was to evaluate the tolerability and prophylactic efficacy of azithromycin (AZ) plus piperaquine (PQ) in pregnant women in Papua New Guinea. The study was an open-label, randomized, parallel-group trial. A total of 122 women (median gestation, 26 weeks [range, 14 to 32 weeks]) were randomized 1:1 to three daily doses of 1 g AZ plus 960 mg PQ tetraphosphate or single-dose SP (4,500 mg sulfadoxine plus 225 mg pyrimethamine), based on computer-generated block randomization. Tolerability was assessed to day 7, and efficacy was assessed to day 42 (when participants were returned to usual care) and at delivery. Data for 119 participants (AZ-PQ, n = 61; SP, n = 58) were analyzed. Both regimens were well tolerated, but AZ-PQ was associated with more gastrointestinal side effects (31%) and dizziness (21%). Eight women (6.7%) were parasitemic at recruitment but all were aparasitemic by 72 h. There were no differences in blood smear positivity rates between AZ-PQ and SP up to day 42 (0% versus 5.2%; relative risk [RR], 0.14 [95% confidence interval [CI], 0.01 to 2.58] [P = 0.18]; absolute risk reduction [ARR], 5.2% [95% CI, -1.3 to 11.6%]) and at the time of delivery (0% versus 8.7%; RR, 0.11 [95% CI, 0.01 to 2.01] [P = 0.14]; ARR, 8.7% [95% CI, -0.2 to 17.6%]). Of 92 women who were monitored to parturition, 89 (97%) delivered healthy babies; there were 3 stillbirths (SP, n = 1; AZ-PQ, n = 2 [twins]). There was a higher live birth weight (mean ± standard deviation) in the AZ-PQ group (3.13 ± 0.42 versus 2.88 ± 0.55 kg [P = 0.016]; mean difference, 0.25 kg [95% CI, 0.02 to 0.48 kg]). AZ-PQ is a promising candidate for IPTp.


Subject(s)
Antimalarials/therapeutic use , Azithromycin/therapeutic use , Malaria, Falciparum/prevention & control , Malaria, Vivax/prevention & control , Parasitemia/prevention & control , Pyrimethamine/therapeutic use , Quinolines/therapeutic use , Sulfadoxine/therapeutic use , Adult , Asymptomatic Diseases , Chemoprevention/methods , Drug Combinations , Erythrocytes/drug effects , Erythrocytes/parasitology , Female , Gestational Age , Humans , Live Birth , Malaria, Falciparum/drug therapy , Malaria, Falciparum/parasitology , Malaria, Vivax/drug therapy , Malaria, Vivax/parasitology , Papua New Guinea , Parasitemia/drug therapy , Parasitemia/parasitology , Plasmodium falciparum/drug effects , Plasmodium falciparum/growth & development , Plasmodium vivax/drug effects , Plasmodium vivax/growth & development , Pregnancy , Random Allocation , Severity of Illness Index , Stillbirth
2.
J Agric Food Chem ; 64(21): 4327-35, 2016 Jun 01.
Article in English | MEDLINE | ID: mdl-27138051

ABSTRACT

Ice crystal formation is of primary concern to the frozen food industry. In this study, the effects of antifreeze peptides (AFPs) on ice crystal formation were assessed in carrot during freezing and thawing. Three synthetic analogues based on naturally occurring antifreeze peptides were used in this study. The AFPs exhibited modification of ice crystal morphology, confirming their antifreeze activity in vitro. The ability of the synthetic AFPs to minimize drip loss and preserve color, structure, texture, and volatiles of frozen carrot was evaluated using the techniques of SEM, GC-MS, and texture analysis. The results prove the potential of these AFPs to preserve the above characteristics in frozen carrot samples.


Subject(s)
Antifreeze Proteins/chemistry , Daucus carota/chemistry , Food Additives/chemistry , Food Preservation/methods , Water/chemistry , Crystallization , Food Preservation/instrumentation , Freezing , Ice/analysis
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