Experiencia preliminar de pacientes pediátricos con infección VIH en tratamiento con Dolutegravir

Los inhibidores de integrasa constituyen la terapia de elección en el tratamiento antirretroviral de inicio en adultos y adolescentes con infección por el virus de inmunodeficiencia humana (VIH), sin embargo, el Dolutegravir (DTG) tiene indicación reciente en la población pediátrica. Objetivo: Describir la experiencia preliminar de pacientes pediátricos con infección VIH en tratamiento con DTG. Método: Se realizó un estudio descriptivo y prospectivo en pacientes pediátricos infectados con VIH, evaluados en el Hospital de Niños JM de los Ríos (Caracas-Venezuela) desde febrero hasta junio 2019. Se evaluaron criterios de indicación DTG, parámetros virológicos e inmunológicos y aparición de efectos adversos. Para el análisis se utilizaron la base de datos Acces 2004 y programa estadístico Epi-Info 7 y los resultados fueron presentados en tablas de frecuencia y porcentaje. Resultados: De 193 pacientes el 56,5 % (n=109) son adolescentes y el 9.2 % (n=10) recibió DTG coformulado. El 60 % pertenecen al género masculino. Se registró como edad una moda de 15,6 años y un peso promedio de 40,75 Kg. El 50 % recibió DTG por no disponer del esquema de TARV previo y solo el 10 % como inicio de TARV. El 70 % no presentó efectos adversos, los presentados fueron leves. Solo el 20 % de los pacientes contaban con carga viral y sub-población linfocitaria previo al inicio DTG sin control posterior. Conclusiones: La principal indicación de DTG fue el reinicio de la terapia antirretroviral por no disponibilidad de esquema anterior. El 70 % de los pacientes no presentaron efectos adversos a la terapia.

Integrase inhibitors constitute the therapy of choice in the antiretroviral treatment of initiation in adults and adolescents with infection by the Human Immunodeficiency Virus (HIV); however Dolutegravir (DTG) has a recent indication in the pediatric population. Objective: To describe the preliminary experience of pediatric patients with HIV infection in treatment with DTG. Method: A descriptive and prospective study was carried out in pediatric patients infected with HIV, in follow-up at JM de los Rios Children's Hospital (Caracas-Venezuela) from February to June 2019. Criteria for indication DTG, virological and immunological parameters were evaluated and appearance of adverse effects. For the analysis, the Access 2004 database and the Epi-Info 7 statistical program were used and the results were presented in frequency and percentage tables. Results: Of 193 patients, 56.5 % (n = 109) are adolescents and 9.2 % (n = 10) received DTG coformulate. 60 % belong to the male gender. A fashion of 15.6 years and an average weight of 40.75 kg were recorded as age. 50 % received DTG due to not having the previous ART scheme and only 10 % as the start of ART. 70 % did not present adverse effects, those presented were mild. Only 20 % of the patients had viral load and lymphocyte sub population prior to ART start without subsequent paraclinical control. Conclusions: The main indication for DTG was due to the resumption of antiretroviral therapy due to the lack of availability of the previous scheme. 70 % of the patients did not present adverse effects to the therapy.

Monitoring trihalomethanes and nitrogenous disinfection by-products in blending desalinated waters using solid-phase microextraction and gas chromatography.

A simple and efficient method has been developed for the extraction and determination of 16 common volatile halogenated disinfection by-products (DBPs) (four trihalomethanes, six haloacetonitriles, and six halonitromethanes) in blending desalinated waters, using headspace solid-phase microextraction and gas chromatography with flame ionization detector (HS-SPME/GC-FID). After the optimization using factorial designs of the HS-SPME parameters (optimum: carboxen/polydimethylsiloxane such as fiber, extraction time of 60 min at 30°C, pH 7, addition of 40% (w/v) of sodium chloride, and desorption time of 2 min at 250°C), quantification limits ranged from 3.03 to 40.8 µg L-1, and relative standard deviation (inter-day) were lower than 9.7% for all the target DBPs. Adequate relative recoveries (with the exception of chloronitromethane) were obtained even when spiking waters at low levels (25 µg L-1), with values between 83.1% and 119% for ultrapure water, and between 87.4% and 115% for blending desalinated waters, supporting in this way the applicability of the method. The influence of various dechlorinating agents on the stability of 16 DBPs in water was evaluated, with ammonium chloride being the most suitable inhibitor of residual chlorine and carrying out the analytical determination of DBPs within 48 h after sampling. Different blending desalinated water samples collected in the South of Tenerife Island (Spain) were successfully analyzed.

Healthy mind and body in a healthy work environment.

OBJECTIVES: To assess the relationship between psychological distress and physical somatic symptoms as well as work environment conditions in the diverse population of dentists based in the Canary Islands (Spain). METHODS: 203 dentists officially registered with the local General Dental Councils, returned the questionnaire delivered by mail. Participants provided information on demographic characteristics, self-constructed questions like self-perceived environmental working conditions (location, access, temperature, humidity and pollution). They also completed the Spanish versions of the 12-item General Health Questionnaire (GHQ-12) and the revised version of the Symptom Checklist (SCL-90-R). The GHQ-12 was used to assess psychological distress and the somatic physical symptoms were assessed with the 12-item somatic subscale extracted from the SCL-90-R. Three different linear regression models were constructed. RESULTS: Psychological distress was positively related to somatic symptoms in all the models even after adjusting for sex and age. This association also remained significant for self-perceived environmental working conditions in the two final models. 23% of the dentists had psychological distress. The mean score for the SCL-90-R somatic subscale was 0.55 points (Standard Deviation: 0.50). CONCLUSIONS: Self-perceived environmental working conditions were also associated with the strong relationship found between psychological distress and physical somatic symptoms among dentists.