Dolutegravir-based anti-retroviral therapy is effective and safe in HIV-infected paediatric patients

BACKGROUND: Treatment of HIV infection in adolescents is challenging due to long duration of therapy and poor adherence. Recently, the integrase strand transfer inhibitor dolutegravir (DTG) has been approved for the use in adolescents with HIV, but evidence in clinical practice is very limited. METHODS: We describe six cases of HIV-infected children/adolescents successfully treated with DTG-based regimen. Data relative to children/adolescents managed at the Referral Center for Pediatric HIV/AIDS of the University of Naples were reviewed. Patients were tested before introduction of DTG, after 1 month and every 3 months in the first 2 years to assess virologic and immunological response, tolerance and development of side effects. Families were asked to report any suspected adverse events. RESULTS: Six patients (2 male, median age 17 years, range 12-18) were started on DTG-based anti-retroviral regimen due to low adherence to anti-retroviral treatment (ART), multiple drug resistance mutations, or development of ART-related side effects. Within 4-8 weeks after DTG treatment onset, a complete viral suppression and a concomitant increase of CD4+ cell count was observed. Four patients showed a persistent suppression after 2 years of follow-up, and 2 patients at about 1 year. One month after the introduction of DTG, the patient enrolled because of severe dyslipidaemia and hyper-transaminasemia showed a complete normalization of laboratory values. During follow-up (median 24 months, range 9-24) no adverse events were reported and most patients demonstrated a good adherence to treatment. CONCLUSIONS: DTG-based treatments demonstrated efficacy and good safety profile in adolescents. All patients demonstrated a rapid virologic and immunological response within 4-8 weeks, with good adherence and absence of side effects

OPTIMASI KONDISI LARUTAN DAN PARAMETER PROSES PEMINTALAN ELEKTRIK PADA SINTESIS SERAT NANO KITOSAN-PEO

Serat nano kitosan telah berhasil dibuat dengan penambahan polietilen oksida (PEO) sebagai polimer sekunder pada kondisi larutan dan parameter proses pemintalan elektrik yang optimum. Pada penelitian ini, larutan polimer kitosan/PEO pada berbagai konsentrasi (3,2, 3,6, dan 4 wt%) dan rasio (3:2 dan 1:1) dipintal secara elektrik (electrospinning) untuk memperoleh serat dengan morfologi paling baik. Selain kondisi larutan, parameter proses pintal elektrik yang penting seperti tegangan, laju alir umpan, dan jarak antara jarum dengan kolektor juga disesuaikan untuk mendapatkan proses dengan kondisi jet polimer yang stabil. Serat nano yang terbaik yakni tanpa butiran polimer (polymer microspheres) dan minim jumlah manik-manik (beads) berhasil diperoleh pada konsentrasi kitosan/PEO 4 wt% dan rasio 3:2. Parameter proses yang digunakan untuk mendapatkan serat ini yaitu tegangan 30 kV, laju alir umpan 0,3 ml/jam, dan jarak antara jarum dan kolektor 30 cm. Karakterisasi morfologi serat dari setiap eksperimen dilakukan dengan menggunakan mikroskop Phenom. Selanjutnya, serat nano terbaik yang diperoleh dikarakterisasi dengan menggunakan SEM dan diameter rata-rata serat diukur dengan aplikasi ImageJ. Hasil menunjukkan bahwa serat nano yang dihasilkan pada kondisi optimum memiliki diameter rata-rata 68 nm dan distribusi ukuran diameter serat tersebar cukup lebar mulai dari 30-150 nm.

Electrochemotherapy in the treatment of cutaneous metastases from breast cancer: a multicenter cohort analysis.

The management of breast cancer (BC) skin metastases represents a therapeutic challenge. Electrochemotherapy (ECT) combines the administration of bleomycin with temporary permeabilization induced by locally administered electric pulses. Preliminary experience with ECT in BC patients is encouraging. METHODS: A total of 125 patients with BC skin metastases who underwent ECT between 2010 and 2013 were enrolled onto a multicenter retrospective cohort study. The treatment was administered following the European Standard Operative Procedures of Electrochemotherapy. Tumor response was clinically assessed adapting the Response Evaluation Criteria in Solid Tumors, and toxicity was evaluated according to Common Terminology Criteria for Adverse Events 4.0. Cox regression analysis was used to identify predictive factors. RESULTS: Response was evaluable in 113 patients for 214 tumors (median 1 per patient, range 1-3). The overall response rate after 2 months was 90.2 %, while the complete response (CR) rate was 58.4 %. In multivariate analysis, small tumor size (P < 0.001), absence of visceral metastases (P = 0.001), estrogen receptor positivity (P = 0.016), and low Ki-67 index (P = 0.024) were significantly associated with CR. In the first 48 h, 10.4 % of patients reported severe skin pain. Dermatologic toxicity included grade 3 skin ulceration (8.0 %) and grade 2 skin hyperpigmentation (8.8 %). Tumor 1-year local progression-free survival was 86.2 % (95 % confidence interval 79.3-93.8) and 96.4 % (95 % confidence interval 91.6-100) in the subgroup of those with CR. CONCLUSIONS: In this study, small tumor size, absence of visceral metastases, estrogen receptor positivity, and low Ki-67 index were predictors of CR after ECT. Patients who experienced CR had durable local control. ECT represents a valuable skin-directed therapy for selected patients with BC

Treatment efficacy with electrochemotherapy: A multi-institutional prospective observational study on 376 patients with superficial tumors

BACKGROUND: Cutaneous metastases represent a therapeutic challenge. An increasing body of experience suggests that electrochemotherapy (ECT) provides effective tumor control, although its evidence basis should be strengthened. METHODS: This prospective, multicenter, observational study enrolled patients with superficial metastases, who underwent ECT at 10 centers between 2008 and 2013. Outcomes included adherence to European Standard Operating Procedures of ECT (ESOPE), tumor response, local progression-free survival (LPFS), toxicity and patient-reported outcomes (PROs, EORTC QLQ-C30 plus an 8-item questionnaire). RESULTS: We enrolled 376 eligible patients. Tumor histotype distribution was as follows: melanoma, 56%; squamous cell carcinoma, 11%; Kaposi sarcoma, 11%; breast carcinoma, 8%; basal cell carcinoma, 6%; soft tissue sarcomas, 3%; others, 5%. We registered 1304 target tumors (median size 1 cm). Treatment adhered to ESOPE in 88% of patients as to the route of drug administration, and in 70% as to electrode application. The procedure was mainly performed under sedation (64.6%) and by using intravenous chemotherapy (93.4%). Tumor response rate at 60 days was 88% (complete, 50%). Small tumor size predicted complete response achievement (OR 2.24, p = 0.003), higher LPFS (HR 0.68, p = 0.004) and improved PROs (Global Health Status, p < 0.001; wound bleeding, p < 0.001; healing, p = 0.002; and aesthetics, p < 0.001). Skin toxicity (grade 653, 7.8%) was lower in patients with tumors <2 cm (p 640.001). One-year LPFS was 73.7% (95%CI 68.4-78.3). CONCLUSIONS: ECT represents a valuable skin-directed therapy across a range of malignancies. The most frequently applied treatment modality is intravenous chemotherapy under sedation. Small tumor size predicts durable tumor control, fewer side-effects and better PROs

Preparation of chitosan-based nanofiber mats containing Soluplus® as a potential polymeric carrier by electrospinning process

A preparation of chitosan-based nanofiber mats loaded with Soluplus as a novel carrier polymer was carried out. Soluplus, a water-soluble amphiphilic copolymer, was added to provide a nanofiber structure that will be useful in applications as drug delivery system. In this study, a mixture of chitosan, polyethylene oxide (PEO), and Soluplus micelles was electrospun into nanofibers and characterized using SEM to observe the fiber morphology. Rhodamine (Rh) was used as a model molecule trapped inside Soluplus micelles. The results showed that chitosan-based nanofiber mats were successfully realized by electrospinning of the chitosan/PEO polymer blend solution at a ratio of 3:2 with 4 wt% total polymer concentration. The optimum electrospinning parameters to obtain the nanofibers were at 30 kV electrical potential, 0.2 ml/hour feed rate, and 30 cm distance between the needle tip and the collector. The addition of Soluplus at four times greater critical micelles concentration (CMC) was still able to provide smooth and bead-less nanofibers morphology. Nanofiber mats with Rh-Soluplus have an average fiber diameter of 56 nm, a slightly thinner than the nanofibers with chitosan/PEO alone (63 nm). A preliminary study of Rh release from Soluplus micelles, as well as from Soluplus loaded in the nanofiber mats, showed slower release of Rh from Soluplus loaded in the nanofiber mats compared to the free Soluplus

The variability of composition of the volatile fraction of olive oil

Aroma of olive oil is a very complex mixture of components. Analysis of head space of a series of virgin olive oil samples indicate a great variability of volatile substances composition in olives and these data probably should be related to the story of olives after collecting

The recovery of biophenols from wastewaters of olive oil production

In this article, the phenolic composition of wastewaters prepared from different cultivars of Olea europaea have been described. The main aim is the recovery of these compounds for technological utilization

Optimasi Kondisi Larutan dan Parameter Proses Pemintalan Elektrik pada Sintesis Serat Nano Kitosan-peo

Serat nano kitosan telah berhasil dibuat dengan penambahan polietilen oksida (PEO) sebagai polimer sekunder pada kondisi larutan dan parameter proses pemintalan elektrik yang optimum. Pada penelitian ini, larutan polimer kitosan/PEO pada berbagai konsentrasi (3,2, 3,6, dan 4 wt%) dan rasio (3:2 dan 1:1) dipintal secara elektrik (electrospinning) untuk memperoleh serat dengan morfologi paling baik. Selain kondisi larutan, parameter proses pintal elektrik yang penting seperti tegangan, laju alir umpan, dan jarak antara jarum dengan kolektor juga disesuaikan untuk mendapatkan proses dengan kondisi jet polimer yang stabil. Serat nano yang terbaik yakni tanpa butiran polimer (polymer microspheres) dan minim jumlah manik-manik (beads) berhasil diperoleh pada konsentrasi kitosan/PEO 4 wt% dan rasio 3:2. Parameter proses yang digunakan untuk mendapatkan serat ini yaitu tegangan 30 kV, laju alir umpan 0,3 ml/jam, dan jarak antara jarum dan kolektor 30 cm. Karakterisasi morfologi serat dari setiap eksperimen dilakukan dengan menggunakan mikroskop Phenom. Selanjutnya, serat nano terbaik yang diperoleh dikarakterisasi dengan menggunakan SEM dan diameter rata-rata serat diukur dengan aplikasi ImageJ. Hasil menunjukkan bahwa serat nano yang dihasilkan pada kondisi optimum memiliki diameter rata-rata 68 nm dan distribusi ukuran diameter serat tersebar cukup lebar mulai dari 30-150 nm

Human immunodeficiency virus per se exerts atherogenic effects.

Objective: Premature atherosclerosis in HIV-infected patients has been attributed to highly active antiretroviral therapy (HAART) and the associated metabolic complications. Whether HIV per se plays a role is an unresolved issue. The purpose of this study was to evaluate whether HIV per se exerts atherogenic effects.Methods: We measured carotid intima-media thickness (IMT) and brachial endothelial-dependent (FMD) and endothelial-independent (NMD) vasodilation in 38 naive untreated HIV-infected patients and 41 healthy control subjects.Results: Control subjects were selected as to match the HIV patients for metabolic risk factors. Mean carotid IMT was higher in HIV patients (0.85 +/- 0.2 mm; p < 0.001) than in controls (0.63 +/- 0.1 mm). In a stepwise multiple regression model, the changes in carotid IMT were predicted by the duration of HIV infection (p < 0.001)and CD4T-cells (p = 0.035). Brachial FMD was impaired in HIV patients (8.8 +/- 3% versus 12.2 +/- 3% in controls; p < 0.001). In contrast, NMD values practically overlapped in the HIV patients and controls. Analysis of the data in relation to viral load showed that FMD was significantly more impaired in the subgroup of patients with viral load values above the median (p < 0.001). In addition, there was a highly significant, inverse correlation between FMD and the HIV-RNA copies (p < 0.001).Conclusion: HIV infection causes functional and structural vascular alterations in a very early stage of the infection independent of HAART and metabolic factors. The data lend support to the viral infectious theory of atherosclerosis. Early assessment of the vascular status in HIV-infected patients is suggested