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Objectives: To determine the prevalence of drug resistance mutations (DRM), the prevalence of drug susceptibility [transmitted drug resistance (TDR)] and the prevalence of HIV-1 variants among treatment-naive HIV-infected children in Manaus, Amazonas state, Brazil.Methods: Children born to HIV-infected mothers and diagnosed with HIV in an HIV reference service centre and with available pol sequence between 2010 and 2015 prior to antiretroviral initiation were included. TDR was identified using the Calibrated Population Resistance Tool. HIV-1 subtypes were defined by Rega and phylogenetic analyses.Results: One hundred and seventeen HIV-infected children with a median age of 3.7 years were included. Among them, 28.2% had been exposed to some form of prevention of mother-to-child transmission (PMTCT). HIV DRM were present in 21.4% of all children. Among PMTCT-exposed children, 3% had NRTI mutations, 15.2% had NNRTI mutations and 3% had PI mutations. Among PMTCT-unexposed children, 1.2% had NRTI mutations, 21.4% had non-NNRTI mutations and 1.2% had PI mutations. The most common DRM was E138A (8.5%). The prevalence of TDR was 16.2%; 21.1% among PMTCT-exposed children and 14.3% among PMTC-unexposed children. The analysis of HIV-1 subtypes revealed that 80.2% were subtype B, 6.0% were subtype C, 3.4% were subtype F1 and 10.3% were possible unique recombinant forms (BF1, 4.3%; DB, 4.3%; BC, 0.9%; KC, 0.9%).Conclusions: We report a high prevalence of DRM in this population, including in almost a quarter of children with no reported PMTCT. The high prevalence of TDR observed might compromise ART effectiveness. Results show extensive HIV-1 diversity and expansion of subtype C, which highlights the need for surveillance of HIV-1 subtypes in Amazonas state. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate in vitro plant regeneration from the shoot apices of juvenile and adult passion fruit plants and provide a basis for future clonal cleanup of superior genotypes through the use of tissue culture. The studies were divided into three experiments to evaluate the effect of age and origin of the donor plant, the culture medium methodology and the size of the explants. The shoot apices were inoculated in Murashige & Skoog (MS) medium with 3% sucrose and three 6-benzylaminopurine (BAP) concentrations: 0, 1 or 2 mg L-1. Next, the samples were transferred to a half-strength mineral salt medium (½ MS) and supplemented with 1 mg L-1 indolebutyric acid (IBA). Two cultivation methods were used: one with variations in the cultivation period in the MS medium (26 or 60 days) and the other with or without transfer to half-strength mineral salt medium (½ MS). The methodology by which explants are maintained in MS medium supplemented with 1 mg L-1 BAP for 26 days, followed by transfer to ½ MS medium supplemented with 1 mg L-1 IBA for 21 days of cultivation and then transfer to ½ MS medium for 14 days is more appropriate for regenerating plants from the shoot apices of adult Passiflora edulis (AGBP accession 38). [ABSTRACT FROM AUTHOR]

The article proposes a discussion about the importance and significance of youth for the Scandinavian peoples of the ninth to eleventh centuries, and their relation with representations of death. We conducted to this end an analysis of some myths found in The Poetic Edda and The Prose Edda which one may find representations of death, youth and old age, as well as the application of theories related to both concepts of death as the Scandinavian mythology itself. [ABSTRACT FROM AUTHOR]

Epidemiological studies reveal a link between osteoporosis and the risk of ischemic cardiovascular disease. We illustrate an association between coronary calcification and bone microarchitecture in older adults based on the SPAH study. This cross-sectional research comprised 256 individuals subjected to cardiac coronary computed tomography angiography (CCTA) for coronary artery calcification (CAC), high-resolution peripheral quantitative computed tomography (HR-pQCT) at the tibia and radius with standardized z score parameters, and dual-energy X-ray absorptiometry (DXA) to evaluate bone status. We used Student's t test and the Mann–Whitney and Chi-squared tests for comparison of basal measurements. Association analysis was performed using the Poisson regression model with adjustment for CAC and sex. Multivariate analysis revealed different bone variables for predicting CAC in DXA and HR-pQCT scenarios. Although most of the bone parameters are related to vascular calcification, only cortical porosity (Ct.Po) remained uniform by HR-pQCT. Results for were as follows: the tibia—women (exp β = 1.12 (95% CI 1.10–1.13, p < 0.001) and men (exp β = 1.44, 95% CI 1.42–1.46, p < 0.001); the radius—women (exp β = 1.07 (95% CI 1.07–1.08, p < 0.001) and men (exp β = 1.33 (95% CI 1.30–1.37, p < 0.001). These findings suggest an inverse relationship between CAC and cortical bone content, as assessed by HR-pQCT, with higher coronary calcification in individuals older than 65 years. [ABSTRACT FROM AUTHOR]

Maternal vaccination is an important area of research and requires appropriate and internationally comparable definitions and safety standards. The GAIA group, part of the Brighton Collaboration was created with the mandate of proposing standardised definitions applicable to maternal vaccine research. This study proposes international definitions for neonatal infections. The neonatal infections GAIA working group performed a literature review using Medline, EMBASE and the Cochrane collaboration and collected definitions in use in neonatal and public health networks. The common criteria derived from the extensive search formed the basis for a consensus process that resulted in three separate definitions for neonatal blood stream infections (BSI), meningitis and lower respiratory tract infections (LRTI). For each definition three levels of evidence are proposed to ensure the applicability of the definitions to different settings. Recommendations about data collection, analysis and presentation are presented and harmonized with the Brighton Collaboration and GAIA format and other existing international standards for study reporting. [ABSTRACT FROM AUTHOR]

A post hoc analysis of 654 children with bacterial meningitis showed that the level of consciousness is the most important predictor of death and/or neurological sequelae, more than is etiology per se. This finding emphasizes the need of including a measurement of the presenting status in all studies examining treatment efficacy. [ABSTRACT FROM AUTHOR]

Background. Despite favorable meta-analyses, no study involving third-generation cephalosporins for the treatment of childhood bacterial meningitis has documented a benefit of adjuvant dexamethasone therapy if the outcomes are examined individually. Methods. We conducted a prospective, randomized, double-blind trial comparing adjuvant dexamethasone or glycerol with placebo in children aged from 2 months through 16 years in Latin America. Ceftriaxone was administered to all children; children were randomized to also receive dexamethasone intravenously, glycerol orally, both agents, or neither agent. Primary end points were death, severe neurological sequelae, or deafness, with the first 2 end points forming a composite end point. A subgroup analysis for Haemophilus influenzae type b meningitis was undertaken. Intention-to-treat analysis was performed using binary logistic regression models. Results. H. influenzae type b, pneumococci, and meningococci were the main agents found among 654 patients; dexamethasone was given to 166, dexamethasone and glycerol were given to 159, glycerol was given to 166, and placebo was given to 163. No adjuvant therapy significantly affected death or deafness. In contrast, glycerol and dexamethasone plus glycerol reduced severe neurological sequelae, compared with placebo; the odds ratios were 0.31 (95% confidence interval [95% CI], 0.13–0.76; ) and 0.39 (95% CI, 0.17–0.93; ), respectively. Pp.010 Pp.033 For neurological sequelae and death, the odds ratios were 0.44 (95% CI, 0.25–0.76; ) and 0.55 (95% CI, Pp.003 0.32–0.93; ), respectively. Dexamethasone therapy prevented deafness in patients with H. influenzae type Pp.027 b meningitis only if patients were divided grossly into dexamethasone recipients and nonrecipients and if timing between dexamethasone and ceftriaxone administration was not taken into account (odds ratio, 0.27; 95% CI, 0.09–0.77; ). Pp.014 Conclusion. Oral glycerol therapy prevents severe neurological sequelae in patients with childhood meningitis. Safety, availability, low cost, and oral administration also add to its usefulness, especially in resource-limited settings. [ABSTRACT FROM AUTHOR]