Recommendations for use of everolimus after heart transplantation: results from a Latin-American Consensus Meeting.

Despite improvements during the last decades, heart transplantation remains associated with several medical complications, which limit clinical outcomes: acute rejection with hemodynamic compromise, cytomegalovirus (CMV) infections, allograft vasculopathy, chronic renal failure, and neoplasias. Everolimus, a proliferation signal inhibitor, represents a new option for adjunctive immunosuppressive therapy. Everolimus displays better efficacy in de novo heart transplant patients than azathioprine for prophylaxis of biopsy-proven acute rejection episodes of at least ISHLT grade 3A (P < .001), of allograft vasculopathy (P < .01), and of CMV infections (P < .01). These findings suggest that everolimus potentially play an important role as part of immunosuppressive therapy in heart transplant recipients. Heart transplant investigators from Latin America produced recommendations for everolimus use in daily practice based on available data and their own experience.

Personal exposure to benzene, toluene and xylene in different microenvironments at the Mexico City metropolitan zone.

The Mexico City Metropolitan Zone (ZMCM) population's exposure to benzene, toluene and xylene was measured at different microenvironments to establish basic indicators of the presence and effects of these characteristic volatile organic compounds (VOC). In particular, VOC personal exposures were measured in different microenvironments during a 5-day working week, with 12-h daily periods. We have found a good agreement of our results with the registered VOC levels of the Metropolitan Automated Monitor System (RAMA) for the corresponding period. From our results, we expect to generate useful information to evaluate the health effects of these VOCs on exposed people.

Anti M. leprae IgM antibody determination by ultramicroimmunoenzymatic (UMELISA HANSEN) for the diagnosis and monitoring leprosy.

The relationship between the IgM antibody response, antigenic load as well as the clinical improvement after chemotherapy was studied in order to obtain useful data for the early diagnosis and monitoring leprosy. A level of 82% (94/115) agreement was obtained between IgM UMELISA HANSEN and slit-skin smear examination. Discrepant results were observed in 16 patients who showed positive IgM response despite negative by the skin smear examination. In these patients, the IgM response was seen to be associated to the early signal for bacilli recurrence in the skin. In one of these patients the presence of bacilli was demonstrated in the skin, two months after IgM antibodies being detected by UMELISA HANSEN. Also in one of the treated patients positive by both diagnostic techniques, a remarkable decrease in the IgM antibody levels was seen, correlating with a significant clinical improvement. Moreover it was found a direct relationship between the IgM antibody response and bacterial antigenic load, regardless the time elapsed in the disease's evolution.

Effect of calpain inhibitors on the invasion of human erythrocytes by the parasite Plasmodium falciparum.

17 different proteinase inhibitors were screened for their effect on the erythrocyte invasion by the malaria parasite Plasmodium falciparum. The effect was tested when the inhibitors were present in the culture medium and when they were trapped into erythrocyte ghosts. A very strong inhibition of invasion was observed in the presence of calpain inhibitors, with IC50 in the order of 10(-7) M. Chymostatin, leupeptin, pepstatin A and bestatin also caused inhibition of the invasion, but with IC50 in the order of 10(-5) M. The results suggest that participation of various proteinases in the process and point to the possibility of a calpain-mediated proteolytic event. This study may explain previous observations on the role of calcium in the invasion of the human erythrocyte by Plasmodium falciparum.

Surveillance study of diltiazem use in black and nonblack angina patients.

Diltiazem hydrochloride was studied in 133 patients with angina to determine whether differing effects were produced in black patients (39 percent of patients) as compared with nonblack patients. The antihypertensive effect of the drug was also assessed. No statistically significant differences between the responses of blacks and nonblacks were found in the reduction of angina frequency (54 percent of blacks improved, 58 percent of nonblacks), nitroglycerin consumption (60 percent of blacks used less, 66 percent of nonblacks), and changes in lifestyle, as measured with the New York Heart Association scale (55 percent of blacks improved, 63 percent of nonblacks). The antihypertensive effects (not analyzed by race) were greatest in patients with uncontrolled hypertension. Average decreases in this group were 18 mmHg in supine systolic pressures and 14 mmHg in supine diastolic pressures, as compared with decreases of only 4 and 3 mmHg in normotensives. Study results suggest that there is a difference in the type of angina afflicting blacks and nonblacks, that hypertension more often accompanies angina in blacks, and that diltiazem is equally effective in treating angina in blacks and nonblacks.