Fungal infections in HIV/AIDS.

Fungi are major contributors to the opportunistic infections that affect patients with HIV/AIDS. Systemic infections are mainly with Pneumocystis jirovecii (pneumocystosis), Cryptococcus neoformans (cryptococcosis), Histoplasma capsulatum (histoplasmosis), and Talaromyces (Penicillium) marneffei (talaromycosis). The incidence of systemic fungal infections has decreased in people with HIV in high-income countries because of the widespread availability of antiretroviral drugs and early testing for HIV. However, in many areas with high HIV prevalence, patients present to care with advanced HIV infection and with a low CD4 cell count or re-present with persistent low CD4 cell counts because of poor adherence, resistance to antiretroviral drugs, or both. Affordable, rapid point-of-care diagnostic tests (as have been developed for cryptococcosis) are urgently needed for pneumocystosis, talaromycosis, and histoplasmosis. Additionally, antifungal drugs, including amphotericin B, liposomal amphotericin B, and flucytosine, need to be much more widely available. Such measures, together with continued international efforts in education and training in the management of fungal disease, have the potential to improve patient outcomes substantially

Intravitreal ranibizumab and bevacizumab in combination with full-fluence verteporfin therapy and dexamethasone for exudative age-related macular degeneration.

Abstract PURPOSE: To evaluate the efficacy and safety of triple therapy with intravitreal anti-vascular-endothelial-growth-factor (VEGF) antibody, dexamethasone and verteporfin photodynamic therapy (PDT) for exudative age-related macular degeneration (AMD). METHODS: Retrospective, comparative, interventional study. Records of treatment-naïve patients who received intravitreal bevacizumab or ranibizumab in monotherapy or in combination with dexamethasone and full-fluence verteporfin PDT in triple therapy were reviewed. logMAR visual acuity, foveal thickness (FT) on optical coherence tomography, intraocular pressure and endophthalmitis occurrence were recorded. RESULTS: Sixty-one eyes were included in the triple-therapy group, 40 eyes were included in the monotherapy group. The mean follow-up was 14.1 ± 3.4 months in the triple-therapy group and 16.3 ± 4.1 months in the monotherapy group. The triple-therapy group enjoyed a lower total number of treatments (1.92 ± 0.44 vs. 3.12 ± 0.37, p < 0.001) and a longer time before first retreatment (5.4 ± 3.3 vs. 3.6 ± 2.5 months, p = 0.001). A significant improvement of visual acuity and FT was present in both groups during the 12 months following first treatment. No adverse effects were observed. CONCLUSION: The combination of intravitreal bevacizumab or ranibizumabwith dexamethasone and full-fluence PDT for exudative AMD provided visual and anatomic improvement and a good safety profile. Triple therapy may reduce the number of retreatments when compared to anti-VEGF alone

PELAKSANAAN PENDAFTARAN PRODUK KOSMETIK POMADE DI KOTA PEKANBARU MENURUT PERATURAN KBPOM NO. HK.03.1.23.12.11.10052 TAHUN 2011 TENTANG PENGAWASAN DAN PEREDARAN KOSMETIKA

ABSTRAK Berdasarkan Peraturan KBPOM No.HK.03.1.23.12.11.10052 tentang Pengawasan dan Peredaran Kosmetika Pasal 2 yang menyatakan bahwa “Setiap kosmetika yang beredar wajib memenuhi standar dan/ atau persyaratan keamanan, manfaat, mutu, penandaan, klaim, dan dinotifikasi”. Namun pada kenyataannya per tanggal 10 Desember 2019 produk kosmetika Pomade yang ternotifikasi pada BPOM sebanyak 505 produk kosmetika Pomade dan masih banyak produk kosmetika pomade lainnya yang belum ternotifikasi pada BPOM. Berdasarkan hal tersebut, maka penulis merumuskan bagaimanakah tinjuan hukum mengenai kosmetik Pomade yang tidak ternotifikasi dari BPOM Pekanbaru dan bagaimana akibat hukum bagi produk-produk kosmetik Pomade yang belum terdaftar BPOM namun telah dipasarkan. Jenis penelitian ini tergolong kepada Yuridis Sosiologis, sedangkan sifat penelitian ini adalah penelitian deskriptif. Maksud dari deskriptif adalah penilaian yang memberikan gambaran secara jelas dan terperinci mengenai pengawasan dan peredaran produk kosmetika Pomade ditinjau berdasarkan Peraturan KBPOM No.HK.03.1.23.12.11.10052 tentang Pengawasan dan Peredaran Kosmetika. Dari hasil penelitian menunjukkan bahwa tinjaun hukum mengenai produk kosmetik Pomade yang tidak terdaftar di BPOM belum efektif karena masih banyaknya produk kosmetik termasuk kosmetik Pomade masih beredar tanpa mendaftarkan produknya ke BPOM. Akibat hukum produk Kosmetik yang tidak terdaftar yaitu sanksi administrasi berupa peringatan tertulis dan larangan pengedarkan kosmetik.Jika sanksi pidana yang dijatuhkan kepada pelaku yang tidak betanggung jawab, sanksi pidana tersebut bergantung terhadap undang- undang yang dilanggar oleh pelaku. Kata Kunci: Brand Image dan Keputusan Pembelia

Regulación de la expresión y función del receptor GPR55 en la homeostasis energética y metabólica

Existen mecanismos, moleculares, celulares y comportamentales implicados en la regulación de la ingesta de alimentos, el gasto de energía y la obesidad. En este sentido, la obesidad, se ha definido como el resultado de un almacenamiento de calorías que excede los requerimientos de energía del organismo, y en consecuencia, la interacción entre factores genéticos, medioambientales que la promueven y el sistema de control homeostático, contribuyen al desarrollo de diferentes tipos de obesidad, convirtiéndola en la enfermedad del siglo XXI (Morton et al., 2006). En el presente trabajo abordamos las funciones metabólicas desempeñadas por el sistema LPI/GPR55, dado que el receptor GPR55 es un receptor putativo cannabinoide y se sabe que el sistema endocannabinoide está involucrado en la regulación de la homeostasis energética (Rodriguez de Fonseca F. et al., 2005) (Di Marzo, 2006; Fowler et al., 2005; Ross, 2009)

Frequency of Certain Established Risk Factors in Soft Tissue Sarcomas in Adults: A Prospective Descriptive Study of 658 Cases

Soft tissue sarcomas are rare tumours with infrequent identified aetiological factors. Several genetic syndromes as well as previous radiation therapy and/or chronic lymphoedema have been suspected to predispose to some soft tissue sarcomas. Between January 1997 and September 2005, we carried out a prospective descriptive study to estimate the frequency of some particular etiological factors among 658 patients with soft tissue sarcomas. Sarcomas associated with a clinically identified genetic disease represent 2.8% out of all cases (95%CI: 1.5–3.8%). Most of these cases (14/19) are related to Recklinghausen neurofibromatosis. Radiation-induced sarcomas represent 3.3% out of all cases (95%CI: 1.7–5.1%). Most of these cases (9/22) are related to prior breast cancer treatment. We had observed only 1 case of Stewart-Treves syndrome. Liposarcoma, the most frequent histological subtype observed, is not associated with any particular aetiological entity. Finally, most of the adult soft tissue sarcomas are not related to any classical clinically identified genetic disease or previous radiation therapy and/or chronic lymphoedema risk factors. Frequency of underlying genetic syndrome which may predispose to soft tissue sarcomas could be higher than previously reported

Infecção por VIH entre imigrantes na Guiana Francesa: alto risco durante os primeiros anos após a chegada

Introduction. Over 75% of HIV patients in French Guiana are foreigners most of whom are actually infected locally.&nbsp;Objectives. We aimed to estimate the distribution of infections in time after arrival using a retrospective cohort.&nbsp;Methods. CD4 erosion modelling allowed to estimate the date of infection which was compared to the date of arrival in French Guiana in the subset of foreign patients that were estimated to have acquired HIV locally.&nbsp;Results. Among patients estimated to have been infected in French Guiana and having arrived after 1999, over half had been infected within 4 years and that a quarter of patients had acquired HIV within the 2 first years after arrival (median 3.9 years IQR=2.1-7.8 years).&nbsp;Conclusions. The added value of the present results is to show the rapid infection dynamics after arrival and emphasize the necessity of increasingly proactive combined prevention in recently arrived immigrants.Introdução. Mais de 75% dos pacientes com HIV na Guiana Francesa são estrangeiros, a maioria dos quais estão realmente infectados localmente.&nbsp;Objetivos. O nosso objetivo era estimar a distribuição das infecções no tempo após a chegada, utilizando uma coorte retrospectiva.&nbsp;Métodos. A modelagem da erosão CD4 permitiu estimar a data da infecção que foi comparada à data de chegada na Guiana Francesa no subconjunto de pacientes estrangeiros que foram estimados como tendo adquirido o HIV localmente.Resultados. Entre os pacientes estimados como tendo sido infectados na Guiana Francesa e tendo chegado após 1999, mais da metade tinha sido infectada dentro de 4 anos e que um quarto dos pacientes tinha adquirido o HIV dentro dos 2 primeiros anos após a chegada (mediana de 3,9 anos IQR=2,1-7,8 anos). Conclusões. O valor agregado dos resultados atuais é mostrar a rápida dinâmica da infecção após a chegada e enfatizar a necessidade de uma prevenção combinada cada vez mais proativa nos imigrantes recém-chegados

Estudio de factibilidad para la creación de un hospedaje especializado

Formular un estudio financiero que defina la viabilidad para la creación de un hospedaje especializado en adultos mayores en el municipio de la vega Cundinamarca.El presente documento presenta un estudio de factibilidad financiera para la creación de un hospedaje especializado en personas de la tercera edad que permita presentar a los inversionistas un panorama real y actualizado sobre el comportamiento actual del mercado, los costos y gastos que tiene operar este tipo de establecimientos teniendo en cuenta insumos y mano de obra. De mismo modo se dan a conocer los requerimientos iniciales en cuanto a normatividad, infraestructura e inmobiliario. Se presenta una propuesta de valor que ofrece unos estándares de calidad que cubre las necesidades de la población objetivo y fundamentada en un estudio que realizó una recolección de datos a un grupo representativo de clientes potenciales asi como el conocimiento de establecimientos que suplen actualmente la demanda de este servicio. Se realizan proyecciónes a 5 años apoyadas en datos económicos que permiten determinar el aumento de los costos e ingresos en el tiempo además de, el análisis de los indicadores financieros obtenidos tras la operación que permitiría a los inversores comprobar si tendría un margen de utilidad atractiva para implentar la idea de negocio.This document presents a financial feasibility study for the creation of a specialized accommodation for the elderly that allows investors to present a real and updated overview of the current market behavior, the costs and expenses of operating this type of establishments taking into account supplies and labor. In the same way, the initial requirements in terms of regulations, infrastructure and real estate are disclosed. A value proposition is presented that offers quality standards that covers the needs of the target population and is based on a study that collected data from a representative group of potential customers as well as the knowledge of establishments that currently supply the demand for this service. The 5-year projections are made supported by economic data that allow determining the increase in costs and income over time, in addition to the analysis of the financial indicators obtained after the operation that would allow investors to check if it would have an attractive profit margin for implement the business idea

Estudio de factibilidad para la creación de un hospedaje especializado

Formular un estudio financiero que defina la viabilidad para la creación de un hospedaje especializado en adultos mayores en el municipio de la vega Cundinamarca.El presente documento presenta un estudio de factibilidad financiera para la creación de un hospedaje especializado en personas de la tercera edad que permita presentar a los inversionistas un panorama real y actualizado sobre el comportamiento actual del mercado, los costos y gastos que tiene operar este tipo de establecimientos teniendo en cuenta insumos y mano de obra. De mismo modo se dan a conocer los requerimientos iniciales en cuanto a normatividad, infraestructura e inmobiliario. Se presenta una propuesta de valor que ofrece unos estándares de calidad que cubre las necesidades de la población objetivo y fundamentada en un estudio que realizó una recolección de datos a un grupo representativo de clientes potenciales asi como el conocimiento de establecimientos que suplen actualmente la demanda de este servicio. Se realizan proyecciónes a 5 años apoyadas en datos económicos que permiten determinar el aumento de los costos e ingresos en el tiempo además de, el análisis de los indicadores financieros obtenidos tras la operación que permitiría a los inversores comprobar si tendría un margen de utilidad atractiva para implentar la idea de negocio.This document presents a financial feasibility study for the creation of a specialized accommodation for the elderly that allows investors to present a real and updated overview of the current market behavior, the costs and expenses of operating this type of establishments taking into account supplies and labor. In the same way, the initial requirements in terms of regulations, infrastructure and real estate are disclosed. A value proposition is presented that offers quality standards that covers the needs of the target population and is based on a study that collected data from a representative group of potential customers as well as the knowledge of establishments that currently supply the demand for this service. The 5-year projections are made supported by economic data that allow determining the increase in costs and income over time, in addition to the analysis of the financial indicators obtained after the operation that would allow investors to check if it would have an attractive profit margin for implement the business idea

Phase II trial of raltitrexed ('Tomudex') in advanced small-cell lung cancer.

Raltitrexed, a thymidylate synthase inhibitor, was given to 21 patients with advanced small-cell lung cancer, at a dose of 3 mg m(-2) as a 15-min intravenous infusion at 21-day intervals. All of the patients had extensive disease and 17 had received prior therapy. Patients with disease refractory to primary chemotherapy were excluded. Forty-one treatment cycles were given (median two, range one to four). The drug was well tolerated. No objective tumour response was documented. The patients had chemoresistant disease, as shown by a response in only one of ten patients who went on to receive alternative cytotoxic regimens. We conclude that raltitrexed given in this schedule is inactive as second line therapy for small-cell lung cancer