Dual Therapy With Darunavir and Ritonavir Plus Lamivudine vs Triple Therapy With Darunavir and Ritonavir Plus Tenofovir Disoproxil Fumarate and Emtricitabine or Abacavir and Lamivudine for Maintenance of Human Immunodeficiency Virus Type 1 Viral Suppression: Randomized, Open-Label, Noninferiority DUAL-GESIDA 8014-RIS-EST45 Trial.

BACKGROUND: Our objective was to assess the therapeutic noninferiority of dual therapy with darunavir/ritonavir and lamivudine compared to triple therapy with darunavir/ritonavir plus 2 nucleos(t)ides for maintenance of human immunodeficiency virus type 1 (HIV-1) suppression. METHODS: This was a multicenter, open-label, noninferiority trial (margin 12%). Patients with HIV-1 RNA <50 copies/mL for 6 months or longer on triple therapy with darunavir/ritonavir and 2 nucleos(t)ides (tenofovir disoproxil fumarate and emtricitabine or abacavir and lamivudine) and with no resistance were randomized to continue therapy (n = 128) or switch to darunavir/ritonavir and lamivudine (n = 129). The primary endpoint was the proportion of participants with HIV-RNA <50 copies/mL after 48 weeks of follow-up according to the snapshot algorithm. RESULTS: A total of 249 participants received study drugs (intention-to-treat exposed). The proportion of participants with HIV-RNA <50 copies/mL in the dual- and triple-therapy arms was 88.9% (112/126) and 92.7% (114/123; difference, -3.8%; 95% confidence interval, -11.0 to 3.4), respectively. Four participants in the dual-therapy arm and 2 in the triple-therapy arm developed protocol-defined virological failure. Switching to dual therapy was associated with a significant increase in total, low-density lipoprotein, and high-density lipoprotein (HDL) cholesterol, but not in the total-to-HDL cholesterol ratio. Serious adverse events and study drug discontinuations due to adverse events occurred in 4.8% vs 4.9%P = .97) and in 0.8% (1/126) vs 1.6% P = .55) in dual therapy vs triple therapy, respectively. CONCLUSIONS: Dual therapy with darunavir/ritonavir and lamivudine demonstrated noninferior therapeutic efficacy and similar tolerability compared to triple therapy. CLINICAL TRIALS REGISTRATION: NCT02159599.

Electrochemical Study of a Hybrid Polymethyl Methacrylate Coating using SiO2 Nanoparticles toward the Mitigation of the Corrosion in Marine Environments.

The demand for hydrophobic polymer-based protective coatings to impart high corrosion resistance has increased recently. The increase of the hydrophobicity in a hybrid coating is a new challenge, for that reason and in order to protect a metallic surface of oxidant agents, a poly (methyl methacrylate) (PMMA) coating with the addition of a different amount of silicon dioxide (SiO2) was developed. The hybrid coating was applied on a sample of stainless steel AISI 304 by the dip-coating method. The characterization of the coatings was determined by electrochemical impedance spectroscopy and with a scanning electrochemical microscopy. The best coatings were PMMA and PMMA + SiO2 0.01% that exhibits a real impedance in the Nyquist diagram of 760 and 427,800 MΩ⋅cm2, respectively, and the modulus of the real impedance in the Bode diagram present values of 2.2 × 108 and 3.3 × 108 Ω⋅cm2. Moreover, the phase angle presents constant values around 75° to 85° and 85° for the PMMA and PMMA + SiO2 0.01%, respectively. Moreover, the values of the real resistance for the PMMA + SiO2 0.01% coating present values in the order of Mega-ohms despite the coating exhibits an artificial defect in their surface. The contact angle test showed that the hydrophobicity of the hybrid PMMA + SiO2 0.01% coating is higher than that of the pure PMMA coatings. The hybrid PMMA + SiO2 coatings developed in this work are a very interesting and promising area of study in order to develop efficient products to protect metallic surfaces from corrosion phenomenon.

[Pulmonary hemorrhage after abciximab. Risk factors and the role of protamine]. / Hemorragia pulmonar por abciximab. Factores de riesgo y papel de la protamina.

Large clinical trials have demonstrated the clinical effectiveness of therapy with inhibitors of the platelet surface-membrane glycoprotein IIb-IIIa receptor in a broad range of patients with ischemic heart disease. Abciximab, a platelet glycoprotein IIb-IIIa receptor blocker, is associated with improved long-term prognosis in patients who require angioplasty and stent placement. Severe bleeding from abciximab use is an uncommon event. We describe a patient with severe pulmonary hemorrhage after treatment with abciximab, and discuss predisposing factors and protamine infusion in this potentially fatal complication.