Nintedanib Treatment for Idiopathic Pulmonary Fibrosis Patients Who Have Been Switched from Pirfenidone Therapy: A Retrospective Case Series Study

BACKGROUND: The efficacy and effectiveness of nintedanib as a first-line therapy in idiopathic pulmonary fibrosis (IPF) patients have been demonstrated by clinical trials and real-life studies. Our aim was to examine the safety profile and effectiveness of nintedanib when it is utilized as a second-line treatment in subjects who have discontinued pirfenidone. METHODS: The medical charts of 12 patients who were switched from pirfenidone to nintedanib were examined retrospectively. The drug's safety was defined by the number of adverse events (AEs) that were reported; disease progression was evaluated based on the patient's vital status and changes in forced vital capacity (FVC) at 12-month follow-up. RESULTS: The numbers of patients experiencing AEs and of the AEs per patient in our study group didn't significantly differ with respect to a group of 56 individuals who were taking nintedanib as a first-line therapy during the study period (5/12 vs. 22/56; p = 0.9999, and 0.00 (0.00-1.00) vs. 0.00 (0.00-3.00); p = 0.517, respectively). Two out of the 3 patients who had been switched to nintedanib due to a rapid disease progression showed stabilized FVC values. CONCLUSIONS: Nintedanib was found to have an acceptable safety profile in the majority of the IPF patients switched from pirfenidone. Prospective studies are warranted to determine if the drug can effectively delay disease progression in these patients

Resíduos de EBDCs e culturas com geração fitogênica de CS2.

A análise de resíduos etilenobis(ditiocarbamatos) (EBDCs) é realizada de maneira indireta, pela dosagem de CS2. Desse modo, plantas que geram fitogenicamente CS2, como as Caricaceas, podem fornecer resultados falso positivos. Todos os métodos de análise de resíduos de EBDCs são uma variação do método de Keppel (1969; 1971), que dosa o CS2 colorimetricamente. O CS2 também pode ser analisado por cromatografia gasosa, utilizando-se a técnica de análise por headspace, ou pela modificação desse método com a dissolução do CS2 em uma camada de solvente orgânico (iso-octano). O objetivo deste estudo foi analisar em amostras testemunha de mamão o nível de CS2 endógeno por três métodos distintos de análise de resíduos de EBDCs: iso-octano, headspace e espectrofotométrico. As concentrações de CS2 foram comparadas com o limite máximo de resíduos adotado pela União Européia (0,05 mg kg-1)

Tolerância para resíduos de EBDCs em culturas com geração fitogênica de CS2.

Neste trabalho foram utilizados três métodos para análise de ditiocarbamatos em amostras testemunha de mamão das variedades Golden, Sunrise solo e Tainung. Os mamões foram cultivados em áreas experimentais sem utilização, durante todo o ciclo da cultura, de agrotóxicos ou fertilizantes sulfurados. O CS2 foi quantificado por espectrofotometria e por cromatografia gasosa utilizando detector fotométrico de chama no modo enxofre, tanto no método por headspace quanto por partição em iso-octano. Todos os métodos forneceram resultados positivos de CS2 no mamão, independentemente da variedade avaliada. As concentrações de CS2 observadas foram comparadas com o limite máximo de resíduos de etilenobis(ditiocarbamatos)(EBDCs), estabelecido na Comunidade Européia em 0,05mg kg-1. A probabilidade de ser encontrada uma amostra de mamão com concentração de CS2 igual ou acima de 0,05 mg kg-1 foi de 12 % pelo método de iso-octano, 55% pelo método de headspace e 94 % pelo método espectrofotométrico. Desse modo, os resíduos de EBDCs quantificados como CS2, devem ser cuidadosamente interpretados em culturas com geração fitogênica de CS2, pois a presença deste não confirma a utilização de fungicidas EBDCs

The relationships between faecal egg counts and gut microbial composition in UK Thoroughbreds infected by cyathostomins

A growing body of evidence, particularly in humans and rodents, supports the existence of a complex network of interactions occurring between gastrointestinal (GI) helminth parasites and the gut commensal bacteria, with substantial effects on both host immunity and metabolic potential. However, little is known of the fundamental biology of such interactions in other animal species. Nonetheless, given the considerable economic losses associated with GI parasites, particularly in livestock and equines, as well as the global threat of emerging anthelmintic resistance, further explorations of the complexities of host-helminth-microbiota interactions in these species are needed. This study characterises the composition of the equine bacterial commensal flora associated with the presence, in faecal samples, of low (Clow) - and high (Chigh) numbers of eggs of an important group of equine GI parasites (i.e. the cyathostomins), prior to and following anthelmintic treatment. High-throughput sequencing of microbial 16S rRNA amplicons and associated bioinformatics and statistical analyses of sequence data revealed strong clustering according to faecal egg counts (P = 0.003). A trend towards increased populations of Methanomicrobia (class) and Dehalobacterium (genus) was observed in Clow in comparison with Chigh. Anthelmintic treatment in Chigh was associated with a significant reduction of the bacterial phylum TM7 14 days post-ivermectin administration, as well as a transient expansion of Adlercreuzia spp. at 2 days post-treatment. This study provides a first known insight into the discovery of the intimate mechanisms governing host-parasite-microbiota interactions in equids, and sets a basis for the development of novel, biology-based intervention strategies against equine GI helminths based on manipulation of the commensal gut flora

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020