Late emergence of A594V and L595W mutations related to ganciclovir resistance in a patient with HCMV retinitis and long-term HIV progression

The emergence of ganciclovir (GCV) resistance during the treatment of human cytomegalovirus (HCMV) infection is a serious clinical challenge, and is associated with high morbidity and mortality. In this case report, we describe the emergence of two consecutive mutations (A594V and L595W) related to GCV resistance in a patient with HCMV retinitis and long-term HIV progression after approximately 240 days of GCV use. Following the diagnosis of retinitis, the introduction of GCV did not result in viral load reduction. The detected mutations appeared late in the treatment, and we propose that other factors (high initial HCMV load, previous GCV exposure, low CD4+ cell count), in addition to the presence of resistance mutations, may have contributed to the treatment failure of HCMV infection in this patient.

Antioxidants in yacon products and effect of long term storage

Yacon (Smallanthus sonchifolius (Poepp. and Endl.) H. Robinson) is a storage root originally grown in the Andean highlands. The fresh roots are perishable and quickly turn brown during handling and processing. Aiming to prolong shelf-life and to preserve the antioxidant compounds in yacon roots, 3 mm thick yacon slices were dried in a drying cabinet at 40, 50, and 60 ºC to a moisture content of 10-14%, and yacon strips were sun dried to a moisture content of 15-20%. The total phenolic content was measured by the Folin-Ciocalteu method, and the quenching capacity was evaluated by measuring the amount of DPPH (1,1-diphenyl-2-pidrylhydrazyl) inhibited in samples after drying and after 7 months of storage. The results showed that it is possible to preserve the antioxidant capacity in yacon after cabinet or sun drying. Both yacon chips and strips presented total phenolic content values similar to those of fresh yacon roots. Both products also showed a high inhibition capacity of DPPH (1,1-diphenyl-2-pidrylhydrazyl). A significant decrease in the phenolic content was observed in the yacon chips after storage, which indicates that the sun dried strips are more suitable for storage.

The long-term use of enalapril and hydrochlorothiazide in two novel mutations patients with Dent's disease type 1

Dent's disease type 1 is an X-linked tubular disease caused by mutations in the renal chloride channel CLCN-5, and it is characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis, and renal failure. Several cases have been described in which the only presenting symptoms were asymptomatic proteinuria, and focal segmental or global glomerulosclerosis. The renal failure in these patients may be caused by hypercalciuria and persistent proteinuria. Therefore, angiotensin converse enzyme inhibitor and thiazides could be useful. Our aim is to report the effects of these drugs in two novel mutations patients with Dent's disease type 1. In this report, no significant correlations between dosage of hydrochlorothiazide and calciuria and no significant correlations between proteinuria and dosage of enalapril were detected. This is important since these are polyuric patients and these drugs could be dangerous to their renal function.

The long-term outcome after acute kidney injury: a narrative review

This review will focus on long-term outcomes after acute kidney injury (AKI). Surviving AKI patients have a higher late mortality compared with those admitted without AKI. Recent studies have claimed that long-term mortality in patients after AKI varied from 15% to 74% and older age, presence of previous co-morbidities, and the incomplete recovery of renal function have been identified as risk factors for reduced survival. AKI is also associated with progression to chronic kidney (CKD) disease and the decline of renal function at hospital discharge and the number and severity of AKI episodes have been associated with progression to CKD. IN the most studies, recovery of renal function is defined as non-dependence on renal replacement therapy which is probably too simplistic and it is expected in 60-70% of survivors by 90 days. Further studies are needed to explore the long-term prognosis of AKI patients.

Uma contribuição ao debate em torno da eficácia da política monetária e algumas implicações para o caso do Brasil

A contribution to the debate on the efficacy of monetary policy and some implications in the case of Brazil. The main opposition between Keynesian and Classic monetary theories is defined by the former's proposition of money non-neutrality in the long period. According to Keynes, it is not possible to describe a monetary economy's long period position without first specifying the monetary policy it is adopting. The policy is described by the choice of the short-term interest rate which exerts an important determining influence on the long term rate and, therefore, on real investment decisions. Based on this reasoning, inflation target monetary policy regimes are criticized, in particular the one adopted in post-1999 balance of payments crisis Brazil because of its deleterious impact on investment and growth.

Resuming growth in Latin America: short and long term policies

The authors of this paper assert that the paralysis of the state generated by the crises of the 1970s and 1980s deprived the economies of the region of an important lever to resume and sustain growth. They thus maintain that to overcome stagnation it will be necessary to reconstruct the state's capacity to implement pro-growth policies. Following Keynes and Kalecki's ideas, but also classical development economists, the authors argue, first, that short-term macroeconomic policies, to reduce unemployment and to increase the degree of capacity utilization, should be used to promote the generation of profits to firms and to wake up entrepreneurs' animal spirits. Short-term expansionary policies should be coupled with measures to improve competitiveness and avoid balance of payments problems. They also claim that alternatives to the liberal programme will fail unless a pro-growth strategy is adopted which includes both short- and long-term policies. They thus propose that long-term policies must complete the package, signaling: a) sustained increases of effective demand in the future; and b) investment priorities to ensure that capacities will be created in strategic sectors and branches of the economy.