Valganciclovir for Symptomatic Congenital Cytomegalovirus Disease

BACKGROUND: The treatment of symptomatic congenital cytomegalovirus (CMV) disease with intravenous ganciclovir for 6 weeks has been shown to improve audiologic outcomes at 6 months, but the benefits wane over time. METHODS: We conducted a randomized, placebo-controlled trial of valganciclovir therapy in neonates with symptomatic congenital CMV disease, comparing 6 months of therapy with 6 weeks of therapy. The primary end point was the change in hearing in the better ear (“best-ear” hearing) from baseline to 6 months. Secondary end points included the change in hearing from baseline to follow-up at 12 and 24 months and neurodevelopmental outcomes, with each end point adjusted for central nervous system involvement at baseline. RESULTS: A total of 96 neonates underwent randomization, of whom 86 had follow-up data at 6 months that could be evaluated. Best-ear hearing at 6 months was similar in the 6-month group and the 6-week group (2 and 3 participants, respectively, had improvement; 36 and 37 had no change; and 5 and 3 had worsening; P=0.41). Totalear hearing (hearing in one or both ears that could be evaluated) was more likely to be improved or to remain normal at 12 months in the 6-month group than in the 6-week group (73% vs. 57%, P=0.01). The benefit in total-ear hearing was maintained at 24 months (77% vs. 64%, P=0.04). At 24 months, the 6-month group, as compared with the 6-week group, had better neurodevelopmental scores on the Bayley Scales of Infant and Toddler Development, third edition, on the language-composite component (P=0.004) and on the receptive-communication scale (P=0.003). Grade 3 or 4 neutropenia occurred in 19% of the participants during the first 6 weeks. During the next 4.5 months of the study, grade 3 or 4 neutropenia occurred in 21% of the participants in the 6-month group and in 27% of those in the 6-week group (P=0.64). CONCLUSIONS: Treating symptomatic congenital CMV disease with valganciclovir for 6 months, as compared with 6 weeks, did not improve hearing in the short term but appeared to improve hearing and developmental outcomes modestly in the longer term. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT00466817.

Langmuir?Blodgett and layer-by-layer films of photoactive fullerene?porphyrin dyads

The fabrication of high quality, robust and photoactive ITO electrodes—in the form of well-defined two- and three-dimensional films—is reported following the Langmuir–Scha¨ fer (LS) and the layer-by-layer (LBL) methods. In the LS approach C60-NiP multilayers were transferred from the air–water interface, while the LBL approach utilizes electrostatic and van der Waals interactions for the step-by-step deposition of individual C60-NiP molecules out of solution. These complementary techniques allow control over the thickness and composition of the films at a molecular level and guarantee the specific alignment and the orientation of the incorporated donor–acceptor system. Modified ITO electrodes were probed in photocurrent experiments, in which the LBL-modified electrodes reveal smaller photon to current conversion efficiencies relative to the LS-modified electrodes

Langmuir-Blodgett and Layer-by-Layer Films of Photoactive Fullerene-Porphyrin Dyads

The fabrication of high quality, robust and photoactive ITO electrodes—in the form of well-defined two- and three-dimensional films—is reported following the Langmuir–Scha¨ fer (LS) and the layer-by-layer (LBL) methods. In the LS approach C60-NiP multilayers were transferred from the air–water interface, while the LBL approach utilizes electrostatic and van der Waals interactions for the step-by-step deposition of individual C60-NiP molecules out of solution. These complementary techniques allow control over the thickness and composition of the films at a molecular level and guarantee the specific alignment and the orientation of the incorporated donor–acceptor system. Modified ITO electrodes were probed in photocurrent experiments, in which the LBL-modified electrodes reveal smaller photon to current conversion efficiencies relative to the LS-modified electrodes