Desempenho de clones de copa e painel de seringueira no sudoeste do Estado do Mato Grosso

O objetivo deste trabalho foi avaliar o desempenho de 12 combinações de três clones de painel (PB 311, PB 314 e RRIM 600) com quatro clones de copa (F 4512, MDF 180, IAN 6158 e IAN 6543) de seringueira cultivados no sudoeste do Estado do Mato Grosso. Utilizou-se o delineamento experimental de blocos ao acaso, com quatro repetições. Foram avaliados: produção de borracha seca, percentagem de plantas aptas à sangria, secamento de painel, estado nutricional, teor de borracha seca, plasticidade Wallace (P0 e P30), índice de retenção de plasticidade e viscosidade Mooney. As combinações das copas IAN 6543 e MDF 180 com os painéis PB 311, RRIM 600 e PB 314 apresentaram estado nutricional adequado, com produtividade de borracha seca acima de 1,41 Mg ha-1 por ano. O clone de copa IAN 6158 propiciou, em oito anos, as maiores quantidades de plantas aptas à sangria. As combinações painel/copa apresentaram baixa incidência de secamento de painel, exceto PB 311 x IAN 6158. As borrachas das 12 combinações painel/copa apresentam boa resistência à degradação térmica e alta retenção de plasticidade.

The cAMP response element binding protein-2 (CREB-2) can interact with the C/EBP-homologous protein (CHOP).

cAMP response element binding protein-2 (CREB-2) is a basic leucine zipper (bZIP) factor that was originally described as a repressor of CRE-dependent transcription but that can also act as a transcriptional activator. Moreover, CREB-2 is able to function in association with the viral Tax protein as an activator of the human T-cell leukemia virus type I (HTLV-I) promoter. Here we show that CREB-2 is able to interact with C/EBP-homologous protein (CHOP), a bZIP transcription factor known to inhibit CAAT/enhancer-dependent transcription. Cotransfection of CHOP with CREB-2 results in decreased activation driven by the cellular CRE motif or the HTLV-I proximal Tax-responsive element, confirming that CREB-2 and CHOP can interact with each other in vivo.

Purification and fractionation by nanotiltration in dairy and sugar and sweetener industry applications

Nanotiltration is a membrane separation method known for its special characteristic of rejecting multivalent ions and passing monovalent ions. Thus, it is commonly applied with dilute aqueous solutions in partial salt removal, like in drinking water production. The possibilities of nanofiltration have been studied and the technique applied in a wide branch of industries, e.g. the pulp and paper, the textile and the chemical processing industry. However, most present applications and most of the potential applications studied involve dilute solutions, the permeating stream being generally water containing monovalent salts. In this study nanotiltration is investigated more as a fractionation method. A well-known application in the dairy industry is concentration and partial salt removal from whey. Concentration and partial demineralization is beneficial for futher processing of whey as whey concentrates are used e.g. in baby foods. In the experiments of this study nanotiltration effectively reduced the monovalent salts in the whey concentrate. The main concern in this application is lactose leakage into the permeate. With the nanofiltration membranes used the lactose retentions were practically ? 99%. Another dairy application studied was the purification and reuse of cleaning solutions. This is an environmentally driven application. An 80% COD reduction by nanofiltration was observed for alkaline cleaning-in-place solution. Nanofiltration is not as commonly applied in the sugar and sweeteners industry as in the dairy industry. In this study one potential application was investigated, namely xylose purification from hemicellulose hydrolyzate. Xylose is raw material for xylitol production. Xylose separation from glucose was initially studied with xylose-glucose model solutions. The ability of nanofiltration to partially separate xylose into the permeate from rather concentrated xylose-glucose solutions (10 w-% and 30 w-%) became evident. The difference in size between xylose and glucose molecules according to any size measure is small, e.g. the Stokes diameter of glucose is 0.73 nm compared to 0.65 nm for xylose. In further experiments, xylose was purified into nanoliltration permeate from a hemicellulose hydrolyzate solution. The xylose content in the total solids was increased by 1.4—1.7 fold depending on temperature, pressure and feed composition.

Ureia de liberação lenta em substituição ao farelo de soja na terminação de bovinos confinados

Resumo: O objetivo deste trabalho foi avaliar o efeito da substituição da proteína bruta do farelo de soja pela ureia de liberação lenta sobre o desempenho, as características de carcaça e o custo alimentar de bovinos Nelore terminados em confinamento. Foram utilizados 48 machos inteiros da raça Nelore, com idade média de 22 meses e peso inicial de 367,95±18,52 kg. Utilizou-se o delineamento inteiramente casualizado com quatro tratamentos: FS, 8,91% de farelo de soja e 0% de ureia de liberação lenta (ULL); OP33, 6,01% de farelo de soja e 0,46% de ULL; OP67, 2,94% de farelo de soja e 0,94% de ULL; e OP100, 0% de farelo de soja e 1,41% de ULL. Não houve diferença entre os tratamentos para as variáveis peso inicial, peso final, ganho médio diário, ganho de carcaça, consumo de matéria seca, conversão alimentar, eficiência biológica, peso de carcaça quente, rendimento de carcaça e custo alimentar da arroba produzida. A ureia de liberação lenta, usada em substituição parcial ou total à proteína do farelo de soja na dieta, não altera o desempenho, as características de carcaça e a eficiência econômica de bovinos de corte confinados.

Germinação de sementes e crescimento inicial de maracujazeiros irrigados com água salina em diferentes volumes de substrato

No período de novembro de 2000 e fevereiro de 2001, estudaram-se os efeitos da salinidade da água de irrigação aos níveis de 0,5; 1,0; 2,0; 3,0; 4,5 e 6,0 dS m-1 e dos volumes de substrato: 0,34 e 1,41 L sobre a germinação de sementes e algumas variáveis de crescimento inicial em plantas de maracujá-amarelo e roxo (Passiflora edulis f. flavicarpa Deg). Os resultados mostraram que, independentemente da cultivar, apesar de a água salina inibir a germinação e o desenvolvimento das plantas, os efeitos foram mais danosos nos tratamentos com menor volume do substrato. Ambos os genótipos sofreram mais a ação da salinidade durante o crescimento inicial avaliado pela altura, diâmetro do caule, área foliar, crescimento da raiz principal e biomassa das raízes e parte aérea, que por ocasião da germinação das sementes. As mudas irrigadas com águas de condutividade elétrica superior a 1,0 dS m-1 não apresentaram qualidade para plantio.

Comportamento fisiológico de sementes de pitombeira [Talisia esculenta (A. ST. Hil) Radlk] submetidas à desidratação

Em condições normais, as sementes de pitombeira [Talisia esculenta (A. St. Hil) Radlk] perdem a qualidade fisiológica rapidamente, o que dificulta sua utilização pelos viveiristas. Em função da escassez de pesquisas referentes à dessecação de suas sementes, o trabalho teve como objetivo avaliar a qualidade fisiológica de sementes de pitombeira submetidas a cinco períodos de secagem (0; 24; 48; 96 e 120 horas). O delineamento experimental foi inteiramente ao acaso, e os dados, submetidos à análise de variância e de regressão polinomial. A avaliação do efeito dos tratamentos foi realizada através da determinação do teor de água, porcentagem de germinação e testes de vigor (primeira contagem, índice de velocidade e tempo médio para germinação, comprimento e massa da matéria seca da raiz primária e parte aérea). Verificou-se um teor de água inicial de 40%, o qual foi reduzindo com os períodos de secagem; conseqüentemente, registraram-se as maiores porcentagens de germinação (99%) com 53 horas de secagem. Quanto ao vigor, os maiores valores de primeira contagem (78%) e comprimento da parte aérea (11,29 cm) foram obtidos com 38 horas de secagem; já o menor tempo médio para germinação (17 dias) e comprimento máximo da raiz primária (15,79 cm) ocorreram quando a secagem foi por 40 horas. Quanto ao índice de velocidades de germinação (1,41), massa da matéria seca das raízes (0,079) e parte aérea (0,229), os valores máximos foram obtidos quando as sementes foram submetidas à secagem por 44; 33 e 50 horas, respectivamente. Diante dos resultados, recomenda-se a secagem de sementes de pitombeira por até 48 horas, como forma de garantir a germinação e o vigor.

Subclinical thyroid dysfunction and fracture risk: a meta-analysis.

IMPORTANCE: Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking. OBJECTIVE: To assess the association of subclinical thyroid dysfunction with hip, nonspine, spine, or any fractures. DATA SOURCES AND STUDY SELECTION: The databases of MEDLINE and EMBASE (inception to March 26, 2015) were searched without language restrictions for prospective cohort studies with thyroid function data and subsequent fractures. DATA EXTRACTION: Individual participant data were obtained from 13 prospective cohorts in the United States, Europe, Australia, and Japan. Levels of thyroid function were defined as euthyroidism (thyroid-stimulating hormone [TSH], 0.45-4.49 mIU/L), subclinical hyperthyroidism (TSH <0.45 mIU/L), and subclinical hypothyroidism (TSH ≥4.50-19.99 mIU/L) with normal thyroxine concentrations. MAIN OUTCOME AND MEASURES: The primary outcome was hip fracture. Any fractures, nonspine fractures, and clinical spine fractures were secondary outcomes. RESULTS: Among 70,298 participants, 4092 (5.8%) had subclinical hypothyroidism and 2219 (3.2%) had subclinical hyperthyroidism. During 762,401 person-years of follow-up, hip fracture occurred in 2975 participants (4.6%; 12 studies), any fracture in 2528 participants (9.0%; 8 studies), nonspine fracture in 2018 participants (8.4%; 8 studies), and spine fracture in 296 participants (1.3%; 6 studies). In age- and sex-adjusted analyses, the hazard ratio (HR) for subclinical hyperthyroidism vs euthyroidism was 1.36 for hip fracture (95% CI, 1.13-1.64; 146 events in 2082 participants vs 2534 in 56,471); for any fracture, HR was 1.28 (95% CI, 1.06-1.53; 121 events in 888 participants vs 2203 in 25,901); for nonspine fracture, HR was 1.16 (95% CI, 0.95-1.41; 107 events in 946 participants vs 1745 in 21,722); and for spine fracture, HR was 1.51 (95% CI, 0.93-2.45; 17 events in 732 participants vs 255 in 20,328). Lower TSH was associated with higher fracture rates: for TSH of less than 0.10 mIU/L, HR was 1.61 for hip fracture (95% CI, 1.21-2.15; 47 events in 510 participants); for any fracture, HR was 1.98 (95% CI, 1.41-2.78; 44 events in 212 participants); for nonspine fracture, HR was 1.61 (95% CI, 0.96-2.71; 32 events in 185 participants); and for spine fracture, HR was 3.57 (95% CI, 1.88-6.78; 8 events in 162 participants). Risks were similar after adjustment for other fracture risk factors. Endogenous subclinical hyperthyroidism (excluding thyroid medication users) was associated with HRs of 1.52 (95% CI, 1.19-1.93) for hip fracture, 1.42 (95% CI, 1.16-1.74) for any fracture, and 1.74 (95% CI, 1.01-2.99) for spine fracture. No association was found between subclinical hypothyroidism and fracture risk. CONCLUSIONS AND RELEVANCE: Subclinical hyperthyroidism was associated with an increased risk of hip and other fractures, particularly among those with TSH levels of less than 0.10 mIU/L and those with endogenous subclinical hyperthyroidism. Further study is needed to determine whether treating subclinical hyperthyroidism can prevent fractures.

Kestävän kehityksen näkökulmien huomioiminen kunnan energiaratkaisussa

Diplomityön tavoitteena on tuottaa informaatiota kunnalliseen päätöksentekoon, jonka avulla kestävän kehityksen näkökulmia voidaan huomioida kunnan energiaratkaisusta päätettäessä. Yhtenä työn lähtökohtana on ollut myös uusi EU-direktiivi, jonka mukaan ympäristönäkökohtia voidaan huomioida julkisten hankintojen tarjouspyyntömenettelyssä valintaperusteena. Tarkastelun kohteena oli kokoluokaltaan 0,5–3 MW:n aluelämpölaitokset sekä polttoaineiden tuotantoketjut. Työssä vertailtavat polttoaineet olivat metsähake, raskas polttoöljy, kevyt polttoöljy ja turve. Diplomityössä on perehdytty kestävän kehityksen käsitteeseen ja muodostettu sen mukaan ekologiselle, sosiaaliselle ja taloudelliselle näkökulmalle kunnallisen energiaratkaisun indikaattoreita. Empiirisessä osassa käsitellään kestävän kehityksen näkökulmien muodostumista Enon energiaosuuskunnan toimintaan perustuen. Käytettävät kestävän kehityksen näkökulmien mukaiset indikaattorit ovat polttoaineen tuotannosta ja käytöstä aiheutuvat kasvihuonekaasupäästöt, polttoaineen tuotannon työllisyysvaikutukset sekä energian hinnan muodostuminen osuuskunnan asiakkaille. Tässä diplomityössä tarkastelluilla kestävän kehityksen indikaattoreilla mitattuna, metsähakkeen käytöllä energiantuotannossa on positiivinen vaikutus niin kunnan kasvihuonekaasutaseessa, työllisyystilanteessa sekä myös enemmän kuluttajaystävällinen asema, lämmön hinnan vakauden ansiosta, kuin muilla työssä käsiteltävillä polttoaineilla. Polttoaineen tuotantoketjun osalta metsähakkeelle saatiin tuotannon ja käytön aiheuttamaksi kasvihuonekaasupäästöksi 2,9–4,2 g CO2-ekv/MJ. Tulos perustuu Enon energiaosuuskunnan polttoaineen hankinnassa käytössä oleviin keskimääräisiin etäisyyksiin metsäkuljetuksessa (250 m) ja kaukokuljetuksessa (15 km). Tuotannon ja käytön aiheuttamat kasvihuonekaasupäästöt olivat raskaalla polttoöljyllä 88,2 g CO2-ekv/MJ, kevyellä polttoöljyllä 85,0 g CO2-ekv/MJ ja turpeella 104,0–108,1 g CO2-ekv/MJ. Metsähakkeen osalta polttoaineen tuotannon osuus koko tarkastellun energiaketjun kasvihuonekaasupäästöistä oli noin 43–57 %. Enon energiaosuuskunnan tapauksessa vuoden 2005 odotetulla toiminta-asteella metsähakkeella tuotetun lämmön tuotantoketjun kasvihuonekaasupäästöt ovat noin 160 t CO2-ekv. Kevyellä polttoöljyllä tuotetun lämmön tuotantoketjun kasvihuonekaasupäästöt olisivat noin 3700 t CO2-ekv sekä turpeen (50 %) ja metsähakkeen (50 %) seoskäyttöön perustuvalla ketjulla noin 2300–2400 t CO2-ekv. Samaisella toiminta-asteella työllisyysvaikutukset ovat käytettäessä metsähaketta 2,2–8,6 htv, raakaöljyä 0,12 htv ja turvetta 1,4–1,6 htv. Metsähakkeen käyttö aluelämpölaitosten pääpolttoaineena takaa myös vakaan hintakehityksen osuuskunnan asiakkaille.

En face optical coherence tomography of foveal microstructure in full-thickness macular hole: a model to study perifoveal müller cells.

PURPOSE: To characterize perifoveal intraretinal cavities observed around full-thickness macular holes (MH) using en face optical coherence tomography and to establish correlations with histology of human and primate maculae. DESIGN: Retrospective nonconsecutive observational case series. METHODS: Macular en face scans of 8 patients with MH were analyzed to quantify the areas of hyporeflective spaces, and were compared with macular flat mounts and sections from 1 normal human donor eye and 2 normal primate eyes (Macaca fascicularis). Immunohistochemistry was used to study the distribution of glutamine synthetase, expressed by Müller cells, and zonula occludens-1, a tight-junction protein. RESULTS: The mean area of hyporeflective spaces was lower in the inner nuclear layer (INL) than in the complex formed by the outer plexiform (OPL) and the Henle fiber layers (HFL): 5.0 × 10(-3) mm(2) vs 15.9 × 10(-3) mm(2), respectively (P < .0001, Kruskal-Wallis test). In the OPL and HFL, cavities were elongated with a stellate pattern, whereas in the INL they were rounded and formed vertical cylinders. Immunohistochemistry confirmed that Müller cells followed a radial distribution around the fovea in the frontal plane and a "Z-shaped" course in the axial plane, running obliquely in the OPL and HFL and vertically in the inner layers. In addition, zonula occludens-1 co-localized with Müller cells within the complex of OPL and HFL, indicating junctions in between Müller cells and cone axons. CONCLUSION: The dual profile of cavities around MHs correlates with Müller cell morphology and is consistent with the hypothesis of intra- or extracellular fluid accumulation along these cells.

Different locations of dermoid cysts in the orbital region.

BACKGROUND: Dermoid cysts are frequent unilateral congenital benign tumors that can be found at different locations throughout the body. In the orbital region, dermoid cysts occur predominantly in the supero-temporal quadrant. However, different orbital locations are possible, making this entity an important differential diagnosis for orbital tumors. PATIENTS AND METHODS: We retrospectively reviewed the charts of 23 consecutive patients operated in our institution between 2005 and 2014 for orbital tumors that were diagnosed as congenital dermoid or epidermoid cysts. RESULTS: There were 21 dermoid and 2 epidermoid cysts. The median age at surgery time was 7 years (range 1-41). There were 15 females and 8 males. Eleven cysts were located supero-temporally (47.8%), seven supero-medially (30.4%), two temporally (8.7%), one at the frontal bone (4.4%) and two in the fossa of the lacrimal gland (8.7%). The mean cyst diameter was 13.1 mm±5.0 (SD). None had signs of malignant disease. No recurrence was observed after complete excision. CONCLUSION: Dermoid cysts of orbital region are mostly located in the supero-temporal quadrant. However, other orbital locations are possible and dermoid cysts must thus be considered in the differential diagnosis of any mass in the orbital region.

Grande fréquence des prescriptions médicamenteuses à visée cardiovasculaire potentiellement inappropriées dans la population âgée [Potentially inappropriate prescribing cardiovascular medications in the aged population: prospective study in a district hospital centre (France)].

OBJECTIVES: Cardiovascular disease is a leading cause of morbidity and mortality in the elderly population. We evaluated the adequacy of prescribing (miss and under used) with respect to STOPP-START criteria. METHODS: A sample of 100 patients hospitalized in cardiovascular specialty divisions (medicine or surgery) or in the different sectors making up the geriatric network (day-care hospital, short or rehabilitation ward, nursing home) has been considered. Drug prescriptions at the admission time were analysed. RESULTS: Eight hundred and seventy-four prescriptions were analysed. In 65% of patients, from 5 to 10 medications were prescribed and in 28% over 10. Fifty-four percent of patients had, at least, one potentially inappropriate prescription (PIP) by STOPP. Among them, 48% of PIP prescriptions contained 1, 41% 2 and 11% 3 or more. The omission of one medication according to START criteria concerned 57% of the sample. Among them, 46% had one omission, 44% 2 to 3 and 10% 4 omissions or over. The cardiovascular system is the one most concerned by the PIP. Whether 28.1% of the PIP by STOPP criteria concerned cardiovascular drugs, the omission of prescription, according to START criteria, was 41.8%. There was no significant difference between the different settings studied. There was no effect of age or sex on the impact of PIP (P>0.20) or being polymédiqué (P=0.44). According to the criteria STOPP-A, the prescription of antiplatelet (indication and dose) was highlighted. Prescribing omission also concerned antiplatelet agents but also statins in patients with atherosclerosis as well as antiplatelet and anticoagulant in patients with permanent atrial fibrillation and inhibitor of angiotensin converting enzyme (ACE) after myocardial infarction or with chronic heart failure. CONCLUSION: Potentially inappropriate prescribing medications were very common in elderly patients with cardiovascular conditions. They concerned as much as underusing of important drugs with potential benefits and prescribing commission of treatment that did not fit with patients' comorbidities and/or characteristics.

Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of specific congenital anomalies: a European register-based study.

Evidence of an association between early pregnancy exposure to selective serotonin reuptake inhibitors (SSRI) and congenital heart defects (CHD) has contributed to recommendations to weigh benefits and risks carefully. The objective of this study was to determine the specificity of association between first trimester exposure to SSRIs and specific CHD and other congenital anomalies (CA) associated with SSRI exposure in the literature (signals). A population-based case-malformed control study was conducted in 12 EUROCAT CA registries covering 2.1 million births 1995-2009 including livebirths, fetal deaths from 20 weeks gestation and terminations of pregnancy for fetal anomaly. Babies/fetuses with specific CHD (n = 12,876) and non-CHD signal CA (n = 13,024), were compared with malformed controls whose diagnosed CA have not been associated with SSRI in the literature (n = 17,083). SSRI exposure in first trimester pregnancy was associated with CHD overall (OR adjusted for registry 1.41, 95 % CI 1.07-1.86, fluoxetine adjOR 1.43 95 % CI 0.85-2.40, paroxetine adjOR 1.53, 95 % CI 0.91-2.58) and with severe CHD (adjOR 1.56, 95 % CI 1.02-2.39), particularly Tetralogy of Fallot (adjOR 3.16, 95 % CI 1.52-6.58) and Ebstein's anomaly (adjOR 8.23, 95 % CI 2.92-23.16). Significant associations with SSRI exposure were also found for ano-rectal atresia/stenosis (adjOR 2.46, 95 % CI 1.06-5.68), gastroschisis (adjOR 2.42, 95 % CI 1.10-5.29), renal dysplasia (adjOR 3.01, 95 % CI 1.61-5.61), and clubfoot (adjOR 2.41, 95 % CI 1.59-3.65). These data support a teratogenic effect of SSRIs specific to certain anomalies, but cannot exclude confounding by indication or associated factors.

Application of intravoxel incoherent motion perfusion imaging to shoulder muscles after a lift-off test of varying duration.

Intravoxel incoherent motion (IVIM) MRI is a method to extract microvascular blood flow information out of diffusion-weighted images acquired at multiple b-values. We hypothesized that IVIM can identify the muscles selectively involved in a specific task, by measuring changes in activity-induced local muscular perfusion after exercise. We tested this hypothesis using a widely used clinical maneuver, the lift-off test, which is known to assess specifically the subscapularis muscle functional integrity. Twelve shoulders from six healthy male volunteers were imaged at 3 T, at rest, as well as after a lift-off test hold against resistance for 30 s, 1 and 2 min respectively, in three independent sessions. IVIM parameters, consisting of perfusion fraction (f), diffusion coefficient (D), pseudo-diffusion coefficient D* and blood flow-related fD*, were estimated within outlined muscles of the rotator cuff and the deltoid bundles. The mean values at rest and after the lift-off tests were compared in each muscle using a one-way ANOVA. A statistically significant increase in fD* was measured in the subscapularis, after a lift-off test of any duration, as well as in D. A fD* increase was the most marked (30 s, +103%; 1 min, +130%; 2 min, +156%) and was gradual with the duration of the test (in 10(-3) mm(2) /s: rest, 1.41 ± 0.50; 30 s, 2.86 ± 1.17; 1 min, 3.23 ± 1.22; 2 min, 3.60 ± 1.21). A significant increase in fD* and D was also visible in the posterior bundle of the deltoid. No significant change was consistently visible in the other investigated muscles of the rotator cuff and the other bundles of the deltoid. In conclusion, IVIM fD* allows the demonstration of a task-related microvascular perfusion increase after a specific task and suggests a direct relationship between microvascular perfusion and the duration of the effort. It is a promising method to investigate non-invasively skeletal muscle physiology and clinical perfusion-related muscular disorders.

Association between resistin levels and cardiovascular disease events in older adults: The health, aging and body composition study.

OBJECTIVE: Prospective data on the association between resistin levels and cardiovascular disease (CVD) events are sparse with conflicting results. METHODS: We studied 3044 aged 70-79 years from the Health, Aging, and Body Composition Study. CVD events were defined as coronary heart disease (CHD) or stroke events. «Hard » CHD events were defined as CHD death or myocardial infarction. We estimated hazard ratio (HR) and 95% confidence intervals (CI) according to the quartiles of serum resistin concentrations and adjusted for clinical variables, and then further adjusted for metabolic disease (body mass index, fasting plasma glucose, abdominal visceral and subcutaneous adipose tissue, leptin, adiponectin, insulin) and inflammation (C-reactive protein, interleukin-6, tumor necrosis factors-α). RESULTS: During a median follow-up of 10.1 years, 559 patients had « hard » CHD events, 884 CHD events and 1106 CVD Events. Unadjusted incidence rate for CVD events was 36.6 (95% CI 32.1-41.1) per 1000 persons-year in the lowest quartile and 54.0 per 1000 persons-year in the highest quartile (95% CI 48.2-59.8, P for trend < 0.001). In the multivariate models adjusted for clinical variables, HRs for the highest vs. lowest quartile of resistin was 1.52 (95% CI 1.20-1.93, P < 0.001) for « Hard » CHD events, 1.41 (95% CI 1.16-1.70, P = 0.001) for CHD events and 1.35 (95% CI 1.14-1.59, P = 0.002) for CVD events. Further adjustment for metabolic disease slightly reduced the associations while adjustment for inflammation markedly reduced the associations. CONCLUSIONS: In older adults, higher resistin levels are associated with CVD events independently of clinical risk factors and metabolic disease markers, but markedly attenuated by inflammation.

Assessing efficacy of different nucleos(t)ide backbones in NNRTI-containing regimens in the Swiss HIV Cohort Study.

BACKGROUND: The most recommended NRTI combinations as first-line antiretroviral treatment for HIV-1 infection in resource-rich settings are tenofovir/emtricitabine, abacavir/lamivudine, tenofovir/lamivudine and zidovudine/lamivudine. Efficacy studies of these combinations also considering pill numbers, dosing frequencies and ethnicities are rare. METHODS: We included patients starting first-line combination ART (cART) with or switching from first-line cART without treatment failure to tenofovir/emtricitabine, abacavir/lamivudine, tenofovir/lamivudine and zidovudine/lamivudine plus efavirenz or nevirapine. Cox proportional hazards regression was used to investigate the effect of the different NRTI combinations on two primary outcomes: virological failure (VF) and emergence of NRTI resistance. Additionally, we performed a pill burden analysis and adjusted the model for pill number and dosing frequency. RESULTS: Failure events per treated patient for the four NRTI combinations were as follows: 19/1858 (tenofovir/emtricitabine), 9/387 (abacavir/lamivudine), 11/344 (tenofovir/lamivudine) and 45/1244 (zidovudine/lamivudine). Compared with tenofovir/emtricitabine, abacavir/lamivudine had an adjusted HR for having VF of 2.01 (95% CI 0.86-4.55), tenofovir/lamivudine 2.89 (1.22-6.88) and zidovudine/lamivudine 2.28 (1.01-5.14), whereas for the emergence of NRTI resistance abacavir/lamivudine had an HR of 1.17 (0.11-12.2), tenofovir/lamivudine 11.3 (2.34-55.3) and zidovudine/lamivudine 4.02 (0.78-20.7). Differences among regimens disappeared when models were additionally adjusted for pill burden. However, non-white patients compared with white patients and higher pill number per day were associated with increased risks of VF and emergence of NRTI resistance: HR of non-white ethnicity for VF was 2.85 (1.64-4.96) and for NRTI resistance 3.54 (1.20-10.4); HR of pill burden for VF was 1.41 (1.01-1.96) and for NRTI resistance 1.72 (0.97-3.02). CONCLUSIONS: Although VF and emergence of resistance was very low in the population studied, tenofovir/emtricitabine appears to be superior to abacavir/lamivudine, tenofovir/lamivudine and zidovudine/lamivudine. However, it is unclear whether these differences are due to the substances as such or to an association of tenofovir/emtricitabine regimens with lower pill burden.