Long‐term safety and efficacy results in hepatitis C virus genotype 1‒infected patients receiving ombitasvir/paritaprevir/ritonavir + dasabuvir ± ribavirin in the TOPAZ‐I and TOPAZ‐II trials

The 3‐DAA regimen consisting of ombitasvir/paritaprevir/ritonavir plus dasabuvir (OBV/PTV/r + DSV) ± ribavirin (RBV) has shown high sustained virologic response rates (~95%) in phase 3 clinical trials including >2300 HCV genotype 1–infected patients. Real‐world evidence studies have confirmed the effectiveness of OBV/PTV/r ± DSV ± RBV in patients with chronic HCV genotype 1 infection and are consistent with clinical trial results. TOPAZ‐I and TOPAZ‐II are ongoing phase 3b trials, assessing safety, efficacy and long‐term progression of liver disease and clinical outcomes for up to 5 years post‐treatment in patients treated with OBV/PTV/r + DSV ± RBV. High rates of sustained virologic response (SVR) were achieved regardless of presence or absence of cirrhosis.In this report, we assessed the long‐term progression of liver disease and incidence of clinical outcomes up to 3 years of post‐treatment follow‐up in patients with chronic HCV GT1 infection who were treated with (OBV/PTV/r + DSV) ± RBV in the TOPAZ‐I and TOPAZ‐II studies. Improvements were observed in liver disease markers including FIB‐4, METAVIR and Child‐Pugh scores as well as platelet counts. Clinical outcomes related to long‐term progression of liver disease such as liver decompensation were infrequent (<1%). Hepatocellular carcinoma (HCC) occurred in 1.4% of cirrhotic patients.     

Extensive longitudinal myelitis due to cytomegalovirus infection

Journal of NeuroVirology - Neurological cytomegalovirus (CMV) infections especially extensive longitudinal myelitis are extremely rare in immunocompetent adults. However, we hereby report a case of...     

The effects of fasting on heart rate variability in hypertensive patients

ABSTRACT

Heart rate variability (HRV) is an independent indicator of increased mortality in patients with myocardial infarction and congestive heart failure. The effects of fasting on the HRV are not known in hypertensive patients. Therefore, studying the effects of Ramadan fasting on hypertensive patients’ HRV seems reasonable to address.

We conducted a prospective study including 20 hypertensive patients with sinus rhythm. HRV was determined twice by ambulatory 24-hour Holter recordings at fasting during and after Ramadan.

Subjects mean age was 55 ± 11.8 years. Sex-ratio was 1.5. When two groups compared, statistically significant differences were found in terms of SDNN (113 ± 71 vs 140 ± 38, p = 0.001), SDANN (109.7 ± 45 vs 134.8 ± 48.3, p = 0.008), T power (2368.7 ± 121.3 vs 3660.5 ± 170.9, p = 0.03) and LF (552.2 ± 31.3 vs 903.7 ± 48.9, p < 0.0001) values.

HRV parameters were found to be decreased in Ramadan. Thus, Ramadan fasting enhances the activity of the sympathetic system in hypertensive patients.     

Mechanical Performance of Bio-Based FRP-Confined Recycled Aggregate Concrete under Uniaxial Compression

This research investigates the effectiveness of bio-sourced flax fiber-reinforced polymer in comparison with a traditional system based on carbon fiber-reinforced epoxy polymer in order to confine recycled aggregate concretes. The experimental investigation was conducted on two series of concrete including three mixtures with 30%, 50%, and 100% of recycled aggregates and a reference concrete made with natural aggregates. The concrete mixtures were intended for a frost environment where an air-entraining agent was added to the mixture of the second series to achieve 4% air content. The first part of the present work is experimental and aimed to characterize the compressive performance of confined materials. The results indicated that bio-sourced composites are efficient in strengthening recycled aggregates concrete, especially the air-entrained one. It was also found that the compressive strength and the strain enhancement obtained from FRP confinement are little affected by the replacement ratio. The second part was dedicated to the analytical modeling of mechanical properties and stress–strain curves under compression. With the most adequate ultimate strength and strain prediction relationships, the full behavior of FRP-confined concrete can be predicted using the model developed by Ghorbel et al. to account for the presence of recycled aggregates in concrete mixtures.     

Tolllike receptor 4 (TLR4) polymorphisms in Tunisian patients with Crohn's disease: genotype-phenotype correlation

Background  

The immune responses to bacterial products through the pattern recognition receptor (PRR) play a pivotal role in pathogenesis of Crohn's disease. A recent study described an association between CD and some gene coding for bacterial receptor like NOD2/CARD15 gene and TLR4. In this study, we sought to determine whether TLR4 gene was associated with Crohn's disease (CD) among the Tunisian population and its correlation with clinical manifestation of the disease.