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1.
J Postgrad Med ; 70(1): 60-63, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38037772

RESUMEN

Neural connections of the seventh cranial nerve with its neighboring nerves are common and well documented; however, communication with ansa cervicalis is as yet unknown. We present a case with such a connection found during cadaveric dissection, with hitherto unknown consequences. In this specimen, after giving the marginal mandibular and cervical branches, the cervicofacial division continued distally to communicate with the distal loop of ansa cervicalis. Presence of such connection may result in facial muscle paralysis on injury to the ansa or strap muscle paralysis on injury to the facial nerve, depending on the direction of nerve fibers. Such unusual connections bring to light the need for extreme care during surgeries in the neck to safeguard any such connections and when using the ansa as donor.


Asunto(s)
Plexo Cervical , Nervio Facial , Humanos , Nervio Facial/cirugía , Cuello , Parálisis
2.
Med J Armed Forces India ; 79(1): 21-25, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36605349

RESUMEN

Background: Purple urinary bag syndrome (PUBS) is a visually striking and rare manifestation of urinary tract infection characterised by purple discolouration of the catheter and the urobag, which are seen primarily in patients who are on long-term indwelling catheter. This rare syndrome results due to the breakdown of indole, a by-product of dietary tryptophan metabolism, to coloured pigments indigo and indirubin by urinary bacteria, which reacts with the catheter and the bag to impart a purple colour. Methods: This was a prospective observational study, wherein all cases of PUBS diagnosed between March 2012 and February 2020 were analysed and followed up. Results: A total of five patients were presented with PUBS. Among them, four were women, and four were chronically constipated. All of them were elderly and debilitated with either being bed bound or having restricted mobility. Three of them had associated chronic kidney disease. All of them were treated successfully with change of catheters and antibiotics. Conclusion: This rare but alarming condition occurs in elderly patients who are on long-term indwelling catheters. The diagnosis is visually apparent, and the treatment may be just a simple change of catheter with oral antibiotics. The awareness may help in correct diagnosis and treatment.

3.
Environ Monit Assess ; 195(1): 168, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36450883

RESUMEN

The Arctic regions experience strong seasonality and are largely affected by increasing temperature. This is particularly evident in the Kongsfjorden, which is surrounded by glaciers and is affected by seasonal and annual changes in temperature. It is largely influenced by glacial meltwater bringing in fluvial inputs such as total suspended matter (TSM) and warm Atlantic waters, which could alter the phytoplankton community. Seven stations in the Kongsfjorden representing glacier-influenced head (KF7, KF6, KF5), mid (KF4, KF3), and open region of the fjord (KF2 and KF1) were considered to evaluate the effect of TSM on phytoplankton community structure, abundance, chlorophyll a (Chl a), diversity index, evenness, and richness during summer 2011 (June) and 2018 (August) and related with atmospheric and hydrological parameters. The annual average atmospheric temperature (AAAT) over Ny-Ålesund showed an increase in temperature by a degree from -3.52 °C in 2011 to -2.44 °C in 2018, while the summer average atmospheric temperature (SAAT) over the same period increased from 5.80 to 6.16 °C. Increased freshening of the fjord led to an increase in TSM during 2018 which coincided with a decrease in Chl a by an order of magnitude. Although sea surface temperature (SST) was warmer in 2011, TSM was higher in 2018. The number of phytoplankton groups identified decreased from 11 in 2011 to 4 in 2018. A distinct alteration in phytoplankton community structure was observed from head fjord to open fjord with higher diversity observed during 2011 compared to 2018. This work highlights the effect of TSM on the phytoplankton community in the Kongsfjorden.


Asunto(s)
Estuarios , Fitoplancton , Estaciones del Año , Clorofila A , Regiones Árticas , Monitoreo del Ambiente , Sedimentos Geológicos
4.
Phys Chem Chem Phys ; 19(21): 14141-14147, 2017 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-28524925

RESUMEN

Modern ionic liquids (ILs) are considered green solvents for the future applications due to their inherited advantages and remarkable transport properties. One of the ubiquitous properties of ILs is their intrinsic ionic conductivity. However, understanding of the super-Arrhenius behavior of the ionic conductivity process at elevated pressure still remains elusive and crucial in glass science. In this work, we investigate the ion transport properties of 1-butyl-3-methylimidazolium bis[(trifluoromethyl)sulfonyl]imide: [C4mim][NTf2], 1-butylimidazolium bis[(trifluoromethyl)-sulfonyl]imide: [C4Him][NTf2] and 1-butylimidazolium hydrogen sulfate: [C4Him][HSO4] ILs in the supercooled liquid state using dielectric spectroscopy at ambient and high pressure. We present the experimental data in the dynamic window of the conductivity formalism to examine the charge transport properties. The frequency-dependent ionic conductivity data have been analyzed using the time-temperature superposition principle. In the Arrhenius diagram, the thermal evolution of the dc-conductivity reveals similar temperature dependence for both protic and aprotic ILs thus making it difficult to distinguish the ion dynamics. However, our results demonstrate the key role of high pressure that unambiguously separates the charge transport properties of protic ILs from aprotic ones through the apparent activation volume parameter. We also highlight that the activation volume can be employed to assess the information connecting the ability of ionic systems to form H-bond networks and the impact of proton transfer involved in the conduction process.

5.
Genomics ; 107(1): 33-9, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26585522

RESUMEN

To understand the molecular mechanisms underlying the ability of the bacteria to survive at high temperature, gene expression profile of Brevibacillusborstelensis at 55°C during 5 and 10min heat shock period was carried out by high-throughput sequencing technology. A total of 2555 non-redundant transcripts were annotated. A total of 575 genes at 5min and 400 genes at 10min exhibited significant differential expression in response to temperature upshift from 50 to 55°C. Genes up-regulated under heat shock were associated with metabolism (mtnE), membrane transport, signal transduction, transcriptional regulation (ycxD, codY) and folding and sorting (hsp90). A larger number of genes encoding hypothetical proteins were identified. RT-PCR experimental results carried out on genes expressed under heat shock were found to be consistent with transcriptome data. The results enhance our understanding of adaptation strategy of thermophilic bacteria thereby providing a strong background for in depth research in thermophiles.


Asunto(s)
Brevibacillus/genética , Respuesta al Choque Térmico , Transcriptoma , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Brevibacillus/metabolismo , Regulación Bacteriana de la Expresión Génica , Proteínas HSP90 de Choque Térmico/genética , Proteínas HSP90 de Choque Térmico/metabolismo , Proteínas de Transporte de Membrana/genética , Proteínas de Transporte de Membrana/metabolismo , Factores de Transcripción/genética , Factores de Transcripción/metabolismo
6.
J Environ Sci (China) ; 55: 76-85, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28477836

RESUMEN

The present study highlights the potential application of zinc peroxide (ZnO2) nanomaterial as an efficient material for the decontamination of cyanide from contaminated water. A process patent for ZnO2 synthesis has been granted in United States of America (US Patent number 8,715,612; May 2014), South Africa, Bangladesh, and India. The ZnO2 nanomaterial was capped with polyvinylpyrrolidone (PVP) to control the particle size. The PVP capped ZnO2 nanomaterial (PVP-ZnO2) before and after adsorption of cyanide was characterized by scanning electron microscope, transmission electron microscope, X-ray diffractometer, Fourier transform infrared spectroscopy and time of flight-secondary ion mass spectrometry. The remaining concentration of cyanide after adsorption by PVP-ZnO2 was determined using ion chromatograph. The adsorption of cyanide over PVP-ZnO2 was also studied as a function of pH, adsorbent dose, time and concentration of cyanide. The maximum removal of cyanide was observed in pH range 5.8-7.8 within 15min. The adsorption data was fitted to Langmuir and Fruendlich isotherm and it has been observed that data follows both the isotherms and also follows second order kinetics.


Asunto(s)
Cianuros/química , Peróxidos/química , Contaminantes Químicos del Agua/química , Purificación del Agua/métodos , Zinc/química , Cianuros/análisis , India , Sudáfrica , Contaminantes Químicos del Agua/análisis , Zinc/análisis
7.
J Neurovirol ; 22(4): 472-8, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-26733457

RESUMEN

Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (<10 and ≥10 years), and age (<35 and ≥35 years). Of 2400 enrolled, 770 completed the 6-month follow-up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p < 0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.


Asunto(s)
Ensayos Clínicos como Asunto , Cognición/fisiología , Personal de Salud/educación , Pruebas de Estado Mental y Demencia , Adulto , África , Factores de Edad , Asia , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/psicología , Países en Desarrollo/economía , Escolaridad , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/psicología , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores Sexuales , América del Sur , Aprendizaje Verbal/fisiología
8.
Phys Chem Chem Phys ; 18(12): 8462-7, 2016 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-26936014

RESUMEN

The fundamental aspects of the relaxation dynamics in niccolite-type, mixed valence metal-organic framework, multiferroic [(CH3)2NH2][Fe(3+)Fe(2+)(HCOO)6] single crystals have been reported using dielectric relaxation spectroscopy covering eight decades in frequency (10(-2) ≤ f ≤ 10(6)) in the temperature range 120 K ≤ T ≤ 250 K. The compound shows antiferroelectric to paraelectric phase transition near T = 154 K with the relaxor nature of electric ordering. The temperature dependent dielectric response in modulus representation indicates three relaxation processes within the experimental window. The variable range hopping model of small polarons explains the bulk non-Debye type conductivity relaxation. The fastest relaxation with activation energy Ea = 0.17 eV is related to progressive freezing of the reorientation motions of DMA(+) cations. X-ray diffraction data revealed that complete freezing of orientational and translational motions of DMA(+) cations occurs well below phase transition temperature. These experimental observations are fundamentally important for the theoretical explanation of relaxation dynamics in niccolite-type metal-organic frameworks.

10.
Environ Monit Assess ; 188(4): 224, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26969156

RESUMEN

Phytoplankton species distribution and composition were determined by using microscopy and pigment ratios in the Kongsfjorden during early autumn 2012. Variation in sea surface temperature (SST) was minimal and matched well with satellite-derived SST. Nutrients were generally limited. Surface phytoplankton abundance ranged from 0.21 × 10(3) to 10.28 × 10(3) cells L(-1). Phytoplankton abundance decreased with depth and did not show any significant correlation with chlorophyll a (chl a). Column-integrated phytoplankton cell counts (PCC) ranged from 94.3 × 10(6) cells m(-2) (Kf4) to 13.7 × 10(6) cells m(-2) (Kf5), while chl a was lowest at inner part of the fjord (6.3 mg m(-2)) and highest towards the mouth (24.83 mg m(-2)). Biomass from prymnesiophytes and raphidophytes dominated at surface and 10 m, respectively. The contribution of Bacillariophyceae to biomass was low. Generally, heterotrophic dinoflagellates were great in abundance (12.82 %) and ubiquitous in nature and were major contributors to biomass. Various chl pigments (chl b, chl c, phaeopigments (phaeo)) were measured to obtain pigment/chl a ratios to ascertain phytoplankton composition. Phaeo were observed only in inner fjord. Chl b:a ratios and microscopic observations indicated dominance of Chlorophyceae at greater depths than surface. Furthermore, microscopic observations confirmed dominance of chl c containing algae throughout the fjord. The study indicates that pigment ratios can be used as a tool for preliminary identification of major phytoplankton groups. However, under the presence of a large number of heterotrophic dinoflagellates such as Gymnodinium sp. and Gyrodinium sp., pigment signatures need to be supplemented by microscopic observations.


Asunto(s)
Monitoreo del Ambiente/métodos , Fitoplancton/clasificación , Biomasa , Clorofila/análisis , Clorofila A , Chlorophyta , Diatomeas , Dinoflagelados , Estuarios , Fitoplancton/crecimiento & desarrollo , Fitoplancton/metabolismo , Estaciones del Año , Svalbard , Temperatura
11.
Indian J Med Res ; 141(1): 90-9, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25857500

RESUMEN

BACKGROUND & OBJECTIVES: Improving quality of life (QOL) of healthy people living with HIV (PLHIV) is critical needing home-based, long-term strategy. Sudarshan Kriya yoga (SKY) intervention is acknowledged for its positive impact on health. It is hypothesised that SKY would improve PLHIV's QOL, justifying an evaluation. METHODS: In this open label randomized controlled pilot trial, 61 adult PLHIV with CD4 count more than 400 cells/µl and Karnofsky scale score above 70 were enrolled. Those with cardiac disease, jaundice, tuberculosis, or on antiretroviral therapy/yoga intervention were excluded. All were given standard care, randomized to SKY intervention (31: I-SKY) and only standard of care in control (30: O-SOC) arms. The I-SKY participants were trained for six days to prepare for daily practice of SKY at home for 30 min. A validated 31-item WHOQOL-HIVBREF questionnaire was used to document effect in both arms from baseline to three visits at 4 wk interval. RESULTS: Baseline QOL scores, hypertension and CD4 count were similar in both arms. An overall 6 per cent improvement of QOL scores was observed in I-SKY group as compared to O-SOC group, after controlling for baseline variables like age, gender, education and occupation ( p =0.016); 12 per cent for physical ( p =0.004), 11 per cent psychological (p =0.023) and 9 per cent level of independence (p =0.001) domains. Improvement in I-SKY observed at post-training and in the SKY adherence group showed increase in these two domains. CONCLUSIONS: A significant improvement in QOL scores was observed for the three health related QOL domains in SKY intervention arm. This low cost strategy improved physical and psychological state of PLHIV calling for upscaling with effective monitoring for sustainability of quality of life.


Asunto(s)
Infecciones por VIH/fisiopatología , Calidad de Vida , Yoga , Adulto , Recuento de Linfocito CD4 , Femenino , Humanos , Estado de Ejecución de Karnofsky , Masculino , Proyectos Piloto
12.
13.
Funct Integr Genomics ; 14(3): 591-601, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24890397

RESUMEN

Klebsiella pneumoniae being ubiquitous in nature encounters wide differences in environmental condition. The organism's abundance in natural water reservoirs exposed to temperature variation forms the basis of its persistence and spread in the soil and other farm produce. In order to investigate the effect of temperature changes on the survival and adaptation of the bacteria, the transcriptional response of K. pneumoniae subjected to low (20 °C) and high (50 °C) temperature shock were executed using Applied Biosystems SOLiD platform. Approximately, 33 and 34% of protein coding genes expressed in response to 20 and 50 °C, respectively, displayed significant up- or downregulation (p < 0.01). Most of the significantly expressed transcripts mapped to metabolism, membrane transport, and cell motility were downregulated at 50 °C, except for protein folding, sorting, and degradation, suggesting that heat stress causes general downregulation of gene expression together with induction of heat shock proteins. While at 20 °C, the transcripts of carbohydrate, lipid, and amino acid metabolism were highly upregulated. Hypothetical proteins as well as canonical heat and cold shock proteins, viz. grpE, clpX, recA, and deaD were upregulated commonly in response to 20 and 50 °C. Significant upregulation of genes encoding ribosomal proteins at 20 and 50 °C possibly suggest their role in the survival of K. pneumoniae cells under low- and high-temperature stress.


Asunto(s)
Respuesta al Choque por Frío , Respuesta al Choque Térmico , Klebsiella pneumoniae/metabolismo , Transcriptoma , Adaptación Fisiológica , Aminoácidos/metabolismo , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Secuencia de Bases , Metabolismo de los Hidratos de Carbono/genética , Secuencia de Consenso , Metabolismo Energético , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/crecimiento & desarrollo , Metabolismo de los Lípidos/genética , Redes y Vías Metabólicas , Viabilidad Microbiana , Regiones Promotoras Genéticas , Regulación hacia Arriba
14.
Mol Biol Rep ; 41(3): 1639-44, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24398554

RESUMEN

Thermophiles exhibit various kinds of molecular mechanisms to survive in extreme environment, but their behavioral responses to long duration stress is poorly understood until date. In the present study, we have prospected for the genes differentially expressed in response to long duration heat stress in thermophilic bacteria. A cDNA library was constructed from Geobacillus thermoglucosidasius grown with a temperature upshift of 10 °C from optimum growth temperature of 45 °C for 16 h. A total of 451 clones from the library were sequenced with accurate base calling that generated 257 high quality sequences with an average read length of 350 bp. We queried our collection of single pass sequences against the NCBI non-redundant database using the BLASTX algorithm and obtained sequences that showed significant similarity (>60%) with heat shock proteins, metabolic proteins and hypothetical proteins. The expressed sequence tags (ESTs) expressed in response to heat stress were annotated that further commuted a strong interaction network among one another. The ESTs based on the best hits were validated by RT-PCR. Di- and tri-nucleotide repeat motifs were also found to be associated with 17 genes involved in heat shock response, metabolism, transport and transcriptional regulation. The present results provide the novel identification of the putative genes responsible for imparting tolerance to bacteria under heat stress and unveil their role for survival of life in environmental extremes.


Asunto(s)
Proteínas Bacterianas/biosíntesis , Geobacillus/genética , Respuesta al Choque Térmico/genética , ARN Mensajero/genética , Etiquetas de Secuencia Expresada , Regulación Bacteriana de la Expresión Génica , Biblioteca de Genes , Calor , Análisis de Secuencia de ADN
15.
Curr Microbiol ; 69(4): 507-16, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24894903

RESUMEN

GroEL, a class I chaperonin, plays an important role in the thermal adaptation of the cell and helps to maintain the viability of the cell under heat shock condition. Function of groEL in vivo depends on the maintenance of proper structure of the protein which in turn depends on the nucleotide and amino acid sequence of the gene. In this study, we investigated the changes in nucleotide and amino acid sequences of the partial groEL gene that may affect the thermotolerance capacity as well as mRNA expression of bacterial isolates. Sequences among the same species having differences in the amino acid level were identified as different alleles. The effect of allelic variation on the groEL gene expression was analyzed by comparison and relative quantification in each allele under thermal shock condition by RT-PCR. Evaluation of K a/K s ratio among the strains of same species showed that the groEL gene of all the species had undergone similar functional constrain during evolution. The strains showing similar thermotolerance capacity was found to carry same allele of groEL gene. The isolates carrying allele having amino acid substitution inside the highly ATP/ADP or Mg(2+)-binding region could not tolerate thermal stress and showed lower expression of the groEL gene. Our results indicate that during evolution of these bacterial species the groEL gene has undergone the process of natural selection, and the isolates have evolved with the groEL allelic sequences that help them to withstand the thermal stress during their interaction with the environment.


Asunto(s)
Bacillus/genética , Proteínas Bacterianas/genética , Brevibacillus/genética , Chaperonina 60/genética , Polimorfismo Genético , ARN Mensajero/genética , Secuencia de Aminoácidos , Bacillus/química , Bacillus/clasificación , Bacillus/aislamiento & purificación , Brevibacillus/química , Brevibacillus/clasificación , Brevibacillus/aislamiento & purificación , Agua Dulce/microbiología , Manantiales de Aguas Termales/microbiología , Calor , Datos de Secuencia Molecular , Filogenia , Alineación de Secuencia
16.
Artículo en Inglés | MEDLINE | ID: mdl-38700838

RESUMEN

Elements such as As, Cd, Cr and Pb are classified as contaminants of major concern for public health, due to their high degree of toxicity. Saffron is an important medicinal herbal spice used in variety of food items, pharmaceutical medicines, and cosmetics. Presence of heavy metals in saffron will increase the health risk to consumers. Also, authentication of geographical origin of saffron is an issue of utmost importance for global trading. The present study is focused on investigation of elemental contaminants in saffron and elemental composition of saffron from India (Jammu and Kashmir); Iran and Afghanistan are also explored for geographical discrimination, using Chemometrics. In total, 29 elements including Ag, Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, Sb, Se, Si, Sr, Ti, Tl, V and Zn were analyzed using ICP-OES. Toxic elemental contaminants including As, Cd, Pb were found below the maximum permissible limit. Using PCA, elements B, Ni, Ba, Fe, V, Si, Al, Ti, K, Na, Sr, and Zn were found as significant discriminators of geographical origin. Elemental composition of saffron may be utilized, to prevent cases of falsified geographical origin in trade.


Asunto(s)
Crocus , Contaminación de Alimentos , Crocus/química , Contaminación de Alimentos/análisis , Metales Pesados/análisis , Quimiometría , India , Irán , Afganistán , Geografía
19.
Nanoscale ; 15(45): 18203-18211, 2023 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-37920920

RESUMEN

Semiconducting transition metal dichalcogenides (TMDCs) are very promising materials for quantum dots and spin-qubit implementation. Reliable operation of spin qubits requires the knowledge of the Landé g-factor, which can be measured by exploiting the discrete energy spectrum on a quantum dot. However, the quantum dots realized in TMDCs are yet to reach the required control and quality for reliable measurement of excited state spectroscopy and the g-factor, particularly in atomically thin layers. Quantum dot sizes reported in TMDCs so far are not small enough to observe discrete energy levels on them. Here, we report on electron transport through discrete energy levels of quantum dots in a single layer MoS2 isolated from its environment using a dual gate geometry. The quantum dot energy levels are separated by a few (5-6) meV such that the ground state and the first excited state transitions are clearly visible, thanks to the low contact resistance of ∼700 Ω and relatively low gate voltages. This well-resolved energy separation allowed us to accurately measure the ground state g-factor of ∼5 in MoS2 quantum dots. We observed a spin-filling sequence in our quantum dots under a perpendicular magnetic field. Such a system offers an excellent testbed to measure the key parameters for evaluation and implementation of spin-valley qubits in TMDCs, thus accelerating the development of quantum systems in two-dimensional semiconducting TMDCs.

20.
Clin Infect Dis ; 55(6): 868-76, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22661489

RESUMEN

BACKGROUND: AIDS Clinical Trials Group (ACTG) A5199 compared the neurological and neuropsychological (NP) effects of 3 antiretroviral regimens in participants infected with human immunodeficiency virus type 1 (HIV-1) in resource-limited settings. METHODS: Participants from Brazil, India, Malawi, Peru, South Africa, Thailand, and Zimbabwe were randomized to 3 antiretroviral treatment arms: A (lamivudine-zidovudine plus efavirenz, n = 289), B (atazanavir, emtricitabine, and didanosine-EC, n = 293), and C (emtricitabine-tenofovir-disoproxil fumarate plus efavirenz, n = 278) as part of the ACTG PEARLS study (A5175). Standardized neurological and neuropsychological (NP) screening examinations (grooved pegboard, timed gait, semantic verbal fluency, and finger tapping) were administered every 24 weeks from February 2006 to May 2010. Associations with neurological and neuropsychological function were estimated from linear and logistic regression models using generalized estimating equations. RESULTS: The median weeks on study was 168 (Q1 = 96, Q3 = 192) for the 860 participants. NP test scores improved (P < .05) with the exception of semantic verbal fluency. No differences in neurological and neuropsychological functioning between treatment regimens were detected (P > .10). Significant country effects were noted on all NP tests and neurological outcomes (P < .01). CONCLUSIONS: The study detected no significant differences in neuropsychological and neurological outcomes between randomized ART regimens. Significant improvement occurred in neurocognitive and neurological functioning over time after initiation of ARTs. The etiology of these improvements is likely multifactorial, reflecting reduced central nervous system HIV infection, better general health, and practice effects. This study suggests that treatment with either of the World Health Organization -recommended first-line antiretroviral regimens in resource-limited settings will improve neuropsychological functioning and reduce neurological dysfunction. CLINICAL TRIALS REGISTRATION: NCT00096824.


Asunto(s)
Complejo SIDA Demencia/epidemiología , Complejo SIDA Demencia/prevención & control , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Antirretrovirales/uso terapéutico , Terapia Antirretroviral Altamente Activa/métodos , Síndrome de Inmunodeficiencia Adquirida/virología , Adulto , Femenino , VIH-1/patogenicidad , Humanos , Masculino , Examen Neurológico , Pruebas Psicológicas , Resultado del Tratamiento
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