Impact of the Ile105Val Polymorphism of the Glutathione S-transferase P1 (GSTP1) Gene on Obesity and Markers of Cardiometabolic Risk in Young Adult Population.

The aim of the study was to investigate the association between Glutathione S-transferase P1 (GSTP1) gene polymorphism with obesity and markers of cardiometabolic risk. A cross-sectional study was carried out in individuals aged≥18 and ≤30 years. The study included 54 normal weight, 27 overweight and 68 obese volunteers. Anthropometric measurements and biochemical parameters were evaluated, the DNA was extracted from blood samples and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to measure GSTP1 Ile105Val gene polymorphism of the study participants. Also, biochemical analysis and hormone assays were carried out. A positive association between GSTP1 polymorphism and obesity was observed on subjects carrying at least one G allele (AG and GG). GG genotype was found only in the obese group. The G allele carriers presented 2.4 times higher chance of obesity when compared to those with the AA genotype. These results were independent of sex and age. We suggest that despite a study in population regional (south of Brazil), the GSTP1 gene polymorphism may play a significant role in the increase of susceptibility of obesity and contribute to identify the cardiovascular risk in young adults.

Liver depurative techniques: a single liver transplantation center experience.

BACKGROUND: In a liver transplant (LT) center, treatments with Prometheus were evaluated. The main outcome considered was 1 and 6 months survival. METHODS: During the study period, 74 patients underwent treatment with Prometheus; 64 were enrolled, with a mean age of 51 ± 13 years; 47 men underwent 212 treatments (mean, 3.02 per patient). The parameters evaluated were age, sex, laboratorial (liver enzymes, ammonia) and clinical (model for end-stage liver disease and Child-Turcotte-Pugh score) data. RESULTS: Death was verified in 23 patients (35.9%) during the hospitalization period, 20 patients (31.3%) were submitted to liver transplantation, and 21 were discharged. LT was performed in 4 patients with acute liver failure (ALF, 23.7%), in 7 patients with acute on chronic liver failure (AoCLF, 43.7%), and in 6 patients with liver disease after LT (30%). Seven patients who underwent LT died (35%). In the multivariate analysis, older age (P = .015), higher international normalized ratio (INR) (P = .019), and acute liver failure (P = .039) were independently associated with an adverse 1-month clinical outcome. On the other hand, older age (P = .011) and acute kidney injury (P = .031) at presentation were both related to worse 6-month outcome. For patients with ALF and AoCLF we did not observe the same differences. CONCLUSIONS: In this cohort, older age was the most important parameter defining 1- and 6-month survival, although higher INR and presence of ALF were important for 1-month survival and AKI for 6-month survival. No difference was observed between patients who underwent LT or did not have LT.

Infections After Liver Transplantation: A Retrospective, Single-center Study.

OBJECTIVE: To access the incidence of infectious problems after liver transplantation (LT). DESIGN: A retrospective, single-center study. MATERIALS AND METHODS: Patients undergoing LT from January 2008 to December 2011 were considered. Exclusion criterion was death occurring in the first 48 hours after LT. We determined the site of infection and the bacterial isolates and collected and compared recipient's variables, graft variables, surgical data, post-LT clinical data. RESULTS: Of the 492 patients who underwent LT and the 463 considered for this study, 190 (Group 1, 41%) developed at least 1 infection, with 298 infections detected. Of these, 189 microorganisms were isolated, 81 (51%) gram-positive bacteria (most frequently Staphylococcus spp). Biliary infections were more frequent (mean time of 160.4 ± 167.7 days after LT); from 3 months after LT, gram-negative bacteria were observed (57%). Patients with infections after LT presented lower aminotransferase levels, but higher requirements in blood transfusions, intraoperative vasopressors, hemodialysis, and hospital stay. Operative and cold ischemia times were similar. CONCLUSION: We found a 41% incidence of all infections in a 2-year follow-up after LT. Gram-positive bacteria were more frequent isolated; however, negative bacteria were commonly isolated later. Clinical data after LT were more relevant for the development of infections. Donors' variables should be considered in future analyses.

Incidence of adverse reactions in HIV patients treated with protease inhibitors: a cohort study. Coordinamento Italiano Studio Allergia e Infezione da HIV (CISAI) Group.

OBJECTIVE: To assess the probability that protease inhibitor (PI) therapy might be discontinued because of adverse events (AE) and to evaluate the incidence rate of adverse reactions during PI treatment. DESIGN: A prospective cohort, multicenter study on HIV-positive patients starting treatment with at least one PI. SETTING: Ten departments of infectious diseases in Northern Italy. PATIENTS: A total of 1207 patients who started PI therapy in September 1997 and were consecutively observed up to April 1999. MAIN OUTCOME MEASURES: Adverse reactions following initiation of PI therapy, and time to therapy discontinuation due to AE. RESULTS: During the study period, 35.9% patients presented adverse reactions of any grade, whereas 9.7% presented at least one serious AE. After 12 months of treatment, the percentage of patients who had interrupted treatment was 36% of ritonavir-treated patients, 14.2% of those treated with indinavir, 13.6% of ritonavir-saquinavir hard gel capsules (HGC)-treated patients, and 8.5% and 2.1%, respectively, for those treated with nelfinavir and saquinavir HGC. Women and patients with hepatitis experienced a significantly greater number of adverse events compared with other categories. Gastrointestinal events were more frequently observed in patients treated with either ritonavir alone or in combination with saquinavir HGC, as well as in patients receiving nelfinavir, although in this group serious events were rare. Here again, neurologic, metabolic, and hepatic toxicity occurred more frequently in ritonavir and ritonavir-saquinavir HGC treated patients. Allergic reactions were more often observed in patients receiving nelfinavir. Indinavir-treated patients presented the highest incidence of renal toxicity. CONCLUSION: Ritonavir is the drug associated with the largest number of reactions, which appear during the first few months of treatment. Saquinavir HGC and nelfinavir are the best tolerated drugs in a clinical setting.

[Causality relationship of drug adverse reactions: experience in the use of HIV-protease inhibitors]. / Relazione di causalità delle reazioni avverse a farmaci: un'esperienza nell'utilizzo degli inhibitori della proteasi di HIV.

PURPOSE: To establish the exact cause and effect relationship between protease inhibitors (PIs) and adverse events. MATERIALS AND METHOD: Prospective, cohort, multicenter study on HIV-positive patients who are beginning treatment with a PI. Causal relationships are evaluated using the RUCAM algorithm. RESULTS: Since the beginning of the study 1207 patients have been enrolled. Average time of observation is 10.7 months. To date, 784 adverse events have been observed, distributed as follows: excluded 3.8%, improbable 18.5%, possible 41.3%, probable 30.1%, and highly probable 6.3%. Saquinavir shows a statistically significant difference in the rate of non-correlated events with respect to other groups. CONCLUSIONS: Over 20% of adverse events during PI treatment are shown to be non-correlated to these drugs. Saquinavir shows the highest rate of non-correlated events.

Influence of arbuscular mycorrhizae and phosphate fertilization on shoot apical growth of micropropagated apple and plum rootstocks.

We studied the effects of phosphate fertilization and inoculation with the arbuscular mycorrhizal fungi Glomus mosseae (Nicol. and Gerd.) Gerdmann and Trappe, Glomus intraradices Schenck and Smith or Glomus viscosum Nicolson on shoot apical growth of plantlets that had been micropropagated from MM 106 apple (Malus pumila L.) and Mr.S. 2/5 plum (Prunus cerasifera Ehrh.) rootstocks. Unfertilized and non-mycorrhizal plantlets showed no apical growth during the post in vitro acclimation phase, whereas P fertilization induced early resumption of shoot apical growth. Growth enhancement and percentage of actively growing apices of mycorrhizal-inoculated plantlets were comparable to those obtained in plantlets fertilized with P. Furthermore, tissue P concentrations of mycorrhizal plantlets were similar to those of plantlets fertilized with P. We conclude that mycorrhizal inoculation can be used as a biotechnological tool to overcome blocked apical growth and to reduce chemical inputs, especially P inputs, to micropropagated fruit trees.

Antiepileptic treatment and oculomotor neurons.

This report describes the changes of the spontaneous firing rate due to an acute non-toxic dose of phenytoin (PHT), a drug commonly used in antiepileptic therapy, in the pre-motor neurons involved in saccadic movement. The drug (500 mg/kg of a 10% PHT suspension in arabic gum) was orally administered, and plasma and brain levels were regularly evaluated (EMIT assay). Results show that PHT significantly modifies the spontaneous electrical activity of the pre-motor neurons localized in the paramedian pontine reticular formation by inducing excitation, inhibition, or a biphasic effect. PHT action was observed 10-15 min after drug administration, when plasma and brain concentrations were still very low. The oculomotor system neurons appear to be a more specific target to this drug in comparison to the cerebellum and the vestibular system. Since the PHT action was observed 1 hour after drug administration in the vestibular nuclei and the cerebellum, which are extensively connected with the oculomotor neurons, it is possible to hypothesize that PHT can affect the oculomotor neurons directly and, with longer latency, indirectly through the vestibular nuclei and the cerebellum.

Arbuscular mycorrhizal induced changes to plant growth and root system morphology in Prunus cerasifera.

We compared root system morphogenesis of micropropogated transplants of Prunus cerasifera L. inoculated with either of the arbuscular mycorrhizal (AM) fungi Glomus mosseae or Glomus intraradices or with the ericoid mycorrhizal species Hymenoscyphus ericae. All plants were grown in sand culture, irrigated with a nutrient solution that included a soluble source of phosphorus, for 75 days after transplanting. Arbuscular mycorrhizal colonization increased both the survival and growth (by over 100%) of transplants compared with either uninoculated controls or transplants inoculated with H. ericae. Arbuscular mycorrhizal colonization increased root, stem and leaf weights, leaf area, root length and specific leaf area, and it decreased root length/leaf area ratio, root/shoot weight ratio and specific root length. Both uptake of phosphorus and its concentration in leaves were increased by AM infection, although the time course of the relationships between intensity of AM infection and P nutrition were complex and suggested a role for factors other than nutrition. The time course for the development of infection varied. It was most rapid with G. mosseae, but it was ultimately higher with G. intraradices. None of the treatments significantly affected the lengths of adventitious roots or the first-, second- or third-order laterals that developed from them. Arbuscular mycorrhizal colonization increased the intensity of branching in all root orders with the effect being most obvious on first-order lateral roots where the number of branches increased from under 100 to over 300 brances m(-1). As a result, although first-order laterals made up 55% of the root systems of control plants, the comparable value was 36% in AM-infected plants. In contrast, second-order laterals represented 25% of control root systems, but 50% of AM-colonized root systems. Glomus intraradices but not G. mosseae increased root diameter. Anatomical studies revealed no changes in the overall form of the root tip, although there were changes in the diameter of the root cap, cell numbers and cell size. Hymenoscyphus ericae increased the duration of the metaphase index. Both AM fungal treatments increased the concentrations of soluble proteins in root extracts and modified the protein profiles by the elimination and addition of protein bands detected by PAGE analysis. We conclude that AM fungal inoculation influenced processes in the root system at different levels, but not all effects were due to improved P nutrition or increased physiological age.

[Complications of induced abortions]. / Complications des interruptions volontaires de grossesse.

PIP: All physicians should be aware of the possible complications of induced abortions if only because the procedure is so commonplace. Some 250,000 induced abortions occur annually in France, amounting to 24.4 abortions per 100 live births. The rates of different complications of induced abortions before 12 weeks are .5-5/1000 for uterine perforation, .5-3.4% for hemorrhage with or without placental retention, 1% for endometritis, .3% for salpingitis .5% for continuing pregnancy, and .006 to .3/10,000 for death. A well done curettage is preferable to a poorly performed aspiration procedure. If an aspiration is done, the practitioner should bear in mind that retention of 50-200 cc of blood clots may occur if dilatation is insufficient. Symptoms appear 1-5 days after the abortion and end with expulsion of the clots or aspiration. Curettage is useless, as the clots do not represent a true retention. Uterine contractions during the aspiration can occasionally prompt a premature decision that evacuation is complete. Retention is difficult to diagnose immediately after aspiration but can be sonographically confirmed after the 8th day. Aspiration should be done after the 6th week and before the 12th week. Aspiration before the 6th week is often painful and is associated with higher rates of partial retention and of complete failure. Endouterine aspiration, regardless of technical proficiency, establishes a pathway between the vagina and the uterine cavity, which exposes the latter to the risk of trauma, endometrial lesions, and perforation. Induced abortion promotes infection by 2 mechanisms. Latent infections that were not detected in the medical history or physical examination can emerge and cause endometritis, which should be treated by ice, rest, and antibiotics. Or contamination of the passage by an infected cervical mucus can lead to salpingitis, abscess, and pelviperitonitis, or even general peritonitis. More often, these conditions develop from inadequately treated nonretentional endometritis. The condition should be treated with antibiotics and ice. Postoperative hemorrhage is unusual and is most frequently caused by retention. Psychological complications of abortion can be minimized by effective counseling. The counselor should seek to identify any history of psychological pathology or particularly stressful current situation. A certain amount of regret is a normal psychic response to abortion, but more serious symptoms such as suicidal thoughts or obvious depression may indicate the need for specialized care. Experience demonstrates that serious psychic reactions are rare and that a population at high risk can be defined. It includes very ambivalent women, those coerced into abortion, and those at the legal time limit. Women with a recent history of death or illness of a child, intrauterine death in the preceding pregnancy, or spontaneous abortions are also at risk.^ieng

Identification of clinically significant anaerobic bacteria.

By combining the various methodologies for anaerobic bacteriology, a scheme has been developed with four flow charts for the identification of the clinically significant anaerobic organisms. This scheme incorporates the use of gas chromatography and a micromethod biochemical system.