Post-discharge mortality in adult patients hospitalized for tuberculosis: a prospective cohort study.

Determining outcomes and predictors of mortality following discharge from tuberculosis (TB) hospitalization is crucial to establish health policies. The objective of this study was to analyze outcomes and, secondarily, predictors of mortality following discharge from TB hospitalization. This was a prospective cohort study of patients diagnosed with TB (all forms) discharged from the hospital who began treatment during hospitalization. Out of 169 subjects included, 38 died during the 13-months of follow-up, within a median of 3 months (95%CI: 1.49-4.51). In the multivariate analysis, the variables independently associated with death were age (HR=1.04, 95%CI: 1.01-1.06, P=0.001), presence of sputum production (HR=2.18, 95%CI: 1.09-4.34, P=0.027), and Charlson Comorbidity Index (HR=1.19, 95%CI: 1.04-1.36, P=0.015). In conclusion, post-discharge mortality in subjects hospitalized for TB was 22.5%, with mean survival of 4.6 months. The mortality was higher in older subjects, in those who reported sputum production, and in those with a high comorbidity index.

Post-discharge mortality in adult patients hospitalized for tuberculosis: a prospective cohort study

Determining outcomes and predictors of mortality following discharge from tuberculosis (TB) hospitalization is crucial to establish health policies. The objective of this study was to analyze outcomes and, secondarily, predictors of mortality following discharge from TB hospitalization. This was a prospective cohort study of patients diagnosed with TB (all forms) discharged from the hospital who began treatment during hospitalization. Out of 169 subjects included, 38 died during the 13-months of follow-up, within a median of 3 months (95%CI: 1.49-4.51). In the multivariate analysis, the variables independently associated with death were age (HR=1.04, 95%CI: 1.01-1.06, P=0.001), presence of sputum production (HR=2.18, 95%CI: 1.09-4.34, P=0.027), and Charlson Comorbidity Index (HR=1.19, 95%CI: 1.04-1.36, P=0.015). In conclusion, post-discharge mortality in subjects hospitalized for TB was 22.5%, with mean survival of 4.6 months. The mortality was higher in older subjects, in those who reported sputum production, and in those with a high comorbidity index.

Aplicación forense de tecnología radiográfica dental portátil en Argentina: estado actual y perspectivas futuras / Forensic application of portable dental radiographic technology in Argentina: current status and future prospects

Objetivos: Mensurar los niveles de radiación de fuga y dispersión emanada a través de los blindajes y estructuras plomadas del tubo de rayos X de la unidad dental portátil NOMAD, controlando la retrodispersión con el uso del escudo protector de acrílico plomado adaptado en el extremo final del tubo localizador plomado. Se midieron las tasas de exposición dispersadas mediante un detector tipo Geiger-Müller y una cámara de ionización con respuesta en el rango de energías aportadas en diagnóstico por imágenes para la medición de la exposición directa y determinación posterior de las dosis. Se utilizó un fantomas diseñado para diagnóstico odontológico, sopesando la radiación en diferentes angulaciones de operación del equipo NOMAD, simulando los gestos posturales de odontólogos, radiólogos y sujetos a identificar. Se controlaron las tasas de exposición para determinar los valores de las dosis aportadas en las zonas significativas corporales más radiosensibles del operador del equipo. Se obtuvo como resultado que la retrodispersión en el cristalino del ojo del operador fue significativamente menor cuando el fantomas estaba acostado, mientras que a nivel de gónadas resultó más baja con el cuerpo sentado. La tasa de dosis máxima de radiación dispersa que impactó en los operadores fue de 350.8 micro Sieverts por hora (uSv/h) en la zona de gónadas, por cada radiografía tomada sin el uso del delantal de goma plomada, reduciéndose a 4.38 micro Sieverts por hora (uSv/h) al utilizarlo (AU)

Prevalence, molecular characterization and risk factor analysis of Ehrlichia canis and Anaplasma platys in domestic dogs from Paraguay.

This is the first study to investigate the prevalence and risk factors associated with Ehrlichia canis and Anaplasma platys positivity in dogs from Paraguay. Conventional PCR assays for the E. canis 16SrRNA gene and A. platys p44 gene were carried out in blood samples from 384 dogs from Asunción city, Paraguay. Sequencing and phylogenetic analysis were performed in selected positive E. canis and (16SrRNA gene) and A. platys (16S and p44 genes) samples. The overall prevalence of E. canis and A. platys in dogs in Paraguay was 10.41% (40/384) and 10.67% (41/384), respectively. Older dogs without veterinary care had higher odds for E. canis positivity and a higher number of dogs in the same household, as well as absence of anti-tick treatment were considered risk factors for A. platys. Ehrlichia canis and A. platys circulate in the dog population from Asunción, and are described for the first time in Paraguay.

Phenology of Guarea macrophylla Vahl (Meliaceae) in subtropical riparian forest in southern Brazil / Fenologia de Guarea macrophylla Vahl (Meliaceae) em mata ciliar subtropical no sul do Brasil

Climate is one of the main factors that affect plant behavior. The phenology of Guarea macrophylla Vahl, which is a small tree used for reforestation of degraded areas, was monitored for 18 months in a riparian forest at the Schmidt Stream, Campo Bom, in the state of Rio Grande do Sul, southern Brazil. Vegetative (leaf fall and leaf flushing) and reproductive events were observed, with the latter divided into flowering (flower buds and anthesis) and fruiting (unripe, ripening and ripe fruit). Phenological events were related to temperature, photoperiod and precipitation and their seasonality was verified by circular statistical analysis. Vegetative phenophases were continuous; they were not related to climate factors and presented low intensity, emphasizing the perennial aspect of the species. Flowering occurred during spring and summer. Both flower buds and anthesis were related to temperature and photoperiod. Fruiting was constant and went through all stages of development. Unripe fruits developed during the months with the lowest photoperiod and ripen more intensely in winter, on colder days. Ripe fruit became available for dispersal in spring, in times of longer photoperiod and higher temperatures. Except for leaf fall, all other phenological events showed seasonality in their manifestation. The one-month difference between the onsets of the flowering phases observed in this study indicated that local climate changes induced the early occurrence of this phenophase.(AU)

O clima é um dos principais fatores que condicionam o comportamento das plantas. A fenologia de Guarea macrophylla Vahl, arvoreta utilizada no reflorestamento de áreas degradadas, foi acompanhada durante 18 meses, em mata ciliar do arroio Schmidt, Campo Bom, RS, Brasil. Foram observados os eventos vegetativos (queda foliar e brotamento) e reprodutivos, separados em floração (botão floral e antese) e frutificação (frutos imaturos, maturando e maduros). Os eventos fenológicos foram relacionados à temperatura, ao fotoperíodo e à precipitação e a sua sazonalidade foi verificada por meio da análise estatística circular. As fenofases vegetativas foram contínuas, não se relacionaram com os fatores climáticos e apresentaram baixa intensidade, ressaltando a característica perene da espécie. A floração ocorreu durante a primavera e o verão e tanto botão floral quanto antese relacionaram-se com temperatura e fotoperíodo. A frutificação foi constante e passou por todos os estádios de desenvolvimento. Os frutos imaturos desenvolveram-se em meses com o menor fotoperíodo e maturaram mais intensamente no inverno, em dias de menor temperatura. Os frutos maduros tornaram-se disponíveis para os dispersores na primavera, em períodos com maior fotoperíodo e temperatura. Com exceção da queda foliar, todos os outros eventos fenológicos apresentaram sazonalidade em sua manifestação. O adiantamento de um mês entre as florações observadas no presente estudo indicou que as alterações climáticas locais de temperatura induziram a ocorrência antecipada dessa fenofase.(AU)

Bartonella vinsonii subsp. berkhoffii and B. henselae in dogs.

This study aimed to molecularly survey Bartonella in dogs from Chile. Quantitative real-time PCR (qPCR) for Bartonella spp. based on nuoG gene was performed in 139 blood samples taken from dogs belonging to rural localities of the Valdivia Province, Los Ríos region, southern Chile. nuoG qPCR-positive samples were submitted to conventional PCR assays for ftsZ, gltA, rpoB and nuoG genes and sequencing for speciation and phylogenetic analysis. Based upon qPCR results, Bartonella spp. occurrence in dogs was 4.3% (6/139). Out of six nuoG qPCR-positive samples, six, three, two and none showed positive results in cPCR assays based on gltA, ftsZ, rpoB and nuoG genes, respectively. Consistent sequencing results were obtained only for the ftsZ gene from sample #1532 (GeneBank accession number: MG252491), and gltA gene from samples #1535 (MG252490) and #1532 (148 bp fragment that was not deposited in GenBank). Phylogenetic analysis of ftsZ and gltA genes allowed speciation of two nuoG-positive samples, one as Bartonella vinsonii subsp. berkhoffii and the other as B. henselae. Bartonella vinsonii subsp. berkhoffii and B. henselae are detected for the first time in dogs from Chile, highlighting the importance of the canine population as a source of zoonotic agents and potential infection risk to humans.

Phenology of Guarea macrophylla Vahl (Meliaceae) in subtropical riparian forest in southern Brazil / Fenologia de Guarea macrophylla Vahl (Meliaceae) em mata ciliar subtropical no sul do Brasil

Abstract Climate is one of the main factors that affect plant behavior. The phenology of Guarea macrophylla Vahl, which is a small tree used for reforestation of degraded areas, was monitored for 18 months in a riparian forest at the Schmidt Stream, Campo Bom, in the state of Rio Grande do Sul, southern Brazil. Vegetative (leaf fall and leaf flushing) and reproductive events were observed, with the latter divided into flowering (flower buds and anthesis) and fruiting (unripe, ripening and ripe fruit). Phenological events were related to temperature, photoperiod and precipitation and their seasonality was verified by circular statistical analysis. Vegetative phenophases were continuous; they were not related to climate factors and presented low intensity, emphasizing the perennial aspect of the species. Flowering occurred during spring and summer. Both flower buds and anthesis were related to temperature and photoperiod. Fruiting was constant and went through all stages of development. Unripe fruits developed during the months with the lowest photoperiod and ripen more intensely in winter, on colder days. Ripe fruit became available for dispersal in spring, in times of longer photoperiod and higher temperatures. Except for leaf fall, all other phenological events showed seasonality in their manifestation. The one-month difference between the onsets of the flowering phases observed in this study indicated that local climate changes induced the early occurrence of this phenophase.

Resumo O clima é um dos principais fatores que condicionam o comportamento das plantas. A fenologia de Guarea macrophylla Vahl, arvoreta utilizada no reflorestamento de áreas degradadas, foi acompanhada durante 18 meses, em mata ciliar do arroio Schmidt, Campo Bom, RS, Brasil. Foram observados os eventos vegetativos (queda foliar e brotamento) e reprodutivos, separados em floração (botão floral e antese) e frutificação (frutos imaturos, maturando e maduros). Os eventos fenológicos foram relacionados à temperatura, ao fotoperíodo e à precipitação e a sua sazonalidade foi verificada por meio da análise estatística circular. As fenofases vegetativas foram contínuas, não se relacionaram com os fatores climáticos e apresentaram baixa intensidade, ressaltando a característica perene da espécie. A floração ocorreu durante a primavera e o verão e tanto botão floral quanto antese relacionaram-se com temperatura e fotoperíodo. A frutificação foi constante e passou por todos os estádios de desenvolvimento. Os frutos imaturos desenvolveram-se em meses com o menor fotoperíodo e maturaram mais intensamente no inverno, em dias de menor temperatura. Os frutos maduros tornaram-se disponíveis para os dispersores na primavera, em períodos com maior fotoperíodo e temperatura. Com exceção da queda foliar, todos os outros eventos fenológicos apresentaram sazonalidade em sua manifestação. O adiantamento de um mês entre as florações observadas no presente estudo indicou que as alterações climáticas locais de temperatura induziram a ocorrência antecipada dessa fenofase.

"Candidatus Neoehrlichia chilensis" sp. nov.: Molecular detection and characterization of a novel Anaplasmataceae in wild rodents from Valdivia, southern Chile.

This study aimed to screen wild rodents from southern Chile, for the presence of Anaplasmatacea. Spleen samples from 33 wild rodents trapped in Valdivia Province were screened by conventional PCR (cPCR), targeting the Anaplasmataceae 16S rRNA gene (16S). Positive samples were further evaluated, targeting a larger 16S fragment, groEL operon, and gltA gene, followed by sequencing and phylogenetic analysis. Anaplasmataceae DNA was detected in 15% (five of 33) of the tested rodents (Abrothrix sp. [four of five] and Mus musculus [one of five]). Analysis of sequenced products based on the 16S gene revealed high similarity with "Ca. Neoehrlichia mikurensis," "Ca. Neoehrlichia lotoris" and "Ca. Neoehrlichia arcana" (97.8%-98.6%). A lower similarity was observed with Candidatus Neoehrlichia groEL (89.7%-92%) and gltA (79.5%-79.9%) loci. According to the 16SrRNA, groEL and gltA phylogenetic analyses, two closely related genotypes of "Candidatus Neoehrlichia" spp. from Chile were observed, which clustered together in a separate clade from other species in this genus. This study suggests the presence of two genotypes of a novel species of "Candidatus Neoehrlichia," proposed as "Candidatus Neoehrlichia chilensis," circulating in rodents from Chile. This is the first report of "Ca. Neoehrlichia" species in rodents from America.

Phenology of Guarea macrophylla Vahl (Meliaceae) in subtropical riparian forest in southern Brazil.

Climate is one of the main factors that affect plant behavior. The phenology of Guarea macrophylla Vahl, which is a small tree used for reforestation of degraded areas, was monitored for 18 months in a riparian forest at the Schmidt Stream, Campo Bom, in the state of Rio Grande do Sul, southern Brazil. Vegetative (leaf fall and leaf flushing) and reproductive events were observed, with the latter divided into flowering (flower buds and anthesis) and fruiting (unripe, ripening and ripe fruit). Phenological events were related to temperature, photoperiod and precipitation and their seasonality was verified by circular statistical analysis. Vegetative phenophases were continuous; they were not related to climate factors and presented low intensity, emphasizing the perennial aspect of the species. Flowering occurred during spring and summer. Both flower buds and anthesis were related to temperature and photoperiod. Fruiting was constant and went through all stages of development. Unripe fruits developed during the months with the lowest photoperiod and ripen more intensely in winter, on colder days. Ripe fruit became available for dispersal in spring, in times of longer photoperiod and higher temperatures. Except for leaf fall, all other phenological events showed seasonality in their manifestation. The one-month difference between the onsets of the flowering phases observed in this study indicated that local climate changes induced the early occurrence of this phenophase.

Left ventricular hypertrophy does not prevent heart failure in experimental hypertension.

BACKGROUND: Left ventricular hypertrophy (LVH) secondary to hypertension has been accepted to prevent heart failure (HF) while paradoxically increasing cardiovascular morbi-mortality. OBJECTIVES: To evaluate whether antihypertensive treatment inhibits LVH, restores beta-adrenergic response and affects myocardial oxidative metabolism. METHODS: Ninety spontaneously hypertensive rats (SHR) were distributed into groups and treated (mg/kg, p.o.) with: losartan 30 (L), hydralazine 11 (H), rosuvastatin 10 (R), carvedilol 20 (C). Hypertension control group comprised 18 normotensive rats (Wistar-Kyoto, WKY). Following euthanasia at 16months, contractility was measured in 50% of rats (Langendorff system) before and after isoproterenol (Iso) 10-9M, 10-7M and 10-5M stimulation. Left ventricular weight (LVW) was measured in the remaining hearts, and normalized by BW. Expression of thioredoxin 1 (Trx-1), peroxyredoxin 2 (Prx-2), glutaredoxin 3 (Grx-3), caspase-3 and brain natriuretic peptide (BNP) was determined. RESULTS: Systolic blood pressure (mmHg): 154±3 (L), 137±1 (H), 190±3 (R)*, 206±3 (SHR)*, 183±1 (C)**, and 141±1 (WKY) (*p<0.05 vs. L, H, WKY, **p<0.05 vs. L, H, WKY, SHR). LVW/BW was higher in SHR and R (p<0.05). Groups SHR, R and C evidenced baseline contractile depression. Response to Iso 10-5M was similar in WKY and L. Expression of Trx-1, Prx-2 and Grx-3 increased in C, H, R and L (p<0.01). CONCLUSIONS: Present findings argue against the traditional idea and support that LVH might not be required to prevent HF. Increased expression of thioredoxins by antihypertensive treatment might be involved in protection from HF.

Responses of skeletal muscle hypertrophy in Wistar rats to different resistance exercise models.

This study aimed to compare the effects of three different resistance exercise models on the quadriceps muscle cross-sectional area, as well as on mTOR phosphorylation and other pivotal molecules involved in the upstream regulation of mTOR. Twenty-four male Wistar rats were divided into untrained (control), endurance resistance training, strength resistance training, and hypertrophy resistance training (HRT) groups (n=6). After 12 weeks of training, the red portion of the quadriceps was removed for histological and Western blot analyses. The results showed that the quadriceps weight and cross-sectional areas in the exercised groups were higher than those of the untrained rats. However, the HRT group presented better results than the other two experimental groups. This same pattern was observed for mTOR phosphorylation and for the most pivotal molecules involved in the upstream control of mTOR (increase of PKB, 14-3-3, ERK, p38 MAPK, and 4E-BP1 phosphorylation, and reduction of tuberin, sestrin 2, REDD1, and phospho AMPK). In summary, our study showed that HRT leads to high levels of mTOR phosphorylation as well as of other proteins involved in the upstream regulation of mTOR.

Phenology of Guarea macrophylla Vahl (Meliaceae) in subtropical riparian forest in southern Brazil

Abstract Climate is one of the main factors that affect plant behavior. The phenology of Guarea macrophylla Vahl, which is a small tree used for reforestation of degraded areas, was monitored for 18 months in a riparian forest at the Schmidt Stream, Campo Bom, in the state of Rio Grande do Sul, southern Brazil. Vegetative (leaf fall and leaf flushing) and reproductive events were observed, with the latter divided into flowering (flower buds and anthesis) and fruiting (unripe, ripening and ripe fruit). Phenological events were related to temperature, photoperiod and precipitation and their seasonality was verified by circular statistical analysis. Vegetative phenophases were continuous; they were not related to climate factors and presented low intensity, emphasizing the perennial aspect of the species. Flowering occurred during spring and summer. Both flower buds and anthesis were related to temperature and photoperiod. Fruiting was constant and went through all stages of development. Unripe fruits developed during the months with the lowest photoperiod and ripen more intensely in winter, on colder days. Ripe fruit became available for dispersal in spring, in times of longer photoperiod and higher temperatures. Except for leaf fall, all other phenological events showed seasonality in their manifestation. The one-month difference between the onsets of the flowering phases observed in this study indicated that local climate changes induced the early occurrence of this phenophase.

Resumo O clima é um dos principais fatores que condicionam o comportamento das plantas. A fenologia de Guarea macrophylla Vahl, arvoreta utilizada no reflorestamento de áreas degradadas, foi acompanhada durante 18 meses, em mata ciliar do arroio Schmidt, Campo Bom, RS, Brasil. Foram observados os eventos vegetativos (queda foliar e brotamento) e reprodutivos, separados em floração (botão floral e antese) e frutificação (frutos imaturos, maturando e maduros). Os eventos fenológicos foram relacionados à temperatura, ao fotoperíodo e à precipitação e a sua sazonalidade foi verificada por meio da análise estatística circular. As fenofases vegetativas foram contínuas, não se relacionaram com os fatores climáticos e apresentaram baixa intensidade, ressaltando a característica perene da espécie. A floração ocorreu durante a primavera e o verão e tanto botão floral quanto antese relacionaram-se com temperatura e fotoperíodo. A frutificação foi constante e passou por todos os estádios de desenvolvimento. Os frutos imaturos desenvolveram-se em meses com o menor fotoperíodo e maturaram mais intensamente no inverno, em dias de menor temperatura. Os frutos maduros tornaram-se disponíveis para os dispersores na primavera, em períodos com maior fotoperíodo e temperatura. Com exceção da queda foliar, todos os outros eventos fenológicos apresentaram sazonalidade em sua manifestação. O adiantamento de um mês entre as florações observadas no presente estudo indicou que as alterações climáticas locais de temperatura induziram a ocorrência antecipada dessa fenofase.

Phenology of Guarea macrophylla Vahl (Meliaceae) in subtropical riparian forest in southern Brazil

Abstract Climate is one of the main factors that affect plant behavior. The phenology of Guarea macrophylla Vahl, which is a small tree used for reforestation of degraded areas, was monitored for 18 months in a riparian forest at the Schmidt Stream, Campo Bom, in the state of Rio Grande do Sul, southern Brazil. Vegetative (leaf fall and leaf flushing) and reproductive events were observed, with the latter divided into flowering (flower buds and anthesis) and fruiting (unripe, ripening and ripe fruit). Phenological events were related to temperature, photoperiod and precipitation and their seasonality was verified by circular statistical analysis. Vegetative phenophases were continuous; they were not related to climate factors and presented low intensity, emphasizing the perennial aspect of the species. Flowering occurred during spring and summer. Both flower buds and anthesis were related to temperature and photoperiod. Fruiting was constant and went through all stages of development. Unripe fruits developed during the months with the lowest photoperiod and ripen more intensely in winter, on colder days. Ripe fruit became available for dispersal in spring, in times of longer photoperiod and higher temperatures. Except for leaf fall, all other phenological events showed seasonality in their manifestation. The one-month difference between the onsets of the flowering phases observed in this study indicated that local climate changes induced the early occurrence of this phenophase.

Resumo O clima é um dos principais fatores que condicionam o comportamento das plantas. A fenologia de Guarea macrophylla Vahl, arvoreta utilizada no reflorestamento de áreas degradadas, foi acompanhada durante 18 meses, em mata ciliar do arroio Schmidt, Campo Bom, RS, Brasil. Foram observados os eventos vegetativos (queda foliar e brotamento) e reprodutivos, separados em floração (botão floral e antese) e frutificação (frutos imaturos, maturando e maduros). Os eventos fenológicos foram relacionados à temperatura, ao fotoperíodo e à precipitação e a sua sazonalidade foi verificada por meio da análise estatística circular. As fenofases vegetativas foram contínuas, não se relacionaram com os fatores climáticos e apresentaram baixa intensidade, ressaltando a característica perene da espécie. A floração ocorreu durante a primavera e o verão e tanto botão floral quanto antese relacionaram-se com temperatura e fotoperíodo. A frutificação foi constante e passou por todos os estádios de desenvolvimento. Os frutos imaturos desenvolveram-se em meses com o menor fotoperíodo e maturaram mais intensamente no inverno, em dias de menor temperatura. Os frutos maduros tornaram-se disponíveis para os dispersores na primavera, em períodos com maior fotoperíodo e temperatura. Com exceção da queda foliar, todos os outros eventos fenológicos apresentaram sazonalidade em sua manifestação. O adiantamento de um mês entre as florações observadas no presente estudo indicou que as alterações climáticas locais de temperatura induziram a ocorrência antecipada dessa fenofase.

In vitro evaluation of the performance of Granada selective enrichment broth for the detection of group B streptococcal colonization.

A broth for the screening of group B streptococcal (GBS) carriage during pregnancy is about to be introduced. Simulating conditions in everyday practice, we have compared the sensitivity of this Granada tube broth (GT) with that of classical Amies transport medium (AT) in vitro. A total of 1,485 GT and 1,485 AT were tested with 33 well-characterized GBS strains in three different concentrations, five different incubation times, and three different temperatures. After initial incubation at room temperature (RT) or 4°C, GT were placed at 37°C. GT were scored for the presence of orange pigment. GT and AT were subcultured on blood agar (BA). Pigment was observed in 98% of GT incubated at 37°C. GBS could be cultured in 91%, 73%, and 55% of GT incubated at 37°C, RT, or 4°C, respectively. For AT, these percentages were only 20% at 37°C, 52% at RT, and 59% at 4°C. When GT initially incubated at RT or 4°C were subsequently incubated at 37°C, the sensitivity improved significantly. We conclude that GT is a more sensitive GBS transport and culture medium than the conventional method, especially for low inocula and prolonged transport/incubation times. GT does not exclude the presence of GBS, and should always be incubated at 37°C and subcultured on solid agar for optimal sensitivity.

Pneumocystis jirovecii pneumonia in developing countries.

Pneumocystis pneumonia (PcP) is a serious fungal infection among immunocompromised patients. In developed countries, the epidemiology and clinical spectrum of PcP have been clearly defined and well documented. However, in most developing countries, relatively little is known about the prevalence of pneumocystosis. Several articles covering African, Asian and American countries were reviewed in the present study. PcP was identified as a frequent opportunistic infection in AIDS patients from different geographic regions. A trend to an increasing rate of PcP was apparent in developing countries from 2002 to 2010.

Ensayo clínico sobre la bioequivalencia clínica de una dosis de clopidogrel leti cravid® (clop-l) 75 mg. Comprimidos frente a clopidogrel sanofi plavix® (clop-s) 75 mg. tabletas administradas en una dosis diaria por 7 días en voluntarios sanos / Clinical trial on clinical bioequivalence dose cravid ® leti clopidogrel (clop-l) 75 mg. Versus clopidogrel tablets sanofi plavix ® (clop-s) 75 mg. tablets administered at a daily dose for 7 days in healthy volunteers

Los pacientes sometidos a procedimientos de intervención coronaria percutánea, al igual que en pacientes con enfermedad coronaria, deben recibir en forma indefinida tratamiento con ácido acetilsalicílico (AAS) y Clopidogrel. El desarrollo de nuevos productos a base de Clopidogrel a menores costos ayudan a evitar la discontinuación prematura de la terapia antiplaquetaria; entre estos productos desarrollados tenemos la marca Cravid® de Laboratorios LETI S.A.V. y esta debe comparar su efectividad e inocuidad con el patrón internacional de Clopidogrel marca Plavix® de Laboratorios Sanofi Aventis. Se realizó un estudio: prospectivo, comparativo, cruzado, aleatorizado, en voluntarios sanos. Cada grupo recibió 1 comprimido de Clopidogrel Leti, CLOP-L o Clopidogrel Sanofi, CLOP-S de 75 mg. en una sola dosis al día durante 7 días continuos. Después de un período de lavado de 7 días recibieron el segundo tratamiento. Se midió la agregación plaquetaria al inicio de cada período y a los 7 días de tratamiento mediante agregometría óptica, con un agregómetro Óptico Modelo 490-2D marca Cronolog, con sistema de autocalibración que trabajó con plasma rico en plaquetas. Lectura 0-100% de paso de luz. En ambos grupos se produjo un descenso importante en la agregabilidad plaquetaria a los 7 días de tratamiento de más del 50 % independiente del reactivo de ADP (Helena y Cronolog) utilizado para agregar (P < 0.05). La relación de las medias e IC del porcentaje de agregación obtenida con las dos diferentes marcas comerciales de ADP se encontraron entre el 80 y 125%, por lo cual se concluye que ambas marcas de Clopidrogrel son bioequivalentes y por lo tanto, son perfectamente intercambiables

The undergoing percutaneous coronary intervention procedures, as in patients with coronary disease should receive treatment indefinitely with acetylsalicylic acid (ASA) and Clopidogrel. Developing new products based on lower costs clopidogrel to help prevent premature discontinuation of antiplatelet therapy, among these products we have developed the brand Cravid® of LETI S,A.V. Laboratories® and this should compare their effectiveness and safety with the international standard Clopidogrel brand Plavix® of Sanofi Aventis Laboratories. We conducted a study: a prospective, comparative, cross-randomized, in healthy volunteers. Each group received 1 tablet of Clopidogrel Leti, CLO-L or Clopidogrel Sanofi-LCLOP-S 75 mg. in a single dose daily for 7 days. Followed for 7 day-washout period before administration of second treatment. Platelet aggregation was measured at the beginning of each period and 7 days of treatment by agregometría optics. With a agregómetro Optical Model 490-2D. In both groups there was a decrease in platelets add to the 7 days of treatment for more than 50% independent of the reagent ADP (Helena and cronolog) used to add (P <0.05). The mean and CI at 90%, obtained with two different trademarks of ADP were between 80 and 125%, which was concluded that both brands are bioequivalent and are therefore perfectly interchangeable

Tei index to assess fetal cardiac performance in fetuses at risk for fetal inflammatory response syndrome.

OBJECTIVES: To examine, in patients with premature rupture of the amniotic membranes (PROM) at < 34 weeks of gestation, the relationship between fetal myocardial performance measured by the Tei index and fetal inflammatory response syndrome (FIRS). METHODS: A case-control study was conducted including 15 preterm PROM patients with gestational age between 24 and 33 weeks admitted to Hospital de Clínicas de Porto Alegre, and 15 controls with the same gestational age range. Fetal echocardiography with Doppler was performed at admission for the preterm PROM group, with serial examinations every 7-10 days thereafter until delivery, and at the time of inclusion in the control group. Flow velocity waveforms were obtained for the left ventricle, from which the Tei index was calculated. Placental histopathology and perinatal outcome were compared between the groups. RESULTS: The left ventricular Tei index was significantly greater in fetuses with preterm PROM compared with controls (0.63 +/- 0.13 vs. 0.51 +/- 0.10, P = 0.007). While there was no difference in isovolumetric times, the left ventricular ejection time was significantly shorter in the preterm PROM group (164 +/- 17 ms vs. 184 +/- 16 ms, P = 0.003). In the preterm PROM group, neonatal sepsis was diagnosed in 73.3%, and funisitis and chorionic vasculitis confirmed FIRS in 53.3%, compared with 6.7% for these three diagnoses in controls (P = 0.001). CONCLUSIONS: These data provide further evidence that cardiac dysfunction is present in the setting of preterm PROM. The study of myocardial performance with the Tei index is a novel non-invasive approach to assess cardiac function and monitor the fetus affected with FIRS.

Differential regulation of IgG-NMO autoantibodies on S100Beta protein and disability in relapsing neuromyelitis optica.

Neuromyelitis optica (NMO), an uncommon central nervous system (CNS) demyelinating disease, produces transverse myelitis and severe optic neuritis. IgG-NMO autoantibody, a specific immunoglobulin binding aquaporin-4 water channel protein, confirms that NMO is a different entity to multiple sclerosis. Parallel to cytokine down-regulations found in serum of relapsing-NMO (rNMO) patients, it has been reported that IgG-NMO may also confer a worse course of the disease in r-NMO Caribbean patients. In this study, we were interested in exploring the influence of IgG-NMO autoantibody on S100beta levels and clinical parameters from serum of r-NMO patients. Serum samples from 24 rNMO patients and 10 controls were evaluated. The reduction of S100beta observed in r-NMO patients was not significant compared to controls; and no differences were present regarding IgG-NMO immunoreactivity. At the same time, a significant correlation was also observed between IgG-NMO autoantibody serum detection and EDSS (Expanded Disability Status Scale) in rNMO. These results corroborate a differential regulation of IgG-NMO autoantibodies on the S100beta glial marker and on the disability present in rNMO patients.