Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19

BACKGROUND: Hydroxychloroquine and azithromycin have been used to treat patients with coronavirus disease 2019 (Covid-19). However, evidence on the safety and efficacy of these therapies is limited. METHODS: We conducted a multicenter, randomized, open-label, three-group, controlled trial involving hospitalized patients with suspected or confirmed Covid-19 who were receiving either no supplemental oxygen or a maximum of 4 liters per minute of supplemental oxygen. Patients were randomly assigned in a 1:1:1 ratio to receive standard care, standard care plus hydroxychloroquine at a dose of 400 mg twice daily, or standard care plus hydroxychloroquine at a dose of 400 mg twice daily plus azithromycin at a dose of 500 mg once daily for 7 days. The primary outcome was clinical status at 15 days as assessed with the use of a seven-level ordinal scale (with levels ranging from one to seven and higher scores indicating a worse condition) in the modified intention-to-treat population (patients with a confirmed diagnosis of Covid-19). Safety was also assessed. RESULTS: A total of 667 patients underwent randomization; 504 patients had confirmed Covid-19 and were included in the modified intention-to-treat analysis. As compared with standard care, the proportional odds of having a higher score on the seven-point ordinal scale at 15 days was not affected by either hydroxychloroquine alone (odds ratio, 1.21; 95% confidence interval [CI], 0.69 to 2.11; P = 1.00) or hydroxychloroquine plus azithromycin (odds ratio, 0.99; 95% CI, 0.57 to 1.73; P = 1.00). Prolongation of the corrected QT interval and elevation of liver-enzyme levels were more frequent in patients receiving hydroxychloroquine, alone or with azithromycin, than in those who were not receiving either agent. CONCLUSIONS: Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care. (Funded by the Coalition Covid-19 Brazil and EMS Pharma; ClinicalTrials.gov number, NCT04322123.)

THE SERO-CONVERSION AND EVALUATION OF RENAL ALTERATIONS IN DOGS INFECTED BY Leishmania (Infantum) chagasi

This study investigated the sero-conversion period in which dogs from endemic areas test positive for visceral leishmaniasis (VL) as well as the early post-infection period in which renal alterations are observed. Dogs that were initially negative for Canine Visceral Leishmaniasis (CVL) were clinically evaluated every three months by serological, parasitological and biochemical tests until sero-conversion was confirmed, and six months later a subsequent evaluation was performed. Samples of kidney tissues were processed and stained with Hematoxylin and Eosin (H&E), Periodic Acid Schiff (PAS) and Massons trichrome stain and lesions were classified based on the WHO criteria. Of the 40 dogs that initially tested negative for VL, 25 (62.5%) exhibited positive serological tests during the study period. Of these 25 dogs, 15 (60%) tested positive within three months, five (20%) tested positive within six months and five (20%) tested positive within nine months. The dogs exhibited antibody titers between 1:40 and 1:80 and 72% of the dogs exhibited clinical symptoms. The Leishmania antigen was present in the kidneys of recently infected dogs. We found higher levels of total protein and globulin as well as lower levels of albumin in the infected dogs when compared to the control dogs. Additionally, infected dogs presented levels of urea and creatinine that were higher than those of the uninfected dogs. Glomerulonephritis was detected in some of the dogs examined in this study. These data suggest that in Teresina, the sero-conversion for VL occurs quickly and showed that the infected dogs presented abnormal serum proteins, as well as structural and functional alterations in the kidneys during the early post-infection period

Agronomical and phytochemical aspects of fafia

A espécie medicinal fáfia (Hebanthe eriantha), é um recurso extrativista da região do Vale do Paraíba, cuja variabilidade genética encontra-se ameaçada. Neste estudo realizou-se a caracterização agronômica e análise de princípio ativo de cinco acessos. Este estudo é uma parceria entre o Laboratório de Plantas Medicinais da UNESP-Botucatu, o Pólo Vale do Paraíba em Pindamonhangaba da Agência Paulista de Tecnologia dos Agronegócios (APTA) e a Divisão de Agrotecnologia do Centro Pluridisciplinar de Pesquisas Químicas Biológicas e Agrícolas (CPQBA) da UNICAMP. Foi instalado um ensaio experimental a campo em blocos casualizados com cinco acessos e sete repetições. Foram avaliadas a massa fresca e seca da parte aérea, a massa fresca e seca da raiz, o comprimento da maior haste, a área foliar, o índice de espuma e o teor de ácido fáfico das amostras. O acesso I1800 apresentou uma massa seca de raiz, massa seca da parte aérea e área foliar superior aos demais acessos (176,16 g/planta, 7,301 kg/planta, 155,04 cm² ). O teor de ácido fáfico não diferiu entre os acessos (0,640-0,366 %/mm) Existe uma correlação positiva entre área foliar e massa seca da parte aérea e entre área foliar e massa seca de raízes entre os cinco acessos.The medicinal species fafia (Hebanthe eriantha), is a product of extractivism in the region of the Paraiba Valley, São Paulo state, Brazil, with endangered genetic variability. This study did an agronomical characterization and an analysis of active compounds of five accessions. This research is a partnership of UNESP-Botucatu Medicinal Plants Laboratory, Paraiba Valley Center (APTA) and CPQBA-UNICAMP Agrotechnological Division. A field experiment using completely random blocks with five accessions and seven replications was used. The stem and leaf wet/dry weights, root wet/dry weight, length of the longest stem, foliar area, foam index and pfaffic acid content samples were evaluated. Accession I1800 had root dry weight, stem and leaf dry weight, and foliar area greater than other accessions (176.16 g/plant, 7.301 kg/plant, 155.04 cm² ). Pfaffic acid content was similar to other accessions (0.640-0.366 %mm-1) Among all five accessions, there is a positive correlation among the foliar area and stem and leaf dry weight and between the foliar area and root dry weight.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)UNESP FCA Depto. Produção VegetalIAC-Campinas Centro de Pesquisa e Desenvolvimento de Recursos Genéticos VegetaisSAA APTAUNICAMP CPQBAUNESP FCA Depto. Produção Vegeta