Systematic review and meta-analysis of secondary prophylaxis for prevention of HIV-related toxoplasmic encephalitis relapse using trimethoprim-sulfamethoxazole

A recent systematic literature and meta-analysis reported relative efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment of toxoplasmic encephalitis (TE) in HIV-infected adults. Here, we estimated relapse rates during secondary prophylaxis with TMP-SMX, and further explored differences in relapse rates prior to introduction of highly active antiretroviral therapy (HAART) and the widespread adoption of HAART. A systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials yielded 707 studies whereby 663 were excluded after abstract screening, and 38 were excluded after full review leaving 6 studies for extraction. We performed double data extraction with a third-party adjudicator. Study designs varied with only one randomized study, four prospective cohorts and one retrospective cohort. Relapse rates were transformed using the Freeman-Tukey method and pooled using both fixed-effect and random-effects meta-analysis models. The TMP-SMX relapse rate was 16.4% (95% CI = 6.2% to 30.3%) based on random-effects models. When the disaggregated pre-HAART studies (n = 4) were included, the relapse rate was 14.9% (random effects; 95% CI = 3.7% to 31.9%). Analysis of two post-HAART studies indicated a relapse rate of 19.2% (random effects; 95% CI = 2.8% to 45.6%). Comparing the relapse rates between pre- and post-HAART studies were contrary to what might be expected based on known benefits of HAART therapy in this population. Nevertheless, cautious interpretation is necessary considering the heterogeneity of the included studies and a limited number of subjects receiving TMP-SMX reported in the post-HAART era.Revisión por pare

Bioavailability, mobility and leaching of phosphorus in a Mediterranean agricultural soil (ne Spain) amended with different doses of biosolids

The precipitation of sparingly soluble calcium phosphate in calcareous soils decreases the bioavailability of macronutrients, which makes their addition by way of fertilisers necessary. Sludge resulting from treating urban wastewater does not only provide significant amounts of phosphorus, but also helps lower the pH, thus increasing its bioavailability. The loss of part of soil nutrients due to irrigation or rain can contaminate groundwater. In order to assess the movement of phosphorus, a experiment was conducted on percolation columns, to which different doses of wastes were applied. The pH decreased by as much as 0.89 units, as well as the assimilable and soluble P, in intervals of 20 cm of depth, obtaining maximum values of 254 mg P kg-1 and 1455 lg P kg-1 respectively, and the P present in the leached water collected, which did not surpass 95 lg PL-1. The intent was to learn which was the majoritarian inorganic formed crystalline phase that immobilised the movement of phosphorus through the percolation column. The results obtained by the diffraction of X-rays are not conclusive, although they point to the formation of octacalcium phosphate. The diffractograms of the studied samples have similar diffraction lines to those of apatites

Tuberculous meningitis in HIV-infected patients in Brazil: clinical and laboratory characteristics and factors associated with mortality

Tuberculous meningitis (TBM) is a growing problem in HIV-infected patients in developing countries, where there is scarce data about this co-infection. Our objectives were to analyze the main features and outcomes of HIV-infected patients with TBM. Methods This was a retrospective study of HIV-infected Brazilian patients admitted consecutively for TBM. All patients had Mycobacterium tuberculosis isolated from the cerebrospinal fluid (CSF). Presenting clinical and laboratory features were studied. Multivariate analysis was used to identify variables associated with death during hospitalization and at 9 months after diagnosis. Survival was estimated using the Kaplan–Meier method. Results We included 108 cases (median age 36 years, 72% male). Only 15% had fever, headache, and meningeal signs simultaneously. Forty-eight percent had extrameningeal tuberculosis. The median CD4+ cell count was 65 cells/μl. Among 90 cases, 7% had primary resistance to isoniazid and 9% presented multidrug-resistant strains. The overall mortality during hospitalization was 29% and at 9 months was 41%. Tachycardia and prior highly active antiretroviral therapy (HAART) were associated with 9-month mortality. The 9-month survival rate was 22% (95% confidence interval 12–43%). Conclusions Clinical and laboratory manifestations were unspecific. Disseminated tuberculosis and severe immunosuppression were common. Mortality was high and the 9-month survival rate was low. Tachycardia and prior HAART were associated with death within 9 months of diagnosis147e586e59

Performance evaluation of Ce3+ doped flexible PVDF fibers for efficient optical pressure sensors

Highlights Centrifugally spun cerium doped nonwoven fibrous mat are explored as a non-contact optical pressure sensor. The developed sensor depicted wide linear dynamic range and good pressure sensitivity. The sensor properties are based on the spectral shift, broadening and intensity enhancement. β-phase in doped fibers increases when compared to undoped PVDF. Cerium nitrate doped fiber exhibits a high-pressure sensitivity (dλ/dP ≈ 0.28 nm/GPa) with no luminescence quenching. Abstract This work proposes a highly novel centrifugally spun lanthanide doped nonwoven fibrous mat as a non-contact optical pressure sensor with a wide linear dynamic range and good pressure sensitivity. The sensor properties are based on the spectral shift, broadening and intensity enhancement of Ce3+ ion in Ce doped PVDF fiber upto significantly high pressure. Two different systems: Ce(NO3)3·6H2O and (NH4)4Ce(SO4)4·2H2O doped PVDF flexible fibers (CeN-PF and CeS-PF) were produced using the Forcespinning® technique. Both CeN-PF and CeS-PF fibers displayed violet-blue emission under UV irradiation due to a 5d-4f transition of Ce3+ ions. Our emission results show that both CeN-PF and CeS-PF spectral characteristics are influenced by high pressures, inducing significant spectral ref shift in 5d-4f. The pressure-induced monotonous changes in bandwidth and emission intensity enhancement along with red shift suggesting the potential application of these fibers for pressure sensing applications. The CeN-PF fiber exhibits a high-pressure sensitivity (dλ/dP ≈ 0.28 nm/GPa) under a comprehensive linear dynamic range (0–64 GPa) with no pressure-induced luminescence quenching. The changes in CeS-PF is less pronounced with a lower pressure sensitivity of 0.10 nm/GPa compared to CeN-PF due to large crystal field splitting energy of nitrate ion compared to sulphate ion. This work presents a highly efficient, cost effective, scalable lanthanide doped flexible fibrous based system with negligible high pressure quenching and a wider linear dynamic range for optical pressure sensing applications

Meningoencefalite chagásica: relato de caso de doença recentemente incluida como indicativa de AIDS no Brasil

Recently, reactivation of Chagas disease (meningoencephalitis and/or myocarditis) was included in the list of AIDS-defining illnesses in Brazil. We report a case of a 52-year-old patient with no history of previous disease who presented acute meningoencephalitis. Direct examination of blood and cerebrospinal fluid (CSF) showed Trypanosoma cruzi. CSF culture confirmed the diagnosis. Serological assays for T. cruzi and human immunodeficiency virus (HIV) were positive. Despite treatment with benznidazol and supportive measures, the patient died 24 hours after hospital admission. In endemic areas, reactivation of Chagas disease should always be considered in the differential diagnosis of meningoencephalitis among HIV-infected patients, and its presence is indicative of AIDS.Recentemente, a reagudização da doença de Chagas (meningoencefalite e/ou miocardite) foi incluída na lista de doenças indicativas de aids no Brasil. Os autores relatam o caso de um paciente de 52 anos de idade, natural de área rural da Bahia e procedente de uma área urbana de São Paulo, sem história de doenças prévias e que apresentou meningoencefalite aguda. As sorologias e pesquisas parasitológicas diretas no sangue e no liquido cefalorraquideano (LCR) demonstraram presença de Trypanosoma cruzi, confirmando-se o diagnóstico mediante cultura do LCR. O teste rápido assim como os ELISA e Western Blot diagnosticaram infecção pelo vírus da imunodeficiência humana (HIV). Apesar do tratamento com benzonidazole e as medidas de suporte, o paciente faleceu 24 horas depois da admissão hospitalar. Em áreas endêmicas, a reagudização da doença de Chagas deve ser sempre considerada no diagnóstico diferencial das meningoencefalites e sua presença em pacientes com infecção pelo HIV é indicativa de aids

Influence of sugar type on the bioavailability of cocoa flavanols.

The beneficial effects of cocoa on vascular function are mediated by the absorption of monomeric flavanols into the circulation from the small intestine. As such, an understanding of the impact of the food matrix on the delivery of flavanols to the circulation is critical in assessing the potential vascular impact of a food. In the present study, we investigated the impact of carbohydrate type on flavanol absorption and metabolism from chocolate. A randomised, double-blind, three-arm cross-over study was conducted, where fifteen volunteers were randomly assigned to either a high-flavanol (266 mg) chocolate containing maltitol, a high-flavanol (251 mg) chocolate with sucrose or a low-flavanol (48 mg) chocolate with sucrose. Test chocolates were matched for micro- and macronutrients, including the alkaloids theobromine and caffeine, and were similar in taste and appearance. Total flavanol absorption was lower after consumption of the maltitol-containing test chocolate compared with following consumption of its sucrose-containing equivalent (P = 0·002). Although the O-methylation pattern observed for absorbed flavanols was unaffected by sugar type, individual levels of unmethylated ( - )-epicatechin metabolites, 3'-O-methyl-epicatechin and 4'-O-methyl-epicatechin metabolites were lower for the maltitol-containing test chocolate compared with the sucrose-containing equivalent. Despite a reduction in the total plasma pool of flavanols, the maximum time (T max) was unaffected. The present data indicate that full assessment of intervention treatments is vital in future intervention trials with flavanols and that carbohydrate content is an important determinant for the optimal delivery of flavanols to the circulation

miR-125b Acts as a Tumor Suppressor in Breast Tumorigenesis via Its Novel Direct Targets ENPEP, CK2-α, CCNJ, and MEGF9

MicroRNAs (miRNAs) play important roles in diverse biological processes and are emerging as key regulators of tumorigenesis and tumor progression. To explore the dysregulation of miRNAs in breast cancer, a genome-wide expression profiling of 939 miRNAs was performed in 50 breast cancer patients. A total of 35 miRNAs were aberrantly expressed between breast cancer tissue and adjacent normal breast tissue and several novel miRNAs were identified as potential oncogenes or tumor suppressor miRNAs in breast tumorigenesis. miR-125b exhibited the largest decrease in expression. Enforced miR-125b expression in mammary cells decreased cell proliferation by inducing G2/M cell cycle arrest and reduced anchorage-independent cell growth of cells of mammary origin. miR-125b was found to perform its tumor suppressor function via the direct targeting of the 3'-UTRs of ENPEP, CK2-alpha, CCNJ, and MEGF9 mRNAs. Silencing these miR-125b targets mimicked the biological effects of miR-125b overexpression, confirming that they are modulated by miR-125b. Analysis of ENPEP, CK2-alpha, CCNJ, and MEGF9 protein expression in breast cancer patients revealed that they were overexpressed in 56%, 40-56%, 20%, and 32% of the tumors, respectively. The expression of ENPEP and CK2-alpha was inversely correlated with miR-125b expression in breast tumors, indicating the relevance of these potential oncogenic proteins in breast cancer patients. Our results support a prognostic role for CK2-alpha, whose expression may help clinicians predict breast tumor aggressiveness. In particular, our results show that restoration of miR-125b expression or knockdown of ENPEP, CK2-alpha, CCNJ, or MEGF9 may provide novel approaches for the treatment of breast cancer

Introduction to special section: Balancing, restoration, and palinspastic reconstruction

Methods to quantify deformation and reverse the process of strain as a mode to illustrate geologic evolution through time have been previously used for a number of decades. Early efforts on the quantification of bed reconstruction were completed either by manually weighing the sections on delicate balances and obtaining the average height and thickness of strata to be reconstructed by applying a scale factor (Chamberlin, 1910), or by hand-drafting sections with conserved bed length between the folded and faulted sedimentary layers, mainly in a 2D cross section (Bally et al., 1966; Dahlstrom, 1969) or map framework (Dennison and Woodward, 1963). Cross-section techniques initially applied to contractional thrust and fold belts and have proven useful in other structural settings, such as extensional and inverted domains. Development of 3D techniques enabled the analysis of strike-slip and salt tectonics where out-of-plane changes of rock volume could be addressed. Through the years, the widespread application of these techniques to predict fault and horizon geometry at depth has generated newer approaches and more sophisticated algorithms, and it has also demonstrated the potential of structural modeling techniques (e.g., construction of balanced sections, palinspastic reconstruction, kinematic and geomechanical restoration, and forward modeling) in reducing the risk and uncertainty associated with the interpretation of geophysical/geological dat