Un programa de atención multidisciplinar al paciente con hepatitis crónica C mejora la eficacia del tratamiento con peginterferon alfa-2a y ribavirina.

La adherencia al tratamiento antiviral de la hepatitis crónica C (HCC) es una variable importante en la obtención de la respuesta viral sostenida (RVS). El objetivo de este trabajo es evaluar el impacto de un programa de atención multidisciplinar (PAM) en la adherencia y eficacia del tratamiento de la HCC. Se incluyeron 447 pacientes tratados con peginterferón-alfa-2a y ribavirina y se clasificaron en tres grupos: grupo control (2003-2004, n=147), grupo PAM (2005-2006, n=131) y grupo Validación-PAM (2007-2009, n=169). La adherencia y los porcentajes de RVS fueron superiores en los pacientes incluidos en los grupos PAM (94.6% y 77.1%) y Validación-PAM (91.7% y 74.6%) en comparación con el grupo control (78.9% y 61.9%) (p<0.05 para todos los casos).

Alfa-toksisen Staphylococcus aureuksen aiheuttama nekrotisoiva mastiitti : tapausselostus

Summary: Gangrenous mastitis caused by alpha-toxic Staphylococcus aureus - a case report

Extended treatment of treatment-naive patients with chronic hepatitis c virus (HCV) genotype 1-infection and slow response to pegylated interferon-alfa and ribavirin: a meta-analysis

Aims: Recently, several clinical trials analyzed if extended duration of treatment with pegylated interferon-alfa and ribavirin over 48 weeks can improve sustained virologic response (SVR) rates in HCV genotype 1-infected patients with slow virologic response. Because results of these clinical trials are conflicting, we performed a metaanalysis to determine the overall impact of extended treatment compared to standard treatment on virologic response rates in treatment-naive HCV genotype 1 slow responders. Methods: Literature search was performed independently by two observers using Pub Med, EMBASE, CENTRAL and abstracts presented in English at international liver and gastroenterology meetings. Randomized controlled clinical trials (RCTs; but studies that re-analyzed data retrospectively RCTs were also allowed) were considered if they included monoinfected treatment-naive HCV genotype 1 patients and compared treatment with pegIFN-alfa 2a or 2b in combination with ribavirin for 48 weeks versus extended treatment (up to 72 weeks) in slow responders. Primary and secondary end points were SVR rates and end-of-treatment (EOT) and relapse rates, respectively. In the present meta-analysis, study endpoints were summarized with a DerSimonian-Laird estimate for binary outcome basing on a random effects model. Results: Literature search yielded seven RTCs addressing the benefit of extended treatment with pegylated interferon-alfa and ribavirin in treatment-naive HCV genotype 1 slow responders. In total, 1330 slow responders were included in our meta-analysis. We show that extended treatment duration compared to the standard of care significantly improves SVR rates in HCV genotype 1 slow responders (12.4% improvement of overall SVR rate, 95% CI 0.055- 0.193, P = 0.0005). In addition, we show that rates of viral relapse were significantly reduced by extended treatment (24.1% reduction of relapse, 95% CI −0.3332 to −0.1487, P < 0.0001), whereas no significant impact of extended treatment on EOT response rates was found. Though extended treatment was burdened with an enhanced rate of premature treatment discontinuation due to interferonalfa- and ribavirin-related side effects, the frequency of serious adverse events was not increased. Conclusions: Treatment extension in HCV genotype 1 slow responders can improve SVR rates in difficult to treat patients and should be considered in patients who need to be treated before specific antivirals will be approved.

Reticulocyte dynamic and hemoglobin variability in hemodialysis patients treated with Darbepoetin alfa and C.E.R.A.: a randomized controlled trial.

BACKGROUND: In a simulation based on a pharmacokinetic model we demonstrated that increasing the erythropoiesis stimulating agents (ESAs) half-life or shortening their administration interval decreases hemoglobin variability. The benefit of reducing the administration interval was however lessened by the variability induced by more frequent dosage adjustments. The purpose of this study was to analyze the reticulocyte and hemoglobin kinetics and variability under different ESAs and administration intervals in a collective of chronic hemodialysis patients. METHODS: The study was designed as an open-label, randomized, four-period cross-over investigation, including 30 patients under chronic hemodialysis at the regional hospital of Locarno (Switzerland) in February 2010 and lasting 2 years. Four subcutaneous treatment strategies (C.E.R.A. every 4 weeks Q4W and every 2 weeks Q2W, Darbepoetin alfa Q4W and Q2W) were compared with each other. The mean square successive difference of hemoglobin, reticulocyte count and ESAs dose was used to quantify variability. We distinguished a short- and a long-term variability based respectively on the weekly and monthly successive difference. RESULTS: No difference was found in the mean values of biological parameters (hemoglobin, reticulocytes, and ferritin) between the 4 strategies. ESAs type did not affect hemoglobin and reticulocyte variability, but C.E.R.A induced a more sustained reticulocytes response over time and increased the risk of hemoglobin overshooting (OR 2.7, p = 0.01). Shortening the administration interval lessened the amplitude of reticulocyte count fluctuations but resulted in more frequent ESAs dose adjustments and in amplified reticulocyte and hemoglobin variability. Q2W administration interval was however more favorable in terms of ESAs dose, allowing a 38% C.E.R.A. dose reduction, and no increase of Darbepoetin alfa. CONCLUSIONS: The reticulocyte dynamic was a more sensitive marker of time instability of the hemoglobin response under ESAs therapy. The ESAs administration interval had a greater impact on hemoglobin variability than the ESAs type. The more protracted reticulocyte response induced by C.E.R.A. could explain both, the observed higher risk of overshoot and the significant increase in efficacy when shortening its administration interval.Trial registrationClinicalTrials.gov NCT01666301.

Comportamiento de glicinina, beta-conglicinina y alfa-amilasa en semillas de soja deterioradas y no deterioradas

El objetivo del trabajo fue estudiar el comportamiento de glicinina y beta-conglicinina y la actividad de alfa-amilasa en semillas deterioradas y no deterioradas de 10 cultivares de soja [Glycine max (L.) Merr.]. Las semillas se sometieron a dos tratamientos: deterioradas por envejecimiento acelerado y no deterioradas. Se determinó la presencia de las proteínas de reserva a partir de semillas con 0, 3 y 8 días de germinadas por electroforesis en geles de poliacrilamida (SDS-PAGE). La actividad de la alfa-amilasa se determinó bioquímicamente en semillas con 0, 3, 8 y 12 días de germinadas. No hubo diferencias en la presencia de bandas de glicinina y beta-conglicinina en semillas no deterioradas hasta los 8 días de germinadas. Las semillas deterioradas se comportaron en forma similar a las no deterioradas. La actividad de la alfa-amilasa aumentó en semillas germinadas hasta 8 días y disminuyó a los 12 días. En semillas deterioradas la actividad enzimática disminuyó con respecto a las no deterioradas. El deterioro artificial no afectó la presencia de glicinina y beta-conglicinina pero alteró la actividad de la alfa-amilasa hasta los 12 días de germinación. Los cultivares estudiados mostraron comportamiento diferencial frente a la actividad de esta enzima.

Vitamin D deficiency and a CYP27B1-1260 promoter polymorphism are associated with chronic hepatitis C and poor response to interferon-alfa based therapy.

BACKGROUND & AIMS: Vitamin D is an important immune modulator and preliminary data indicated an association between vitamin D deficiency and sustained virologic response (SVR) rates in hepatitis C virus (HCV) genotype 1 patients. We, therefore, performed a comprehensive analysis on the impact of vitamin D serum levels and of genetic polymorphisms with functional relevance within the vitamin D cascade on chronic hepatitis C and its treatment. METHODS: Vitamin D serum levels, genetic polymorphisms within the vitamin D receptor and 1α-hydroxylase were determined in a cohort of 468 HCV genotype 1, 2, and 3 infected patients who were treated with interferon-alfa based regimens. RESULTS: Chronic hepatitis C was associated with a high incidence of severe vitamin D deficiency compared to controls (25(OH)D(3)<10 ng/ml in 25% versus 12%, p<0.00001). 25(OH)D(3) deficiency correlated with SVR in HCV genotype 2 and 3 patients (50% and 81% SVR for patients with and without severe vitamin D deficiency, respectively, p<0.0001). In addition, the CYP27B1-1260 promoter polymorphism rs10877012 had substantial impact on 1,25-dihydroxyvitamin D serum levels (72, 61, and 60 pmol/ml for rs10877012 AA, AC, and CC, respectively, p=0.04) and on SVR rates in HCV genotype 1, 2, and 3 infected patients (77% and 65% versus 42% for rs10877012 AA, AC, and CC, respectively, p=0.02). CONCLUSIONS: Chronic hepatitis C virus infection is associated with vitamin D deficiency. Reduced 25-hydroxyvitamin D levels and CYP27B1-1260 promoter polymorphism leading to reduced 1,25-dihydroxyvitamin D levels are associated with failure to achieve SVR in HCV genotype 1, 2, and 3 infected patients.

Unidades fototérmicas e temperatura-base inferior de frutos de Mangueira Alfa, na Baixada Cuiabana

O objetivo deste trabalho foi determinar a temperatura-base inferior (Tb) a partir da unidade fototérmica (UF) para o cultivo experimental de manga Alfa sob condições de cerrado. Foram utilizados dados diários da temperatura do ar disponibilizados pela Estação Agrometeorológica Padre Ricardo Remetter, localizada em Santo Antônio do Leverger-MT (15,8° S e 56,1° W, 140 m), e avaliação sensorial do estádio de maturação dos frutos de manga. A Tb foi determinada pelo método da menor variabilidade das unidades fototérmicas (UF) acumuladas do período da floração à colheita dos frutos, variabilidade avaliada pelo coeficiente de variação (cv) simulado para diferentes valores da Tb. De julho a novembro de 2007, em três plantas de um pomar demonstrativo irrigado, foram identificados 82 frutos para o acompanhamento do crescimento e maturação. Entre esses frutos, em meados de dezembro de 2007, foi possível identificar 13 frutos que atingiram a maturidade fisiológica, após um período médio de observação de 112 dias. Para exigência fototérmica de 1.878.166,1 UF, encontrou-se Tb de 10 °C, valor consistente com os apresentados na literatura para a cultivar de manga, o que comprova a eficiência do método que combina a ação da temperatura e do fotoperíodo sobre a maturação dos frutos e que confere um caráter mais racional que o método tradicional da soma térmica.

Estudo morfológico do efeito radioprotetor da vitamina E (dl-alfa-tocoferil) na reparação tecidual em ratos

Esta pesquisa teve por finalidade avaliar a ação da vitamina E como radioprotetora no processo de reparação tecidual em ratos, após sofrerem um procedimento cirúrgico, que consistiu da produção de uma ferida na região dorsal anterior. Os animais foram divididos em cinco grupos: grupo CO (controle) - constituído de animais em que foi produzida somente a ferida; grupo VE - pré-tratamento com vitamina E (90 UI); grupo IR - irradiação três dias após a cirurgia; grupo VEIR - pré-tratamento com 90 UI de vitamina E e irradiação de suas bordas três dias após a cirurgia; grupo OIR - pré-tratamento com óleo de oliva e irradiação de suas bordas três dias após a cirurgia. A ação radioprotetora da vitamina E foi avaliada pela coloração por hematoxilina-eosina para análise morfológica do tecido de granulação, aos 4, 7, 14 e 21 dias após a cirurgia. A análise dos resultados mostrou que o retardo no processo de reparação tecidual causado por 6 Gy de radiação de elétrons com feixe de 6 MeV não ocorreu no grupo de animais que recebeu vitamina E, mostrando-se esta substância efetiva como radioprotetora.

Compostos alfa-diazo carbonílicos: uma estratégia atraente para a síntese orgânica

Diazocarbonyl compounds are a very important class of organic substances which have a long history of useful aplications in organic chemistry. The focus of this report deals with the use of diazocarbonyl compounds in a ariety of important reactions and their application in organic synthesis. These reactions are briefly summarized showing their broad scope.

Determinação de alfa-Tocoferol em alho irradiado utilizando cromatografia líquida de alta eficiência (CLAE)

The effects of 60Co ionizing radiations in doses of 0, 75, 100, 150, 200 and 250Gy on garlic, upon the alpha-tocopherol concentration were studied. The alpha-tocopherol contents were established by high performance liquid chromatography (HPLC), after direct hexane extraction from the garlic samples. The alpha-tocopherol was determined through normal-phase column, and mobile phase was composed by hexane: iso-propyl alcohol (99:01 v/v), with 2mL/min flow rate and fluorescence detector. It is statistically shown that an irradiation dose of up to 150 Gy does not affect the garlic alpha-tocopherol content.

Aplicação da calorimetria exploratória diferencial no estudo da cinética de transição alfa -> delta HMX

Octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) or octogen is a white crystalline substance which occurs in four polymorphous forms. It is used in a wide variety of military and industrial formulations owing to its suitable properties. Researchers have demonstrated the usefulness of this energetic material in explosive components. In the present work we apply differential scanning calorimetry (DSC) to measure the a ® d solid-solid phase transition energy of HMX. The results obtained by Kissinger's and Ozawa's methods were 487 and 495 kJ/mol, respectively.

Síntese e caracterização de alfa-fosfato de zircônio(IV) contendo agregados de cobre metálico

The alpha-zirconium (IV) hydrogenphosphate (alpha-ZrP) has received great attention in the last years due to its properties like ion exchange, intercalation, ionic conductivity and catalytic activity. This work reports a method to produce metallic copper clusters on alpha-ZrP to be used as catalysts in petrochemical processes. It was found that the solids were non-crystalline regardless of the uptake of copper and the reduction. The specific surface area increased as a consequence of the increase of the interlayer distance to accept the copper ions between the layers. During the reduction, big clusters of copper (0,5-11µ) with different sizes and shapes were produced.

Bioquímica e ação citotóxica de alfa-aminocetonas endógenas

alpha-Aminoketones are expected to undergo enolization and subsequent aerobic oxidation yielding oxyradicals and highly toxic a-oxoaldehydes. Our interest has been focused on two endogenous a-aminoketones: 5-aminolevulinic acid (ALA) and aminoacetone (AA), accumulated in porphyrias and diabetes mellitus, respectively, and recently implicated as contributing sources of oxyradicals in these diseases. The final oxidation product of ALA, 4,5-dioxovaleric acid (DOVA), is able to alkylate DNA guanine moieties and expected to promote protein cross-linking. Methylglyoxal (MG), the final oxidation product of AA, is also highly cytotoxic and able to aggregate protein molecules. This review covers chemical and biochemical aspects of these alpha-aminoketones and their putative roles in the oxidative stress associated with porphyric disorders and diabetes.

Fotoquímica de alfa,alfa-dimetilvalerofenona adsorvida em celulose microcristalina

Irradiation of a,a-dimethylvalerophenone (1) adsorbed on microcrystalline cellulose employing methanol as the solvent shows a Norrish Type II/Type I ratio of 1.0±0.1. In solution, values of 2.3±0.3 in benzene and 8.7±2.0 in terc-butanol were obtained. The cyclization/elimination ratio for the Norrish Type II reaction of 1 shows values of 1.2±0.3 in cellulose, 17.9±2.7 in benzene and 3.2±03 in terc-butanol. When samples of 1/microcrystalline cellulose were prepared employing n-hexane, the Type II/Type I (29.5±2.9) and the cycl/elim (113.3±12.1) ratios were dramatically modified. These results demonstrate the difference in the behavior of 1 when entrapped in the cellulose chains or adsorbed on the cellulose surface.

alfa e b-glucosidases como alvos moleculares para desenvolvimento de fármacos

Glucosidases are involved in key steps in the processing of oligosaccharides by cleaving O-glucose residues. Since they catalyze breaking and transfer reactions of glucosidic groups for the normal growth and development of all the cells, defects or genetic deficiencies in these enzymes are associated with serious disorders of the carbohydrate metabolism. Thus, glucosidases represent important targets to develop inhibitors, owing to their potential activities against viruses, tumoral growth and metastasis, diabetes, Gaucher's disease and other syndromes associated with the lisosomal storage of glucoesphingolipids, and osteoarthritis. This paper presents a description of the biochemical pathways and mechanisms of alpha and beta-glucosidases, and the currently available drugs capable to inhibit these enzymes.