Inflammatory bowel disease is presenting sooner after immigration in more recent US immigrants from Cuba.

BACKGROUND: Despite a rising incidence of inflammatory bowel disease (IBD) in Hispanics in the United States, there are no studies examining the relationship between immigrant generation and IBD onset among Hispanics. AIMS: To determine whether age of IBD diagnosis, time from immigration to IBD diagnosis and IBD phenotype, differed across immigration periods in South Florida Cuban immigrants. METHODS: This was a cohort of consecutively identified Cuban-born adults who developed IBD in the United States and were followed in gastroenterology (GI) clinic. We divided time cohorts of immigration by historical relevance: before 1980, 1980-1994 and 1995-to-present. We examined differences across time cohorts in diagnosis age, time from immigration to IBD diagnosis, and IBD phenotype (ie, IBD type, disease location). RESULTS: A total of 130 Cuban patients with IBD were included. Age of IBD diagnosis was older in Cubans arriving before 1980 than in those arriving between 1980-1994 or after 1995 (44.7 vs 33.79 and 33.71, respectively, P<.0001). Time between immigration and diagnosis was shorter in patients arriving to the US after 1980 (31.77 years, Standard deviation (SD) 12.83 (<1980) vs 17.13 years, SD 8.55 (1980-1994) and 8.30 years, SD 4.72 (1995-to-present). IBD phenotype, including type of IBD, disease location and surgeries, did not differ significantly across time cohorts. CONCLUSIONS: Our study describes changing patterns of IBD onset following immigration in Cubans, suggesting that environmental changes either in the United States, Cuba or both are resulting in faster IBD onset in younger immigrant generations. These studies can inform the search for environmental triggers that may result in IBD.

A systematic review and meta-analysis of the relative efficacy and safety of treatment regimens for HIV-associated cerebral toxoplasmosis: is trimethoprim-sulfamethoxazole a real option?

OBJECTIVES: The objective of this study was to perform a systematic review and meta-analysis of the literature to evaluate the efficacy and safety of therapies for cerebral toxoplasmosis in HIV-infected adults. The pyrimethamine plus sulfadiazine (P-S) combination is considered the mainstay therapy for cerebral toxoplasmosis and pyrimethamine plus clindamycin (P-C) is the most common alternative treatment. Although trimethoprim-sulfamethoxazole (TMP-SMX) has potential advantages, its use is infrequent. METHODS: We searched PubMed and four other databases to identify randomized controlled trials (RCTs) and cohort studies. Two independent reviewers searched the databases, identified studies and extracted data. Risk ratios (RRs) were pooled across studies using random-effects models. RESULTS: Nine studies were included (five RCTs, three retrospective cohort studies and one prospective cohort study). In comparison to P-S, treatment with P-C or TMP-SMX was associated with similar rates of partial or complete clinical response [P-C: RR 0.87; 95% confidence interval (CI) 0.70-1.08; TMP-SMX: RR 0.97; 95% CI 0.78-1.21], radiological response (P-C: RR 0.92; 95% CI 0.82-1.03), skin rash (P-C: RR 0.81; 95% CI 0.56-1.17; TMP-SMX: RR 0.17; 95% CI 0.02-1.29), gastrointestinal impairment (P-C: RR 5.16; 95% CI 0.66-40.11), and drug discontinuation because of adverse events (P-C: RR 0.32; 95% CI 0.07-1.47). Liver impairment was more frequent with P-S than P-C (P-C vs. P-S: RR 0.48; 95% CI 0.24-0.97) CONCLUSIONS: The current evidence fails to identify a superior regimen in terms of relative efficacy or safety for the treatment of HIV-associated cerebral toxoplasmosis. Use of TMP-SMX as preferred treatment may be consistent with the available evidence and other real-world considerations. Larger comparative studies are needed

A systematic review and meta-analysis of the relative efficacy and safety of treatment regimens for HIV-associated cerebral toxoplasmosis: is trimethoprim-sulfamethoxazole a real option?

OBJECTIVES: The objective of this study was to perform a systematic review and meta-analysis of the literature to evaluate the efficacy and safety of therapies for cerebral toxoplasmosis in HIV-infected adults. The pyrimethamine plus sulfadiazine (P-S) combination is considered the mainstay therapy for cerebral toxoplasmosis and pyrimethamine plus clindamycin (P-C) is the most common alternative treatment. Although trimethoprim-sulfamethoxazole (TMP-SMX) has potential advantages, its use is infrequent. METHODS: We searched PubMed and four other databases to identify randomized controlled trials (RCTs) and cohort studies. Two independent reviewers searched the databases, identified studies and extracted data. Risk ratios (RRs) were pooled across studies using random-effects models. RESULTS: Nine studies were included (five RCTs, three retrospective cohort studies and one prospective cohort study). In comparison to P-S, treatment with P-C or TMP-SMX was associated with similar rates of partial or complete clinical response [P-C: RR 0.87; 95% confidence interval (CI) 0.70-1.08; TMP-SMX: RR 0.97; 95% CI 0.78-1.21], radiological response (P-C: RR 0.92; 95% CI 0.82-1.03), skin rash (P-C: RR 0.81; 95% CI 0.56-1.17; TMP-SMX: RR 0.17; 95% CI 0.02-1.29), gastrointestinal impairment (P-C: RR 5.16; 95% CI 0.66-40.11), and drug discontinuation because of adverse events (P-C: RR 0.32; 95% CI 0.07-1.47). Liver impairment was more frequent with P-S than P-C (P-C vs. P-S: RR 0.48; 95% CI 0.24-0.97). CONCLUSIONS: The current evidence fails to identify a superior regimen in terms of relative efficacy or safety for the treatment of HIV-associated cerebral toxoplasmosis. Use of TMP-SMX as preferred treatment may be consistent with the available evidence and other real-world considerations. Larger comparative studies are needed.

The action of red scorpion (Mesobuthus tamulus coconsis, pocock) venom and its isolated protein fractions on blood sodium levels

Red scorpion (Mesobuthus tamulus or Buthus tamulus) venom samples were collected at different regions of India: western (Chiplun and Ahmednagar from Maharashtra State) and southern (Ratnagiri and Chennai from Tamil Nadu State). The action of whole venoms on the blood sodium levels of mice was assessed using flame photometry. Seven peptides were common to all venom samples. They were separated using the native polyacrylamide gel electrophoresis (PAGE) technique and their activities were also studied using flame photometry. There was a decrease in the concentration of sodium ions in the serum, which suggested the blockage of such ions by scorpion venom toxins. Among the 10 protein bands isolated, the band at 79.6 kDa presented maximum activity in decreasing serum sodium ions concentration. Whole venom from Chiplun region also showed maximum activity. The western blotting technique demonstrated that the anti-scorpion venom sera produced by Haffkine Biopharmaceuticals Corporation Ltd., India, neutralized all four venom samples.

The action of red scorpion (Mesobuthus tamulus coconsis, pocock) venom and its isolated protein fractions on blood sodium levels

Red scorpion (Mesobuthus tamulus or Buthus tamulus) venom samples were collected at different regions of India: western (Chiplun and Ahmednagar from Maharashtra State) and southern (Ratnagiri and Chennai from Tamil Nadu State). The action of whole venoms on the blood sodium levels of mice was assessed using flame photometry. Seven peptides were common to all venom samples. They were separated using the native polyacrylamide gel electrophoresis (PAGE) technique and their activities were also studied using flame photometry. There was a decrease in the concentration of sodium ions in the serum, which suggested the blockage of such ions by scorpion venom toxins. Among the 10 protein bands isolated, the band at 79.6 kDa presented maximum activity in decreasing serum sodium ions concentration. Whole venom from Chiplun region also showed maximum activity. The western blotting technique demonstrated that the anti-scorpion venom sera produced by Haffkine Biopharmaceuticals Corporation Ltd., India, neutralized all four venom samples.(AU)

Intraspecific variation in protein pattern of red scorpion (Mesobuthus tamulus, coconsis, pocock) venoms from Western and Southern India

Red scorpions Mesobuthus tamulus (Coconsis, Pocock) were obtained from different regions of West and South India (Ratnagiri, Chiplun and Ahmednagar from Maharashtra and Chennai from Tamil Nadu, respectively). Their venoms composition was analyzed using gel electrophoresis (SDS-PAGE). All venom samples shared six bands of 170, 80, 60, 57, 43, and 38 kDa molecular weights. Bands of 115 kDa and 51.5 kDa were characteristic of venoms obtained from red scorpions of Chiplun region, and the 26kDa band was absent in scorpion venom from Tamil Nadu. The separated protein band patterns suggest that the venoms from Ratnagiri, Ahmednagar and Tamil Nadu had high similarities in their biochemical composition but differed from that of Chiplun region. These data were also supported by the Jaccard (J) index. The J value was 0.33 for venom obtained from Ratnagiri-Ahmednagar, 0.31 for venom from Ratnagiri-Tamil Nadu, and 0.3 for venom from Ratnagiri-Chiplun region. This suggests the existence of genetic variation among the different strains of red scorpion in western and southern India. The antiserum produced by Haffkine Biopharmaceuticals Corporation Ltd. completely neutralized proteins of venoms from all the regions studied.

Intraspecific variation in protein pattern of red scorpion (Mesobuthus tamulus, coconsis, pocock) venoms from Western and Southern India

Red scorpions Mesobuthus tamulus (Coconsis, Pocock) were obtained from different regions of West and South India (Ratnagiri, Chiplun and Ahmednagar from Maharashtra and Chennai from Tamil Nadu, respectively). Their venoms composition was analyzed using gel electrophoresis (SDS-PAGE). All venom samples shared six bands of 170, 80, 60, 57, 43, and 38 kDa molecular weights. Bands of 115 kDa and 51.5 kDa were characteristic of venoms obtained from red scorpions of Chiplun region, and the 26kDa band was absent in scorpion venom from Tamil Nadu. The separated protein band patterns suggest that the venoms from Ratnagiri, Ahmednagar and Tamil Nadu had high similarities in their biochemical composition but differed from that of Chiplun region. These data were also supported by the Jaccard (J) index. The J value was 0.33 for venom obtained from Ratnagiri-Ahmednagar, 0.31 for venom from Ratnagiri-Tamil Nadu, and 0.3 for venom from Ratnagiri-Chiplun region. This suggests the existence of genetic variation among the different strains of red scorpion in western and southern India. The antiserum produced by Haffkine Biopharmaceuticals Corporation Ltd. completely neutralized proteins of venoms from all the regions studied.(AU)