Variability of voriconazole plasma levels measured by new high-performance liquid chromatography and bioassay methods, [and] Voriconazole therapeutic drug monitoring in patients with invasive mycoses improves efficacy and safety outcomes

Rapport de synthèse1. Partie de laboratoireCette première étude décrit le développement et la validation, selon les standards internationaux, de deux techniques de mesure des concentrations sanguines de voriconazole, un nouvel agent antifongique à large spectre: 1) la chromatographic en phase liquide à haute pression et 2) le bio-essai utilisant une souche mutante de Candida hypersensible au voriconazole. Ce travail a aussi permis de mettre en évidence une importante et imprévisible variabilité inter- et intra-individuelle des concentrations sanguines de voriconazole malgré l'utilisation des doses recommandées par le fabriquant. Ce travail a été publié dans un journal avec "peer-review": "Variability of voriconazole plasma levels measured by new high- performance liquid chromatography and bioassay methods" by A. Pascual, V. Nieth, T. Calandra, J. Bille, S. Bolay, L.A. Decosterd, T. Buclin, P.A. Majcherczyk, D. Sanglard, 0. Marchetti. Antimicrobial Agents Chemotherapy, 2007; 51:137-432. Partie CliniqueCette deuxième étude a évalué de façon prospective l'impact clinique des concentrations sanguines de voriconazole sur l'efficacité et sécurité thérapeutique chez des patients atteints d'infections fongiques. Des concentrations sanguines élevées étaient significativement associés à la survenue d'une toxicité neurologique (encéphalopathie avec confusion, hallucinations et myoclonies) et des concentrations sanguines basses à une réponse insuffisante au traitement antifongique (persistance ou progression des signes cliniques et radiologiques de l'infection). Dans la majorité des cas, un ajustement de la dose de voriconazole, sur la base des concentrations mesurées, a abouti à une récupération neurologique complète ou à une résolution de l'infection, respectivement. Ce travail a été publié dans un journal avec "peer-review": " Voriconazole Therapeutic Drug Monitoring in Patients with Invasive Mycoses Improves Efficacy and Safety Outcomes" by A. Pascual, T. Calandra, S. Bolay, T. Buclin, J. Bille, and O. Marchetti. Clinical Infectious Diseases, 2008 January 15; 46(2): 201-11.Ces deux études, financées de façon conjointe par un "grant" international de la Société suisse d'infectiologie et la Société internationale de maladies infectieuses et par la Fondation pour le progrès en microbiologie médicale et maladies infectieuses (FAMMID, Lausanne), ont été réalisées au sein du Service des Maladies Infectieuses, Département de Médecine, au CHUV, en étroite collaboration avec la Division de Pharmacologie Clinique, Département de Médecine, au CHUV et l'Institut de Microbiologie du CHUV et de l'Université de Lausanne.

Molecular and pathogenic variability of Drechslera isolates from oats

Severe epidemics of leaf blotch and black leaf spot of oat (Avena sativa) caused by Drechslera avenae and Drechslera sp., respectively, are frequently observed in the State of Paraná, Brazil. Although some morphological differences between the isolates causing two different symptoms were noticed, the genetic relationship between them was not clear. Twenty-four isolates of D. avenae and Drechslera sp, collected between 1996-98, were assessed for the genetic variability by molecular and pathogenic analyses. The amplification products using primer pair ITS4/ITS5 showed a fragment length of approximately 600 bp for all the isolates except for one black spot isolate, where the fragment length was approximately 550 bp. Restriction enzymes Hinf I and Taq I, that cut in the ITS region, produced similar restriction patterns for all the isolates, whereas four others produced variable restriction patterns. RAPD analysis also showed distinctive patterns for some isolates. No clear difference between the black spot and the leaf blotch isolates was observed either by the molecular or by the pathogenicity analysis. Nonetheless, the rDNA analysis suggests that Drechslera probably comprises at least three distinct taxa. The results indicate that the difference observed between the isolates originating from two types of symptoms is due to intra-specific variants of D. avenae.

Spatial variability of noise level in agricultural machines

The knowledge of the spatial variability of noise levels and the build of kriging maps can help the evaluation of the salubrity of environments occupied by agricultural workers. Therefore, the objective of this research was to characterize the spatial variability of the noise level generated by four agricultural machines, using geostatistics, and to verify if the values are within the limits of human comfort. The evaluated machines were: harvester, chainsaw, brushcutter and tractor. The data were collected at the height of the operator's ear and at different distances. Through the results, it was possible to verify that the use of geostatistics, by kriging technique, made it possible to define areas with different levels for the data collected. With exception of the harvester, all of machines presented noise levels above than 85 dB (A) near to the operator, demanding the use of hearing protection.

Intrapartum hypoxia and power spectral analysis of fetal heart rate variability

Reliable detection of intrapartum fetal acidosis is crucial for preventing morbidity. Hypoxia-related changes of fetal heart rate variability (FHRV) are controlled by the autonomic nervous system. Subtle changes in FHRV that cannot be identified by inspection can be detected and quantified by power spectral analysis. Sympathetic activity relates to low-frequency FHRV and parasympathetic activity to both low- and high-frequency FHRV. The aim was to study whether intra partum fetal acidosis can be detected by analyzing spectral powers of FHRV, and whether spectral powers associate with hypoxia-induced changes in the fetal electrocardiogram and with the pH of fetal blood samples taken intrapartum. The FHRV of 817 R-R interval recordings, collected as a part of European multicenter studies, were analyzed. Acidosis was defined as cord pH ≤ 7.05 or scalp pH ≤ 7.20, and metabolic acidosis as cord pH ≤ 7.05 and base deficit ≥ 12 mmol/l. Intrapartum hypoxia increased the spectral powers of FHRV. As fetal acidosis deepened, FHRV decreased: fetuses with significant birth acidosis had, after an initial increase, a drop in spectral powers near delivery, suggesting a breakdown of fetal compensation. Furthermore, a change in excess of 30% of the low-to-high frequency ratio of FHRV was associated with fetal metabolic acidosis. The results suggest that a decrease in the spectral powers of FHRV signals concern for fetal wellbeing. A single measure alone cannot be used to reveal fetal hypoxia since the spectral powers vary widely intra-individually. With technical developments, continuous assessment of intra-individual changes in spectral powers of FHRV might aid in the detection of fetal compromise due to hypoxia.

Genetic variability among Commelina weed species from the states of Paraná and São Paulo, Brazil

This work aims to carry out a comparative analysis using RAPD molecular markers in four Commelina weed species from the state of Paraná and C. benghalensis populations from the states of Paraná and São Paulo, Brazil. The genomic plant DNA sample was extracted from the leaves, separated, randomly fragmented and amplified by PCR. Random amplified polymorphic DNA fragments (RAPD markers) were analyzed by using POPGENE statistical program. Eighty-five primer sequences were tested but only three were suitable as molecular markers producing 37 DNA polymorphic fragments for comparisons among four Commelina species and 22 polymorphic fragments for comparisons among C. benghalensis populations. The results showed that there were inter-specific and intra-specific genetic variabilities among Commelina plant genera. Genetic diversity analysis between species indicated four mono-specific clusters and it was suggested to keep C. villosa as one species. Regarding the intra-specific genetic variability of C. benghalensis alone, three groups were verified, although there were 13 populations from two geographical areas. However, these clusters do not correspond to the distinct characteristics verified.

Variabilidade intra-específica em cinco populações de Oncidium varicosum Lindl. (Orchidaceae -- Oncidiinae) em Minas Gerais

Com o objetivo de estudar a variabilidade genética intra-específica em Oncidium varicosum Lindl. (Orchidaceae - Oncidiinae), foram avaliadas cinco populações de Minas Gerais, coletadas em Alfenas (AL), Estiva (ES), Pedra do Coração (PC), Pedra Branca (PB) e Pouso Alegre (PA). Foram considerados 22 caracteres florais, medidos a partir de "vouchers" (fichas florais), empregando-se métodos estatísticos univariados e multivariados (análise discriminante canônica - CDA e análise de agrupamento a partir de distância de Mahalanobis). Houve diferença significativa (p < 0,05) entre populações, pelo teste F, para 13 caracteres. O primeiro eixo canônico separou a população PA de PB e de PC. Os indivíduos de PA são menores que os de PC, que são menores que os de PB. AL se sobrepôs a PA, ES e PC pelo primeiro eixo, mas se separou completamente de PA e quase que totalmente das demais populações de acordo com o segundo eixo canônico, por apresentar características como colunas compridas e espessas, sépalas laterais compridas e estreitas e ovários mais curtos. De acordo com a análise de agrupamento, novamente a população AL divergiu das demais. Observou-se que as populações ES, PC e PB são mais próximas entre si, seguidas da população de PA. O padrão de variabilidade genética observado não parece estar relacionado a diferenças de latitude. Entretanto, parece estar associado a diferenças de longitude, embora este único fator pode não ser suficiente para explicá-lo.

Reproducibility of heart rate variability parameters measured in healthy subjects at rest and after a postural change maneuver

Heart rate variability (HRV) provides important information about cardiac autonomic modulation. Since it is a noninvasive and inexpensive method, HRV has been used to evaluate several parameters of cardiovascular health. However, the internal reproducibility of this method has been challenged in some studies. Our aim was to determine the intra-individual reproducibility of HRV parameters in short-term recordings obtained in supine and orthostatic positions. Electrocardiographic (ECG) recordings were obtained from 30 healthy subjects (20-49 years, 14 men) using a digital apparatus (sampling ratio = 250 Hz). ECG was recorded for 10 min in the supine position and for 10 min in the orthostatic position. The procedure was repeated 2-3 h later. Time and frequency domain analyses were performed. Frequency domain included low (LF, 0.04-0.15 Hz) and high frequency (HF, 0.15-0.4 Hz) bands. Power spectral analysis was performed by the autoregressive method and model order was set at 16. Intra-subject agreement was assessed by linear regression analysis, test of difference in variances and limits of agreement. Most HRV measures (pNN50, RMSSD, LF, HF, and LF/HF ratio) were reproducible independent of body position. Better correlation indexes (r > 0.6) were obtained in the orthostatic position. Bland-Altman plots revealed that most values were inside the agreement limits, indicating concordance between measures. Only SDNN and NNv in the supine position were not reproducible. Our results showed reproducibility of HRV parameters when recorded in the same individual with a short time between two exams. The increased sympathetic activity occurring in the orthostatic position probably facilitates reproducibility of the HRV indexes.

Genetic diversity and phenotypic variability of phytoplankton populations in the Baltic Sea

En av naturens mest grundläggande aspekter är den enorma mängd av variation som existerar mellan arter. Denna variation har lett oss till att klassificera olika organismer på basis av morfologiska skillnader och på senare tid till att jämföra genetiska skillnader på individens nivå. Den marina kiselalgen Skeletonema marinoi är en av de vanligaste växtplanktonarter i Östersjön under vårblomningen och anses viktig för den årliga produktionen. En av mina främsta målsättningar var att beskriva den intra-specifika diversiteten hos denna art längs med miljögradienter i Östersjön. Ett annat mål var att klargöra de faktorer som eventuellt är involverade i konfigurationen av genetisk diversitet och differentiering. Med hjälp av genetiska markörer visade jag att den genetiska diversiteten hos S. marinoi populationer i Östersjön är lägre jämfört med populationer i östra delen av Nordsjön. Arten är genetiskt uppdelad så att en utpräglad population förekommer i Östersjön och en annan, genetiskt åtskild population förekommer norr om de Danska sunden. Resultaten visar att de genetiskt åtskilda populationerna är anpassade till lokala salinitetsförhållanden. Genflödet mellan populationerna korrelerade kraftigt med havströmmar i området. Mina studier avslöjade även omfattande variation av fenotypiska, ekologiskt vikitga särdrag hos olika kloner. Djurplankton som äter kiselalger kunde modifiera den klonala mångfalden av fenotypiskt variabla S. marinoi populationer. En ökad klonal mångfald ledde till högre prestationsförmåga i fråga om primär produktion och stabiliserade ekofysiologiska funktioner. Som visas i denna avhandling består en art allt som oftast av åtskilliga genetiska varianter med fenotypiska skillnader. Kunskap om sådana intra-specifika skillnader är en förutsättning för att vi skall kunna förstå var och varför arter förekommer. Denna kunskap utgör även en grund för prognoser som siktar på att förutspå huruvida arter kan anpassa sig till framtida miljöförhållanden. ------------------------------------------------------ Suunnaton määrä variaatioita eliölajien välillä on perustavanlaatuinen ominaisuus luonnossa. Perinteisesti tätä monimuotoisuutta on käytetty organismien luokittelemiseen eri lajeihin niiden morfologisten eroavaisuuksien perusteella. Hiljattain myös geneettisten erojen huomioimista yksilötasolla on hyödynnetty lajien luokittelemisessa. Merialueilla esiintyvä piilevä, Skeletonema marinoi on yksi Itämeren tavallisimmista kasviplanktonlajeista kevätkukinnan aikana. Tavoitteenani oli selventää geneettistä ja fenotyyppistä monimuotoisuutta pitkin Itämeren ympäristögradienttejä. Geneettisen monimuotoisuuteen ja erkaantumiseen vaikuttavien tekijöiden selvittäminen oli tärkeä aspekti väitöstutkimuksessani. Geneettisiä markkereita käyttämällä pystyin toteamaan, että S. marinoi levän geneettinen monimuotoisuus on Itämeressä merkittävästi alhaisempi kuin läheisessä Pohjanmeren itäosassa. Tutkittu laji jakautuu geneettisesti yhteen erilliseen populaatioon Itämeressä ja toiseen selvästi erottuvaan populaatioon Tanskan salmien pohjoispuolella. Kokeellisten tulosten perusteella nämä geneettisesti erilaistuneet populaatiot ovat kumpikin sopeutuneet paikalliseen veden suolapitoisuuteen. Populaatioiden välisen geenivirran ja merivirtojen luoman yhteyden välillä havaittiin vahva korrelaatio. Tutkimukseni paljastivat myös laajaa vaihtelua Skeletonema-kloonien ekologisesti tärkeissä ominaisuuksissa. Kokeellisten tutkimusteni perusteella laiduntajat pystyivät muuttamaan geneettisten kloonien lukumäärää monimuotoisissa S. marinoi populaatioissa. Lisääntynyt kloonien lukumäärä paransi perustuotantokykyä ja vakautti ekofysiologisia toimintoja. Kuten tässä väitöstutkimuksessa osoitetaan, lajit koostuvat useimmiten lukuisista geneettisistä muunnelmista, jotka eroavat usein fenotyypeiltään. Ymmärtääksemme missä tietyt lajit esiintyvät ja miksi, tarvitsemme tietoa lajien sisäisistä vaihteluista. Tämä tieto on tarpeellista, jotta voimme ennustaa lajien sopeutumista tuleviin ympäristönmuutoksiin.

South-West Monsoon Rainfall of Kerala and Its Variability

This study focuses on the south –west monsoon rainfall over Kerala and its variability both on the spatial and temporal scales. The main objectives of the study are, interanual, long-term and decadal variabilities in MRF(monsoon rain fall),relationship between antecedent global circulation parameters, diurnal variability using data of a large number of stations in Kerala and the spatial distribution of rainfall under two large scale synoptic. Kerala gets nearly 190cm of rainfall during the south-west monsoon season 1st June to 30th September. This is more than twice the monsoon rainfall of India. A good part of kerala’s rainfall is caused by the orography of the Western Ghats Mountain ranges. The state receives 286cm of annual rainfall of which 68%is during the south-west monsoon season. The summer monsoon rainfall of Kerala shows a decreasing trend of 12.0%in 96 years. The study shows that the Intra Seasonal Oscillations(ISO) of the monsoon season has large interanual variability,some years having long period and other years having short period ISO. It is seen that Western Ghats has a strong control on the east west profile on the monsoon rainfall.

Thermohaline variability in the upper layers of the Arabian Sea

The Arabian Sea is an area of complex air-sea interaction processes with seasonal reversing monsoons. The associated thermohaline variability in the upper layers appears to control the large scale monsoon flow which is not yet completely understood. The variability in the thermohaline fields is known to occur in temporal domain ranging from intra-diurnal to inter-annual time scales and on spatial domains of few tens of kilometers to few thousands of kilometers. In the Arabian Sea though the surface temperature was routinely measured by both conventional measurements and satellites, the corresponding information on the subsurface thermohaline field is very sparse due to the lack cw adequate measurements. In such cases the numerical models offer promise in providing information on the subsurface features given an initial thermohaline field and surface heat flux boundary conditions. This thesis is an outcome of investigations carried out on the various aspects of the thermohaline variability on different time scales. In addition to the description of the mean annual cycle. the one dimensional numerical models of Miller (1976) and Price et a1 (1986) are utilised to simulate the observed mixed layer characteristics at selected locations in the Arabian Sea on time scales ranging from intra-diurnal to synoptic scales under variable atmospheric forcing.

Resolving the spatial variability of soil N using fractions of soil organic matter

The spatial variability of soil nitrogen (N) mineralisation has not been extensively studied, which limits our capacity to make N fertiliser recommendations. Even less attention has been paid to the scale-dependence of the variation. The objective of this research was to investigate the scale-dependence of variation of mineral N (MinN, N–NO3− plus N–NH4+) at within-field scales. The study was based on the spatial dependence of the labile fractions of SOM, the key fractions for N mineralisation. Soils were sampled in an unbalanced nested design in a 4-ha arable field to examine the distribution of the variation of SOM at 30, 10, 1, and 0.12 m. Organic matter in free and intra-aggregate light fractions (FLF and IALF) was extracted by physical fractionation. The variation occurred entirely within 0.12 m for FLF and at 10 m for IALF. A subsequent sampling on a 5-m grid was undertaken to link the status of the SOM fractions to MinN, which showed uncorrelated spatial dependence. A uniform application of N fertiliser would be suitable in this case. The failure of SOM fractions to identify any spatial dependence of MinN suggests that other soil variables, or crop indicators, should be tested to see if they can identify different N supply areas within the field for a more efficient and environmentally friendly N management.

Implications of genetic variability of Trypanosoma cruzi for the pathogenesis of Chagas disease

O Trypanosoma cruzi, agente etiológico da doença de Chagas, apresenta elevado grau de variabilidade genética intra-específica, com possíveis implicações na forma clínica da doença, como o desenvolvimento de cardiopatia, do megaesôfago e do megacólon de forma isolada ou em associação. Este tropismo tecidual envolvido na patogênese da doença não está totalmente esclarecido. Assim, nesta revisão são abordados alguns aspectos referentes à diversidade genética dos parasitas isolados, às formas clínicas da doença de Chagas, ao processo de infecção do parasita na célula hospedeira e resposta imune. Outros aspectos também são enfocados, como os fatores imunossupressivos liberados pelo parasita que atuam na regulação das respostas imunes, a inibição da apoptose da célula hospedeira, assim como da patogênese do megaesôfago chagásico que pode estar relacionada à interação hospedeiro- parasita e sua associação com risco aumentado para o desenvolvimento do carcinoma epidermóide do esôfago. Porém, apesar dos avanços no entendimento desta doença, ainda não é possível estabelecer o verdadeiro perfil da variabilidade genética do parasita com a forma clínica da doença de Chagas.

Morphological characterization and reproductive aspects in genetic variability studies of forage peanut

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Mapping five repetitive DNA classes in sympatric species of Hypostomus (Teleostei: Siluriformes: Loricariidae): analysis of chromosomal variability

Fish belonging to the genus Hypostomus are known for exhibiting a striking diversity in its karyotype structure, however the knowledge concerning the distribution patterns of heterochromatin and location of repetitive DNA sequences in the karyotypes is still limited. Aiming a better understanding of the chromosomal organization in this group, we analyzed three sympatric species of Hypostomus collected in the Hortelã stream, a component of the Paranapanema River basin, Botucatu/SP/Brazil. The analyses involved the cytogenetic characterization and chromosomal mapping of repetitive sequences and intra/interspecific comparisons using sequences of the cytochrome C oxidase subunit I. The results revealed that H. ancistroides presents a karyotype with 2n = 68 chromosomes, H. strigaticeps 2n = 72 chromosomes, and H. nigromaculatus 2n = 76 chromosomes. In addition to differences found in the diploid number, it was also observed variations in karyotypic formulae, amount of constitutive heterochromatin, and location of nucleolus organizer regions. The cytogenetic mapping of 5S and 18S rDNA, as well as of the H3 histone gene, disclosed a differential dispersion process among the three species. In some cases the Rex1 transposable element showed to be co-located with 5S rDNA sites. The molecular analyses support the cytogenetic data and represent an additional tool for the characterization of the analyzed species. The results evidenced that chromosomal variations are not restricted to differences in diploid number or karyotypic macrostructure in the genus Hypostomus, indicating that events such as transposition of heterochromatin and rDNA segments may participate in the differentiation process occurred in these species. © 2013 Springer Science+Business Media Dordrecht.

Genetic variability among Commelina weed species from the states of Paraná and São Paulo, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)