Association of fenofibrate therapy with long-term cardiovascular risk in statin-treated patients with type 2 diabetes

IMPORTANCE: Patients with type 2 diabetes are at high risk of cardiovascular disease (CVD) in part owing to hypertriglyceridemia and low high-density lipoprotein cholesterol. It is unknown whether adding triglyceride-lowering treatment to statin reduces this risk. OBJECTIVE: To determine whether fenofibrate reduces CVD risk in statin-treated patients with type 2 diabetes. DESIGN, SETTING, AND PARTICIPANTS: Posttrial follow-up of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Lipid Study between July 2009 and October 2014; 5 years of follow-up were completed for a total of 9.7 years at general community and academic outpatient research clinics in the United States and Canada. Of the original 5518 ACCORD Lipid Trial participants, 4644 surviving participants were selected based on the presence of type 2 diabetes and either prevalent CVD or CVD risk factors and high-density lipoprotein levels less than 50 mg/dL (<55 mg/dL for women and African American individuals). INTERVENTIONS: Passive follow-up of study participants previously treated with fenofibrate or masked placebo. MAIN OUTCOMES AND MEASURES: Occurrence of cardiovascular outcomes including primary composite outcome of fatal and nonfatal myocardial infarction and stroke in all participants and in prespecified subgroups. RESULTS: The 4644 follow-on study participants were broadly representative of the original ACCORD study population and included significant numbers of women (n = 1445; 31%), nonwhite individuals (n = 1094; 21%), and those with preexisting cardiovascular events (n = 1620; 35%). Only 4.3% of study participants continued treatment with fenofibrate following completion of ACCORD. High-density lipoprotein and triglyceride values rapidly equalized among participants originally randomized to fenofibrate or placebo. Over a median total postrandomization follow-up of 9.7 years, the hazard ratio (HR) for the primary study outcome among participants originally randomized to fenofibrate vs placebo (HR, 0.93; 95% CI, 0.83-1.05; P = .25) was comparable with that originally observed in ACCORD (HR, 0.92; 95% CI, 0.79-1,08; P = .32). Despite these overall neutral results, we continued to find evidence that fenofibrate therapy effectively reduced CVD in study participants with dyslipidemia, defined as triglyceride levels greater than 204 mg/dL and high-density lipoprotein cholesterol levels less than 34 mg/dL (HR, 0.73; 95% CI, 0.56-0.95). CONCLUSIONS AND RELEVANCE: Extended follow-up of ACCORD-lipid trial participants confirms the original neutral effect of fenofibrate in the overall study cohort. The continued observation of heterogeneity of treatment response by baseline lipids suggests that fenofibrate therapy may reduce CVD in patients with diabetes with hypertriglyceridemia and low high-density lipoprotein cholesterol. A definitive trial of fibrate therapy in this patient population is needed to confirm these findings. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00000620

Piometra em uma leoa (Panthera leo): relato de caso

A piometra é uma infecção aguda ou crônica do útero que ocorre frequentemente em cadelas não castradas, podendo também ocorrer em gatas domésticas e selvagens, sendo poucos os estudos relacionados à piometra em grandes felídeos. O objetivo deste relato foi descrever um caso de piometra em uma leoa (Panthera leo) de cativeiro, as lesões de necropsia e histológicas, bem como os resultados da análise microbiológica. Uma leoa com aproximadamente 23 anos, pertencente a um criadouro conservacionista de Santa Maria-RS, foi encontrada morta pela manhã em seu recinto. Após coleta de dados, procedeu-se à necropsia e à coleta de material para análise histopatológica e bacteriológica. A análise microbiológica revelou predomínio das bactérias Streptococcus sp. e Escherichia coli no conteúdo purulento do útero, caracterizando como piometra, e a bactéria predominante em plasma, fígado e medula óssea foi E. coli. De acordo com o laudo histopatológico, as alterações observadas nessa leoa sugerem um quadro de septicemia grave, sendo a origem do foco infeccioso bacteriano, provavelmente, a piometra. Considera-se importante chamar a atenção dos médicos veterinários de animais selvagens para um diagnóstico precoce dessa doença, que é comum em cadelas, mas que pode acometer também felídeos selvagens e levá-los à morte

Variants of the recently discovered avian gyrovirus 2 are detected in Southern Brazil and The Netherlands

A genome of a virus preliminarily named avian gyrovirus 2 (AGV2), a close relative to chicken anemia virus, was recently discovered in a chicken in the state of Rio Grande do Sul, Southern Brazil. To study the occurrence of AGV2 in Rio Grande do Sul and the neighboring state Santa Catarina, a number of adult chickens (n = 108 and n = 48, respectively) were tested for the presence of AGV2 DNA. An AGV2-specific PCR was developed, optimized and used to analyze DNA extracted from clinical samples. AGV2 DNA was detected in 98/108 (90.7%) of samples collected in the state of Rio Grande do Sul and 29/48 (60.4%) of the samples collected in the state of Santa Catarina. In order to check whether AGV2 DNA would be detected in samples from a geographically distant region, DNA from brain samples of 21 diseased chickens from the Netherlands were tested independently, by the same method. In such specimens, 9/21 (42.9%) brain tissue samples were found to contain AVG2 DNA. Sequence analysis of some of the PCR products demonstrated that the amplified AGV2 sequences could vary up to 15.8% and could preliminarily be divided in three groups. This indicated the occurrence of variants of AGV2, which may reflect differences in geographical origin and/or in biological properties. The data presented here provides evidence that AGV2 seems fairly distributed in chickens in Southern Brazil and that AGV2 also circulates in the Netherlands. Besides, circulating viruses display genetic variants whose significance should be further examined, particularly to determine whether AGV2 would play any role in chicken diseases

Sementes de Cássia tora L: estudo da germinação visando o controle em áreas cultivadas

O trabalho é um estudo das condições de germinação das sementes de Cassia tora L., planta invasora das culturas em geral e, principalmente, da cultura da soja. Nesta pesquisa, estudou se a quebra da dormência, o efeito da profundidade de semeadura sobre a emergência de plântulas e o potencial de armazenamento, considerando o envelhecimento natural e precoce com o objetivo de um controle mais racional desta espécie. As profundidades de semeadura de 4 a 6 cm apresentaram as porcentagens mais altas de emergência das plântulas. A porcentagem de germinação de sementes, logo após a colheita, encontra-se próxima de 42%, decrescendo para 40%, 39% e 30%, aproximadamente, nos períodos de armazenamento por 90, 180 e 270 dias, respectivamente, evidenciando uma porcentagem média de germinação próxima de 38% nos períodos considerados. O processo de escarificação mecânica mostrou-se o mais eficiente para quebra da dormência das sementes<br>The objective of the present research was to study the germination of Cassia tora L. seeds, which is known to be a weed mainly at soybean plantations and other general crops. This work should verify the effect of planting seeds on different depths on seedling emergence, the potential of seed storage related to natural and accelerated aging and the dormancy breaking process, in order to obtain a more rational control of this species. Seeds which were planted 4 and 6 cm deep gave best seedling emergence percentagens. After harvest the percentage seed germination of which about 42%, decreased to 40%, 39% and 30% on storage periods of 90, 180 and 270 days respectively, showing an average of 38% of germination. The best treatment dormancy breaking of there seeds was found to be mechanical scarificatio

DIFERENCIAÇÃO ENTRE OS VÍRUS DA RINOTRAQUEÍTE INFECCIOSA BOVINA (BHV-1) E HERPESVÍRUS DA ENCEFALITE BOVINA (BHV-5) COM ANTICORPOS MONOCLONAIS Monoclonal antibody differentiation between bovine herpesviruses type 1 and 5

Amostras de herpesvírus bovinos (BHV) tipo 1 (Virus da Rinotraqueíte Infecciosa Bovina/Vulvovaginite Pustular Infecciosa; BHV-1) e tipo 5 (Herpesvírus da Encefalite Bovina; BHV-5) tiveram seu perfil de reatividade analisado em testes de imunoperoxidase frente a um painel composto por cinco anticorpos monoclonais (AcM) produzidos contra antígenos de BHV-1. Um dos AcM reconheceu todas as amostras de BHV examinadas. Os quatro AcM restantes reconheceram somente amostras de BHV-1. Todas as amostras isoladas de casos de encefalites (BHV-5) apresentaram um padrão de reação distinto daquelas isoladas de outros síndromes associados à infecção pelo BHV-1. Os resultados obtidos indicam que os AcM avaliados permitem a diferenciação entre amostras de BHV-1 e BHV-5, havendo perfeita correlação entre os quadros clínicos observados com os perfis de reatividade obtidos in vitro.<br>Bovine Herpesviruses (BHV) type 1 (BHV-1) and type 5 (BHV-5) were analysed by immunoperoxidase staining with a panel of monoclonal antibodies (Mabs) prepared against BHV antigens. One of the Mabs recognized all BHV isolates tested. The remainder four mabs recognized only BHV-1 samples, including standard laboratory strains. All isolates associated with clinical cases of encephalitis (BHV-5) displayed a pattern of reactivity distinct from that of viruses isolated from syndromes associated with BHV-1 infections. The results obtained indicate that such Mabs allowed the differentiation between BHV-1 and BHV-5, with a perfect correlation between the clinical pictures and the patterns of reactivity in vitro