Phase III study of ACVBP versus ACVBP plus rituximab for patients with localized low-risk diffuse large B-cell lymphoma (LNH03-1B).

Background The superiority of a chemotherapy with doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisone (ACVBP) in comparison with cyclophosphamide, doxorubicin, vincristin and prednisone plus radiotherapy for young patients with localized diffuse large B-cell lymphoma (DLBCL) was previously demonstrated. We report the results of a trial which evaluates the role of rituximab combined with ACVBP (R-ACVBP) in these patients. Patients and methods Untreated patients younger than 66 years with stage I or II DLBCL and no adverse prognostic factors of the age-adjusted International Prognostic Index were randomly assigned to receive three cycles of ACVBP plus sequential consolidation with or without the addition of four infusions of rituximab. Results A total of 223 patients were randomly allocated to the study, 110 in the R-ACVBP group and 113 in the ACVBP group. After a median follow-up of 43 months, our 3-year estimate of event-free survival was 93% in the R-ACVBP group and 82% in the ACVBP group (P = 0.0487). Three-year estimate of progression-free survival was increased in the R-ACVBP group (95% versus 83%, P = 0.0205). Overall survival did not differ between the two groups with a 3-year estimates of 98% and 97%, respectively (P = 0.686). Conclusion In young patients with low-risk localized DLBCL, rituximab combined with three cycles of ACVBP plus consolidation is significantly superior to ACVBP plus consolidation alone.

Deletion of the Vaccinia Virus Gene A46R, Encoding for an Inhibitor of TLR Signalling, Is an Effective Approach to Enhance the Immunogenicity in Mice of the HIV/AIDS Vaccine Candidate NYVAC-C.

Viruses have developed strategies to counteract signalling through Toll-like receptors (TLRs) that are involved in the detection of viruses and induction of proinflammatory cytokines and IFNs. Vaccinia virus (VACV) encodes A46 protein which disrupts TLR signalling by interfering with TLR: adaptor interactions. Since the innate immune response to viruses is critical to induce protective immunity, we studied whether deletion of A46R gene in a NYVAC vector expressing HIV-1 Env, Gag, Pol and Nef antigens (NYVAC-C) improves immune responses against HIV-1 antigens. This question was examined in human macrophages and in mice infected with a single A46R deletion mutant of the vaccine candidate NYVAC-C (NYVAC-C-ΔA46R). The viral gene A46R is not required for virus replication in primary chicken embryo fibroblast (CEF) cells and its deletion in NYVAC-C markedly increases TNF, IL-6 and IL-8 secretion by human macrophages. Analysis of the immune responses elicited in BALB/c mice after DNA prime/NYVAC boost immunization shows that deletion of A46R improves the magnitude of the HIV-1-specific CD4 and CD8 T cell immune responses during adaptive and memory phases, maintains the functional profile observed with the parental NYVAC-C and enhances anti-gp120 humoral response during the memory phase. These findings establish the immunological role of VACV A46R on innate immune responses of macrophages in vitro and antigen-specific T and B cell immune responses in vivo and suggest that deletion of viral inhibitors of TLR signalling is a useful approach for the improvement of poxvirus-based vaccine candidates.

Intensified chemotherapy with ACVBP plus rituximab versus standard CHOP plus rituximab for the treatment of diffuse large B-cell lymphoma (LNH03-2B): an open-label randomised phase 3 trial.

BACKGROUND: The outcome of diffuse large B-cell lymphoma has been substantially improved by the addition of the anti-CD20 monoclonal antibody rituximab to chemotherapy regimens. We aimed to assess, in patients aged 18-59 years, the potential survival benefit provided by a dose-intensive immunochemotherapy regimen plus rituximab compared with standard treatment plus rituximab. METHODS: We did an open-label randomised trial comparing dose-intensive rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone (R-ACVBP) with subsequent consolidation versus standard rituximab, doxorubicin, cyclophosphamide, vincristine, and prednisone (R-CHOP). Random assignment was done with a computer-assisted randomisation-allocation sequence with a block size of four. Patients were aged 18-59 years with untreated diffuse large B-cell lymphoma and an age-adjusted international prognostic index equal to 1. Our primary endpoint was event-free survival. Our analyses of efficacy and safety were of the intention-to-treat population. This study is registered with ClinicalTrials.gov, number NCT00140595. FINDINGS: One patient withdrew consent before treatment and 54 did not complete treatment. After a median follow-up of 44 months, our 3-year estimate of event-free survival was 81% (95% CI 75-86) in the R-ACVBP group and 67% (59-73) in the R-CHOP group (hazard ratio [HR] 0·56, 95% CI 0·38-0·83; p=0·0035). 3-year estimates of progression-free survival (87% [95% CI, 81-91] vs 73% [66-79]; HR 0·48 [0·30-0·76]; p=0��0015) and overall survival (92% [87-95] vs 84% [77-89]; HR 0·44 [0��28-0��81]; p=0·0071) were also increased in the R-ACVBP group. 82 (42%) of 196 patients in the R-ACVBP group experienced a serious adverse event compared with 28 (15%) of 183 in the R-CHOP group. Grade 3-4 haematological toxic effects were more common in the R-ACVBP group, with a higher proportion of patients experiencing a febrile neutropenic episode (38% [75 of 196] vs 9% [16 of 183]). INTERPRETATION: Compared with standard R-CHOP, intensified immunochemotherapy with R-ACVBP significantly improves survival of patients aged 18-59 years with diffuse large B-cell lymphoma with low-intermediate risk according to the International Prognostic Index. Haematological toxic effects of the intensive regimen were raised but manageable. FUNDING: Groupe d'Etudes des Lymphomes de l'Adulte and Amgen.

Progress in a-Si:H/c-Si heterojunction emitters obtained by Hot-Wire CVD at 200°C

In this work, we investigate heterojunction emitters deposited by Hot-Wire CVD on p-type crystalline silicon. The emitter structure consists of an n-doped film (20 nm) combined with a thin intrinsic hydrogenated amorphous silicon buffer layer (5 nm). The microstructure of these films has been studied by spectroscopic ellipsometry in the UV-visible range. These measurements reveal that the microstructure of the n-doped film is strongly influenced by the amorphous silicon buffer. The Quasy-Steady-State Photoconductance (QSS-PC) technique allows us to estimate implicit open-circuit voltages near 700 mV for heterojunction emitters on p-type (0.8 ��cm) FZ silicon wafers. Finally, 1 cm 2 heterojunction solar cells with 15.4% conversion efficiencies (total area) have been fabricated on flat p-type (14 ��cm) CZ silicon wafers with aluminum back-surface-field contact.

Platinum (II) and palladium (II) complexes with (N,N') and (C,N,N') ligands derived from pyrazole as anticancer and antimalarial agents: synthesis, characterization and in vitro activities

The study of the reactivity of three 1-(2-dimethylaminoethyl)-1H-pyrazole derivatives of general formula [1-(CH2)2NMe2}-3,5-R2-pzol] {where pzol represents pyrazole and Rdouble bond; length as m-dashH (1a), Me (1b) or Ph (1c)} with [MCl2(DMSO)2] (Mdouble bond; length as m-dashPt or Pd) under different experimental conditions allowed us to isolate and characterize cis-[M{κ2-N,N��-{[1-(CH2)2NMe2}-3,5-R2-pzol])}Cl2] {MMdouble bond; length as m-dashPtPt (2a-2c) or Pd (3a-3c)} and two cyclometallated complexes [M{��3-C,N,N���-{[1-(CH2)2NMe2}-3-(C5H4)-5-Ph-pzol])}Cl] {Mdouble bond; length as m-dashPt(II) (4c) or Pd(II) (5c)}. Compounds 4c and 5c arise from the orthometallation of the 3-phenyl ring of ligand 1c. Complex 2a has been further characterized by X-ray crystallography. Ligands and complexes were evaluated for their in vitro antimalarial against Plasmodium falciparum and cytotoxic activities against lung (A549) and breast (MDA MB231 and MCF7) cancer cellular lines. Complexes 2a-2c and 5c exhibited only moderate antimalarial activities against two P. falciparum strains (3D7 and W2). Interestingly, cytotoxicity assays revealed that the platinacycle 4c exhibits a higher toxicity than cisplatin in the three human cell lines and that the complex 2a presents a remarkable cytotoxicity and selectivity in lung (IC50 = 3 ��M) versus breast cancer cell lines (IC50 > 20 ��M). Thus, complexes 2c and 4c appear to be promising leads, creating a novel family of anticancer agents. Electrophoretic DNA migration studies in presence of the synthesized compounds have been performed, in order to get further insights into their mechanism of action.

Amorphous silicon thin film solar cells deposited entirely by Hot-Wire Chemical Vapour Deposition at low temperature (<150 ºC)

Amorphous silicon n-i-p solar cells have been fabricated entirely by Hot-Wire Chemical Vapour Deposition (HW-CVD) at low process temperature < 150 ��C. A textured-Ag/ZnO back reflector deposited on Corning 1737F by rf magnetron sputtering was used as the substrate. Doped layers with very good conductivity and a very less defective intrinsic a-Si:H layer were used for the cell fabrication. A double n-layer (μc-Si:H/a-Si:H) and μc-Si:H p-layer were used for the cell. In this paper, we report the characterization of these layers and the integration of these layers in a solar cell fabricated at low temperature. An initial efficiency of 4.62% has been achieved for the n-i-p cell deposited at temperatures below 150 ��C over glass/Ag/ZnO textured back reflector.

Brief cognitive assessment instruments in schizophrenia and bipolar patients, and healthy control subjects: A comparison study between the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) and the Screen for Cognitive Impairment in Psychiatry (SCIP)

Cognitive impairment in schizophrenia and psychosis is ubiquitous and acknowledged as a core feature of clinical expression, pathophysiology, and prediction of functioning. However, assessment of cognitive functioning is excessively time-consuming in routine practice, and brief cognitive instruments specific to psychosis would be of value. Two screening tools have recently been created to address this issue, i.e., the Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) and the Screen for Cognitive Impairment in Psychiatry (SCIP). The aim of this research was to examine the comparative validity of these two brief instruments in relation to a global cognitive score. 161 patients with psychosis (96 patients diagnosed with schizophrenia and 65 patients diagnosed with bipolar disorder) and 76 healthy control subjects were tested with both instruments to examine their concurrent validity relative to a more comprehensive neuropsychological assessment battery. Scores from the B-CATS and the SCIP were highly correlated in the three diagnostic groups, and both scales showed good to excellent concurrent validity relative to a Global Cognitive Composite Score (GCCS) derived from the more comprehensive examination. The SCIP-S showed better predictive value of global cognitive impairment than the B-CATS. Partial and semi-partial correlations showed slightly higher percentages of both shared and unique variance between the SCIP-S and the GCCS than between the B-CATS and the GCCS. Brief instruments for assessing cognition in schizophrenia and bipolar disorders, such as the SCIP-S and B-CATS, seem to be reliable and promising tools for use in routine clinical practice.

Micrasterias C. Agardh ex Ralfs (Zygnematophyceae) de duas ��reas de Prote��ão Ambiental da planície litorânea do norte da Bahia, Brasil

Estudo taxonômico do g��nero Micrasterias C. Agardh ex Ralfs realizado em duas ��reas de Prote��ão Ambiental (APA Rio Capivara e APA Lagoas de Guarajuba), ambas situadas no Munic��pio de Camaçari, Estado da Bahia, nordeste do Brasil. Os materiais estudados, de origem do plâncton e do perifíton, provieram de 96 amostras coletadas no verão (dezembro de 2006 a março de 2007) e no inverno (maio a agosto de 2007), em ambientes l��ticos e lênticos. Foram identificados 14 t��xons, dos quais M.americana (Ehrenb.) Ralfs var. bahiensis I. B. Oliveira, C. E. M. Bicudo &amp; C. W. N. Moura foi descrita como nova para a ci��ncia e 10 constituem citacões pioneiras para a desmidiofl��rula da Bahia, quais sejam: M. alata G. C. Wall., M. arcuata Bailey var.subpinnatifida West &amp; G. S. West f. subpinnatifida, M. borgei H. Krieg. var. borgei, M. foliacea Bailey ex Ralfs var. foliacea, M. furcata C. Agardh ex Ralfs var. furcata f. furcata, M. laticeps Nordst. var. laticeps, M. laticeps Nordst. var.acuminata H. Krieg., M. mahabuleshwarensis J. Hobson var.ampullacea (W. M. Maskell) Nordst., M. mahabuleshwarensis J. Hobson var. mahabuleshwarensis f. mahabuleshwarensis, M. pinnatifida (K��tz.) Ralfs var. pinnatifida f. pinnatifida, M. radiosa Ralfs var. elegantior (G. S. West) Croasdale, M. rotata (Grev.) Ralfs var. rotata e M. truncata (Corda) Bréb. ex Ralfs var. pusilla G. S. West. As espécies mais bem representadas na ��rea estudada foram M. alata e M. pinnatifida presentes, respectivamente, em 50% e 45,83% das amostras analisadas. Micrasteriaslaticeps var.acuminata e M.americana var. bahiensis, foram as menos representadas, por terem sido registradas apenas em 2,08% e 1,04% respectivamente.

A polymerase chain reaction-based assay to identify genotype F of hepatitis B virus

We have developed a polymerase chain reaction (PCR) assay which distinguishes genotype F from the other genotypes of hepatitis B virus (HBV). The method was used to characterize HBV strains isolated in urban areas of the Brazilian Amazon. DNA was amplified in 54 of a total of 78 HBsAg-positive serum samples, using universal, non-genotype-specific primers. Only 4 (7.4%) were identified as genotype F by our genotype-specific PCR assay. This proportion is notably lower than that previously reported in Argentina, Venezuela, Peru, and Central America.

Cost-effective analysis of different algorithms for the diagnosis of hepatitis C virus infection

We compared the cost-benefit of two algorithms, recently proposed by the Centers for Disease Control and Prevention, USA, with the conventional one, the most appropriate for the diagnosis of hepatitis C virus (HCV) infection in the Brazilian population. Serum samples were obtained from 517 ELISA-positive or -inconclusive blood donors who had returned to Fundação Pró-Sangue/Hemocentro de São Paulo to confirm previous results. Algorithm A was based on signal-to-cut-off (s/co) ratio of ELISA anti-HCV samples that show s/co ratio &sup3;95% concordance with immunoblot (IB) positivity. For algorithm B, reflex nucleic acid amplification testing by PCR was required for ELISA-positive or -inconclusive samples and IB for PCR-negative samples. For algorithm C, all positive or inconclusive ELISA samples were submitted to IB. We observed a similar rate of positive results with the three algorithms: 287, 287, and 285 for A, B, and C, respectively, and 283 were concordant with one another. Indeterminate results from algorithms A and C were elucidated by PCR (expanded algorithm) which detected two more positive samples. The estimated cost of algorithms A and B was US$21,299.39 and US$32,397.40, respectively, which were 43.5 and 14.0% more economic than C (US$37,673.79). The cost can vary according to the technique used. We conclude that both algorithms A and B are suitable for diagnosing HCV infection in the Brazilian population. Furthermore, algorithm A is the more practical and economical one since it requires supplemental tests for only 54% of the samples. Algorithm B provides early information about the presence of viremia.

Impacto da hepatite C na mortalidade de pacientes em hemodi��lise

OBJETIVO: As causas mais importantes de mortalidade em pacientes com Doença Renal Crônica Terminal (DRCT) são as doenças cardiovasculares. No entanto, existem doen��as infecciosas virais (hepatite B e C) que se tornaram uma questão de grande importância para pacientes em hemodiálise, pois afetam a sua sobrevida aumentando a morbidade e a mortalidade. Nosso objetivo foi estudar a influ��ncia da hepatite C na mortalidade em pacientes em hemodiálise. MÉTODOS: Realizamos um estudo de coorte n��o concorrente durante 10 anos. RESULTADOS: Foram estudados 74 pacientes em cada coorte. A hepatite C não aumentou o risco de morte nos pacientes e a sobrevida dos pacientes com essa infec��ão foi melhor do que no grupo sem hepatite C. A sobrevida em pacientes n��o infectados no primeiro e quinto anos foi de 93,9% e 52,3%; e para os não infectados foi de 95,5% e 73,1%, respectivamente (Log Rank Mantel Cox, p = 0,02). CONCLUSÃO: Não encontramos aumento no risco de mortalidade. A hepatite C não se correlaciona com aumento de mortalidade em pacientes com DRCT em programa de hemodiálise.

c-Myc dans le développeemnt rénal et la polykystose rénale autosomique dominante

Th��se numérisée par la Division de la gestion de documents et des archives de l'Universit�� de Montréal.

Búsqueda de selección en el polimorfismo 677C>T (c.665C>T) del gen de la metilentetrahidrofolato reductasa (MTHFR) en una población Colombiana

Se realizó un estudio gen��tico – poblacional en dos grupos etarios de población colombiana con la finalidad de evaluar las diferencias genéticas relacionadas con el polimorfismo MTHFR 677CT en busca de eventos genéticos que soporten la persistencia de este polimorfismo en la especie humana debido que este ha sido asociado con múltiples enfermedades. De esta manera se genotipificaron los individuos, se analizaron los genotipos, frecuencias alélicas y se realizaron diferentes pruebas gen��ticas-poblacionales. Contrario a lo observado en poblaciones Colombianas revisadas se identificó la ausencia del Equilibrio Hardy-Weinberg en el grupo de los niños y estructuras poblacionales entre los adultos lo que sugiere diferentes historias demográficas y culturales entre estos dos grupos poblacionales al tiempo, lo que soporta la hipótesis de un evento de selecci��n sobre el polimorfismo en nuestra población. De igual manera nuestros datos fueron analizados junto con estudios previos a nivel nacional y mundial lo cual sustenta que el posible evento selectivo es debido a que el aporte de ácido fólico se ha incrementado durante las ��ltimas dos décadas como consecuencia de las campañas de fortificación de las harinas y suplementación a las embarazadas con ácido f��lico, por lo tanto aqu�� se propone un modelo de selección que se ajusta a los datos encontrados en este trabajo se establece una relación entre los patrones nutricionales de la especie humana a través de la historia que explica las diferencias en frecuencias de este polimorfismo a nivel espacial y temporal.  

Genotipificaci��n de HLA-B en pacientes colombianos afectados por el síndrome Stevens-Johnson y la Necrólisis Epidérmica Tóxica

Las reacciones al��rgicas a medicamentos cut��neas severas (RAM) como el S��ndrome Stevens Johnson (SJS) y la Necrólisis Epidérmica Tóxica (NET),caracterizadas por exantema, erosi��n de la piel y las membranas mucosas, flictenas, desprendimiento de la piel secundario a la muerte de queratinocitos y compromiso ocular. Son infrecuentes en la población pero con elevada morbi-mortalidad, se presentan luego de la administraci��n de diferentes fármacos. En Asia se ha asociado el alelo HLA-B*15:02 como marcador gen��tico para SJS. En Colombia no hay datos de la incidencia de estas RAM, ni de la relaci��n con medicamentos específicos o potenciales y tampoco estudios de aproximación gen��mica de genes de susceptibilidad.

Evaluaci��n del programa uso seguro de medicamentos en un hospital especializado en pediatría y ortopedia infantil ��� Bogotá d.c., 2012 -2013

El uso de seguro de medicamentos, dentro del proceso de atenci��n en salud, ha tomado importancia a nivel nacional e internacional al evidenciarse el aumento de incidentes y eventos relacionados con los medicamentos, que involucran desde el procesos de adquisici��n, pasando por la prescripci��n médica, la dispensación, la administración de medicamentos, hasta llegar a la utilización en los pacientes y cuidadores. El uso adecuado de medicamentos es una de las metas de seguridad del paciente de la Organización Mundial de la Salud, en las cuales trabaja todos los d��as el Instituto de Ortopedia Infantil Roosevelt, y en el caso espec��fico de medicamentos lo hace a través de su Programa de Farmacovigilancia haciendo seguimiento y clasificaci��n de los casos reportados, donde para los a��os 2012 al 2013 se observan avances considerables y la consolidaci��n de estrategias que mejoran el uso del medicamento, que se da con una inducción adecuada a cada uno de los funcionarios que intervienen en este proceso y a la educación permanente de colaboradores, pacientes y sus cuidadores. El propósito de este estudio fue analizar los datos encontrados en las bases de del programa de Farmacovigilancia en el Instituto de Ortopedia Infantil Roosevelt en los a��os 2012-2013, estableciendo variables, comparando los resultados, determinando el estado actual y de ser posible establecer lineamientos de mejora al mismo