Success Rate and Utility of Ultrasound-guided Synovial Biopsies in Clinical Practice

OBJECTIVE: The utility of synovial biopsy in increasing our understanding of the pathogenesis of inflammatory arthropathies, as well as in evaluating treatments, is well established. Ultrasound (US) allows synovial assessment and therefore assists in biopsying synovial tissue in a safe and well-tolerated manner. This study's objectives were to (1) determine the rate of success in retrieving synovial tissue using US guidance, (2) describe the indications for US-guided synovial biopsies in the clinical setting, (3) determine how frequently the synovial biopsy can lead to a clear diagnosis, and (4) assess the quality of the synovial tissue obtained using this technique. METHODS: Synovial biopsies of small and large joints were performed under US guidance between February 2007 and December 2014 using a semiautomatic core biopsy needle. The biopsy procedure was considered successful if synovial tissue was found at histological examination. RESULTS: Seventy-four patients with undifferentiated arthritis underwent 76 synovial biopsies. The success rate in retrieving synovial tissue was 81.6% (62/76). One patient taking acetyl salicylic acid at 75 mg at the time of the biopsy presented with hemarthrosis 48 h after the procedure, which resolved following simple arthrocentesis. A definitive diagnosis was achieved in 16% of the patients where synovial tissue was sampled successfully. CONCLUSION: US-guided synovial biopsies in clinical practice can be performed safely on patients with undifferentiated arthritis and with heterogeneous presentations. The rate of success in acquiring synovial tissue is high. The procedure usually retrieves quality tissue and leads to a definite diagnosis in a significant minority of patients

Twenty-six years of HIV science: an overview of anti-HIV drugs metabolism

From the identification of HIV as the agent causing AIDS, to the development of effective antiretroviral drugs, the scientific achievements in HIV research over the past twenty-six years have been formidable. Currently, there are twenty-five anti-HIV compounds which have been formally approved for clinical use in the treatment of AIDS. These compounds fall into six categories: nucleoside reverse transcriptase inhibitors (NRTIs), nucleotide reverse transcriptase inhibitors (NtRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), cell entry inhibitors or fusion inhibitors (FIs), co-receptor inhibitors (CRIs), and integrase inhibitors (INIs). Metabolism by the host organism is one of the most important determinants of the pharmacokinetic profile of a drug. Formation of active or toxic metabolites will also have an impact on the pharmacological and toxicological outcomes. Therefore, it is widely recognized that metabolism studies of a new chemical entity need to be addressed early in the drug discovery process. This paper describes an overview of the metabolism of currently available anti-HIV drugs.Da identificação do HIV como o agente causador da AIDS, ao desenvolvimento de fármacos antirretrovirais eficazes, os avanços científicos na pesquisa sobre o HIV nos últimos vinte e seis anos foram marcantes. Atualmente, existem vinte e cinco fármacos anti-HIV formalmente aprovados pelo FDA para utilização clínica no tratamento da AIDS. Estes compostos são divididos em seis classes: inibidores nucleosídeos de transcriptase reversa (INTR), inibidores nucleotídeos de transcriptase reversa (INtTR), inibidores não-nucleosídeos de transcriptase reversa (INNTR), inibidores de protease (IP), inibidores da entrada celular ou inibidores de fusão (IF), inibidores de co-receptores (ICR) e inibidores de integrase (INI). O metabolismo consiste em um dos maiores determinantes do perfil farmacocinético de um fármaco. A formação de metabólitos ativos ou tóxicos terá impacto nas respostas farmacológicas ou toxicológicas do fármaco. Portanto, é amplamente reconhecido que estudos do metabolismo de uma nova entidade química devem ser realizados durante as fases iniciais do processo de desenvolvimento de fármacos. Este artigo descreve uma abordagem do metabolismo dos fármacos anti-HIV atualmente disponíveis na terapêutica

Characterisation of Sanguinhal Mire, Terceira Island (Azores): a protected quaking bog habitat

The Azores archipelago in the North Atlantic is an important area for biodiversity because it is rich in rare species and habitats, and almost undisturbed. Sanguinhal mire was originally a lake that evolved through paludification into a peat habitat. It is located inside Nature 2000 (European Union for Protection of Nature and Biodiversity, Council Directive 92/43/EEC of 21 May 1992 on the conservation of natural habitats and of wild fauna and flora, Habitat Directive Annex I(b) habitat 7140) area of Santa Bárbara and Pico Alto Mountains on the island of Terceira, and it is a good example of a basin peatland type that was first discovered in 1998. This paper provides baseline information on its flora, vegetation communities, structure, surface hydrology and chemistry. Forty-one plant species including six Sphagnum species and ten endemic vascular plants have been recorded, and eight plant communities are distinguished. The maximum peat depth is 2.5 m. The mire receives flowing water from its margins, in addition to intercepted precipitation and fog. After precipitation, water drains through several placic rupture points. Both pH and water conductivity were measured, with some ecological tendencies observed. The conservation status of the mire is good, but it is subject to increasing pressure from cattle pasture and a walking trail that constrains natural surface water movement.<br>O Arquipélago dos Açores no Atlântico Norte é uma área importante em biodiversidade, rica em espécies e habitats raros em estado selvagem. A turfeira do Sanguinhal foi originalmente uma lagoa que evoluiu por paludificação para um habitat de turfa. Esta localiza-se na Rede Natura 2000 (União Europeia para a Proteção da Natureza e Biodiversidade, Directive do Conselho 92/43/EEC de 21 de Maio 1992 sobre a concervação de habitats naturais e da fauna e flora, Diretiva de Habitat Anexo I(b) habitat 7140) da Serra de Santa Bárbara e Pico Alto e é um bom exemplo de um tipo de turfeira de bacia, descoberto pela primeira vez em 1998. Este trabalho provê informações iniciais sobre a flora, as comunidades vegetais, a estrutura, as caracteristicas químicas da água e o regime hidrológico de superfície. Foram identificadas 41 espécies vegetais, incluindo 6 espécies do género Sphagnum, e 10 espécies de plantas vasculares endêmicas, forma identificadas oito comunidades vegetais. A profundidade máxima de turfa é de 2,5 m. A turfeira recebe água superficial de suas margens, além da precipitação interceptada e da névoa. Depois das chuvas, a água é drenada por vários pontos da turfeira onde o placic se rompeu. O pH e a condutividade das água foram medidos tendo-se verificado algumas tendências. O estado de conservação da turfeira é bom embora esteja sujeita a um crescente pastoreio por gado selvagem e a abertura de trilhos de forma desordenada altera o natural movimento de água na turfeira