Single and multiple oral amoxicillin treatment in geese: a pharmacokinetic evaluation.

1. Although amoxicillin has broad-spectrum antibiotic activity and is extensively used in poultry, its use has never been investigated in geese. This study aimed to evaluate the pharmacokinetics of amoxicillin after a single and multiple oral doses in geese.2. A total of 20 geese were enrolled in this study and randomly pooled in two groups (n = 10). In group I, animals were treated with a single oral 20 mg/kg dose of amoxicillin, while geese in group II were administered multiple doses (20 mg/kg/day for 4 d). Concentrations of amoxicillin in plasma were analysed using a validated HPLC-UV method and drug plasma concentrations were modelled for each subject using a non-compartmental approach.3. amoxicillin showed rapid absorption after a single-dose treatment, with an elimination half-life of approximately 1 h. Cmax, Tmax and AUC values differed statistically between groups I and II (after the first dose administered). A large variability was observed in the pharmacokinetic profiles and drug accumulation may occur after the multiple administration.4. No accumulation in plasma was predicted from an in-silico simulation performed using the same multiple dosage schedule. The in-silico simulation does not seem to accurately predict in-field conditions.

Non-specific blood tests as proxies for COVID-19 hospitalisation: are there plausible associations after excluding noisy predictors?

This study applied causal criteria in directed acyclic graphs for handling covariates in associations for prognosis of severe coronavirus disease 2019 (COVID-19) cases. To identify non-specific blood tests and risk factors as predictors of hospitalisation due to COVID-19, one has to exclude noisy predictors by comparing the concordance statistics (area under the curve - AUC) for positive and negative cases of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Predictors with significant AUC at negative stratum should be either controlled for their confounders or eliminated (when confounders are unavailable). Models were classified according to the difference of AUC between strata. The framework was applied to an open database with 5644 patients from Hospital Israelita Albert Einstein in Brazil with SARS-CoV-2 reverse transcription - polymerase chain reaction (RT-PCR) exam. C-reactive protein (CRP) was a noisy predictor: hospitalisation could have happened due to causes other than COVID-19 even when SARS-CoV-2 RT-PCR is positive and CRP is reactive, as most cases are asymptomatic to mild. Candidates of characteristic response from moderate-to-severe inflammation of COVID-19 were: combinations of eosinophils, monocytes and neutrophils, with age as risk factor; and creatinine, as risk factor, sharpens the odds ratio of the model with monocytes, neutrophils and age.

Características evidenciadas em recém-nascidos de gestantes hipertensas e diabéticas: revisão sistemática da literatura / Characteristics evidenced in newborns of hypertensive and diabetic pregnant women: systematic review of the literature

Objetivo: evidenciar quais são as repercussões no leito vascular e as características dos neonatos de gestantes com Síndromes Hipertensivas Gestacionais e/ou Diabetes Mellitus Gestacional. Método: trata-se de uma revisão sistemática de literatura, as buscas da pesquisa foram realizadas no mês de julho do ano de 2017, nas bases de dados da Literatura Latino-Americana do Caribe em Ciências da Saúde e na National Library of Medicine. Os dados foram tabulados em planilhas do Excel, sendo aplicada a análise de conteúdo. Resultados: os recém-nascidos de mães hipertensas estiveram relacionados a prematuridade e baixo peso para a idade gestacional, enquanto os recém-nascidos de mães diabéticas são relacionados a uma maior idade gestacional ao nascimento e peso considerado grande para a idade gestacional. Considerações finais: salienta-se a importância do acompanhamento através do pré-natal desde os primórdios da gestação, como medida protetiva à saúde materno-infantil.

Objective: investigate the repercussions in the vascular bed and the characteristics of the neonates of pregnant women with Hypertensive Syndromes in Pregnancy and/or Gestational Diabetes Mellitus. Methods: it is a systematic review of the literature, the research searches were carried out in July of the year 2017, in the databases of Latin American Literature of the Caribbean in Health Sciences and National Library of Medicine. Data were tabulated in Excel spreadsheets, and content analysis was applied. Results: newborns of hypertensive mothers were related to prematurity and low birth weight for gestational age, while the newborns of diabetic mothers are related to a higher gestational age at birth and a heaviest for gestational age. Final considerations: importance of follow-up through prenatal care from the earliest stages of gestation, as a protective measure for maternal and child health.

Primary breast lymphoma: a report of 20 cases.

Limited data are available concerning treatment and outcome of primary lymphoma of the breast (PLB), especially after CHOP (cyclophosphamide, hydroxydoxorubicin, vincristine, prednisone) chemotherapy. We retrospectively reviewed 20 consecutive cases of localized PLB seen at our institution over a 20 year period. All PLB were of B-cell origin: treatment was CHOP or a CHOP-like regimen in all patients. Sixteen of the 20 patients achieved complete remission (CR) and two achieved partial remission (> 75% tumour regression). Two patients had progressive disease on therapy. With a median follow-up of 54 months, six patients relapsed after 8-66 months. Two of the relapses involved the central nervous system (CNS) (isolated in one case, associated with other sites of relapse in the other). The two patients who achieved partial remission also had progression in the CNS, 4 and 8 months after the end of CHOP chemotherapy. All four patients have died as a result of their disease 3, 6, 10 and 13 months after CNS relapse. Of the 16 centroblastic diffuse large B-cell lymphoma (DLCL), three had CNS disease at relapse. We also observed three (15%) controlateral breast relapses. Thirteen of the initial 20 patients are alive in CR, six patients have died as a result of their lymphoma and one of unrelated disease. In conclusion, we observed a high incidence of CNS relapse in this group of localized extranodal lymphoma, strongly suggesting that CNS prophylaxis should be associated with systemic chemotherapy in localized PLB.

Thrombotic microangiopathy: a new dose-limiting toxicity of high-dose sequential chemotherapy.

Ten patients with refractory (n = 8) or early relapsing (n = 2) aggressive non-Hodgkin's lymphoma were enrolled in a pilot study evaluating a high-dose sequential chemotherapy regimen with peripheral blood stem cell (PBSC) support. Five treatment phases were scheduled: phase I (cyclophosphamide + etoposide followed by lenograstim (G-CSF), and a PBSC harvest); phase II (cisplatinum + cytarabine + etoposide followed by lenograstim); phases III and IV (cyclophosphamide + cytarabine + etoposide followed by autologous PBSC infusion and lenograstim); and phase V (carmustine + cytarabine + etoposide + melphalan followed by autologous PBSC infusion and lenograstim). Ten, nine, eight, six and four of the 10 patients received one, two, three, four and five of the five scheduled phases of treatment, respectively. Four patients were withdrawn from the study due to progressive disease and two due to thrombotic microangiopathy (TM). Moreover, in the four patients who completed all treatment phases, an additional case of TM was seen. In all three patients with TM, laboratory studies showed evidence of Coombs negative hemolytic anemia, thrombocytopenia, renal dysfunction and in addition cardiac failure in two patients. TM may be a new dose-limiting toxicity of high-dose sequential chemotherapy followed by repeated PBSC transplantation.