Evaluation of Primary Resistance to HIV Entry Inhibitors Among Brazilian Patients Failing Reverse Transcriptase/Protease Inhibitors Treatment Reveal High Prevalence of Maraviroc Resistance-Related Mutations

Entry inhibitor is a new class of drugs that target the viral envelope protein. This region is variable; hence resistance to these drugs may be present before treatment. The aim of this study was to analyze the frequency of patients failing treatment with transcriptase reverse and protease inhibitors that would respond to the entry inhibitors Enfuvirtide, Maraviroc, and BMS-806. The study included 100 HIV-1 positive patients from one outpatient clinic in the city of Sao Paulo, for whom a genotype test was requested due to treatment failure. Proviral DNA was amplified and sequenced for regions of gp120 and gp41. A total of 80 could be sequenced and from those, 73 (91.3%), 5 (6.3%) and 2 (2.5%) were classified as subtype B, F, and recombinants (B/F and B/C), respectively. CXCR4 co-receptor use was predicted in 30% of the strains. Primary resistance to Enfuvirtide was found in 1.3%, following the AIDS Society consensus list, and 10% would be considered resistant if a broader criterion was used. Resistance to BMS-806 was higher; 6 (7.5%), and was associated to non-B strains. Strikingly, 27.5% of samples harbored one or more mutation among A316T, I323V, and S405A, which have been related to decreased susceptibility of Maraviroc; 15% of them among viruses predictive to be R5. A more common mutation was A316T, which was associated to the Brazilian B strain harboring the GWGR motif at the tip of V3 loop and their derivative sequences. These results may be impact guidelines for genotype testing and treatment in Brazil.

Effects of high-dose creatine supplementation on kidney and liver responses in sedentary and exercised rats

This study evaluated the effects of high-dose of short-term creatine supplementation (5g.kg(-1). day(-1) to 1 week) and long-term creatine supplementation (1g.kg(-1). day(-1) to 4-8 weeks) on kidney and liver structure and function of sedentary and exercised Wistar rats ( Exercise sessions consisted of swimming at 80% of maximal work load supported during 5 days per week with daily sessions of 60 minutes throughout the duration of the supplementation). Seventy-two animals ( 245 +/- 5g) were divided into four groups (n = 18): control diet Sedentary ( SED), Creatine diet Sedentary (CRE), control diet Exercised (EXE), and Creatine diet Exercised (EXECRE). Histological and blood biochemical studies were performed after one, four, and eight weeks of creatine supplementation and exercise ( n = 6). No differences were found when comparing SED, EXE and EXECRE groups for kidney and liver structure and function at one, four and eight weeks. However, the CRE group showed higher levels of creatinine (1.1 +/- 0.2 vs. 0.4 +/- 0.1 mg.dl(-1); p < 0.05), and urea ( 37 +/- 3 vs. 19 +/- 1 mg. dl(-1); p < 0.05) when compared with all others groups at four and eight weeks. At eight weeks, the CRE group presented increased levels of ALT (41 +/- 7 vs. 23 +/- 7 U.L(-1); p < 0.05), AST (89 +/- 6 vs. 62 +/- 5 U. L(-1); p < 0.05), GGT (8.0 +/- 0.9 vs. 3.9 +/- 1.0 U. L(-1); p < 0.05), and AP (125 +/- 10 vs. 69 +/- 9 U. L(-1); p < 0.05) also when compared with all others groups. Moreover, the CRE group demonstrated some structural alterations indicating renal and hepatic damage at four and eight weeks, respectively. These results suggest that long-term creatine supplementation (up to 4-8 weeks) may adversely affect kidney and liver structure and function of sedentary but not of exercised rats.

High-Dose Antipsychotic Medication; A Practical Pocket Checklist

There is evidence that a significant number of patients with schizophrenia and other chronic psychotic psychosis are prescribed high-dose antipsychotic drugs despite the fact that clinical guidelines recommend the routine use of a single antipsychotic drug in a standard dose. The prescriptions for high-dose and combined antipsychotic drugs are relatively common in clinical practice. This occurs despite the fact that results of published trials of high-dose antipsychotic drug treatment for schizophrenia provide little evidence to support effectiveness of using high-dose antipsychotic treatment and most importantly such strategy is not recommended. Moreover, there is mounting evidence of higher incidence of side effects and mortality associated with high dose antipsychotic treatment. Therefore we are presenting a practical pocket checklist which is aimed at minimizing predicted and unpredicted side effects during such treatments.

Detection of Human Bocavirus mRNA in Respiratory Secretions Correlates with High Viral Load and Concurrent Diarrhea

Human bocavirus (HBoV) is a parvovirus recently identified in association with acute respiratory infections (ARI). Despite its worldwide occurrence, little is known on the pathogenesis of HBoV infections. In addition, few systematic studies of HBoV in ARI have been conducted in Latin America. Therefore, in order to test whether active viral replication of human bocavirus is associated with respiratory diseases and to understand the clinical impact of this virus in patients with these diseases, we performed a 3-year retrospective hospital-based study of HBoV in outpatients and inpatients with symptoms of Acute Respiratory Infections (ARI) in Brazil. Nasopharyngeal aspirates (NPAs) from 1015 patients with respiratory symptoms were tested for HBoV DNA by PCR. All samples positive for HBoV were tested by PCR for all other respiratory viruses, had HBoV viral loads determined by quantitative real time PCR and, when possible, were tested by RT-PCR for HBoV VP1 mRNA, as evidence of active viral replication. HBoV was detected in 4.8% of patients, with annual rates of 10.0%, 3.0% and 3.0% in 2005, 2006 and 2007, respectively. The range of respiratory symptoms was similar between HBoV-positive and HBoV-negative ARI patients. However, a higher rate of diarrhea was observed in HBoV-positive patients. High HBoV viral loads (> 10(8) copies/mL) and diarrhea were significantly more frequent in patients with exclusive infection by HBoV and in patients with detection of HBoV VP1 mRNA than in patients with viral co-infection, detected in 72.9% of patients with HBoV. In summary, our data demonstrated that active HBoV replication was detected in a small percentage of patients with ARI and was correlated with concurrent diarrhea and lack of other viral co-infections.

High-Intensity Laser and Photodynamic Therapy as a Treatment for Recurrent Herpes Labialis

Objective: The aim of this study was to report the treatment of recurrent herpes labialis (RHL) using a high-intensity laser or methylene blue (MB)-mediated photodynamic therapy (PDT) in combination with low-level laser therapy (LLLT). Materials and Methods: Four clinical cases of patients diagnosed with RHL are described in this report. Two patients were subjected to high-intensity laser therapy (HILT) followed by LLLT, and two patients received MB-mediated PDT, again followed by LLLT. LLLT was conducted at 24, 48, 72 h, and 7 d after HILT or PDT. Patients were followed up after 6 mo. Results: Throughout the follow-up period, all patients reported pain relief and did not show any signs or symptoms of RHL. A favorable healing process was observed in all cases. None of the patients reported pain as a consequence of the treatment. Conclusion: These results suggest that HILT and MB-mediated PDT, in combination with LLLT, may constitute a benefit when treating vesicles in RHL.

Venous Lake of the Lips Treated Using Photocoagulation with High-Intensity Diode Laser

Objective: To evaluate the effectiveness of photocoagulation with high-intensity diode laser in the treatment of venous lake (VL) lesions. Background Data: VL is a common vascular lesion characterized by elevated, usually dome-shaped papules, ranging in color from dark blue to dark purple, seen more frequently in elderly patients. They often occur as single lesions on the ears, face, lips, or neck. Once formed, lesions persist throughout life. Although these lesions are usually asymptomatic, they can bleed if injured. Methods: Seventeen patients (7 men and 10 women) with VL on the lip were treated using a noncontact diode laser (wavelength 808 nm, power output 2-3 W in continuous wave). Results: After only one irradiation exposure, all lesions were successfully treated. Healing was completed in approximately 2 to 3 weeks, and none of the patients experienced complications. Postoperative discomfort and scarring were not present or were minimal. Conclusion: Photocoagulation with high-intensity diode laser is an effective, bloodless procedure for the treatment of VL.

Low- and High-Intensity Lasers in the Treatment of Herpes Simplex Virus 1 Infection

Herpes simplex virus (HSV) is one of the most common viral infections of the human being. Although most of the seropositive persons do not manifest symptoms, infected individuals may present recurrent infections, characterized by cold sores. HSV-1 infection can result in potentially harmful complications in some patients, especially in those with compromised immunity. We report a clinical case of a patient with severe oral HSV-1 infection in the lower lip. The treatment of the lesions with the association of high-intensity (erbium-doped yttrium aluminum garnet, 2.94 mu m, 80 mJ/pulse, 2-4 Hz) and low-intensity (indium gallium aluminum phosphide, 660 nm, 3.8 J/cm(2), 10mW) lasers has not been reported in the literature. During treatment, no systemic or topical medication was used. Pain sensitivity was completely gone after the first irradiation with the low-intensity laser. During the healing process, lesions were traumatized twice, on the days 4 and 7. Even though the lesions were completely healed within 10 days.

Leucine supplementation improves adiponectin and total cholesterol concentrations despite the lack of changes in adiposity or glucose homeostasis in rats previously exposed to a high-fat diet

Background: Studies suggest that leucine supplementation (LS) has a therapeutic potential to prevent obesity and to promote glucose homeostasis. Furthermore, regular physical exercise is a widely accepted strategy for body weight maintenance and also for the prevention of obesity. The aim of this study was to determine the effect of chronic LS alone or combined with endurance training (ET) as potential approaches for reversing the insulin resistance and obesity induced by a high-fat diet (HFD) in rats. Methods: Forty-seven rats were randomly divided into two groups. Animals were fed a control diet-low fat (n = 10) or HFD (n = 37). After 15 weeks on HFD, all rats received the control diet-low fat and were randomly divided according to treatment: reference (REF), LS, ET, and LS+ET (n = 7-8 rats per group). After 6 weeks of treatment, the animals were sacrificed and body composition, fat cell volume, and serum concentrations of total cholesterol, HDL-cholesterol, triacylglycerol, glucose, adiponectin, leptin and tumor necrosis factor-alpha (TNF-alpha) were analyzed. Results: At the end of the sixth week of treatment, there was no significant difference in body weight between the REF, LS, ET and LS+ET groups. However, ET increased lean body mass in rats (P = 0.019). In addition, ET was more effective than LS in reducing adiposity (P = 0.019), serum insulin (P = 0.022) and TNF-alpha (P = 0.044). Conversely, LS increased serum adiponectin (P = 0.021) levels and reduced serum total cholesterol concentration (P = 0.042). Conclusions: The results showed that LS had no beneficial effects on insulin sensitivity or adiposity in previously obese rats. On the other hand, LS was effective in increasing adiponectin levels and in reducing total cholesterol concentration.

CAN OLD GALAXIES AT HIGH REDSHIFTS AND BARYON ACOUSTIC OSCILLATIONS CONSTRAIN H(0)?

A new age-redshift test is proposed in order to constrain H(0) on the basis of the existence of old high-redshift galaxies (OHRGs). In the flat Lambda cold dark matter model, the value of H(0) is heavily dependent on the mass density parameter Omega(M) = 1- Omega(Lambda). Such a degeneracy can be broken through a joint analysis involving the OHRG and baryon acoustic oscillation signature. By assuming a galaxy incubation time, t(inc) = 0.8 +/- 0.4 Gyr, our joint analysis yields a value of H(0) = 71 +/- 4 km s(-1) Mpc(-1) (1 sigma) with the best-fit density parameter Omega(M) = 0.27 +/- 0.03. Such results are in good agreement with independent studies from the Hubble Space Telescope key project and recent estimates of the Wilkinson Microwave Anisotropy Probe, thereby suggesting that the combination of these two independent phenomena provides an interesting method to constrain the Hubble constant.

MULTILINE DOPPLER IMAGING OF MR SER IN HIGH STATE

Doppler images in Balmer, He I, He II and C II lines, and simultaneous I-band photometry of the polar MR Ser are presented and analyzed. The Balmer and Helium Doppler tomograms, of this bright polar at high mass transfer state show the emission from the accretion flow and the heated surface of the companion star. As a result of a comparison between the Doppler tomograms, the ionization structure of the flow could be constrained. The highest ionization region was found in the vicinity of the magnetospheric radius. Photoionization modeling of the accretion column indicates that the Balmer and Helium emission line production in this system can be explained only by the central soft X-ray illumination. The orbital ephemeris of MR Ser has been revised.

High spatial resolution spectroscopy of W51IRS 2E and IRS 2W: Two very massive young stars in early formation stages

We present K-band spectra of the near infrared counterparts to IRS 2E and IRS 2W which is associated with the ultracompact H II region W51d, both of them embedded sources in the Galactic compact H II region W51 IRS 2. The high spatial resolution observations were obtained with the laser guide star facility and Near-infrared Integral Field Spectrograph (NIFS) mounted at the Gemini-North observatory. The spectrum of the ionizing source of W51d shows the photospheric features N III ( 21155 angstrom) in emission and He II ( 21897 angstrom) in absorption which lead us to classify it as a young O3 type star. We detected CO overtone in emission at 23000 angstrom in the spectrum of IRS 2E, suggesting that it is a massive young object still surrounded by an accretion disk, probably transitioning from the hot core phase to an ultracompact H II region.

Detection of high-velocity material from the wind-wind collision zone of Eta Carinae across the 2009.0 periastron passage

We report near-infrared spectroscopic observations of the Eta Carinae massive binary system during 2008-2009 using the CRIRES spectrograph mounted on the 8m UT 1 Very Large Telescope (VLT Antu). We detect a strong, broad absorption wing in He I lambda 10833 extending up to -1900 km s(-1) across the 2009.0 spectroscopic event. Analysis of archival Hubble Space Telescope/Space Telescope Imaging Spectrograph ultraviolet and optical data identifies a similar high-velocity absorption (up to -2100 km s(-1)) in the ultraviolet resonance lines of Si IV lambda lambda 1394, 1403 across the 2003.5 event. Ultraviolet resonance lines from low-ionization species, such as Si II lambda lambda 1527, 1533 and CII lambda lambda 1334, 1335, show absorption only up to -1200 km s(-1), indicating that the absorption with velocities -1200 to -2100 km s(-1) originates in a region markedly more rapidly moving and more ionized than the nominal wind of the primary star. Seeing-limited observations obtained at the 1.6m OPD/LNA telescope during the last four spectroscopic cycles of Eta Carinae (1989-2009) also show high-velocity absorption in He I lambda 10833 during periastron. Based on the large OPD/LNA dataset, we determine that material with velocities more negative than -900 km s(-1) is present in the phase range 0.976 <= phi <= 1.023 of the spectroscopic cycle, but absent in spectra taken at phi <= 0.947 and phi >= 1.049. Therefore, we constrain the duration of the high-velocity absorption to be 95 to 206 days (or 0.047 to 0.102 in phase). We propose that the high-velocity absorption component originates in shocked gas in the wind-wind collision zone, at distances of 15 to 45 AU in the line-of-sight to the primary star. With the aid of three-dimensional hydrodynamical simulations of the wind-wind collision zone, we find that the dense high-velocity gas is along the line-of-sight to the primary star only if the binary system is oriented in the sky such that the companion is behind the primary star during periastron, corresponding to a longitude of periastron of omega similar to 240 degrees-270 degrees. We study a possible tilt of the orbital plane relative to the Homunculus equatorial plane and conclude that our data are broadly consistent with orbital inclinations in the range i = 40 degrees-60 degrees.

Chemical abundances of 11 bulge stars from high-resolution, near-IR spectra

Context. It is debated whether the Milky Way bulge has characteristics more similar to those of a classical bulge than those of a pseudobulge. Detailed abundance studies of bulge stars are important when investigating the origin, history, and classification of the bulge. These studies provide constraints on the star-formation history, initial mass function, and differences between stellar populations. Not many similar studies have been completed because of the large distance and high variable visual extinction along the line-of-sight towards the bulge. Therefore, near-IR investigations can provide superior results. Aims. To investigate the origin of the bulge and study its chemical abundances determined from near-IR spectra for bulge giants that have already been investigated with optical spectra. The optical spectra also provide the stellar parameters that are very important to the present study. In particular, the important CNO elements are determined more accurately in the near-IR. Oxygen and other alpha elements are important for investigating the star-formation history. The C and N abundances are important for determining the evolutionary stage of the giants and the origin of C in the bulge. Methods. High-resolution, near-infrared spectra in the H band were recorded using the CRIRES spectrometer mounted on the Very Large Telescope. The CNO abundances are determined from the numerous molecular lines in the wavelength range observed. Abundances of the alpha elements Si, S, and Ti are also determined from the near-IR spectra. Results. The abundance ratios [O/Fe], [Si/Fe], and [S/Fe] are enhanced to metallicities of at least [Fe/H] = -0.3, after which they decline. This suggests that the Milky Way bulge experienced a rapid and early burst of star formation similar to that of a classical bulge. However, a similarity between the bulge trend and the trend of the local thick disk seems to be present. This similarity suggests that the bulge could have had a pseudobulge origin. The C and N abundances suggest that our giants are first-ascent red-giants or clump stars, and that the measured oxygen abundances are those with which the stars were born. Our [C/Fe] trend does not show any increase with [Fe/H], which is expected if W-R stars contributed substantially to the C abundances. No ""cosmic scatter"" can be traced around our observed abundance trends: the measured scatter is expected, given the observational uncertainties.

BONA FIDE, STRONG-VARIABLE GALACTIC LUMINOUS BLUE VARIABLE STARS ARE FAST ROTATORS: DETECTION OF A HIGH ROTATIONAL VELOCITY IN HR CARINAE

We report optical observations of the luminous blue variable (LBV) HR Carinae which show that the star has reached a visual minimum phase in 2009. More importantly, we detected absorptions due to Si lambda lambda 4088-4116. To match their observed line profiles from 2009 May, a high rotational velocity of nu(rot) similar or equal to 150 +/- 20 km s(-1) is needed (assuming an inclination angle of 30 degrees), implying that HR Car rotates at similar or equal to 0.88 +/- 0.2 of its critical velocity for breakup (nu(crit)). Our results suggest that fast rotation is typical in all strong-variable, bona fide galactic LBVs, which present S-Dor-type variability. Strong-variable LBVs are located in a well-defined region of the HR diagram during visual minimum (the ""LBV minimum instability strip""). We suggest this region corresponds to where nu(crit) is reached. To the left of this strip, a forbidden zone with nu(rot)/nu(crit) > 1 is present, explaining why no LBVs are detected in this zone. Since dormant/ex LBVs like P Cygni and HD 168625 have low nu(rot), we propose that LBVs can be separated into two groups: fast-rotating, strong-variable stars showing S-Dor cycles (such as AG Car and HR Car) and slow-rotating stars with much less variability (such as P Cygni and HD 168625). We speculate that supernova (SN) progenitors which had S-Dor cycles before exploding (such as in SN 2001ig, SN 2003bg, and SN 2005gj) could have been fast rotators. We suggest that the potential difficulty of fast-rotating Galactic LBVs to lose angular momentum is additional evidence that such stars could explode during the LBV phase.

High Glucose-Mediated Oxidative Stress Impairs Cell Migration

Deficient wound healing in diabetic patients is very frequent, but the cellular and molecular causes are poorly defined. In this study, we evaluate the hypothesis that high glucose concentrations inhibit cell migration. Using CHO.K1 cells, NIH-3T3 fibroblasts, mouse embryonic fibroblasts and primary skin fibroblasts from control and diabetic rats cultured in 5 mM D-glucose (low glucose, LG), 25 mM D-glucose (high glucose, HG) or 25 mM L-glucose medium (osmotic control - OC), we analyzed the migration speed, protrusion stability, cell polarity, adhesion maturation and the activity of the small Rho GTPase Rac1. We also analyzed the effects of reactive oxygen species by incubating cells with the antioxidant N-Acetyl-Cysteine (NAC). We observed that HG conditions inhibited cell migration when compared to LG or OC. This inhibition resulted from impaired cell polarity, protrusion destabilization and inhibition of adhesion maturation. Conversely, Rac1 activity, which promotes protrusion and blocks adhesion maturation, was increased in HG conditions, thus providing a mechanistic basis for the HG phenotype. Most of the HG effects were partially or completely rescued by treatment with NAC. These findings demonstrate that HG impairs cell migration due to an increase in oxidative stress that causes polarity loss, deficient adhesion and protrusion. These alterations arise, in large part, from increased Rac1 activity and may contribute to the poor wound healing observed in diabetic patients.