Efficacy and safety of atazanavir-ritonavir plus abacavir-lamivudine or tenofovir-emtricitabine in patients with hyperlipidaemia switched from a stable protease inhibitor-based regimen including one thymidine analogue.

Randomized, open-label, prospective clinical trial assessing efficacy and safety on hyperlipidemia of a switching from a regimen including one protease inhibitor and one thymidine analogue to atazanavir/ritonavir plus abacavir/lamivudine or tenofovir/emtricitabine. Adult HIV-infected patients on their first antiretroviral therapy (of at least 48-week duration), including one protease inhibitor and zidovudine or stavudine, with stable immunovirologic features, and having diagnosis of persisting hyperlipidemia, were randomized to replace current treatment with atazanavir/ritonavir plus abacavir/lamivudine (arm A) or tenofovir/emtricitabine (arm B), and were followed for 48 weeks. Eighty-nine patients were enrolled: 42 patients were randomized to arm A, and 47 to arm B. At the end of the 48-week follow-up, incidence of virologic failure was comparable in both arms, and associated with a poor drug compliance. Increase in CD4 lymphocyte count was significantly higher in arm A after a 24-week study period (62.5 versus 39.2 x 10(6) cells/L; p < 0.05), while immunologic responses were comparable at the end of 48-week follow-up (91.5 versus 83.6; p > 0.05). A statistically significant reduction (-15.4%) in mean triglyceridaemia versus respective baseline values was reported in both groups (p < 0.05), without statistically significant difference between arm A and B. Similar results were reported for total cholesterol and low-density lipoprotein (LDL) cholesterol levels. Safety and tolerability profiles were comparable in both groups. Switching from a protease inhibitor- and thymidine analogue-based antiretroviral regimen to atazanavir/ritonavir plus abacavir/lamivudine or tenofovir/emtricitabine proved effective in the management of hyperlipidemia, without significant differences in lipid-lowering effect, virologic efficacy, and safety profile between these regimens

Osteoblastic flare assessed by serum alkaline phosphatase activity is an index of short duration of response in prostate cancer patients with bone metastases submitted to systemic therapy.Gruppo Onco Urologico Piemontese (G.O.U.P).

A transient rise in serum alkaline phosphatase (ALP) activity (ALP flare) after androgen deprivation in prostate cancer patients with bone metastases has been previously correlated with both response to therapy and poor prognosis. In the present study we analyzed data coming from an Italian multicenter phase III, trial aimed to compare the efficacy of treatment with goserelin alone with that of goserelin plus mitomycin C. Sixty-seven bone metastatic patients were enrolled: 32 were treated with goserelin and 35 with and goserelin plus mitomycin. 58 cases had ALP measured every month; and were considered for flare assessment. Remarkably elevated ALP and PSA levels at baseline were significantly correlated with poor prognosis. The addition of mitomycin to goserelin resulted in a greater percent reduction of PSA values with respect to goserelin alone but did not augment the time to progression and overall survival. The monthly profile of ALP serum levels was superimposable in patients assigned to hormone therapy or chemotherapy plus hormone therapy. Patients showing a flare in ALP activity (transient rise > 15% in ALP values with respect to baseline at the first month) were classified as responders to therapy or as having stable disease upon PSA evaluation and/or at bone pain assessment, but had a shorter time to progression (median 12 months) in comparison to those showing a different ALP pattern (median 23 months). The measurement of flare in ALP activity during androgen suppression with or without concomitant mitomycin administration, may permit the early identification of patients who are likely to progress rapidly, and hence be candidate for more aggressive treatments

Patogenicidade cruzada de Ceratobasidium spp. do caquizeiro (Diospyros kaki) e do chá(Camellia sinensis) e reação de cultivares de caqui ao patógeno Cross pathogenicity of Ceratobasidium spp. from kaki (Diospyros kaki) and tea (Camellia sinensis) and reaction of kaki varieties to the pathogen

O fungo Ceratobasidium spp. é o agente causal da doença mal-do-fio ou queima-do-fio em várias plantas frutíferas, em cafeeiro e em chá. Esta doença ocorre com maior freqüência em zonas de alta precipitação e temperaturas elevadas, típicas de regiões de florestas tropicais como a Amazônica e a Mata Atlântica. Em São Paulo, o primeiro relato do mal-do-fio em caquizeiro ocorreu na região de Mogi das Cruzes. O objetivo deste estudo foi testar a patogenicidade cruzada de isolados de Ceratobasidium spp. de caquizeiro e chá para ambas as culturas e também para o cafeeiro e citros. Avaliou-se, também, a reação de oito cultivares de caquizeiro, sob condições controladas, a isolados de Ceratobasidium spp. obtidos da mesma cultura. Constatou-se que os isolados de caquizeiro e de chá, embora filogeneticamente distintos, foram patogênicos para ambas as culturas, além de afetarem cafeeiro e citros. Não foram verificados indícios de reação de resistência aos isolados de Ceratobasidium spp. para as oito cultivares de caquizeiro testadas.<br>The fungus Ceratobasidium spp. causes the white-thread blight disease, which affects several fruit trees, coffee and tea crops. This disease frequently occurs in zones of high precipitation and temperatures, typical of the tropical forest regions such as the Amazon and the Atlantic Forests. In São Paulo State, Brazil, this disease was reported by the first time affecting kaki plants in Mogi das Cruzes county. The objective of this study was to test the cross-pathogenicity of Ceratobasidium spp. isolates from kaki and tea to both host plants and also to coffee and citrus. This study also aimed to determine the reaction of local kaki varieties to Ceratobasidium spp. isolates from kaki under controlled conditions. Although phylogenetically distinct, kaki- and tea-infecting isolates were cross-pathogenic to both hosts, besides infecting coffee and citrus. There was no indication of resistance reaction among the eight kaki varieties tested