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The marine cockroach Chiton articulatus is distributed in rocky coastlines intertidal zones all over the world. There are about 600 species of Chiton who play an important role in the tropic chain. Mexico has a long coastline with these characteristics. This herbivorous mollusc attached to the rocks, can be found throughout the year, however availability is low during the months of July to September due to deep water flow and flood tides as well as rough weather conditions that difficult their harvest. The aim of this research is to assess minerals in Chiton articulatus and to promote their consumption amongst the general population to help prevent chronic diseases from mineral deficiencies. Sampling was performed over 10 Km in the rocky seaboard of Acapulco port in the Pacific Ocean, once every four weeks for a period of six months. The material obtained was analysed to determine mineral composition of the mollusc: Na, K, Cu, Fe, Zn, Ca, and Mg were determined by atomic absorption spectrophotometry; P by colorimetric and I by titration. The data obtained was: Na 320mg/100g; K 17.00 mg/100g; Cu 0.52 mg/100g; Fe 2.66 mg/100g; Zn 1.68 mg/100g; Ca 125mg/100g; P 131 mg/100g; I 18.01 mg/100g and Mg 16.60 mg/100g. Not all minerals in the marine cockroach were quantified. Some of them were found in small amounts, but the nutrient value can be complemented with other foods in a mixed diet. The inorganic composition can vary according to the abiotic condition of the environment. The mineral content of the Chiton is related with inorganic biodiversity of the surrounding areas and can be modified by abiotic conditions. Chiton is well accepted by the population and, therefore, its consumption may play an important role in human health. [ABSTRACT FROM AUTHOR]

Various studies have been conducted to evaluate the role of antiretroviral therapy in the onset of cardiovascular risk among HIV-1-infected patients, while fewer data are available regarding antiretroviral-naïve patients. Our objective was to evaluate the cardiovascular risk among naïve subjects examining traditional risk factors, immunovirologic parameters, assessing the Framingham risk score (FRS), and detecting the presence of subclinical carotid lesions by means of color Doppler ultrasonography. One hundred seventy-two antiretroviral-naïve patients underwent color Doppler ultrasonography. An intima-media thickness (IMT) greater than 0.9 mm and/or atherosclerotic plaques were considered pathologic findings. Demographic, immunovirologic data, and risk factors for cardiovascular disease were collected. The 10-year probability of acute coronary events was assessed by the FRS. The statistical analysis was performed using t test and chi(2), Fisher's test, and conditional multiple logistic. Thirty-six patients (20.9%) had lesions at ultrasonographic investigation. The presence of lesions was significantly related to male gender (p = 0.005), age (p = 0.003), sedentary life (p = 0.05), Centers for Disease Control and Prevention (CDC) group C or CD4(+) less than 150 cells/mm(3), and viral load (VL) > 100,000 copies per milliliter (p = 0.04). The presence of subclinical carotid lesions showed a highly significant direct association with the estimated FRS (p < 0.002). The presence of subclinical atheromasic lesion results was also high among antiretroviral-naïve patients. FRS is highly predictive of the lesions, but also an advanced stage of disease plays a significant role. Our data support the hypothesis that HIV infection per se is a risk factor for atherosclerosis. We recommend an ultrasonographic assessment both among patients with FRS 6% or more and among those in advanced stage of disease. [ABSTRACT FROM AUTHOR]

In the last few years there are increasing evidences suggesting that osteopenia and osteoporosis are frequent among HIV positive patients. It is still not clear if the bone demineralization is a direct consequence of viral infection or of the antiretroviral drugs. Studies to date therefore give conflicting results. We performed a study to evaluate the prevalence of osteopenia and osteoporosis in HIV positive patients, either untreated or receiving antiretroviral therapy, to asses the frequency of these conditions and the role of antiretroviral drugs. [Copyright &y& Elsevier]

Background Injective immunotherapy is a well-known and recognized treatment for allergic diseases, but its safety has been questioned during recent years. Alternative administration routes have been proposed and there is a growing interest and experience in sublingual therapy. The safety of alternative routes is nonetheless a real advantage, so long as it is not counterbalanced by a loss of clinical benefit. Objective We have compared the efficacy of the same biologically standardized grass pollen extract administered through the injective or the sublingual route, in a group of 20 patients followed for two pollen seasons. Methods Both therapies were administered for 12 months according to a doubleblind (double-dummy) plan: at the end of the trial the cumulative dosage of the sublingual therapy was 2.4 times higher than that of the injective therapy. Data about skin reactivity, symptoms and drugs scores during the pollen season, as well as total specific IgG and specific IgG4. during and after the trial, were obtained. Results Our data show that sublingual and injective therapy are equally effective according to subjective clinical parameters, with a statistically highly significant reduction of symptoms and drugs (P = 0.002 for symptoms and drugs in SLIT-treated patients; P = 0.002 for symptoms and P = 0.0039 for drugs in patients given injections). On the other hand, objective parameters (total specific IgG, specific IgG4, skin reactivity) changed only in patients treated with active injective therapy, with P < 0.001, P < 0.001 and P = 0.021, respectively. Conclusions The discrepancies observed could be interpreted as a consequence of different mechanisms of action of the two therapies or to the lack of close relationships between the clinical and the objective parameters which were considered here. [ABSTRACT FROM AUTHOR]

Presents a response by the author to a letter to the editor about his article "African Immigrant With Weight Loss and Disseminated Skin Lesions," published in the February 2004 issue of the Journal "Clinical Infectious Diseases."

Moringa oleifera Lam (Moringaceae) is a highly valued plant, distributed in many countries of the tropics and subtropics. Many parts of the Moringa are edible. Regional uses of the Moringa as food vary widely, and include: the immature seed pods, called "drumsticks", popular in Asia and Africa, leaves, particularly in South India and Africa, mature seeds, oil pressed from the mature seeds and roots. The objective of this study was to evaluate the potential of different morphological parts of this tree as food or feed. Moringa leaves, flowers, seedpods and seeds were collected from Michoacán State, Mexico and analyzed according for mineral contents. The leaves of M. oleifera and the residue obtained after the recovery of oil from seeds can be good sources of proteins for human and animal feeds. [ABSTRACT FROM AUTHOR]

Studies on the spatial relationship between mother and young in the domestic goat ( Capra hircus ) have suggested that nursing behaviour is infrequent immediately post-partum, owing to “hiding” behaviour in the kids. We hypothesized that: (1) nursing frequency is low during the first 2–5 days post-partum, compared to subsequent days and weeks; and (2) nursing variables are related to milk yield of the mother and weight of the kids. Nursing behaviour was determined in 12 creole goat-kid pairs during the first 6 h post-partum and at 1, 2, 3, 4, 5, 6, 7, 14, 21, 28, 35, and 42 days post-partum. No increases in nursing frequency and total nursing time were observed at the end of the first week post-partum, rather these variables decreased. The percentage of nursing attempts rejected and nursing episode terminations by the mother increased from 14 day post-partum. Some nursing variables were positively correlated with milk yield. The weight of kids was positively correlated with the milk yield of the dams. The results of the present study suggest that more intense nursing behaviour is evident during the first week post-partum and is thereafter reduced, as the post-partum period progresses. [ABSTRACT FROM AUTHOR]

The relationship between hepatic tolerance and hepatitis C virus (HCV) co-infection has not been extensively studied in clinical practice. We assessed the efficacy and safety of raltegravir-based therapy in an Italian cohort of HIV/HCV co-infected patients. One hundred and forty patients with HIV/HCV co-infection initiating raltegravir from SCOLTA project (Surveillance Cohort Long-Term Toxicity Antiretrovirals) were examined. Of them, 43 were women, with mean age of 45.4 ± 6.4 years; 65 (46%) had undetectable HIV-RNA < 50 copies/mL and 75 (54%) HIV-RNA ≥ 50 copies/mL. According to CDC classification, 49 (35%) were in stage C. Based on Fib4 score at the time of starting raltegravir, patients were classified in class I in 41 cases, class II in 68 and in class III in 31 cases. Globally, the Fib4 score slightly decreased during 24 months follow-up, from 2.2 to a value of 1.8. Hepatic adverse events of any grade were observed in 67 patients, of which only 2 cases (3%) had severe liver toxicity (grade 3–4). Only one patient had to discontinue the therapy because of adverse events. According to univariate analysis, being in CDC stage C represented a risk for the development of liver toxicity, with a hazard ratio (HR) of 2.27 (95% CI 1.06–4.84, P = 0.033). None of the other variables considered (age, sex, years since detection of HIV and HCV-RNA detectable, years of previous HIV therapy, concomitant therapy with PI or NRTI, CD4+ cell count, Fib4, and transaminases level at baseline) resulted statistically correlated to the outcome. In conclusion, raltegravir-based regimens can be safely used in HCV infected patients; in this study, the hepatic toxicity has been found to be more frequent in patients with an advanced HIV disease (CDC stage C), independently of HIV-RNA suppression at raltegravir initiation. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Evaluate gender differences with regard to baseline characteristics and outcome of therapy in cohorts of the SCOLTA (surveillance cohort long-term toxicity of antiretrovirals) project. Methods: The SCOLTA project is an active pharmacovigilance system for new antiretroviral drugs. Since 2002, patients were enrolled in nine cohorts (lopinavir, tenofovir, atazanavir, fosamprenavir, enfuvirtide, tipranavir, darunavir, raltegravir and maraviroc). Results: Two thousand one hundred and fifty-four patients were included in 5 PI cohorts; 607 (28.2%) were female. Women were younger and less frequently HCV-coinfected than men. At study entry, they were less frequently in CDC stage C, but CD4+ cells/mm3 and detectable HIV-RNA were not different by gender. Women had triglycerides alterations less frequently than men, but showed a higher proportion of low HDL-cholesterol. Women were protected from incident grade 2-4 triglycerides increase (odds ratio=0.39, 95% confidence interval 0.18–0.88; P =0.02). Mean CD4+ cell count increased in both men and women; despite a non-significantly lower initial CD4+ level, women had a better immunological recovery. Women discontinued PI treatment for adverse events and their own will more frequently. Conclusions: In these cohorts, gender distribution mirrored the Italian HIV population. Women were younger than men when they started their first ARV therapy and when they entered our cohorts. On the same treatment, they had a better immune response, though no significant difference emerged on virologic control and treatment durability. As compared to men, women appeared at lower risk of hypertriglyceridaemia. They stopped PI-based treatment of their own will more frequently than men, suggesting the need for a focused effort on adherence. [Copyright &y& Elsevier]

Intestinal mucosal immune system is an early target for human immunodeficiency virus type 1 (HIV-1) infection, resulting in CD4+ T-cell depletion, deterioration of gut lining, and fecal microbiota composition. We evaluated the effects of a prebiotic oligosaccharide mixture in highly active antiretroviral therapy (HAART)-naive HIV-1-infected adults. In a pilot double-blind, randomized, placebo-controlled study, 57 HAART-naive HIV-1-infected patients received a unique oligosaccharide mixture (15 or 30 g short chain galactooligosaccharides/long chain fructooligosaccharides/pectin hydrolysate-derived acidic oligosaccharides (scGOS/lcFOS/pAOS) daily) or a placebo for 12 weeks. Microbiota composition improved significantly with increased bifidobacteria, decreased Clostridium coccoides/Eubacterium rectale cluster, and decreased pathogenic Clostridium lituseburense/Clostridium histolyticum group levels upon prebiotic supplementation. In addition, a reduction of soluble CD14 (sCD14), activated CD4+/CD25+ T cells, and significantly increased natural killer (NK) cell activity when compared with control group were seen in the treatment group. The results of this pilot trial highly significantly show that dietary supplementation with a prebiotic oligosaccharide mixture results in improvement of the gut microbiota composition, reduction of sCD14, CD4+ T-cell activation (CD25), and improved NK cell activity in HAART-naive HIV-infected individuals. [ABSTRACT FROM AUTHOR]

Background Atazanavir (ATV) has demonstrated high efficacy and safety in both treatment-naïve and treatment-experienced patients. Some comparative data are available on the durability of ritonavir-boosted (ATV/r) and unboosted formulations, but there are no data on clinicians' motivations for choosing one or another in everyday practice. The aim of this study was to evaluate the long-term efficacy of boosted and unboosted ATV in a cohort of treatment-experienced patients. Methods All patients included in the study were enrolled in an observational cohort within the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) Project. Data on CD4 cell count, HIV viral load, metabolic parameters and adverse events of grade 3–4 are collected through an on-line system every six months. The duration of treatment with ATV was evaluated using the Kaplan–Meier curve and boosted and unboosted regimens were compared using the log-rank test. Results A total of 509 patients starting ATV as a component of their antiretroviral therapy were enrolled in the SCOLTA Project at the time of the study. Boosted ATV was received by 379 patients (74.5%) while 130 (25.5%) were treated with the unboosted formulation. The last therapeutic regimen did not influence the choice of ATV formulation. The mean observational time was 23.9 months. At the end of follow-up, 58.5% of patients on unboosted ATV and 58.1% of patients on ATV/r continued the treatment and no statistically significant differences were observed for ATV durability between the formulations or among the single causes of therapy interruption. Conclusions Our results suggest that, in unselected clinical settings, ATV-containing antiretroviral therapy is durable and safe in both its formulations. [ABSTRACT FROM AUTHOR]

The article discusses the low frequency of skin reactions reported in patients taking raltegravir. It mentions the association of antiretroviral drugs with cutaneous adverse events, particularly non-nucleoside reverse transcriptase inhibitors and protease inhibitors. It concludes that raltegravir-treated patients seen in a real-life setting illustrated a low frequency of severe skin reactions.

Complexity of antiretroviral treatment (ART) is a reason for non-adherence and may impact treatment outcome. The association between daily dosing and pill burden and chance of virological success (VS) of first ART has been rarely assessed. 3,674 naïve patients who started treatment after January 2000 were identified from the ICoNA cohort. Number of daily doses and pills were estimated on the basis of the drugs used to rank first ART complexity: 1-2 daily pills once a day (low-pills QD [lpQD]); 3-6 daily pills QD (high-pills QD [hpQD]); 2-5 daily pills BID (low-pills BID [lpBID]); >6 daily pills BID (high-pills BID [hpBID]). VS was the date of first HIV RNA <50 cp/ml. Follow-up was censored at the date of VS or last available HIV RNA. Kaplan-Meier curves estimated probability of achieving VS according to ART complexity. Univariable and multivariable Cox regression stratified by clinical site was used to identify variables associated with VS. ITT principle was applied, using competing risk approach for death. Population: male 75%; median age 37 y (IQR, 32-44); HIV transmission heterosexual 43%, homosexual 33%, drug use 16%; Italian origin 86%; CDC group C 17%; median pre-ART CD4 and log HIV-RNA were 271/mm3 (range, 0-1672) and 4.84 cp/ml (1.70-6.38), respectively. Regimens were started in '00-'02 24%,'03-'05 17%,'06-'08 17%,'09-'12 42% and based on NNRTI in 40%, PI/r 43%, PI 8%, other ART 10%. Frequencies in complexity ranks were: 19% lpQD, 23% hpQD, 32% lpBID, 26% hpBID. VS was achieved by 85% of patients with an overall median time to VS of 5.6 months (95% CI: 5.4-5.8). Median months to VS were shorter with decreasing complexity: hpBID 6.5; lpBID 6.0; hpQD 5.3, lpQD 4.5. Kaplan-Meier curves are shown (Figure). [ABSTRACT FROM AUTHOR]

Atripla is a fixed-dose drug combining FTC/TDF/EFV into a single pill and may increase adherence. To our knowledge, there is little data comparing the durability of Atripla vs. other regimens. Our first aim was to compare the durability of Truvada (TVD)/EFV or TVD/PIr or Atripla started when ART-naïve, in terms of time to virological failure (VF first of 2 consecutive values>50 and>200 copies/mL), time to discontinuation of any drug in the regimens, or both. Then, we aimed to compare the incidence of virological rebound (VR)>200 copies/mL in patients (pts) currently receiving these same regimens after achieving a viral load (VL)≤80 copies/mL. Pts in the Icona Foundation Study who started for the first time a cART regimen with TVD/EFV or TVD/PIr or Atripla, either while ART-naïve (analysis 1) or while with a VL≤80 (analysis 2) were included. In analysis 1, pts' follow-up accrued from cART initiation to the date of the event (VF or discontinuation of any drug in the regimen) or to the date of last available visit/VL. In the TVD/EFV group a switch to Atripla was not counted as an event. Survival analysis employing KM curves and Cox regression model was used. In analysis 2, follow-up accrued from the date of first VL≤80 (which could be achieved with any cART) to VR or last VL and only person years (PY) on the regimens of interest were considered. Rates were calculated as number of VR per 1000 PY and relative rates (RR) compared using a Poisson regression model. In analysis 1, 515 pts starting TVD/EFV, 1001 TVD/PIr and 160 Atripla when ART-naïve on average in 2010 (IQR: 2008-2011) were included. PI/r were LPV (33%), ATV (38%) fos-APV (4%) and DRV (24%). Median age was 38 years, 19% females, 40% heterosexuals. Pts starting Atripla were younger, less likely to be female, IDU, HCV co-infected, to have AIDS and they had higher CD4 count (334 vs. 280). By 2 years, 48% (95% CI: 43-53) of those initiating TVD/PIr experienced the composite endpoint of VF or drug discontinuation vs. 20% in the other groups (p=0.0001). Median time to switch from TVD to Atripla in the EFV group was 17 months (95% CI: 12-23). The table shows the results of the Cox regression analysis. In analysis 2 (n=1,425), the rates of VR were 16.8 per 1000 PY for TVD/PIr, 11.17 for TVD/EFV and 5.3 for Atripla (adjusted RR vs. TVD/PIr=0.51, 95% CI: 0.19-1.34). Durability of Atripla was comparable to that of TVD/EFV and potentially longer than that of TVD/PIr. Unmeasured confounding cannot be ruled out. [ABSTRACT FROM AUTHOR]

The article presents a study focusing on metabolic syndrome (MS) as a primary risk factor for diabetes and cardiovascular disease among HIV-infected patients. The measurement of waist circumference (WC) was recommended by the European Clinical Society as it is an essential component of MS, based on the correlation between central obesity and insulin resistance. Researchers proposed that the measurement of MS should be properly assessed to determine the prevalence and characteristics of MS.

Describes a case of anticonvulsant hypersensitivity syndrome induced by carbamazepine. Signs and symptoms of disease; Prevalence of serious cutaneous reactions to antiepileptic and antidepressive drugs.

7-11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK [ABSTRACT FROM AUTHOR]

An abstract of the research paper "Muscle Symptoms and Creatine Phosphokinase Elevations in Patients Receiving Raltegravir in Clinical Practice: Results From a Multicenter Study," by G. Madeddu and colleagues which was presented at the Tenth International Congress on Drug Therapy in HIV Infection held at Glasgow, Scotland from November 7-11, 2010 is presented.