Long COVID incidence in adults and children between 2020 and 2023: a real-world data study from the RECOVER Initiative.

Estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) incidence, also known as Long COVID, have varied across studies and changed over time. We estimated PASC incidence among adult and pediatric populations in three nationwide research networks of electronic health records (EHR) participating in the RECOVER Initiative using different classification algorithms (computable phenotypes). Overall, 7% of children and 8.5%-26.4% of adults developed PASC, depending on computable phenotype used. Excess incidence among SARS-CoV-2 patients was 4% in children and ranged from 4-7% among adults, representing a lower-bound incidence estimation based on two control groups - contemporary COVID-19 negative and historical patients (2019). Temporal patterns were consistent across networks, with peaks associated with introduction of new viral variants. Our findings indicate that preventing and mitigating Long COVID remains a public health priority. Examining temporal patterns and risk factors of PASC incidence informs our understanding of etiology and can improve prevention and management.

Uncovering a pseudoscience: an analysis of 'biological dentistry' Instagram posts.

OBJECTIVE: This infodemiology study aimed to analyze characteristics of English-language Instagram posts on 'Biological Dentistry'. MATERIALS AND METHODS: Using CrowdTangle, we analyzed 500 'Biological Dentistry' posts published on Instagram from May 2017 to May 2022. Two researchers assessed each post for facticity, motivation, author's profile, sentiment, and interaction metrics. Statistical analysis was employed to compare interaction metrics between dichotomized categories of posts' characteristics and determine predictors of misinformation and user engagement. RESULTS: Over half of the posts (58.4%) were from health-related authors, and a considerable number contained misinformation (68.2%) or were financially motivated (52%). Sentiment was mostly negative or neutral (59.8%). Misinformation was associated with financial motivation (OR = 2.12) and health-related authors (OR = 5.56), while non-health-related authors' posts associated with higher engagement (OR = 1.98). Reliable content, non-health-related authorship, and positive sentiment were associated with increased user interaction. CONCLUSION: Misinformation about 'Biological Dentistry' on Instagram is mainly spread by financially incentivized health-related authors. Yet, non-health-related authors' posts resonate more with audiences, highlighting a nuanced relationship between content facticity, authorship, and engagement.

Liposomal nanoformulations with trans-caryophyllene and caryophyllene oxide: do they have an inhibitory action on the efflux pumps NorA, Tet(K), MsrA, and MepA?

This study aimed to evaluate the antibacterial and inhibitory action of NorA, Tet(K), MsrA and MepA efflux pumps in S. aureus strains using the sesquiterpenes named trans-caryophyllene and caryophyllene oxide, both isolated and encapsulated in liposomes. The antibacterial and inhibitory action of these efflux pumps was evaluated through the serial microdilution test in 96-well microplates. Each sesquiterpene and liposome/sesquiterpene was combined with antibiotics and ethidium bromide (EtBr). The antibiotics named norfloxacin, tetracycline and erythromycin were used. The 1199 B, IS-58, RN4220 and K2068 S. aureus strains carrying NorA, Tet(K), MsrA and MepA, respectively, were tested. In the fluorescence measurement test, K2068 S. aureus was incubated with the sesquiterpenes and EtBr, and the fluorescence emission by EtBr was measured. The tested substances did not show direct antibacterial activity, with MIC >1024 µg/mL. Nonetheless, the isolated trans-caryophyllene and caryophyllene oxide reduced the MIC of antibiotics and EtBr, indicating inhibition of NorA, Tet(K) and MsrA. In the fluorescence test, these same sesquiterpenes increased fluorescence emission, indicating inhibition of MepA. Therefore, the sesquiterpenes named trans-caryophyllene and caryophyllene oxide did not show direct antibacterial action; however, in their isolated form, they showed possible inhibitory action on NorA, Tet(K), MsrA and MepA efflux pumps. They may also act in antibiotic potentiation. Further studies are needed to identify the mechanisms involved in antibiotic potentiation and efflux pump inhibitory action.

Comparative Antibacterial and Efflux Pump Inhibitory Activity of Isolated Nerolidol, Farnesol, and α-Bisabolol Sesquiterpenes and Their Liposomal Nanoformulations.

The efflux systems are considered important mechanisms of bacterial resistance due to their ability to extrude various antibiotics. Several naturally occurring compounds, such as sesquiterpenes, have demonstrated antibacterial activity and the ability to inhibit efflux pumps in resistant strains. Therefore, the objective of this research was to analyze the antibacterial and inhibitory activity of the efflux systems NorA, Tet(K), MsrA, and MepA by sesquiterpenes nerolidol, farnesol, and α-bisabolol, used either individually or in liposomal nanoformulation, against multi-resistant Staphylococcus aureus strains. The methodology consisted of in vitro testing of the ability of sesquiterpenes to reduce the Minimum Inhibitory Concentration (MIC) and enhance the action of antibiotics and ethidium bromide (EtBr) in broth microdilution assays. The following strains were used: S. aureus 1199B carrying the NorA efflux pump, resistant to norfloxacin; IS-58 strain carrying Tet(K), resistant to tetracyclines; RN4220 carrying MsrA, conferring resistance to erythromycin. For the EtBr fluorescence measurement test, K2068 carrying MepA was used. It was observed the individual sesquiterpenes exhibited better antibacterial activity as well as efflux pump inhibition. Farnesol showed the lowest MIC of 16.5 µg/mL against the S. aureus RN4220 strain. Isolated nerolidol stood out for reducing the MIC of EtBr to 5 µg/mL in the 1199B strain, yielding better results than the positive control CCCP, indicating strong evidence of NorA inhibition. The liposome formulations did not show promising results, except for liposome/farnesol, which reduced the MIC of EtBr against 1199B and RN4220. Further research is needed to evaluate the mechanisms of action involved in the inhibition of resistance mechanisms by the tested compounds.

Valencene, Nootkatone and Their Liposomal Nanoformulations as Potential Inhibitors of NorA, Tet(K), MsrA, and MepA Efflux Pumps in Staphylococcus aureus Strains.

Valencene and nootkatone are aromatic sesquiterpenes with known biological activities, such as antimicrobial, antioxidant, anti-inflammatory, and antitumor. Given the evidence that encapsulation into nanosystems, such as liposomes, could improve the properties of several compounds, the present study aimed to evaluate the activity of these sesquiterpenes in their isolated state or in liposomal formulations against strains of Staphylococcus aureus carrying efflux pumps. The broth microdilution method evaluated the antibiotic-enhancing activity associated with antibiotics and ethidium bromide (EtBr). The minimum inhibitory concentration was assessed in strains of S. aureus 1199B, IS-58, and RN4220, which carry the efflux proteins NorA, Tet(K), and MsrA. In tests with strain 1199B, valencene reduced the MIC of norfloxacin and EtBr by 50%, while the liposomal formulation of this compound did not show a significant effect. Regarding the strain IS-58, valencene, and its nanoformulation reduced norfloxacin MIC by 60.3% and 50%, respectively. In the non-liposomal form, the sesquiterpene reduced the MIC of EtBr by 90%. Against the RN4220 strain, valencene reduced the MIC of the antibiotic and EtBr by 99% and 93.7%, respectively. Nootkatone and its nanoformulation showed significant activity against the 1199B strain, reducing the EtBr MIC by 21.9%. Against the IS-58 strain, isolated nootkatone reduced the EtBr MIC by 20%. The results indicate that valencene and nootkatone potentiate the action of antibiotics and efflux inhibitors in strains carrying NorA, Tet(K), and MsrA proteins, which suggests that these sesquiterpenes act as efflux pump inhibitors in S. aureus. Therefore, further studies are needed to assess the impact of incorporation into liposomes on the activity of these compounds in vivo.

Impacts of the Residual Trace Metals of Aquaculture in Net Cages on the Quality of Sediment.

Anthropogenic pollution by trace metals in aquatic environments in semiarid zones is a critical area of investigation. The objective of this study was to investigate the concentration and spatial distribution of trace metals in surface sediments in the Rosário reservoir, which is affected by the intensive aquaculture of Tilápia-do-Nilo (Oreochromis niloticus). Sediment samples were collected in three different areas, postculture (PCTV), cultivation (CTV) and control (CTRL) in the dry season in 2019. The granulometric composition, organic matter and concentrations of Fe, Mn, Zn, Cu, Cr, Cd, Pb and Ni metals were determined. Multivariate statistics were used. Geochemical and ecotoxicological indices and a comparison with sediment quality guidelines (SQG) were used. The sediment was characterized by silty clay loam with an average organic matter of 18.76 ± 4.27. The analytical merit figures demonstrated accuracy (metal recoveries in certified standards) between 89 to 99% and high precision (RSD < 5%). The concentration ranges for the metals were Fe: 0.11-0.85 (%), Mn: 14.46-86.91, Zn: 2.6-220.56, Cu: 26.89-98.75, Cr: 60.18-76.06, Cd: 0.38-0.59, Pb: 18.13-43.13, and Ni: 34.4-46.75, all in (mg/kg-1). The highest concentration values were found in the CTV areas (Fe: 40 ± 0.22, Mn: 66.48 ± 19.11, Zn: 114.83 ± 59.75 and Cr: 70.85 ± 2.62) and PCTV (Cd: 0.53 ± 0.04, Cu: 71.83 ± 21.20, Pb: 33.71 ± 4.34 and Ni: 44.60 ± 1.79). Pearson's correlation, hierarchical cluster analysis and principal component analysis confirmed the influence of fish farming on metals. Only Ni presented concentration values higher than the reference value established in the SQG. Thus, considering the probable geochemical and ecotoxicological effects, they comprise the two lowest levels of impact.

Insulinoma / Insulinoma

RESUMEN El insulinoma es un tumor poco frecuente de las células de los islotes pancreáticos, caracterizado por la proliferación de las células betas. Son tumores neuroendocrinos pancreáticos, generalmente benignos y de pequeño tamaño, caracterizados por el síndrome de hipersecreción de insulina con el desarrollo de hipoglucemia. La mayoría de estos tumores son esporádicos, solo alrededor de 15-30 % es hereditario; está asociado a enfermedades como la neoplasia endocrina múltiple tipo 1, o el síndrome de Von Hippel-Lindau. La incidencia de dicho tumor es de 3-10 casos por cada millón de habitantes. La edad media de aparición es entre 40-50 años de edad y es más frecuente en mujeres. El reconocimiento temprano y el diagnóstico adecuado de este tumor pancreático raro, son aspectos importantes pues es potencialmente curable con un tratamiento quirúrgico oportuno.

ABSTRACT Insulinoma is a rare pancreatic islet cell tumor characterized by proliferation of beta cells. They are pancreatic neuroendocrine tumors, generally benign and small in size, characterized by insulin hypersecretion syndrome with the development of hypoglycemia. Most of these tumors are sporadic, only about 15-30% are hereditary; it is associated with diseases such as multiple endocrine neoplasia type 1, or Von Hippel-Lindau syndrome. The incidence of this tumor is 3-10 cases per million inhabitants. The average age of onset is between 40-50 years of age and it is more frequent in women. Early recognition and proper diagnosis of this rare pancreatic tumor are important aspects, as it is potentially curable with timely surgical treatment.

Psychophysiological Reactions of Internet Users Exposed to Fluoride Information and Disinformation: Protocol for a Randomized Controlled Trial.

BACKGROUND: False messages on the internet continually propagate possible adverse effects of fluoridated oral care products and water, despite their essential role in preventing and controlling dental caries. OBJECTIVE: This study aims to evaluate the patterns of psychophysiological reactions of adults after the consumption of internet-based fluoride-related information and disinformation. METHODS: A 2-armed, single-blinded, parallel, and randomized controlled trial will be conducted with 58 parents or caregivers of children who attend the Clinics of Pediatric Dentistry at the Bauru School of Dentistry, considering an attrition of 10% and a significance level of 5%. The participants will be randomized into test and intervention groups, being respectively exposed to fluoride-related information and disinformation presented on a computer with simultaneous monitoring of their psychophysiological reactions, including analysis of their heart rates (HRs) and 7 facial features (mouth outer, mouth corner, eye area, eyebrow activity, face area, face motion, and facial center of mass). Then, participants will respond to questions about the utility and truthfulness of content, their emotional state after the experiment, eHealth literacy, oral health knowledge, and socioeconomic characteristics. The Shapiro-Wilk and Levene tests will be used to determine the normality and homogeneity of the data, which could lead to further statistical analyses for elucidating significant differences between groups, using parametric (Student t test) or nonparametric (Mann-Whitney U test) analyses. Moreover, multiple logistic regression models will be developed to evaluate the association of distinct variables with the psychophysiological aspects. Only factors with significant Wald statistics in the simple analysis will be included in the multiple models (P<.2). Furthermore, receiver operating characteristic curve analysis will be performed to determine the accuracy of the remote HR with respect to the measured HR. For all analyses, P<.05 will be considered significant. RESULTS: From June 2022, parents and caregivers who frequent the Clinics of Pediatric Dentistry at the Bauru School of Dentistry will be invited to participate in the study and will be randomized into 1 of the 2 groups (control or intervention). Data collection is expected to be completed in December 2023. Subsequently, the authors will analyze the data and publish the findings of the clinical trial by June 2024. CONCLUSIONS: This randomized controlled trial aims to elucidate differences between psychophysiological patterns of adults exposed to true or false oral health content. This evidence may support the development of further studies and digital strategies, such as neural network models to automatically detect disinformation available on the internet. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (RBR-7q4ymr2) U1111-1263-8227; https://tinyurl.com/2kf73t3d. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/39133.

Sexual behavior and medication adherence in men who have sex with men participating in a pre-exposure prophylaxis study of combinations of Maraviroc, Tenofovir Disoproxil Fumarate and/or Emtricitabine (HPTN 069/ACTG 5305).

HPTN 069/ACTG 5305 was designed to evaluate potential new PrEP regimens that included maraviroc, tenofovir disoproxil fumarate, and/or emtricitabine. The current analyses assessed antiretroviral (ARV) plasma concentrations in relation to sexual behavior in 224 cisgender men who have sex with men and 2 transgender women at risk for HIV. Poisson generalized estimating equations (GEE) regression were used to test for associations between self-reported sexual behavior, sociodemographic, behavioral variables, and study drug levels The median (IQR) age was 30 [25, 37] years old; 48.2% had completed college; 27.4% were Black and 21.7% Latino. At weeks 24 and 48, one third of participants reported condomless anal sex (CAS) in the prior month with more than one partner. CAS was associated with daily ARV drug use (χ2 = 12.64, p = 0.002). Older individuals and those with greater education were more likely to ingest ARV drugs daily (χ2 = 9.36, p = 0.009 and χ2 = 8.63, p = 0.013, respectively), while neither race nor ethnicity was associated with daily ARV drug use. Participants who reported recent condomless anal sex and/or advanced education had higher rates of daily ARV drug use. These data support the need for ongoing adherence counseling in clinical trials of new PrEP modalities.

Over-the-counter bleaching agents can help with tooth whitening maintenance.

OBJECTIVE: This study evaluated the influence of over-the-counter agents on the maintenance of color and microhardness of the enamel after home bleaching protocol. MATERIALS AND METHODS: Specimens of bovine teeth (6 × 6 × 2 mm) were prepared, and color (Easyshade, VITA) and microhardness (HMV-2, Shimadzu) readings were performed. All the specimens were bleached using 22% carbamide peroxide (22%CP), except for the control group, and then separated into seven groups (n = 10) according to the interaction of toothpaste (whitening, conventional, and whitening with peroxide) and mouth rinse (whitening and conventional). The study simulated 1 year of toothbrushing (Pepsodent, MAVTEC) and mouth rinse by immersion. After that, final color and microhardness measurements were performed. Data were analyzed by one-way ANOVA, Tukey's test (P < .05). RESULTS: The group submitted to 22%CP + whitening toothpaste + whitening mouth rinse showed higher color maintenance (P < .05) than the control group. The perception of whitening of teeth (ΔWID ) was higher than the color change (ΔE00 ). There was a decrease in microhardness after treatment with 22%CP + conventional toothpaste + whitening mouth rinse. CONCLUSIONS: Over-the-counter products can help with the maintenance of tooth whitening after bleaching with carbamide peroxide; however, special attention should be given since the association of products can also reduce the microhardness of the dental enamel. CLINICAL SIGNIFICANCE: The association between whitening toothpastes and mouth rinses might be beneficial for maintaining color during 1 year after bleaching treatment.

Fluorescent characteristics of bee honey constituents: A brief review.

The eligible articles were obtained from databases such as ScienceDirect, SciELO, PubMed and Springer. The searches were performed using the terms "honey", "vitamins", "fluorescence" and their combinations. The titles and abstracts of the articles found were read and revised to verify their relevance to the review. From the selected titles, it was possible to elaborate the systematic review, based on scientific studies and sources considered faithful and true. The systematic review presented confirms the necessity for studies to identify compounds using fluorescence techniques, using cheaper and more accessible techniques. Few studies are covered in this theme, when treated about Apis mellifera honey, and it has been observed that in the last 12 years, the few researches have only tried to show the viability of using the technique without quantifying the present compounds, while others demonstrate the fluorescent aspects, but performing through techniques considered more expensive.

Spectrofluorimetric analyzes of thiamine and riboflavin in monofloral honey varieties of africanized bees (Apis mellifera).

This research aimed to study the validation of a viable and low-cost spectrofluorimetric method, capable of detecting and quantifying B vitamins in floral varieties of bee honey. The analyzes were performed using chemical and operational methods of pre-defined solutions and standards, performed in triplicate and the results expressed as mean ± standard deviation. The data were recorded in a Microsoft Office Excel spreadsheet (version 2013) and studied using the statistical program Bioestatic version 3.0. The calibration curves of the vitamins showed the linearity and precision of the method. Subsequently, a descriptive analysis of the data was performed, being considered normal in the Lilliefors normality tests. Finally, the data were subjected to Pearson's correlation test, showing positive and strong correlations, with r (Pearson) ranging from 0.7619 to 1. Honey had positive results regarding the detection and quantification of vitamins B1 and B2 through the spectrofluorimetric method.

Cylindrical vector beam generator using a two-element interferometer.

We realize a robust and compact cylindrical vector beam generator that consists of a simple two-element interferometer composed of a beam displacer and a cube beamsplitter. The interferometer operates on the higher-order Poincaré sphere transforming a homogeneously polarized vortex into a cylindrical vector (CV) beam. We experimentally demonstrate the transformation of a single vortex beam into all the well-known CV beams and show the operations on the higher-order Poincaré sphere according to the control parameters. Our method offers an alternative to the Pancharatnam-Berry phase optical elements and has the potential to be implemented as a monolithic device.

Technical aspects for counting and timing photons with a digital oscilloscope.

Photon counting and timing are generic tasks in many photonics laboratories. However, the cost of a commercial photon counter system can be a limiting factor to establish a new laboratory. Homemade photon counters can present a cost-saving solution, but they can also present a demanding side project not always part of the main research. Modern digital oscilloscopes are available in most universities and can provide a simple solution to measure photon statistics. Here, we describe the technicalities and limitations for counting and timing photons using a digital oscilloscope.

Safety and Tolerability of Maraviroc-Containing Regimens to Prevent HIV Infection in Women: A Phase 2 Randomized Trial.

BACKGROUND: Maraviroc (MVC) is a candidate drug for HIV preexposure prophylaxis (PrEP). OBJECTIVE: To assess the safety and tolerability of MVC-containing PrEP over 48 weeks in U.S. women at risk for HIV infection. DESIGN: Phase 2 randomized, controlled, double-blinded study of 4 antiretroviral regimens used as PrEP. (ClinicalTrials.gov: NCT01505114). SETTING: 12 clinical research sites of the HIV Prevention Trials Network and AIDS Clinical Trials Group. PARTICIPANTS: HIV-uninfected women reporting condomless vaginal or anal intercourse with at least 1 man with HIV infection or unknown serostatus within 90 days. INTERVENTION: MVC only, MVC-emtricitabine (FTC), MVC-tenofovir disoproxil fumarate (TDF), and TDF-FTC (control). MEASUREMENTS: At each visit, clinical and laboratory (including HIV) assessments were done. Primary outcomes were grade 3 and 4 adverse events and time to permanent discontinuation of the study regimen. All randomly assigned participants were analyzed according to their original assignment. RESULTS: Among 188 participants, 85% completed follow-up, 11% withdrew early, and 4% were lost to follow-up; 19% discontinued their regimen prematurely. The number discontinuing and the time to discontinuation did not differ among regimens. Grade 3 or 4 adverse events occurred in 5 (MVC), 13 (MVC-FTC), 9 (MVC-TDF), and 8 (TDF-FTC) participants; rates did not differ among regimens. One death (by suicide) occurred in the MVC-TDF group but was judged not to be related to study drugs. Of available plasma samples at week 48 (n = 126), 60% showed detectable drug concentrations. No new HIV infections occurred. LIMITATIONS: Participants were not necessarily at high risk for HIV infection. The regimen comprised 3 pills taken daily. The study was not powered for efficacy. CONCLUSION: Maraviroc-containing PrEP regimens were safe and well-tolerated compared with TDF-FTC in U.S. women. No new HIV infections occurred, although whether this was due to study drugs or low risk in the population is uncertain. Maraviroc-containing PrEP for women may warrant further study. PRIMARY FUNDING SOURCE: National Institutes of Health.

Crazy Lady is an early old woman and needs care / Dona Doida está envelhecendo e precisa de cuidados / Crazy Lady es una anciana y necesita cuidados

"Old Age is a way of feeling cold that assaults me/ and a certain acidity": that's the beginning of a poem of Adélia Prado, in which she deals with the thematic of aging, old age and the care that is necessary in this phase of life. In opposition to the initial impression that these stanzas transmit to us, the perspective of Adélia Prado on this entire poem and on the other poems that we'll discuss in this article, is the concern for the elderly, for instrumental practices of care, and for the bio-political, humanitarian and democratic conditions that may optimize the elderly life in our society. Adélia Prado has an illusio about the inexorable of old age and we will discuss this illusio. We will also discuss dispositions towards care that are evoked in her poems. These care practices may alleviate the "natural" physical, psychosocial deconstructions that old age might bring to all of us. In this work we deal with conceptual elements from Simone de Beauvoir, Leonardo Boff, Pierre Bourdieu and others.

"Old Age es una forma de sentimiento frío que asaults me / and a cierto accidencia": que es el comienzo de la poem de Adelia Prado, en cuyo caso, con el temblor del enveje, la edad y el cuidado que es necesario en Esta fase de la vida. En contraste con la impresión inicial que estas transcripciones transmiten, la perspectiva de Adelina Prado en este pozo y sobre los demás poemas que vamos a discutir en este artículo, es el referente a los ancianos, a las prácticas instrumentales, Para la bio-política, las reglas y las condiciones establecidas para optimizar la vida de la vida en nuestra sociedad. Adélia Prado ha an ilusio sobre el inexorable de edad antigua y nosotros vamos a discutir esta ilusión. También se discutirán las disposiciones de cuidado que se evocan en los poemas. Las costosas costumbres pueden aligerar el "natural" físico, psicocial deconstrucciones que la edad actúe para todos. En este trabajo se trata de conceptos conceptuales de Simone de Beauvoir, Leonardo Boff, Pierre Bourdieu y otros.

"A velhice é uma forma de sentir frio que me assalta/ e uma certa acidez": esse é o começo de um poema de Adélia Prado, no qual se trata da temática do envelhecimento, da velhice e do cuidado que é necessário nessa fase da vida. Em oposição à impressão inicial que essas estrofes nos transmitem, a perspectiva de Adélia Prado, neste poema inteiro, e sobre os outros poemas que abordaremos neste artigo, é a preocupação com a pessoa idosa, as práticas instrumentais de cuidado, as condições biopolíticas humanitárias e democráticas que podem otimizar a vida de idosos em nossa sociedade. Adélia Prado está inserida na illusio sobre a inexorabilidade da velhice e trataremos disso. Discutiremos também os dispositivos de cuidados que são evocados em seus poemas. Essas práticas de cuidado podem aliviar as desconstruções físicas e psicossociais "naturais" que a velhice pode trazer a todos nós. Neste estudo, trabalharemos com elementos conceituais de Simone de Beauvoir, Leonardo Boff, Pierre Bourdieu e outros.

Phase 2 Study of the Safety and Tolerability of Maraviroc-Containing Regimens to Prevent HIV Infection in Men Who Have Sex With Men (HPTN 069/ACTG A5305).

BACKGROUND: Maraviroc (MVC) is a candidate for human immunodeficiency virus (HIV) pre-exposure prophylaxis. METHODS: Phase 2 48-week safety/tolerability study was conducted, comparing 4 regimens: MVC alone, MVC plus emtricitabine (FTC), MVC plus tenofovir disoproxil fumarate (TDF), and TDF plus FTC. Eligible participants were HIV-uninfected men and transgender women reporting condomless anal intercourse with ≥1 HIV-infected or unknown-serostatus man within 90 days. At each visit, assessments, laboratory testing, and counseling were done. Analyses were intention to treat. RESULTS: Among 406 participants, 84% completed follow-up, 7% stopped early, and 9% were lost to follow-up; 9% discontinued their regimen early. The number discontinuing and the time to discontinuation did not differ among study regimens (P = .60). Rates of grade 3-4 adverse events did not differ among regimens (P = .37). In a randomly selected subset, 77% demonstrated detectable drug concentrations at week 48. Five participants acquired HIV infection (4 MVC alone, 1 MVC + TDF; overall annualized incidence, 1.4% [95% confidence interval, .5%-3.3%], without differences by regimen; P = .32); 2 had undetectable drug concentrations at every visit, 2 had low concentrations at the seroconversion visit, and 1 had variable concentrations. CONCLUSIONS: MVC-containing regimens were safe and well tolerated compared with TDF + FTC; this study was not powered for efficacy. Among those acquiring HIV infection, drug concentrations were absent, low, or variable. MVC-containing regimens may warrant further study for pre-exposure prophylaxis. CLINICAL TRIALS REGISTRATION: NCT01505114.

Putative virulence factors of Corynebacterium pseudotuberculosis FRC41: vaccine potential and protein expression.

BACKGROUND: Corynebacterium pseudotuberculosis, a facultative intracellular bacterial pathogen, is the etiological agent of caseous lymphadenitis (CLA), an infectious disease that affects sheep and goats and it is responsible for significant economic losses. The disease is characterized mainly by bacteria-induced caseous necrosis in lymphatic glands. New vaccines are needed for reliable control and management of CLA. Thus, the putative virulence factors SpaC, SodC, NanH, and PknG from C. pseudotuberculosis FRC41 may represent new target proteins for vaccine development and pathogenicity studies. RESULTS: SpaC, PknG and NanH presented better vaccine potential than SodC after in silico analyses. A total of 136 B and T cell epitopes were predicted from the four putative virulence factors. A cluster analysis was performed to evaluate the redundancy degree among the sequences of the predicted epitopes; 57 clusters were formed, most of them (34) were single clusters. Two clusters from PknG and one from SpaC grouped epitopes for B and T-cell (MHC I and II). These epitopes can thus potentially stimulate a complete immune response (humoral and cellular) against C. pseudotuberculosis. Several other clusters, including two from NanH, grouped B-cell epitopes with either MHC I or II epitopes. The four target proteins were expressed in Escherichia coli. A purification protocol was developed for PknG expression. CONCLUSIONS: In silico analyses show that the putative virulence factors SpaC, PknG and NanH present good potential for CLA vaccine development. Target proteins were successfully expressed in E. coli. A protocol for PknG purification is described.

Uropatía obstructiva alta: aspectos clínicos, epidemiológicos y terapéuticos / Upper obstructive uropathy. Clinical and epidemiological therapeutic aspects

Introducción: la Uropatía Obstructivase observa con frecuencia y en todas las edades y las entidades que la producen varían según la edad y el género del paciente, es más común en los hombres, sobre todo luego de los 60 años de edad. Objetivo: caracterizar desde el punto de vista clínico, epidemiológico y terapéutico a los pacientes con Uropatías Obstructivas Altas. Método: se realizó un estudio descriptivo retrospectivo de los pacientes con diagnóstico de uropatía obstructiva alta en el Hospital Clínico Quirúrgico Celia Sánchez Manduley de Manzanillo en el servicio de urología,durante el periodo comprendido entre enero del 2011 hasta diciembre del 2012. Resultados: el grupo de edad entre 42-51 años fue el que predominó con una media de edad de 51.61 y una DE de 7.12. El municipio que mayor número de pacientes presentó fue Manzanillo con 27 casos. La causa principal de Uropatía Obstructiva Alta fue la Litiasis Renoureteral con 50 pacientes. El tipo de Uropatía Obstructiva que predominó fue la unilateral crónica con 51 pacientes, y la Hidronefrosis fue la principal complicación con 20 casos seguido de las infecciones urinarias con 15. La principal técnica quirúrgica que se empleó fue la Pielolitotomía a 18 pacientes seguido de la Ureterolitotomía a 13 casos. Conclusiones: la causa principal de la uropatía obstructiva alta fue la litiasis renoureteral(AU)

Introduction: obstructive uropathy is observed frequently and at all ages, and the entities that produce it vary by age and gender of the patient, it is more common in men, especially after 60 years. Objective: to characterize patients with upper obstructive uropathy from the clinical, epidemiological and therapeutic point of view. Method: it was performed adescriptive and retrospective study of patients diagnosed with upper obstructive uropathy at Celia Sanchez Clinical Surgical Hospital in Manzanillo in the urology service during the period of January 2011-December 2012. Results: the age group of 42-51 years prevailed with an average age of 51-61 and SD of 7.12. The municipality with the greatest number of patients was presented with 27 cases in Manzanillo. The main cause of upper obstructive uropathy was the renoureteral lithiasis with 50 patients. The prevailing type of obstructive uropathy was the unilateral chronic with 51 patients, and hydronephrosis was the main complication with 20 cases followed by urinary infection with 15 cases. The main surgical technique applied was the Pyelolithotomyin18 patients followed by Ureterolithotomyin13 cases.Conclusions:the main cause of upperobstructive uropathy was renoureteral lithiasis(EU)

HIV Salvage Therapy Does Not Require Nucleoside Reverse Transcriptase Inhibitors: A Randomized, Controlled Trial.

BACKGROUND: Nucleoside reverse transcriptase inhibitors (NRTIs) are often included in antiretroviral regimens in treatment-experienced patients in the absence of data from randomized trials. OBJECTIVE: To compare treatment success between participants who omit versus those who add NRTIs to an optimized antiretroviral regimen of 3 or more agents. DESIGN: Multicenter, randomized, controlled trial. (ClinicalTrials.gov: NCT00537394). SETTING: Outpatient HIV clinics. PARTICIPANTS: Treatment-experienced patients with HIV infection and viral resistance. INTERVENTION: Open-label optimized regimens (not including NRTIs) were selected on the basis of treatment history and susceptibility testing. Participants were randomly assigned to omit or add NRTIs. MEASUREMENTS: The primary efficacy outcome was regimen failure through 48 weeks using a noninferiority margin of 15%. The primary safety outcome was time to initial episode of a severe sign, symptom, or laboratory abnormality before discontinuation of NRTI assignment. RESULTS: 360 participants were randomly assigned, and 93% completed a 48-week visit. The cumulative probability of regimen failure was 29.8% in the omit-NRTIs group versus 25.9% in the add-NRTIs group (difference, 3.2 percentage points [95% CI, -6.1 to 12.5 percentage points]). No significant between-group differences were found in the primary safety end points or the proportion of participants with HIV RNA level less than 50 copies/mL. No deaths occurred in the omit-NRTIs group compared with 7 deaths in the add-NRTIs group. LIMITATION: Unblinded study design, and the study may not be applicable to resource-poor settings. CONCLUSION: Treatment-experienced patients with HIV infection starting a new optimized regimen can safely omit NRTIs without compromising virologic efficacy. Omitting NRTIs will reduce pill burden, cost, and toxicity in this patient population. PRIMARY FUNDING SOURCES: National Institute of Allergy and Infectious Diseases, Boehringer Ingelheim, Janssen, Merck, ViiV Healthcare, Roche, and Monogram Biosciences (LabCorp).