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The guava (Psidium guajava L.) is a plant native to the tropical region of America. In Mexico, the area established with guava cultivation is 20,525 ha (SIAP 2021). Guava is commonly consumed as fresh fruit, being rich in nutrients such as vitamins and minerals (Murthy et al. 2020). During October 2020, in the municipality of Cocula (18.207835N, 99.670322W, 595 m above sea level), Guerrero, Mexico, severely infected immature guava fruits were observed. The incidence of disease in 150 sampled fruits was 12%. Were collected fifteen symptomatic fruits. The symptoms were circular to irregular dark brown spots that varied in size (0.5 to 2.5 cm). From symptomatic fruits, tissues were cut approximately 3 x 3 mm and disinfested with 1% NaOCl, washed three times with sterile distilled water, and transferred to PDA medium amended with streptomycin and tetracycline, and incubated at 28°C. Developing colonies were retransferred to new culture PDA medium, and purified by hyphal tip technique. Two representative isolates (PHYGUA7 and PHYGUA3) were selected for morphological and molecular characterization. After 15 days in PDA at 28°C in an incubator, colonies were flat, irregular, granular and greenish gray, pycnidia were black, granular, and grouped. The conidia were hyaline and ellipsoid, unicellular and smooth-walled, 7-11×5-6.5 µm (n=50), these characteristics were consistent with those described for the fungus Phyllosticta capitalensis (Wikee et al. 2013). Molecular identification was performed by partially sequencing the internal transcribed spacer gene (ITS), the actin gene (ACT), and the translation elongation factor 1-alpha (EF-1α) gene, using primers ITS1 and ITS4, ACT-512F/ ACT-783R, and EF1-728F/EF1-986R, respectively (White et al. 1990; Carbone and Kohn 1999). The resulting sequences were deposited in GenBank (PHYGUA7: OP810947, PHYGUA3: OP810948 for ITS, PHYGUA7: OP819845, PHYGUA3: OP819846 for ACT, and PHYGUA7: OP819847, PHYGUA3: OP819848 for EF-1α). Phylogenetic analysis using maximum likelihood concatenated sequences ITS, ACT and EF-1α with MEGA X, indicated that PHYGUA7 and PHYGUA3 isolated grouped with P. capitalensis (CPC 18848 type strain). For pathogenicity test of P. capitalensis, 15 healthy immature fruits in a field experiment in the fruits on the trees, and 15 healthy mature guava fruits (detached fruits) were superficially disinfected with 70% ethanol, wounded with a sterile toothpick, and inoculated at two equidistant points by inserting PHYGUA7 isolate mycelium. As a control treatment, 10 healthy immature fruits and 10 healthy mature fruits were only injured with a sterile toothpick. After 3 days symptoms were observed in mature fruits and numerous dark pycnidia developed, and seven days later symptoms were observed in immature fruits in all the points inoculated with the PHYGUA7 isolate, similar to the symptoms observed in the field. The control fruits remained asymptomatic. The fungus P. capitalensis was re-isolated from inoculated fruits, thus confirming Koch's postulates. In Mexico P. capitalensis has been reported in Mangifera indica, Epidendrum sp., and Schomburgkia tibicinis (Farr and Rossman, 2022). In Egypt and China P. capitalensis causes black spot on guava fruits (Arafat 2016; Liao et al. 2020). To our knowledge, this is the first report of P. capitalensis as the cause of brown spot on immature guava fruit in Mexico. This research provides relevant information to the design of disease management strategies.
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Hypertension is a medical condition that affects millions of people worldwide. Despite the high efficacy of the current antihypertensive drugs, they are associated with serious side effects. Peptides constitute attractive options for chemical therapy against hypertension, and computational models can accelerate the design of antihypertensive peptides. Yet, to the best of our knowledge, all the in silico models predict only the antihypertensive activity of peptides while neglecting their inherent toxic potential to red blood cells. In this work, we report the first sequence-based model that combines perturbation theory and machine learning through multilayer perceptron networks (SB-PTML-MLP) to enable the simultaneous screening of antihypertensive activity and hemotoxicity of peptides. We have interpreted the molecular descriptors present in the model from a physicochemical and structural point of view. By strictly following such interpretations as guidelines, we performed two tasks. First, we selected amino acids with favorable contributions to both the increase of the antihypertensive activity and the diminution of hemotoxicity. Then, we assembled those suitable amino acids, virtually designing peptides that were predicted by the SB-PTML-MLP model as antihypertensive agents exhibiting low hemotoxicity. The potentiality of the SB-PTML-MLP model as a tool for designing potent and safe antihypertensive peptides was confirmed by predictions performed by online computational tools reported in the scientific literature. The methodology presented here can be extended to other pharmacological applications of peptides.
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Anti-Hipertensivos , Hipertensão , Aminoácidos , Anti-Hipertensivos/química , Anti-Hipertensivos/farmacologia , Humanos , Hipertensão/tratamento farmacológico , Aprendizado de Máquina , Peptídeos/química , Peptídeos/farmacologiaRESUMO
Medication compliance is critical to achieve therapeutic efficacy in patients with rheumatoid arthritis; however, among other factors, low patient-health literacy plays a negative role. Therefore, the development and validation of audiovisual educational material with the participation of health specialists and patients could lead to an improved level of compliance with treatment, while favoring its acceptance. To design and validate audiovisual educational material generated by a multidisciplinary and participative group of patients and health specialists. This study was carried out using a sequential methodology, including qualitative and quantitative techniques: (1) a non-participative observational study with patients and a non-systematic literature search were performed to identify conceptual topics. (2) Pilot videos were qualitatively assessed by patients and health specialists (focus groups and expert committees). (3) Improved versions of seven videos were quantitatively evaluated by patients and specialists following qualitative criteria of attraction, understanding, involvement, acceptance and induction of action. 74 patients with RA, 10 rheumatologists, 4 pharmacists and 2 medical anthropologists participated in the different phases of validation. A total of seven videos lasting 3 min each were generated, incorporating the most relevant suggestions by patients and healthcare professionals. The final version of the videos led to a mean compliance of 96.04 ± 5.2%, according to a representative group of patients and a mean 89.6 ± 9.4%, according to health professionals. With the participation of both patients and health specialists, seven audiovisual educational video recordings were developed and validated, reaching high levels of compliance in accordance with international criteria.
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Artrite Reumatoide , Artrite Reumatoide/tratamento farmacológico , Grupos Focais , Pessoal de Saúde , Humanos , Adesão à Medicação , ReumatologistasRESUMO
OBJECTIVES: Expression of α4ß7 integrin can identify gut-homing immune cells. This study aimed to determine the expression of Toll-like receptor 2 (TLR2) and TLR4 in α4ß7-positive leukocytes of patients with axial SpA (axSpA). METHODS: We analysed the frequencies of α4ß7-positive T cells, Tγδ cells and monocytes in 14 patients with axSpA and 14 healthy controls, together with the expression of TLR2 and TLR4 by flow cytometry. Also, the concentration of faecal calprotectin was measured in all patients and controls. RESULTS: We found significantly higher percentages of α4ß7-positive T (P = 0.026) and Tγδ cells (P = 0.0118) in the patients with axSpA than in controls; these cells showed differential expression of TLR2 and TLR4 when compared with α4ß7-negative cells. Such differences were not correlated with disease activity or faecal calprotectin concentration. CONCLUSION: There is an increase in circulating α4ß7-positive T and Tγδ cells in patients with axSpA. These cells differentially express TLR2 and TLR4.
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Monócitos/metabolismo , Espondiloartropatias/metabolismo , Subpopulações de Linfócitos T/metabolismo , Linfócitos T/metabolismo , Receptor 2 Toll-Like/metabolismo , Receptor 4 Toll-Like/metabolismo , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Integrinas/metabolismo , Complexo Antígeno L1 Leucocitário/metabolismo , Masculino , Receptores de Antígenos de Linfócitos T gama-delta/metabolismoRESUMO
Lipid supplementation of ruminant diets may trigger changes in the ruminal microbiota and in anaerobic digestion. Changes in the bacterial community composition and in the fatty acid hydrogenation caused by the addition of different supplemental plant oils to a high concentrate diet were investigated in vitro using RUSITEC (rumen simulation technique) fermenters. The control (CTR) diet was a high-concentrate total mixed ration for dairy sheep, with no supplementary oil. The other experimental diets were supplemented with olive (OLV), sunflower (SFL) or linseed (LNS) oils at 6% (dry matter basis). Four RUSITEC fermenters were used for each experimental diet, all inoculated with rumen digesta of sheep. Extent of dry matter and fat degradation, composition of the bacterial community and long-chain fatty acids in digesta were determined. The addition of plant oils increased (P < 0.001) apparent degradation of fat in the fermenters, whereas fermentation kinetics (gas production and average fermentation rate) were lower (P < 0.05) with the LNS than with the CTR diet. Hydrogenation of C18 unsaturated fatty acids (P < 0.05), in particular that of oleic acid (P < 0.001), and stearic acid proportion (P < 0.001) were reduced, and oleic acid proportion was increased (P < 0.001) with all oil supplements. Addition of OLV decreased linoleic and LNS increased α-linolenic (P < 0.001), whereas conjugated linoleic was increased with SFL oil (P = 0.025) and vaccenic increased with both SFL and LNS oils (P = 0.008). Addition of 6% OLV and LNS reduced (P < 0.05) microbial community diversity and quantity of total bacteria relative to the control. Some specific microbial groups were affected (P < 0.001) by oil addition, with less relative abundance of Clostridiales and Actinobacteria and increased Bacteroidales, Aeromonadales and Lactobacillales species. In conclusion, the supplementation of high-concentrate ruminant diets with plant oils, in particular from sunflower or linseed, causes shifts in the rumen microbiota and fatty acid hydrogenation in the rumen increasing the formation of vaccenic and conjugated linoleic acids.
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Suplementos Nutricionais , Ácidos Graxos/metabolismo , Fermentação , Microbiota , Óleos de Plantas , Rúmen/microbiologia , Ração Animal/análise , Animais , Técnicas Bacteriológicas , Metagenômica/métodosRESUMO
C. citratus essential oil and carvacrol have shown an antitumor effect on breast tumor cell lines; the main objective of this research was to evaluate the antitumor effect of the essential oil of Cymbopogon citratus (EOCc) and carvacrol on 7,12-dimethylbenz [a] anthracene (DMBA)-induced breast cancer in female rats. Cancer was induced by a single administration of DMBA at dose of 80 mg/kg body weight (BW). A total of 54 female Holtzman rats were randomly assigned into 9 groups (n = 6). Group I: PS (Physiological saline); Group II: DMBA; Groups III, IV, and V: DMBA + EOCc at doses of 50, 100 and 200 mg/kg/day BW, respectively; Groups VI, VII, and VIII: DMBA + carvacrol at doses of 50, 100 and 200 mg/kg/day BW, respectively; and group IX: DMBA + EOCc + carvacrol at doses of 100 mg/kg/day BW. The treatment lasted 14 weeks. As results, EOCc showed a reduction in tumors as well as necrosis and mitosis. Animals treated with carvacrol did not show necrosis, mitosis, or infiltration. Carvacrol at dose of 100 mg/kg/day BW revealed a significant decrease in the cumulative tumor volume down to 0.11 ± 0.05 cm3 compared to 0.38 ± 0.04 cm3 of the DMBA group (p < 0.01). It is concluded that EOCc and carvacrol had an antitumor effect on DMBA-induced breast cancer in female rats.
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Cymbopogon/química , Cimenos/uso terapêutico , Neoplasias Mamárias Experimentais/induzido quimicamente , Neoplasias Mamárias Experimentais/tratamento farmacológico , Óleos Voláteis/uso terapêutico , 9,10-Dimetil-1,2-benzantraceno , Animais , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Compostos de Bifenilo/química , Peso Corporal/efeitos dos fármacos , Carcinogênese/efeitos dos fármacos , Carcinogênese/patologia , Feminino , Neoplasias Mamárias Experimentais/patologia , Óleos Voláteis/análise , Óleos Voláteis/farmacologia , Picratos/química , Ratos Sprague-DawleyRESUMO
BACKGROUND AND AIM: undiagnosed hepatitis C virus (HCV) infection and/or inadequate access to care are barriers to the elimination of HCV. Reflex testing has proven to facilitate referral to care, treatment and viral elimination. In this study, a reflex testing program was implemented in Andalusia and its impact on access to care was evaluated. PATIENTS AND METHODS: an observational, retrospective and prospective study was performed across diagnostic laboratories responsible for HCV diagnosis in southern Spain. After surveying the barriers to performing reflex testing, the number of patients that were not referred for care in 2016 was retrospectively studied (pre-reflex cohort). Subsequently, several measures were proposed to overcome the identified barriers. Finally, reflex testing was implemented and its impact evaluated. RESULTS: the pre-reflex cohort included information from 1,053 patients. Slightly more than half of the patients (n = 580; 55%) visited a specialist for treatment evaluation during a median period of 71 days (interquartile range = 35-134) since the date of diagnosis. The post-reflex cohort (September 2017 to March 2018) included 623 patients. Only 17% (n = 106) of the patients had not been referred for care or evaluated for treatment in a median period of 52 days (interquartile range = 28-86). CONCLUSIONS: in 2016, nearly half of new HCV diagnoses in southern Spain were not referred for care. Barriers to the implementation of reflex testing were overcome in our study. Moreover, this strategy was effectively implemented in 2017. Reflex testing contributed to improving referral for care. This program will contribute to the micro-elimination of hepatitis C in Spain.
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Hepacivirus , Hepatite C , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Humanos , Estudos Prospectivos , Reflexo , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
There is an urgent need to discover and develop new drugs to combat parasitic diseases as Chagas disease (Trypanosoma cruzi), sleeping sickness (Trypanosoma brucei), and leishmaniasis (Leishmania ssp.). These diseases are considered among the 13 most unattended diseases worldwide according to the WHO. In the present work, the synthesis of 14 arylsubstituted imidazoles and its molecular docking onto sterol 14α-demethylase (CYP51) was executed. In addition, the compounds, antiprotozoal activity against T. brucei, T. cruzi, Trypanosoma brucei rhodesiense, and Leishmania infantum was evaluated. In vitro antiparasitic results of the arylsubstituted imidazoles against T. brucei, T. cruzi, T.b. rhodesiense, and L. infantum indicated that all samples from arylsubstituted imidazole compounds presented interesting antiparasitic activity to various extent. The ligands 5a, 5c, 5e, 5f, 5g, 5i, and 5j exhibited strong activity against T. brucei, T. cruzi, T.b. rhodesiense, and L. infantum with IC50 values ranging from 0.86 to 10.23 µM. Most samples were cytotoxic against MRC-5 cell lines (1.12 < CC50 < 51.09 µM) and only ligand 5c showed a good selectivity against all tested parasites. According to the results of the molecular docking, the aromatic substituents in positions 1, 4, and 5 have mainly stabilizing hydrophobic interactions with the enzyme matrix, while the oxygen from NO2, SO3H, and OH groups interacts with the Fe2+ ion of the Heme group.
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Antiprotozoários/química , Doença de Chagas/tratamento farmacológico , Imidazóis/química , Leishmania infantum/enzimologia , Leishmaniose/tratamento farmacológico , Esterol 14-Desmetilase/química , Trypanosoma brucei brucei/enzimologia , Trypanosoma cruzi/enzimologia , Tripanossomíase Africana/tratamento farmacológico , Animais , Antiprotozoários/farmacologia , Linhagem Celular , Humanos , Imidazóis/farmacologia , Leishmania infantum/efeitos dos fármacos , Simulação de Acoplamento Molecular , Esterol 14-Desmetilase/metabolismo , Trypanosoma brucei brucei/efeitos dos fármacos , Trypanosoma cruzi/efeitos dos fármacosRESUMO
OBJECTIVE: To establish the relationship among age, sex, body mass index, consumption of alcoholic beverages and cigarettes with the inadequate response to the vaccine against Hepatitis B in patients with HIV infection who were treated in the Clinical Unit of Infectious and Tropical Diseases of the Regional Hospital of Trujillo - Peru, from 2014 to 2015. MATERIALS AND METHODS: The study was observational, retrospective, cross-sectional, type cases and controls. RESULTS: In the vaccinated patients, it was found that the age ≥ 50 years old; with OR = 3.4 and CD4 < 200, with OR = 35.0, are the risk factors to get the inadequate response to the vaccine against Hepatitis B. CONCLUSIONS: There is a relationship between the re-count of cells CD4 < 00 and the age over 50 years old with an Inadequate response to the vaccination against hepatitis B in HIV-infected patients in the Regional Hospital of Trujillo.
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Infecções por HIV/imunologia , Vacinas contra Hepatite B/imunologia , Imunogenicidade da Vacina , Fatores Etários , Consumo de Bebidas Alcoólicas/efeitos adversos , Índice de Massa Corporal , Fumar Cigarros/efeitos adversos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores SexuaisRESUMO
Chronic hepatitis E virus infection with rapid progression to cirrhosis is reported in 2 human immunodeficiency virus (HIV)-infected patients with severe immunosuppression. Monotherapy with ribavirin led to temporary viral response and marked improvement of liver damage. Chronic hepatitis E should be regarded as another opportunistic event within HIV infection.
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Antivirais/uso terapêutico , Infecções por HIV/complicações , Hepatite E/complicações , Hepatite Crônica/complicações , Cirrose Hepática/patologia , Ribavirina/uso terapêutico , Hepatite E/tratamento farmacológico , Hepatite Crônica/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
BACKGROUND: The prevalence of spondyloarthritis (SpA) varies across populations. In Mexicans, the prevalence of SpA is still unknown. OBJECTIVE: The objective of this study was to determine the prevalence of SpA in the community as well as that of inflammatory back pain (IBP) and ankylosing spondylitis (AS). METHODS: We identified individuals older than 18 years with nontraumatic back pain (BP) in a door-to-door nurse survey using the Community Oriented Program for the Control of Rheumatic Diseases. Then, general physicians and rheumatology fellows selected those likely to have IBP (Berlin criteria). Finally, 2 expert rheumatologists assessed IBP individuals according to clinical data and classification criteria and requested HLA-B27 and radiographic studies to determine the clinical condition of the individual and SpA (European SpA Study Group) classification. RESULTS: The prevalence of BP among 4059 individuals was 14.6% (95% confidence interval [CI], 13.6-15.8). The prevalence of IBP and SpA was 1.3% (95% CI, 1.0-1.7) and 0.6% (95% CI, 0.4-0.9), respectively. Ankylosing spondylitis prevalence was 0.1% (95% CI, 0.02-0.2). Inflammatory back pain and SpA percentage of males and females was similar. The percentage of individuals with IBP according to the 2 experts was lower than that determined by general physicians and rheumatology fellows, but all cases with HLA-B27, radiographic sacroiliitis, SpA, and AS had previous IBP confirmation by the expert. CONCLUSIONS: The prevalence and sex distribution of patients classified with SpA in this community study--as well as that of patients diagnosed with AS--are consistent with those found in recent studies. Expert assessment of individuals with positive responses to questionnaires is relevant for the classification of IBP and SpA.
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Dor nas Costas/epidemiologia , Espondilartrite/epidemiologia , Adulto , Dor nas Costas/etiologia , Dor nas Costas/imunologia , Feminino , Antígeno HLA-B27/sangue , Inquéritos Epidemiológicos , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Características de Residência , Espondilartrite/complicações , Espondilartrite/imunologia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/epidemiologia , Espondilite Anquilosante/imunologia , Inquéritos e QuestionáriosRESUMO
Simulation models represent a low-cost approach to evaluating agricultural systems. In the current study, the precision and accuracy of the RUMINANT model to predict dry matter intake (DMI) and methane emissions from beef cattle fed tropical diets (characteristic of Colombia) was assessed. Feed intake (DMI) and methane emissions were measured in Brahman steers housed in polytunnels and fed six forage diets. In addition, DMI and methane emissions were predicted by the RUMINANT model. The model's predictive capability was measured on the basis of precision: coefficients of variation (CV%) and determination (R2, percentage of variance accounted for by the model), and model efficiency (ME) and accuracy: the simulated/observed ratio (S/O ratio) and slope and mean bias (MB%). In addition, combined measurements of accuracy and precision were carried out by means of mean square prediction error (MSPE) and correlation correspondence coefficient (CCC) and their components. The predictive capability of the RUMINANT model to simulate DMI resulted as valuable for mean S/O ratio (1.07), MB% (2.23%), CV% (17%), R2 (0.886), ME (0.809), CCC (0.869). However, for methane emission simulations, the model substantially underestimated methane emissions (mean S/O ratio = 0.697, MB% = -30.5%), and ME and CCC were -0.431 and 0.485, respectively. In addition, a subset of data corresponding to diets with Leucaena was not observed to have a linear relationship between the observed and simulated values. It is suggested that this may be related to anti-methanogenic factors characteristic of Leucaena, which were not accounted for by the model. This study contributes to improving national inventories of greenhouse gases from the livestock of tropical countries.
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BACKGROUND: High altitude exposure triggers a series of physiological changes to maintain homeostasis. Although longer-term (days to years) acclimatization processes are well studied, less is known about the physiological changes upon rapid ascent. We took advantage of Peru's geography to measure the first physiological changes following rapid transport from a low to a high-altitude environment among lowlanders. METHODS: Blood glucose, insulin, C-peptide, and salivary cortisol among healthy lowland Peruvians were measured before and after glucose ingestion at 40 m and upon arrival at 3470 m. Resting heart rate, blood oxygen saturation, and blood pressure were also monitored. RESULTS: At high altitude, we find a significant ( p<0.05) increase in heart rate and a decrease in blood oxygen saturation and salivary cortisol. Additionally, baseline levels of blood glucose, plasma C-peptide, and cortisol were reduced ( p<0.05). Blood glucose, plasma insulin, and plasma C-peptide returned to baseline or below faster at high altitude after glucose ingestion. CONCLUSIONS: Although many overlapping environmental and physiological factors are present in the high-altitude environment, the first steps of acclimatization in this population appear to be caused by increased energy expenditure and glucose metabolism to maintain oxygen homeostasis until the longer-term acclimatization mechanisms become more significant.
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Altitude , Glicemia , Humanos , Peru , Peptídeo C , Hidrocortisona , GlucoseRESUMO
Micromineral elements have a fundamental participation in the processes of organogenesis and fetal development. The objective of this study was to assess the effect of selenium (Se) injection in pregnant female rabbits, during organogenesis or rapid fetal growth, on the productive performance of their progeny. An experiment was carried out with 30 New Zealand female rabbits, with an average age of 6 months. At the end of mating (day 0), using a randomized complete design, the female rabbits were distributed into three experimental groups, which were assigned to the following treatments: Control, female rabbits were injected intramuscularly (IM) with 0.5 ml of saline on days 13 and 23 of gestation; Early administration, female rabbits that were injected IM with Se (0.10 mg/kg BW) on day 13 of gestation (organogenesis) and 0.5 ml of saline on day 23 of gestation; and Late administration, female rabbits that were injected IM with 0.5 ml of saline on day 13 of gestation and Se (0.10 mg/kg BW) on day 23 of gestation (rapid fetal growth). No differences were found on kindling performance of dams and pre-weaning growth of rabbit offspring. However, an injection of Se to pregnant rabbits affected the growth and development of their progeny, with the treatment leading to changes in the yield of some carcass traits (forelimb weight and forelimb muscle weight) and weights of some organs (liver, lungs, and spleen). The Se treatment (both early and late) also resulted in lower concentrations of glucose, triglycerides, and cholesterol when compared to the control group. These effects were different when Se injection was performed during organogenesis or rapid fetal development. The results from this study suggest that there are beneficial effects of gestational Se injection of rabbit dams on important productive traits of their progeny.
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OBJECTIVE: We aimed to compile evidence for the efficacy and safety of therapeutic options for the peripheral arthritis domain of psoriatic arthritis (PsA) for the revised 2021 Group in Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) treatment recommendations. METHODS: A working group consisting of clinicians and patient research partners was convened. We reviewed the evidence from new randomized controlled trials (RCTs) for PsA treatment from February 19, 2013, to August 28, 2020. We used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-informed approach to derive evidence for the classes of therapeutic options for 3 patient groups: (1) naïve to treatment, (2) inadequate response to conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and (3) inadequate response to biologic DMARDs (bDMARDs). Recommendations were derived through consensus meetings. RESULTS: The evidence review included 69 RCTs. We derived GRADE evidence for each class of therapeutic options and achieved consensus for the recommendations. For patients naïve to treatment, the working group strongly recommends csDMARDs (methotrexate, sulfasalazine, leflunomide) and phosphodiesterase 4 inhibitors, and emphasizes regular assessment and early escalation to achieve treatment target. bDMARDs (tumor necrosis factor inhibitors [TNFi], interleukin 17 inhibitors [IL-17i], IL-12/23i, IL-23i) and Janus kinase inhibitors (JAKi) are also strongly recommended. For patients with inadequate response to csDMARDs, we strongly recommend TNFi, IL-17i, IL-12/23i, IL-23i, and JAKi. For those who had prior experience with bDMARDs, we strongly recommend a second TNFi, IL-17i, IL-23i, and JAKi. The evidence supporting nonpharmacological interventions was very low. An expert panel conditionally recommends adequate physical activity, smoking cessation, and diet to control weight gain. CONCLUSION: Evidence supporting optimal therapy for the peripheral arthritis domain of PsA was compiled for the revised 2021 GRAPPA treatment recommendations.
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Antirreumáticos , Artrite Psoriásica , Inibidores de Janus Quinases , Psoríase , Humanos , Artrite Psoriásica/tratamento farmacológico , Antirreumáticos/uso terapêutico , Psoríase/tratamento farmacológico , Metotrexato/uso terapêutico , Interleucina-12 , Inibidores de Janus Quinases/uso terapêuticoRESUMO
BACKGROUND: A recent study conducted by Medina et al. disclosed that virgin olive oil has a bactericidal effect in vitro against Helicobacter pylori because of its contents of certain phenolic compounds with dialdehydic structures. We carried out two clinical trials to evaluate the effect of virgin olive oil on H. pylori-infected individuals. MATERIALS AND METHODS: Two different pilot studies were performed with 60 H. pylori-infected adults. In the first study, thirty subjects who tested positive for H. pylori received 30 g of washed virgin olive oil for 14 days, and after 1 month, the patients took 30 g of unwashed virgin olive oil for another 14 days. In a second study, a group of 30 subjects received 30 g of a different virgin olive oil for 14 days. Helicobacter pylori-infection status was checked by the urea breath test. RESULTS: Helicobacter pylori was eradicated in 8 of 30 individuals when microorganism status was checked after 4-6 weeks from the first clinical intervention although 12 of 30 individuals did not show H. pylori infection at 24-72 hour of the last oil dose. Eradication rates were 27 and 40% by intention to treat and per protocol, respectively. Moreover, only 3 of 30 individuals were H. pylori negative after 4-6 weeks from the second clinical intervention but 5 of 30 were negative at 24-72 hour of the last oil dose. Eradication rates were 10 and 11% by intention to treat and per protocol, respectively. It must also be noted that 13 subjects withdrew from the studies because of taste and nausea drawbacks. CONCLUSIONS: The administration of virgin olive oil showed moderate effectiveness in eradicating H. pylori. Further studies are needed to confirm these findings, especially with longer periods, different administration conditions, and several types of olive oils.
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Antibacterianos/farmacologia , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/microbiologia , Óleos de Plantas/farmacologia , Adulto , Idoso , Antibacterianos/química , Feminino , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/genética , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Azeite de Oliva , Projetos Piloto , Óleos de Plantas/química , Adulto JovemRESUMO
INTRODUCTION: The aim of this study was to assess the prevalence of occult HBV infection in HIV-positive patients in a centre in Southern Spain. METHODS: The HBV serological markers were investigated in all the patients and the presence of HBV-DNA was tested by PCR in patients with isolated anti-HBc. RESULTS: An isolated anti-HBc pattern was detected in 144/520 (27.7%) patients. HBV-DNA was detected in one of these patients (0.7%). CONCLUSIONS: In Southern Spain, there is a low prevalence of occult HBV infection among HIV-infected patients, despite increasing immigration from endemic countries.
Assuntos
Infecções por HIV/epidemiologia , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Adulto , África/etnologia , Idoso , Comorbidade , Estudos Transversais , DNA Viral/sangue , Emigrantes e Imigrantes , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Antígenos de Superfície da Hepatite B/sangue , Hepatite C/epidemiologia , Humanos , Evasão da Resposta Imune , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Comportamento Sexual , Espanha/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adulto JovemRESUMO
OBJECTIVES: To determine: (a) The prevalence of active infection by the hepatitis C virus (HCV) and hepatitis B virus (HBV) in HIV-infected patients, as well as previous exposure to hepatitis A virus (HAV), HBV and HCV. (b) The proportion of patients who have been vaccinated against HAV and/or HBV. (c) The HCV genotype distribution and the percentage of patients who have started treatment against HCV infection. METHODS: All HIV-infected patients who attended the Infectious Diseases Unit of a tertiary care hospital in Southern Spain between September 2008 and February 2009 were included in a prospective cross-sectional study. RESULTS: A total of 520 patients were included. Three hundred and fifty-eight (69%) patients had positive HCV antibody, while 71% of them showed detectable HCV-RNA. The HCV genotype distribution was: 153 (62%) genotype 1, 49 (20%) genotype 3, and 45 (18%) genotype 4. One hundred and thirteen (36.5%) subjects had received treatment against HCV. The prevalence of active HBV infection was 4.4%, while the exposure to HBV was 54.8%. Four hundred and thirty-seven (84%) patients had positive markers of infection of HAV. Of the patients eligible to be vaccinated, 25.6% and 22.3% patients were vaccinated against HAV and HBV, respectively. CONCLUSIONS: The current prevalence of active HCV infection remains high in our area. There were no changes in the HCV genotype distribution. The number of patients with indication for HBV and HAV vaccination and receive these vaccines is low.
Assuntos
Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adulto , Comorbidade , Estudos Transversais , Feminino , Genótipo , Hepacivirus/genética , Hepacivirus/isolamento & purificação , Hepatite A/sangue , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Anticorpos Anti-Hepatite A/sangue , Hepatite B/sangue , Hepatite B/prevenção & controle , Anticorpos Anti-Hepatite B/sangue , Hepatite C/sangue , Hepatite C/prevenção & controle , Hepatite C/virologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , RNA Viral/sangue , Estudos Soroepidemiológicos , Sexualidade/estatística & dados numéricos , Espanha/epidemiologia , Vacinação/estatística & dados numéricos , Vacinas contra Hepatite ViralRESUMO
Croton linearis Jacq. is an aromatic shrub that has been utilized in traditional medicine in the Bahamas, Jamaica, and Cuba. Recent studies have revealed the antiprotozoal potential of its leaves. The present work is aimed to identify the volatile constituents of essential oil from the stems of C. linearis (CLS-EO) and evaluate its in vitro antileishmanial activity. In addition, an in silico study of the molecular interactions was performed using molecular docking. A gas chromatographic-mass spectrometric analysis of CLS-EO identified 1,8-cineole (27.8%), α-pinene (11.1%), cis-sabinene (8.1%), p-cymene (5.7%), α-terpineol (4.4%), epi-γ-eudesmol (4.2%), linalool (3.9%), and terpinen-4-ol (2.6%) as major constituents. The evaluation of antileishmanial activity showed that CLS-EO has good activity on both parasite forms (IC50Promastigote = 21.4 ± 0.1 µg/mL; IC50Amastigote = 18.9 ± 0.3 µg/mL), with a CC50 of 49.0 ± 5.0 µg/mL on peritoneal macrophages from BALB/c mice (selectivity index = 2 and 3 using the promastigote and amastigote results). Molecular docking showed good binding of epi-γ-eudesmol with different target enzymes of Leishmania. This study is the first report of the chemical composition and anti-Leishmania evaluation of CLS-EO. These findings provide support for further studies of the antileishmanial effect of this product.
RESUMO
Objective: To compare the assessment of entheses in subjects with spondyloarthritis (SpA) with patients with gout by the Madrid Sonographic Enthesis Index (MASEI). Method: This cross-sectional study includes videos of entheses evaluated by ultrasound (US) of 30 patients with SpA diagnosed according to the ASAS criteria and 30 patients with gout established by the presence of monosodium urate crystals. Entheses were evaluated for MASEI in 2 Institutes located in two different countries. Demographic and clinical data were registered. Total MASEI score, MASEI-inflammatory, and MASEI-chronic damage were analyzed. Comparisons between groups were obtained by chi-square test and Student's t-test. An inter-reading US reliability was realized. Results: Patients with gout were older and had significantly more comorbidities than those with SpA. The total MASEI score was not significantly different among diseases (p = 0.07). MASEI-inflammatory was significantly more prevalent at the Achilles tendon in SpA, while the proximal patellar tendon was in gout. Power Doppler was higher in SpA compared to gout (p = 0.005). MASEI-chronic damage related to calcification/enthesophytes predominated in gout (p = 0.043), while calcaneal erosions did in SpA (p = 0.008). The inter-reader concordance was excellent (0.93, CI 95% 0.87-0.96, p = 0.001). Conclusions: SpA and gout similarly involve entheses according to MASE, however, some inflammatory and chronic lesions differ significantly depending on the underlying disease and tendon scanned.