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Gobbato J, Becchi A, Bises C, Siena F, Lasagni M, Saliu F, Galli P, Montano S. Occurrence of phthalic acid esters (PAEs) and active pharmaceutical ingredients (APIs) in key species of anthozoans in Mediterranean Sea. Mar Pollut Bull 2024; 200:116078. [PMID: 38290362 DOI: 10.1016/j.marpolbul.2024.116078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/17/2024] [Accepted: 01/24/2024] [Indexed: 02/01/2024]
Abstract
The Mediterranean Sea's biodiversity is declining due to climate change and human activities, with plastics and emerging contaminants (ECs) posing significant threats. This study assessed phthalic acid esters (PAEs) and active pharmaceutical ingredients (APIs) occurrence in four anthozoan species (Cladocora caespitosa, Eunicella cavolini, Madracis pharensis, Parazoanthus axinellae) using solid phase microextraction (SPME) and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). All specimens were contaminated with at least one contaminant, reaching maximum values of 57.3 ng/g for the ∑PAEs and 64.2 ng/g (wet weight) for ∑APIs, with dibutyl phthalate and Ketoprofen being the most abundant. P. axinellae was the most contaminated species, indicating higher susceptibility to bioaccumulation, while the other three species showed two-fold lower concentrations. Moreover, the potential adverse effects of these contaminants on anthozoans have been discussed. Investigating the impact of PAEs and APIs on these species is crucial, given their key role in the Mediterranean benthic communities.
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Affiliation(s)
- J Gobbato
- Department of Earth and Environmental Sciences (DISAT), University of Milan - Bicocca, Piazza della Scienza, 20126 Milan, Italy; MaRHE Center (Marine Research and High Education Center), Magoodhoo Island, 12030 Faafu Atoll, Maldives.
| | - A Becchi
- Department of Earth and Environmental Sciences (DISAT), University of Milan - Bicocca, Piazza della Scienza, 20126 Milan, Italy
| | - C Bises
- Department of Earth and Environmental Sciences (DISAT), University of Milan - Bicocca, Piazza della Scienza, 20126 Milan, Italy; MaRHE Center (Marine Research and High Education Center), Magoodhoo Island, 12030 Faafu Atoll, Maldives
| | - F Siena
- Department of Earth and Environmental Sciences (DISAT), University of Milan - Bicocca, Piazza della Scienza, 20126 Milan, Italy; MaRHE Center (Marine Research and High Education Center), Magoodhoo Island, 12030 Faafu Atoll, Maldives
| | - M Lasagni
- Department of Earth and Environmental Sciences (DISAT), University of Milan - Bicocca, Piazza della Scienza, 20126 Milan, Italy
| | - F Saliu
- Department of Earth and Environmental Sciences (DISAT), University of Milan - Bicocca, Piazza della Scienza, 20126 Milan, Italy
| | - P Galli
- Department of Earth and Environmental Sciences (DISAT), University of Milan - Bicocca, Piazza della Scienza, 20126 Milan, Italy; MaRHE Center (Marine Research and High Education Center), Magoodhoo Island, 12030 Faafu Atoll, Maldives; University of Dubai, P.O. Box 14143, Dubai Academic City, United Arab Emirates; NBFC (National Biodiversity Future Center), 90133 Palermo, Italy
| | - S Montano
- Department of Earth and Environmental Sciences (DISAT), University of Milan - Bicocca, Piazza della Scienza, 20126 Milan, Italy; MaRHE Center (Marine Research and High Education Center), Magoodhoo Island, 12030 Faafu Atoll, Maldives; NBFC (National Biodiversity Future Center), 90133 Palermo, Italy
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Dehnert I, Galli P, Montano S. Ecological impacts of coral gardening outplanting in the Maldives. Restor Ecol 2022. [DOI: 10.1111/rec.13783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- I Dehnert
- Department of Earth and Environmental Sciences (DISAT) University of Milan – Bicocca, Piazza della Scienza 20126 Milan Italy
- MaRHE Center (Marine Research and High Education Center), Magoodhoo Island, Faafu Atoll Republic of Maldives
| | - P Galli
- Department of Earth and Environmental Sciences (DISAT) University of Milan – Bicocca, Piazza della Scienza 20126 Milan Italy
- MaRHE Center (Marine Research and High Education Center), Magoodhoo Island, Faafu Atoll Republic of Maldives
| | - S Montano
- Department of Earth and Environmental Sciences (DISAT) University of Milan – Bicocca, Piazza della Scienza 20126 Milan Italy
- MaRHE Center (Marine Research and High Education Center), Magoodhoo Island, Faafu Atoll Republic of Maldives
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Barazorda KA, Salas CJ, Braga G, Ricopa L, Ampuero JS, Siles C, Sanchez JF, Montano S, Lizewski SE, Joya CA, Bishop DK, Valdivia HO. Validation study of Boil & Spin Malachite Green Loop Mediated Isothermal Amplification (B&S MG-LAMP) versus microscopy for malaria detection in the Peruvian Amazon. PLoS One 2021; 16:e0258722. [PMID: 34695122 PMCID: PMC8544869 DOI: 10.1371/journal.pone.0258722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/04/2021] [Indexed: 11/19/2022] Open
Abstract
Malaria elimination efforts in Peru have dramatically reduced the incidence of cases in the Amazon Basin. To achieve the elimination, the detection of asymptomatic and submicroscopic carriers becomes a priority. Therefore, efforts should focus on tests sensitive enough to detect low-density parasitemia, deployable to resource-limited areas and affordable for large screening purposes. In this study, we assessed the performance of the Malachite–Green LAMP (MG-LAMP) using heat-treated DNA extraction (Boil & Spin; B&S MG-LAMP) on 283 whole blood samples collected from 9 different sites in Loreto, Peru and compared its performance to expert and field microscopy. A real-time PCR assay was used to quantify the parasite density. In addition, we explored a modified version of the B&S MG-LAMP for detection of submicroscopic infection in 500 samples and compared the turnaround time and cost of the MG-LAMP with microscopy. Compared to expert microscopy, the genus B&S MG-LAMP had a sensitivity of 99.4% (95%CI: 96.9%– 100%) and specificity of 97.1% (95%CI: 91.9%– 99.4%). The P. vivax specific B&S MG-LAMP had a sensitivity of 99.4% (96.6%– 100%) and specificity of 99.2% (95.5%– 100%) and the P. falciparum assay had a sensitivity of 100% (95%CI: 78.2%– 100%) and specificity of 99.3% (95%CI: 97.3%– 99.8%). The modified genus B&S MG-LAMP assay detected eight submicroscopic malaria cases (1.6%) which the species-specific assays did not identify. The turnaround time of B&S MG-LAMP was faster than expert microscopy with as many as 60 samples being processed per day by field technicians with limited training and utilizing a simple heat-block. The modified B&S MG-LAMP offers a simple and sensitive molecular test of choice for the detection of submicroscopic infections that can be used for mass screening in resources limited facilities in endemic settings nearing elimination and where a deployable test is required.
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Affiliation(s)
| | - Carola J. Salas
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Greys Braga
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Leonila Ricopa
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Julia S. Ampuero
- Department of Virology and Emerging infections, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Crystyan Siles
- Department of Virology and Emerging infections, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Juan F. Sanchez
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Silvia Montano
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Stephen E. Lizewski
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Christie A. Joya
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Danett K. Bishop
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
| | - Hugo O. Valdivia
- Department of Parasitology, U.S. Naval Medical Research Unit N°6 (NAMRU-6), Lima, Peru
- * E-mail:
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Abanto C, Ulrich AK, Valencia A, Dueñas V, Montano S, Tirschwell D, Zunt J. Adherence to American Heart Association/American Stroke Association Clinical Performance Measures in a Peruvian Neurological Reference Institute. J Stroke Cerebrovasc Dis 2020; 29:105285. [PMID: 33066929 PMCID: PMC7575824 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/12/2020] [Accepted: 08/23/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Little is known about adherence to American Heart Association/American Stroke Association (AHA/ASA) stroke performance measures in developing countries like Peru. AIMS We assessed adherence and determined factors associated with adherence to the AHA/ASA stroke performance measures at a reference center for neurological diseases in Lima, Peru. METHODS We conducted a retrospective chart review of 150 stroke patients admitted to the Neurological Institute of Neurological Science from 2014 to 2016 to ascertain adherence to 15 different AHA/ASA stroke performance measures. Adherence was measured as a simple proportion, with both single and composite measures. Associations were analyzed with nonparametric statistics and multivariate logistic regression. RESULTS Mean adherence to AHA/ASA stroke performance measures was 47%. We observed a statistically significant relationship between adherence to ischemic stroke performance measures and being married (OR = 3.78, 95% CI: 1.05-13.55), as well as an inverse relationship with an onset of symptoms of greater than 4.5 h prior to arrival at the hospital compared to those with ≤ 4.5 h (OR = 0.14, 95% CI: 0.02-0.97). Compared to patients with a lower National Institutes of Health Stroke Scale (NIHSS) score (<13), those with a score of ≥13 were less likely to have good adherence (OR = 0.11, 95% CI: 0.04-0.31). CONCLUSIONS The mean composite measure of adherence to internationally recognized standards of stroke management in our Peruvian institution was below the level needed for an achievement award by AHA/ASA. An intervention targeted toward stroke prevention and training could lead to improved outcomes of stroke patients in Peru.
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Affiliation(s)
- Carlos Abanto
- Instituto Nacional de Ciencias Neurológicas, Departamento de Enfermedades Neurovasculares, Jirón Ancash 1271, Barrios Altos, Lima 01, Peru.
| | - Angela K Ulrich
- University of Washington, Department of Global Health, 1959 NE Pacific Street, Box 357965, Seattle, WA 98195-7965, United States.
| | - Ana Valencia
- Instituto Nacional de Ciencias Neurológicas, Departamento de Enfermedades Neurovasculares, Jirón Ancash 1271, Barrios Altos, Lima 01, Peru
| | - Víctor Dueñas
- Complejo Hospitalario Alberto Leopoldo Barton Thompson, Av Argentina 3525, Callao 07001, Peru
| | - Silvia Montano
- Instituto de Medicina Tropical, Daniel Alcides Carrión, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - David Tirschwell
- Harborview Medical Center, Department of Neurology, 325 Ninth Ave Seattle, WA 98104, United States.
| | - Joseph Zunt
- Harborview Medical Center, Department of Neurology, 325 Ninth Ave Seattle, WA 98104, United States.
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Nash TE, Mahanty S, Loeb JA, Theodore WH, Friedman A, Sander JW, Singh G, Cavalheiro E, Del Brutto OH, Takayanagui OM, Fleury A, Verastegui M, Preux PM, Montano S, Pretell EJ, White AC, Gonzales AE, Gilman RH, Garcia HH. In response: Multifactorial basis of epilepsy in patients with neurocysticercosis. Epilepsia 2015; 56:975-6. [PMID: 26040533 DOI: 10.1111/epi.12986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Theodore E Nash
- Laboratory of Parasitic Disease, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, U.S.A.
| | - Siddhartha Mahanty
- Laboratory of Parasitic Disease, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, U.S.A
| | - Jeffrey A Loeb
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Illinois, U.S.A
| | - William H Theodore
- Epilepsy Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, U.S.A
| | - Alon Friedman
- The Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Department of Medical Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Josemir W Sander
- Department of Clinical & Experimental Epilepsy, UCL Institute of Neurology, Hospitals Biomedical Research Centre, London, United Kingdom.,London & Epilepsy Society, Buckinghamshire, United Kingdom.,Epilepsy Institute of the Netherlands Foundation, Heemstede, The Netherlands
| | - Gagandeep Singh
- Department of Neurology, Dayan and Medical College, Ludhiana, India
| | - Esper Cavalheiro
- Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | | | - Osvaldo M Takayanagui
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Agnes Fleury
- Institute of Biomedical Research, National Institute of Neurology and Neurosurgery (INNN), National Autonomous University of Mexico, Mexico City, Mexico
| | - Manuela Verastegui
- Department of Cellular and Molecular Sciences, Faculty of Science and Philosophy, University Peruana Cayetano Heredia, Lima, Peru
| | - Pierre-Marie Preux
- UMR1094 INSERM, CHU Limoges, Institute of Neuroepidemiology and Tropical Neurology, University of Limoges, Limoges, France
| | | | | | - A Clinton White
- Infectious Disease Division, Department of Internal Medicine, University of Texas, Galveston, Texas, U.S.A
| | - Armando E Gonzales
- Department of Veterinary Public Health, School of Veterinary Medicine, National University of San Marcos, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A
| | - Hector H Garcia
- Cysticercosis Unit, Institute of Neurological Diseases, Lima, Peru.,Center for Global Health-Tumbes, University Peruana Cayetano Heredia, Lima, Peru.,Department of Microbiology, University Peruana Cayetano Heredia, Lima, Peru
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Rosenbaum M, Mendoza P, Ghersi BM, Wilbur AK, Perez-Brumer A, Cavero Yong N, Kasper MR, Montano S, Zunt JR, Jones-Engel L. Detection of Mycobacterium tuberculosis Complex in New World Monkeys in Peru. Ecohealth 2015; 12:288-297. [PMID: 25515075 PMCID: PMC4470872 DOI: 10.1007/s10393-014-0996-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 10/13/2014] [Accepted: 11/17/2014] [Indexed: 06/04/2023]
Abstract
The Mycobacterium tuberculosis complex causes tuberculosis in humans and nonhuman primates and is a global public health concern. Standard diagnostics rely upon host immune responses to detect infection in nonhuman primates and lack sensitivity and specificity across the spectrum of mycobacterial infection in these species. We have previously shown that the Oral Swab PCR (OSP) assay, a direct pathogen detection method, can identify the presence of M. tuberculosis complex in laboratory and free-ranging Old World monkeys. Addressing the current limitations in tuberculosis diagnostics in primates, including sample acquisition and pathogen detection, this paper furthers our understanding of the presence of the tuberculosis-causing bacteria among New World monkeys in close contact with humans. Here we use the minimally invasive OSP assay, which includes buccal swab collection followed by amplification of the IS6110 repetitive nucleic acid sequence specific to M. tuberculosis complex subspecies, to detect the bacteria in the mouths of Peruvian New World monkeys. A total of 220 buccal swabs from 16 species were obtained and positive amplification of the IS6110 sequence was observed in 30 (13.6%) of the samples. To our knowledge, this is the first documentation of M. tuberculosis complex DNA in a diverse sample of Peruvian Neotropical primates.
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Affiliation(s)
- Marieke Rosenbaum
- Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536, USA.
| | - Patricia Mendoza
- Wildlife Health and Policy, Wildlife Conservation Society, Avenida 15 de Enero 591, Miraflores, Lima, Peru.
| | - Bruno M Ghersi
- Department of Ecology and Environmental Biology, Tulane University, 6823 St. Charles Ave., New Orleans, LA, 70118, USA.
| | - Alicia K Wilbur
- Washington National Primate Research Center, University of Washington, 1705 Pacific St NE, HSB I-039, Box 357330, Seattle, WA, 98105, USA.
| | - Amaya Perez-Brumer
- Department of Sociomedical Sciences, Mailman School of Public Health, Colombia University, 722 W 168th St #14, New York, NY, 10032, USA.
| | - Nancy Cavero Yong
- Wildlife Health and Policy, Wildlife Conservation Society, Avenida 15 de Enero 591, Miraflores, Lima, Peru.
| | - Matthew R Kasper
- Department of Bacteriology, U.S. Naval Medical Research Unit No. 6, Lima, Peru.
| | - Silvia Montano
- Department of Bacteriology, U.S. Naval Medical Research Unit No. 6, Lima, Peru.
| | - Joseph R Zunt
- Departments of Global Health, Neurology, Epidemiology and Medicine (Infectious Disease), University of Washington, Harborview Medical Center, 325 9th Ave., Room 3EH70, Seattle, WA, 98104, USA.
| | - Lisa Jones-Engel
- Washington National Primate Research Center, University of Washington, 1705 Pacific St NE, HSB I-039, Box 357330, Seattle, WA, 98105, USA.
- Department of Anthropology, University of Washington, 1705 Pacific St NE, HSB I-039, Box 357330, Seattle, WA, 98105, USA.
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Nash TE, Mahanty S, Loeb JA, Theodore WH, Friedman A, Sander JW, Singh G, Cavalheiro E, Del Brutto OH, Takayanagui OM, Fleury A, Verastegui M, Preux PM, Montano S, Pretell EJ, White AC, Gonzales AE, Gilman RH, Garcia HH. Neurocysticercosis: A natural human model of epileptogenesis. Epilepsia 2014; 56:177-83. [PMID: 25534640 DOI: 10.1111/epi.12849] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To develop a better understanding of mechanisms of seizures and long-term epileptogenesis using neurocysticercosis. METHODS A workshop was held bringing together experts in epilepsy and epileptogenesis and neurocysticercosis. RESULTS Human neurocysticercosis and parallel animal models offer a unique opportunity to understand basic mechanisms of seizures. Inflammatory responses to degenerating forms and later-stage calcified parasite granulomas are associated with seizures and epilepsy. Other mechanisms may also be involved in epileptogenesis. SIGNIFICANCE Naturally occurring brain infections with neurocysticercosis offer a unique opportunity to develop treatments for one of the world's most common causes of epilepsy and for the development of more general antiepileptogenic treatments. Key advantages stem from the time course in which an acute seizure heralds a start of the epileptogenic process, and radiographic changes of calcification and perilesional edema provide biomarkers of a chronic epileptic state.
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Affiliation(s)
- Theodore E Nash
- Laboratory of Parasitic Disease, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, U.S.A
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Anastario M, Chun H, Soto E, Montano S. A trial of questionnaire administration modalities for measures of sexual risk behaviour in the uniformed services of Peru. Int J STD AIDS 2013; 24:573-7. [DOI: 10.1177/0956462413476273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Summary Modalities of questionnaire administration may affect data quality, particularly when conducting Biological and Behavioral Surveillance Surveys (BBSS) of uniformed personnel. We aimed to examine differences in administration, reporting and data quality across several common modalities of administration for BBSS endeavors. Prior to a large-scale BBSS endeavor with the uniformed services of Peru, we pilot tested three modes of questionnaire administration among personnel engaged in internal combat: face-to-face interview (FFI), self-administered paper-based interview (SAPI), and audio computer-assisted self-interview (ACASI). Individuals who took the survey using ACASI were less likely to have missing data on measures of sexual risk and alcohol abuse and were more likely to report sexual risk behaviours and symptoms of alcohol abuse; however, more individuals took the survey using SAPI given inadequate time to devote to sitting through an entire FFI or ACASI. Sexually transmitted infections did not vary significantly across modes of questionnaire administration. While more logistically complicated for BBSS efforts in resource-constrained settings, we recommend the use of ACASI in collecting BBSS data from uniformed personnel if conditions are permissible.
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Affiliation(s)
- M Anastario
- Center for the Study of Gender and Sexuality, New York University, New York, NY, USA
| | - H Chun
- Department of Defense HIV/AIDS Prevention Program, San Diego, CA, USA
| | - E Soto
- Peruvian Armed Forces and Police Committee for the Prevention of HIV/AIDS (COPRECOS)
| | - S Montano
- US Naval Medical Research Unit N.6, Lima, Peru
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Abanto C, Ton TGN, Tirschwell DL, Montano S, Quispe Y, Gonzales I, Valencia A, Calle P, Garate A, Zunt J. Predictors of functional outcome among stroke patients in Lima, Peru. J Stroke Cerebrovasc Dis 2013; 22:1156-62. [PMID: 23352681 DOI: 10.1016/j.jstrokecerebrovasdis.2012.11.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 10/08/2012] [Accepted: 11/20/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Because of the aging population in low- and middle-income countries, cerebrovascular disease is expected to remain a leading cause of death. Little has been published about stroke in Peru. We conducted a retrospective cohort study of hospitalized stroke patients at a referral center hospital in Lima, Peru to explore factors associated with functional outcome among stroke patients. METHODS We identified 579 patients hospitalized for ischemic stroke or intracerebral hemorrhage stroke at the National Institute of Neurologic Sciences in Lima, Peru in 2008 and 2009. A favorable outcome was defined as a modified Rankin scale score of ≤ 2 at discharge. RESULTS The mean age was 63.3 years; 75.6% had ischemic stroke; the average duration of stay was 17.3 days. At hospital discharge, 231 (39.9%) had a favorable outcome. The overall mortality rate was 5.2%. In multivariate models, the likelihood of having a favorable outcome decreased linearly with increasing age (P = .02) and increasing National Institutes of Health Stroke Scale (NIHSS) score (P = .02). Favorable outcome was also associated with male gender (relative risk [RR] 1.2; 95% confidence interval [CI] 1.0-1.5) and divorced status (RR 1.3; 95% CI 1.1-1.7). Patients on Salud Integral de Salud (SIS; public assistance-type insurance; RR 0.7; 95% CI 0.5-1.0) were also less likely to have a favorable outcome. CONCLUSIONS Favorable outcome after stroke was independently associated with younger age, a lower NIHSS score, male gender, being divorced, and not being on SIS insurance. These findings suggest that additional study of worse functional outcomes in patients with SIS insurance be conducted and confirm the importance of risk adjustment for age, stroke severity (according to the NIHSS scale), and other socioeconomic factors in outcomes studies. Future studies should preferentially assess outcome at 30 days and 6 months to provide more reliable comparisons and allow additional study of Peruvian end-of-life decision-making and care.
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Affiliation(s)
- Carlos Abanto
- Department of Cerebrovascular Disease, National Institute of Neurological Sciences, Lima, Peru
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Lemos MP, Perez ML, Sanchez J, Lama J, Montano S, McElrath J. Cell free HIV-1 virus can infect inner and outer foreskin polarized explants. Retrovirology 2012. [PMCID: PMC3441660 DOI: 10.1186/1742-4690-9-s2-o22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Robertson K, Jiang H, Kumwenda J, Supparatpinyo K, Evans S, Campbell TB, Price R, Tripathy S, Kumarasamy N, La Rosa A, Santos B, Silva MT, Montano S, Kanyama C, Faesen S, Murphy R, Hall C, Marra CM, Marcus C, Berzins B, Allen R, Housseinipour M, Amod F, Sanne I, Hakim J, Walawander A, Nair A. Improved neuropsychological and neurological functioning across three antiretroviral regimens in diverse resource-limited settings: AIDS Clinical Trials Group study a5199, the International Neurological Study. Clin Infect Dis 2012; 55:868-76. [PMID: 22661489 PMCID: PMC3491853 DOI: 10.1093/cid/cis507] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 05/11/2012] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AIDS Clinical Trials Group (ACTG) A5199 compared the neurological and neuropsychological (NP) effects of 3 antiretroviral regimens in participants infected with human immunodeficiency virus type 1 (HIV-1) in resource-limited settings. METHODS Participants from Brazil, India, Malawi, Peru, South Africa, Thailand, and Zimbabwe were randomized to 3 antiretroviral treatment arms: A (lamivudine-zidovudine plus efavirenz, n = 289), B (atazanavir, emtricitabine, and didanosine-EC, n = 293), and C (emtricitabine-tenofovir-disoproxil fumarate plus efavirenz, n = 278) as part of the ACTG PEARLS study (A5175). Standardized neurological and neuropsychological (NP) screening examinations (grooved pegboard, timed gait, semantic verbal fluency, and finger tapping) were administered every 24 weeks from February 2006 to May 2010. Associations with neurological and neuropsychological function were estimated from linear and logistic regression models using generalized estimating equations. RESULTS The median weeks on study was 168 (Q1 = 96, Q3 = 192) for the 860 participants. NP test scores improved (P < .05) with the exception of semantic verbal fluency. No differences in neurological and neuropsychological functioning between treatment regimens were detected (P > .10). Significant country effects were noted on all NP tests and neurological outcomes (P < .01). CONCLUSIONS The study detected no significant differences in neuropsychological and neurological outcomes between randomized ART regimens. Significant improvement occurred in neurocognitive and neurological functioning over time after initiation of ARTs. The etiology of these improvements is likely multifactorial, reflecting reduced central nervous system HIV infection, better general health, and practice effects. This study suggests that treatment with either of the World Health Organization -recommended first-line antiretroviral regimens in resource-limited settings will improve neuropsychological functioning and reduce neurological dysfunction. CLINICAL TRIALS REGISTRATION NCT00096824.
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Affiliation(s)
- K Robertson
- University of North Carolina, Chapel Hill, 27599-7025, USA.
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Nureña CR, Zúñiga M, Zunt J, Mejía C, Montano S, Sánchez JL. Diversity of commercial sex among men and male-born trans people in three Peruvian cities. Cult Health Sex 2011; 13:1207-21. [PMID: 21936651 PMCID: PMC3244347 DOI: 10.1080/13691058.2011.609908] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
In Peru, commercial sex involving men and male-born travestis, transgenders and transsexuals (CSMT) is usually represented as a dangerous practice carried out on the streets by people experiencing economic hardship and social exclusion. However, in reality little is known about the complexities of this practice in Peru. This paper presents findings from an ethnographic study of the characteristics, patterns and sociocultural aspects of CSMT in three Peruvian cities. The study included participant observation in sex work venues and interviews with 42 sex workers and 25 key informants. We found that CSMT in Peru takes many forms (some not previously described in the country) and is practised in different places by people from various socioeconomic levels. In many cases, the practice appears linked to ideals of social mobility, migratory experiences and other economic activities. In addition, the increasing use of the Internet and mobile phones has changed patterns of sex work in Peru. We review the implications of these findings for future research and public health interventions.
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Affiliation(s)
- César R Nureña
- Escuela de Antropología, Facultad de Ciencias Sociales, Universidad Nacional Mayor de San Marcos, Lima, Peru.
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Tejada R, Alarcon J, Zunt J, Montano S. SP3-42 Trends and characteristics of self-reported HIV testing in women of childbearing age, in Peru 2000, 2004-2008. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976o.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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14
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Robertson K, Kumwenda J, Supparatpinyo K, Jiang JH, Evans S, Campbell TB, Price RW, Murphy R, Hall C, Marra CM, Marcus C, Berzins B, Masih R, Santos B, Silva MT, Kumarasamy N, Walawander A, Nair A, Tripathy S, Kanyama C, Hosseinipour M, Montano S, La Rosa A, Amod F, Sanne I, Firnhaber C, Hakim J, Brouwers P. A multinational study of neurological performance in antiretroviral therapy-naïve HIV-1-infected persons in diverse resource-constrained settings. J Neurovirol 2011; 17:438-47. [PMID: 21786076 DOI: 10.1007/s13365-011-0044-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 06/10/2011] [Accepted: 06/24/2011] [Indexed: 11/25/2022]
Abstract
Little is known about how the prevalence and incidence of neurological disease in HIV-infected patients in resource-limited settings. We present an analysis of neurological and neurocognitive function in antiretroviral naïve individuals in multinational resource-limited settings. This prospective multinational cohort study, a substudy of a large international randomized antiretroviral treatment trial, was conducted in seven low- and middle-income countries in sub-Saharan Africa, South America, and Asia. Subjects were HIV-infected and met regional criteria to initiate antiretroviral therapy. Standardized neurological examination and a brief motor-based neuropsychological examination were administered. A total of 860 subjects were studied. Overall 249 (29%) had one or more abnormalities on neurological examinations, but there was a low prevalence of HIV-associated dementia (HAD) and minor neurocognitive disorder (MND). Twenty percent of subjects had evidence of peripheral neuropathy. There were significant differences across countries (p < 0.001) in neuropsychological test performance. In this first multinational study of neurological function in antiretroviral naïve individuals in resource-limited settings, there was a substantial prevalence of peripheral neuropathy and low prevalence of dementia and other CNS diseases. There was significant variation in neurocognitive test performance and neurological examination findings across countries. These may reflect cultural differences, differences in HIV-related and unrelated diseases, and variations in test administration across sites. Longitudinal follow-up after antiretroviral treatment initiation may help to define more broadly the role of HIV in these differences as well as the impact of treatment on performance.
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Affiliation(s)
- Kevin Robertson
- University of North Carolina, Chapel Hill, NC 27599-7025, USA.
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15
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Czechowicz JA, Messner AH, Alarcon-Matutti E, Alarcon J, Quinones-Calderon G, Montano S, Zunt JR. Hearing impairment and poverty: the epidemiology of ear disease in Peruvian schoolchildren. Otolaryngol Head Neck Surg 2010; 142:272-7. [PMID: 20115987 DOI: 10.1016/j.otohns.2009.10.040] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 10/14/2009] [Accepted: 10/27/2009] [Indexed: 01/08/2023]
Abstract
OBJECTIVES 1) To measure prevalence of hearing impairment (HI) in schoolchildren living in poverty in Peru. 2) To identify risk factors for HI and assess its impact on academic performance. STUDY DESIGN Cross-sectional. SETTING Elementary schools in an asentimiento humano (shantytown) near Lima, Peru, October 2008 to March 2009. SUBJECTS Schoolchildren (n = 335), ages six to 19 years. METHODS Audiological health was assessed with pure-tone audiometry, tympanometry, and otoscopy. The primary outcome was HI, defined as average threshold >25 dB HL for 0.5, 1, 2, and 4 kHz, in one or both ears (per World Health Organization/International Organization for Standardization). A questionnaire on health history was administered to parents. Statistical analysis included univariate analysis for chi(2) values and odds ratios (ORs), and multivariate logistic regression. RESULTS HI prevalence: 6.9 percent (95% confidence interval [CI] 4.2%-9.6%). Risk factors for HI (OR, 95% CI, P value): neonatal jaundice (5.59, 1.63-19.2, 0.015), seizure (7.31, 2.50-21.4, 0.0013), hospitalization (4.01, 1.66-9.68, 0.003), recurrent otitis media (5.06, 1.98-12.9, 0.002), past otorrhea (4.70, 1.84-12.0, 0.003), family history of HI at <35 years (2.91, 1.19-7.14, 0.026), tympanic membrane abnormality (13.8, 4.48-42.7, <0.001), cerumen impaction (15.8, 4.71-53.1, <0.001), and eustachian tube dysfunction (4.87, 1.74-13.7, <0.001). HI was an independent predictor of academic failure (3.36, 1.15-9.82, 0.03). CONCLUSIONS Impoverished Peruvian schoolchildren were four to seven times more likely to experience HI than children living in higher-income countries. Untreated middle ear disease in the context of limited access to pediatric care was a major risk factor for HI. Furthermore, HI was associated with worse scholastic achievement. These results support prioritization of pediatric ear health as an essential component of the global health agenda, especially in resource-poor countries.
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Affiliation(s)
- Josephine A Czechowicz
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
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Czechowicz JA, Alarcon-Matutti E, Alarcon JO, Zunt JR, Quinones-Calderon G, Montano S, Messner AH. Pediatric ear disease and poverty: Hearing loss in Peru. Otolaryngol Head Neck Surg 2009. [DOI: 10.1016/j.otohns.2009.06.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Chretien JP, Blazes DL, Coldren RL, Lewis MD, Gaywee J, Kana K, Sirisopana N, Vallejos V, Mundaca CC, Montano S, Martin GJ, Gaydos JC. The importance of militaries from developing countries in global infectious disease surveillance. Bull World Health Organ 2007; 85:174-80. [PMID: 17486207 PMCID: PMC2636235 DOI: 10.2471/blt.06.037101] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Accepted: 12/04/2006] [Indexed: 11/27/2022] Open
Abstract
Military forces from developing countries have become increasingly important as facilitators of their government's foreign policy, taking part in peacekeeping operations, military exercises and humanitarian relief missions. Deployment of these forces presents both challenges and opportunities for infectious disease surveillance and control. Troop movements may cause or extend epidemics by introducing novel agents to susceptible populations. Conversely, military units with disease surveillance and response capabilities can extend those capabilities to civilian populations not served by civilian public health programmes, such as those in remote or post-disaster settings. In Peru and Thailand, military health organizations in partnership with the military of the United States use their laboratory, epidemiological, communications and logistical resources to support civilian ministry of health efforts. As their role in international affairs expands, surveillance capabilities of militaries from developing countries should be enhanced, perhaps through partnerships with militaries from high-income countries. Military-to-military and military-to-civilian partnerships, with the support of national and international civilian health organizations, could also greatly strengthen global infectious disease surveillance, particularly in remote and post-disaster areas where military forces are present.
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Affiliation(s)
- Jean-Paul Chretien
- Department of Defense, Global Emerging Infections Surveillance and Response System, Silver Spring, MD 20910, USA.
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Sanchez J, Lama JR, Kusunoki L, Manrique H, Goicochea P, Lucchetti A, Rouillon M, Pun M, Suarez L, Montano S, Sanchez JL, Tabet S, Hughes JP, Celum C. HIV-1, Sexually Transmitted Infections, and Sexual Behavior Trends Among Men Who Have Sex With Men in Lima, Peru. J Acquir Immune Defic Syndr 2007; 44:578-85. [PMID: 17279049 DOI: 10.1097/qai.0b013e318033ff82] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess and estimate trends in HIV, sexually transmitted infections (STIs), and sexual behavior among men who have sex with men (MSM) in Lima, Peru. DESIGN Second-generation HIV sentinel surveillance surveys conducted in 1996, 1998, 2000, and 2002. METHODS Adult men reporting sex with at least 1 man during the previous year were eligible to participate. Sexual behavior and serum HIV-1 and syphilis antibodies were assessed. HIV seroincidence was estimated by a sensitive/less-sensitive enzyme immunoassay strategy. Rectal and pharyngeal swabs for Neisseria gonorrhoeae culture and a first-void urine sample for urethral leukocytes for presumptive diagnosis of urethritis were obtained. Herpes simplex virus 2 (HSV-2) antibodies were measured in 2002. RESULTS Although HIV prevalence increased from 18.5% to 22.3% from 1996 through 2002, bacterial prevalence declined significantly for syphilis (16.0% to 12.4%), early syphilis (8.6% to 3.4%), and rectal gonorrhea (5.1% to 0.2%). High HIV seroincidence was estimated, with the lowest (4.8%) incidence in 1998. In 2002, HSV-2 seroprevalence was 51.0%. After adjustment for age, education, and self-reported sexual identity, our data suggest that a yearly increase by 6% in the prevalence of HIV occurred among MSM in Lima, with a corresponding decline in syphilis (by 9%), early syphilis (by 18%), and rectal gonorrhea (by 64%). Condom use during last sexual intercourse increased by 26% each year with the most recent male steady partner and, among non-sex workers, by 11% with the most recent casual partner. CONCLUSIONS HIV continued to spread among MSM in Lima even when a decline in bacterial STIs and increase in condom use were estimated to occur. Intensification of medical and behavior prevention interventions is warranted for MSM in Peru.
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Affiliation(s)
- Jorge Sanchez
- Asociation Civil Impacta Salud y Educacion, Av. Grimaldo Del Solar 805, Lima 18, Peru.
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19
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Chretien JP, Blazes DL, Coldren RL, Lewis MD, Gaywee J, Kana K, Sirisopana N, Vallejos V, Mundaca CC, Montano S, Martin GJ, Gaydos JC. The importance of militaries from developing countries in global infectious disease surveillance. World Hosp Health Serv 2007; 43:32-37. [PMID: 18405198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Military forces from developing countries have become increasingly important as facilitators of their government's foreign policy, taking part in peacekeeping operations, military exercises and humanitarian relief missions. Deployment of these forces presents both challenges and opportunities for infectious disease surveillance and control. Troop movements may cause or extend epidemics by introducing novel agents to susceptible populations. Conversely, military units with disease surveillance and response capabilities can extend those capabilities to civilian populations not served by civilian public health programmes, such as those in remote or post-disaster settings. In Peru and Thailand, military health organizations in partnership with the military of the United States use their laboratory, epidemiological, communications and logistical resources to support civilian ministry of health efforts. As their role in international affairs expands, surveillance capabilities of militaries from developing countries should be enhanced, perhaps through partnerships with militaries from high-income countries. Military-to-military and military-to-civilian partnerships, with the support of national and international civilian health organizations, could also greatly strengthen global infectious disease surveillance, particularly in remote and post-disaster areas where military forces are present.
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Affiliation(s)
- Jean-Paul Chretien
- Department of Defense--Global Emerging Infections Surveillance and Response System, Silver Spring, USA
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20
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De Castro-Costa CM, Araújo AQC, Barreto MM, Takayanagui OM, Sohler MP, da Silva ELM, de Paula SMB, Ishak R, Ribas JGR, Rovirosa LC, Carton H, Gotuzzo E, Hall WW, Montano S, Murphy EL, Oger J, Remondegui C, Taylor GP. Proposal for diagnostic criteria of tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM). AIDS Res Hum Retroviruses 2006; 22:931-5. [PMID: 17067261 DOI: 10.1089/aid.2006.22.931] [Citation(s) in RCA: 178] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
After the first description of TSP/HAM in 1985 and the elaboration of WHO's diagnostic criteria in 1988, the experience of the professionals in this field has increased so that a critical reappraisal of these diagnostic guidelines was considered timely. Brazilian neurologists and observers from other countries met recently to discuss and propose a modified model for diagnosing TSP/HAM with levels of ascertainment as definite, probable, and possible, according to myelopathic symptoms, serological findings, and/or detection of HTLV-I DNA and exclusion of other disorders.
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Affiliation(s)
- Carlos M De Castro-Costa
- Departamento de Fisiologia e Farmacologia, Universidade Federal do Ceará, Rodolfo Teófilo, 60430-270, Fortaleza-CE, Brazil
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21
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Ramos MS, Zun JR, Montano S, Salvatierra J. 313 RISK FACTORS AND KNOWLEDGE OF SEXUALLY TRANSMITTED DISEASES IN THE NON-REGISTERED FEMALE SEX WORKERS OF CALLAO, PERU. J Investig Med 2005. [DOI: 10.2310/6650.2005.00005.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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22
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O'Keeffe G, Montano S, Zunt JR. 20 PERUVIAN HEALTH CARE SPANNING THREE ECOSYSTEMS. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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23
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Pando MDLA, Maulen S, Weissenbacher M, Marone R, Duranti R, Peralta LM, Salomón H, Russell K, Negrete M, Sosa Estani S, Montano S, Sanchez JL, Avila MM. High human immunodeficiency virus type 1 seroprevalence in men who have sex with men in Buenos Aires, Argentina: risk factors for infection. Int J Epidemiol 2003; 32:735-40. [PMID: 14559741 DOI: 10.1093/ije/dyg104] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To determine human immunodeficiency virus (HIV) seroprevalence in a sample of men who have sex with men (MSM) in Buenos Aires City and to identify risk factors associated with HIV type 1 infection. METHODS Participants were invited to receive HIV counselling and testing at "NEXO" (a gay non-governmental organization) by means of informative leaflets distributed in gay nightclubs, porno cinemas, gymnasiums, and in the streets. During the encounter, the study was explained by a trained social worker and individuals were invited to volunteer for the study. Diagnosis of HIV was performed using two screening tests and Western Blot assay was used as confirmatory. RESULTS Human immunodeficiency virus was detected in 96 (13.8%; 95% CI: 11.4-16.7) of 694 MSM. Fourteen (14.6%) of the 96 HIV-positive MSM were already aware of their HIV serostatus. In univariate analysis, HIV-1 infection (odds ratio [OR] >1.5) was found to be associated with older age (30-39 years), being unemployed, a previous sexually transmitted disease (STD) history, and having an HIV-positive partner. Cocaine consumption and irregular use of condoms with occasional partners were also found to be risk factors. In multivariate logistic regression analysis, being unemployed (OR = 3.42; 95% CI: 1.17-9.99) and having an HIV-positive partner (OR = 2.67; 95% CI: 1.09-6.52) remained significant risk factors. DISCUSSION The high HIV-1 prevalence observed suggests an urgent need for implementation of effective prevention campaigns. This represents the first cross-sectional epidemiological study of HIV among the high-risk group of MSM in Argentina.
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Carrion G, Hierholzer J, Montano S, Alava A, Perez J, Guevara A, Laguna-Torres V, Mosquera C, Russell K, Chauca G, Kochel T, Birx DL, Sanchez JL, Carr JK. Circulating recombinant form CRF02_AG in South America. AIDS Res Hum Retroviruses 2003; 19:329-32. [PMID: 12816083 DOI: 10.1089/088922203764969537] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
With the objective of monitoring the distribution of HIV-1 subtypes and circulating recombinant forms (CRFs)in South America, population-based surveillance studies were performed in seven countries. Peripheral blood mononuclear cell, filter paper, fresh blood, and cocultivation samples were collected from HIV-positive patients from Colombia, Ecuador, Peru, Bolivia, Chile, Argentina, and Uruguay, during a 7-year period(1995-2001). DNA was prepared and HIV envelope subtypes were determined by heteroduplex mobility as-say and DNA sequencing from 1289 HIV-positive samples. While subtypes B and F were the most commonly observed subtypes, two CRF02_AG strains were detected, in Ecuador. This is the first report of the existence of this CRF in South America.
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Affiliation(s)
- G Carrion
- US Naval Medical Research Center Detachment, Lima, Peru
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25
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Hierholzer J, Montano S, Hoelscher M, Negrete M, Hierholzer M, Avila MM, Carrillo MG, Russi JC, Vinoles J, Alava A, Acosta ME, Gianella A, Andrade R, Sanchez JL, Carrion G, Sanchez JL, Russell K, Robb M, Birx D, McCutchan F, Carr JK. Molecular Epidemiology of HIV Type 1 in Ecuador, Peru, Bolivia, Uruguay, and Argentina. AIDS Res Hum Retroviruses 2002; 18:1339-50. [PMID: 12487805 DOI: 10.1089/088922202320935410] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Surveillance for HIV infection among people at increased risk was conducted in five countries in South America. Seroprevalence studies were conducted in more than 36,000 people in Ecuador, Peru, Boliva, Uruguay, and Argentina, along with genetic analysis of the HIV-1 strains. In all countries, the prevalence of HIV-1 among men who have sex with men (MSM) was high (3-30%), whereas the prevalence among female commercial sex workers (FCSMs) was low (0.3-6%). By envelope heteroduplex mobility assay, subtype B predominated in MSM communities and in FCSWs in Ecuador, Bolivia, and Peru. A new genetic screening assay, the multiregion hybridization assay for subtypes B and F (MHA-bf), was developed to improve large-scale genetic screening in South America. MHA-bf can screen four regions of the genome for subtype B or subtype F, and thus can detect most recombinants. The sensitivity of MHA-bf when applied to a panel of pure subtypes and CRF12_BF was 100%, and 88% of unique recombinants were also detected as recombinant. Using MHA-bf, more than 80% of samples from Ecuador, Peru, and Bolivia were classified as pure subtype B, whereas in Uruguay and Argentina this proportion was only 30 to 40%. BF recombinants were the most prevalent form of HIV-1 in Uruguay and Argentina. Subtype B is the most common subtype in countries lacking injecting drug use (IDU) epidemics, whereas BF recombinants are more common in countries where extensive IDU epidemics have been documented, suggesting the ontogeny of recombinant strains in particular risk groups in South America.
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Affiliation(s)
- Jesse Hierholzer
- U.S. Military HIV Research Program, Henry M. Jackson Foundation, Rockville, Maryland 20850, USA
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Abstract
At variance with the current view that only liver and kidney are gluconeogenic organs, because both are the only tissues to express glucose-6-phosphatase (Glc6Pase), we have recently demonstrated that the Glc6Pase gene is expressed in the small intestine in rats and humans and that it is induced in insulinopenic states such as fasting and diabetes. We used a combination of arteriovenous balance and isotopic techniques, reverse transcription-polymerase chain reaction, Northern blot analysis, and enzymatic activity assays. We report that rat small intestine can release neosynthesized glucose in mesenteric blood in insulinopenia, contributing 20-25% of total endogenous glucose production. Like liver glucose production, small intestine glucose production is acutely suppressed by insulin infusion. In the small intestine, glutamine and, to a much lesser extent, glycerol are the precursors of glucose, whereas alanine and lactate are the main precursors in liver. Accounting for these metabolic fluxes: 1) the phosphoenolpyruvate carboxykinase gene (required for the utilization of glutamine) is strongly induced at the mRNA and enzyme levels in insulinopenia; 2) the glycerokinase gene is expressed, but not induced; 3) the pyruvate carboxylase gene (required for the utilization of alanine and lactate) is repressed by 80% at the enzyme level in insulinopenia. These studies identify small intestine as a new insulin-sensitive tissue and a third gluconeogenic organ, possibly involved in the pathophysiology of diabetes.
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Affiliation(s)
- M Croset
- Institut National de la Santé et de la Recherche Médicale, Faculté de Médecine RTH Laennec, Lyon, France
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Abstract
PEPCK is a key enzyme of gluconeogenesis in liver and kidney. Recently, we have shown that small intestine also contributes to the endogenous glucose production in insulinopenia in rats and that glutamine is the main precursor of glucose synthesized in this tissue. The expression of the PEPCK gene in rat and human small intestine and the effect of streptozotocin-induced diabetes and fasting have been studied using reverse transcriptase-polymerase chain reaction, Northern blot analysis, and determination of enzyme activity. The PEPCK gene is expressed along the whole small intestine in adult rat and human. The abundance of PEPCK mRNA was increased approximately 30 times in the duodenum, 15 times in the jejunum, and only 3 times in the ileum from diabetic rats. PEPCK mRNA was downregulated in all parts of the tissue upon insulin treatment for 10 h. In 48-h fasted rats, the PEPCK mRNA abundance was increased 17 times in the duodenum and the jejunum and 3 times in the ileum, and it was normalized upon refeeding for 7 h. PEPCK activity was also increased 2-5 times in diabetic and fasted rats in the duodenum and jejunum but not in the ileum. We conclude that PEPCK is a crucial enzyme contributing to the induction of gluconeogenesis in small intestine, just as it is well known to be in the liver and kidney.
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Affiliation(s)
- F Rajas
- Faculté de Médecine Laënnec, Institute National de la Santé et de la Recherche Médical (INSERM) U.449, Lyon, France
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Minassian C, Montano S, Mithieux G. Regulatory role of glucose-6 phosphatase in the repletion of liver glycogen during refeeding in fasted rats. Biochim Biophys Acta 1999; 1452:172-8. [PMID: 10559470 DOI: 10.1016/s0167-4889(99)00130-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We analyzed the biochemical mechanisms involved in the liver glycogen repletion upon refeeding for 360 min in 48 and 96 h-fasted rats. In 48 h-fasted rats, the glycogen synthesis involved a rapid and further sustained induction of glucokinase (GK) (increased twice from 90 min) and a rapid but transient activation of glycogen synthase a (GSa) (maximal increase by 150% at 90 min). It did not involve the inhibition of glycogen phosphorylase a (GPa). In 96 h-fasted rats, the glycogen repletion did not involve the induction of GK for the first 180 min of refeeding. It involved a slow activation of GSa (maximal 150% increase at 180 min) and a rapid inhibition of GPa (significant from 90 min, maximal 50% inhibition by 180 min). In both groups of rats, there was a progressive inhibition of the glucose-6 phosphatase (Glc6Pase) activity (maximal suppression by 30% in both groups at 360 min). These results highlighted a key role for the inhibition of Glc6Pase activity in the liver glycogen repletion upon refeeding.
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Affiliation(s)
- C Minassian
- INSERM U. 449, Faculté de Médecine Laennec, rue Guillaume Paradin, 69372, Lyon, France
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Zunt JR, Alarcón JO, Montano S, Longstreth WT, Price R, Holmes KK. Quantitative assessment of subclinical spasticity in human T-cell lymphotropic virus type I infection. Neurology 1999; 53:386-90. [PMID: 10430431 PMCID: PMC2678023 DOI: 10.1212/wnl.53.2.386] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare human T-cell lymphotrophic virus type I (HTLV-I) seropositive and seronegative women for symptoms and signs of spasticity. BACKGROUND Infection with HTLV-I causes tropical spastic paraparesis/ HTLV-I-associated myelopathy (TSP/HAM). Certain populations, including female commercial sex workers (FSW), are at increased risk of developing this infection. Fewer than 5% of HTLV-I-seropositive persons develop TSP/HAM, which is typically associated with spasticity. METHODS Cross-sectional study of 255 registered FSW in Callao, Perú, involving a questionnaire detailing demographics and neurologic symptoms, standard neurologic examination, quantitative assessment of spasticity (QSA) of muscle tone, and serologic testing for HTLV-I. Participants and examiners were blinded to serology results. RESULTS On the questionnaire and neurologic examination, none of the 32 HTLV-I-seropositive or 223 seronegative women had signs or symptoms of spasticity. However, mean values on QSA were significantly higher among seropositive women (27.1 Newton-meters/radian [N-m/r]) than among seronegative women (21.6 N-m/r, p = 0.01), indicating a subclinical increase in lower extremity tone. With values of QSA divided into tertiles, and the first tertile serving as the comparison group, the odds ratio for seropositivity was 1.4 (95% confidence interval [CI] 1.0 to 2.0) in the second and 3.1 (95% CI 2.2 to 4.3) in the third tertile, after adjusting for age and place of birth. CONCLUSIONS Although a standard neurologic evaluation could not distinguish between women with and without HTLV-I infection, QSA indicated significantly increased lower extremity tone in those with infection. Long-term follow-up will determine whether these subclinical findings in asymptomatic women progress to overt TSP/HAM.
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Affiliation(s)
- J R Zunt
- Department of Neurology, Center for AIDS and STD, University of Washington School of Medicine, Seattle, USA.
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Rajas F, Bruni N, Montano S, Zitoun C, Mithieux G. The glucose-6 phosphatase gene is expressed in human and rat small intestine: regulation of expression in fasted and diabetic rats. Gastroenterology 1999; 117:132-9. [PMID: 10381919 DOI: 10.1016/s0016-5085(99)70559-7] [Citation(s) in RCA: 136] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS Glucose-6 phosphatase (Glc6Pase) is the last enzyme of gluconeogenesis and glycogenolysis, previously assumed to be expressed in the liver and kidney only, conferring on both tissues the capacity to produce endogenous glucose in blood. METHODS Using Northern blotting and reverse-transcription polymerase chain reaction and a highly specific Glc6Pase assay, we studied expression of the Glc6Pase gene in human and in rat tissues (fasted and diabetic). RESULTS The Glc6Pase gene is expressed in the duodenum and jejunum in normal fed rats and in the duodenum, jejunum, and ileum in humans. The Glc6Pase messenger RNA (mRNA) abundance was increased eightfold and sixfold in the duodenum and jejunum of streptozotocin diabetic rats. It was normalized in both tissues after 10 hours of insulin treatment. Glc6Pase activity was increased by 300% in the duodenum and jejunum in diabetic rats compared with normal rats. The Glc6Pase mRNA abundances and enzymatic activities were increased in a similar manner in both tissues in 48-hour-fasted rats. Normalization of mRNA abundance was achieved after refeeding for 7 hours. In addition, Glc6Pase mRNA and activity were also expressed in the ileum during fasting in rats. CONCLUSIONS These data show that the small intestine has the ability to release endogenous glucose and strongly suggest that its contribution to systemic glucose production might be increased in situations of insulinopenia (type 1 diabetes) and insulin resistance (type 2 diabetes and others).
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Affiliation(s)
- F Rajas
- INSERM Unité 449, Faculté de Médecine R. Laënnec, Lyon, France
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Bruni N, Rajas F, Montano S, Chevalier-Porst F, Maire I, Mithieux G. Enzymatic characterization of four new mutations in the glucose-6 phosphatase (G6PC) gene which cause glycogen storage disease type 1a. Ann Hum Genet 1999; 63:141-6. [PMID: 10738525 DOI: 10.1046/j.1469-1809.1999.6320141.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Glycogen storage disease type 1a (GSD1a) is caused by mutations in the gene of glucose-6 phosphatase (G6PC), encoding the last enzyme of gluconeogenesis and glycogenolysis. To study the effect of mutations previously identified, but not yet enzymatically characterized, in French GSD1a patients, we used an in vitro expression system of the human glucose-6 phosphatase (hGlc6Pase) cDNA. Wild type hGlc6Pase expressed in COS-7 cells exhibited kinetic features comparable to microsomal Glc6Pase from normal human liver and kidney. Four new mutations inducing aminoacid changes in the coding sequence, e.g. W77R, A124T, G184E and L211P, were inserted into the Glc6Pase cDNA by site-directed mutagenesis, and studied after transient expression in COS-7 cells. All four mutations totally abolished Glc6Pase activity.
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Affiliation(s)
- N Bruni
- Institut National de la Santé et de la Recherche Médicale (Unité 449), Faculté de Médecine R. T. H. Laennec, Lyon, France
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Abstract
In patients with Crohn's disease (CD) we investigated the C3 conversion of zymosan-activated serum (ZAS) and looked for the occurrence of chemotactic factor inactivation (CFI). We also studied the cell-directed inhibitory effect (CDI) of the CD patients' plasma and, in the same group, complement activation and complement-mediated deactivation. The mean value of ZAS C3 conversion in CD was no different from that of healthy controls, but in steroid-treated patients it was lower than in untreated CD. CFI occurred in 1 of the 23 CD sera tested, and CDI was observed in 6 out of the 22 patients tested. EDTA C3 conversion was present in 12 patients, and complement-mediated deactivation was associated with high values of EDTA C3 conversion. Our findings indicate that complement dysfunction and inhibitory factors of neutrophil chemotaxis are present in CD. These findings could explain the defective neutrophil migration into skin windows. Whether they are relevant to the pathogenesis of tissue injury or of infectious complications and are specific for CD, however, remains to be established.
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Paganelli R, Pallone F, Montano S, Le Moli S, Matricardi PM, Fais S, Paoluzi P, D'Amelio R, Aiuti F. Isotypic analysis of antibody response to a food antigen in inflammatory bowel disease. Int Arch Allergy Appl Immunol 1985; 78:81-5. [PMID: 2863223 DOI: 10.1159/000233867] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We studied the class-specific antibody response to the cow's milk antigen beta-lactoglobulin (beta-LG) in sera from patients with ulcerative colitis and Crohn's disease. IgG and IgM to beta-LG were significantly higher in patients when compared to healthy non-atopic controls, whereas IgA values were similar, and specific IgE absent in all groups. No correlation between IgG- or IgM-containing immune complexes was found with the corresponding isotype of antibody to beta-LG; however, IgM complexes correlated with serum total IgM in ulcerative colitis. In these patients, IgG antibodies were higher in active cases, whereas IgM increased in patients without signs of disease activity. Antibody titers did not correlate with disease duration or administration of antiinflammatory drugs. This pattern of anti-beta-LG reactivity suggests that the presence of intestinal lesions may be revealed by the selective increase of some antibody isotypes to orally administered antigens. Enhanced mucosal permeability may be studied by this type of serological analysis.
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Pallone F, Montano S, Fais S, Boirivant M, Signore A, Pozzilli P. Studies of peripheral blood lymphocytes in Crohn's disease. Circulating activated T cells. Scand J Gastroenterol 1983; 18:1003-8. [PMID: 6608783 DOI: 10.3109/00365528309181833] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Peripheral blood mononuclear cells have been investigated in 43 patients with Crohn's disease (CD) by means of a panel of 4 monoclonal antibodies (UCHT1, UCHT4, 4F2, 5E9). A decrease of total T cells (UCHT1+) (p less than 0.01) and a slight increase of cytotoxic/suppressor T cells (UCHT4+) were observed. Evidence of T-cell activation, as shown by the highly significant increase of 4F2+ and 5E9+ cells, was also found. The latter finding lends support to the concept that cell-mediated immune phenomena are an important feature in CD.
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D'Amelio R, Rossi P, Le Moli S, Ricci R, Montano S, Pallone F. In vitro studies on cellular and humoral chemotaxis in Crohn's disease using the under agarose gel technique. Gut 1981; 22:566-70. [PMID: 7262631 PMCID: PMC1419327 DOI: 10.1136/gut.22.7.566] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The locomotor function of polymorphonuclear cells (cellular chemotaxis) and serum chemotactic activity (humoral chemotaxis) were studied in 51 patients with Crohn's disease using a method of migration under agarose gel. To study cellular chemotaxis patient's polymorphonuclear cells were challenged against normal Zymosan activated serum and humoral chemotaxis was evaluated testing the patient's Zymosan activated serum against normal polymorphonuclear cells. Cellular chemotaxis in the Crohn's disease group was normal (although 30% of the 51 patients had migration values out of the normal range), while humoral chemotaxis was significantly lower in Crohn's disease patients than in the control group. However, the value of humoral chemotaxis in the group of Crohn's disease patients treated with steroids was lower than that of patients not treated, thus accounting for the low mean value observed inthe Crohn's disease-group as a whole. The present results suggest that a defective chemotactic response may occur in some Crohn's disease patients, particularly during steroid treatment. These findings might be related either to a defective generation of complement derived chemotactic factors or to the presence of circulating inhibitors.
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Pallone F, Montano S, Ricci R, Iavicoli M, Di Mario U. New evidence of circulating immune complexes in Crohn's disease using two sensitive methods. J Clin Lab Immunol 1981; 5:23-5. [PMID: 7218324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Circulating immune complexes (AgAb) were studied in 183 serum samples from 119 patients with Crohn's Disease. AgAb were studied by the solid phase C1q binding test in all sera and also by the conglutinin binding assay in 161 sera. A significantly higher prevalence of circulating AgAb was observed in Crohn's disease patients in comparison with the control population. About one half of the sera were AgAb positive when the results of both tests were combined whereas AgAb were found in about one third of the sera by each individual method. Complexes revealed by the C1q-SP appeared to be related to the disease activity and to the occurrence of complications. Such a correlation was not observed as far as conglutinin results are concerned. Data emerging from the present investigation indicate that circulating AgAb may be present in Crohn's disease and suggest that the AgAb material is heterogeneous. They also suggest the possibility that AgAb represent a secondary phenomenon.
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