Safety and efficacy of fenproporex for obesity treatment: a systematic review

ABSTRACT OBJECTIVE To evaluate clinical evidence on the safety and efficacy of fenproporex for treating obesity. METHODS MEDLINE, LILACS and Cochrane Controlled Trials Register were searched as well as references cited by articles and relevant documents. Two authors independently assessed the studies for inclusion and regarding risk of bias, collected data, and accuracy. Eligible studies were all those placebo-controlled that provided data on the efficacy and safety of Fenproporex to treat obesity. RESULTS Only four controlled studies met the inclusion criteria. One randomized, placebo-controlled trial on Fenproporex was found on electronic databases. Three placebo-controlled studies (in non-indexed journals) were identified by hand-searching. Patients with cardiovascular and other comorbidities were excluded in all studies. Trials lasted from 40 to 364 days and doses ranged from 20 to 33.6 mg/d. All controlled studies found that weight loss among Fenproporex-treated patients was greater than that produced by the placebo, but drug effect was modest. Fenproporex produced additional weight reductions of 4.7 kg (one year), 3.8 kg (six months) and 1.55 kg (two months) in average, in relation to diet and exercise only (three trials). Insomnia, irritability, and anxiety were the most frequently reported side effects in the four studies. CONCLUSIONS There is a paucity of randomized, placebo-controlled trials on Fenproporex and those identified here present major methodological flaws. These studies suggest that Fenproporex is modestly effective in promoting weight loss. Nonetheless, they failed to provide evidence that it reduces obesity-associated morbidity and mortality. Data from these studies are insufficient to determine the risk-benefit profile of Fenproporex. Abuse potential and amphetamine-like adverse effects are causes for concern

Inflammatory and bone regulators expression in murine macrophages under exposure of commercial and experimental mineral trioxide aggregate

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background: Mineral trioxide aggregate (MTA) has been used in a variety of surgical and non-surgical endodontic applications. The aim of this study was to evaluate the gene expression and protein production of TNF-alpha, IL-1 beta and IL-6, as well as the gene expression of RANKL and OPG using both commercial and experimental MTA in macrophage cell cultures. Methods: Peritoneal macrophage cell culture was performed. Viability, gene expression of cytokines, RANKL and OPG, and protein levels in experimental- and commercial-grey MTA co-cultured with peritoneal macrophages was determined by tryptan blue, real time PCR and ELISA. Results: The expression of TNF-alpha for both commercial and experimental MTA was higher, while the expression of IL-1 beta and IL-6 was similar when compared to the negative control. At protein expression level, no differences were observed between the negative control and cements. RANKL did not show a significant improvement in gene expression when compared with the negative control, but OPG expression in cement samples was higher when compared to the negative control. Conclusions: This study suggests that commercial and experimental MTA promotes anti-inflammatory processes, as well as bone healing capacity.573284291Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [07/58796-4, 07/56731-2

Mycobacteraemia among HIV-1-infected patients in São Paulo, Brazil: 1995 to 1998

From July 1995 to August 1998, mycobacterial blood Cultures were obtained from 1032 HIV-infected patients seen at the Centro de Referncia e Treinamento de AIDS (CRTA), Hospital São Paulo (HSP), and Centro de Referncia de AIDS de Santos (CRAS). Overall, 179 episodes of mycobacteraemia were detected: 111 (62.0%) at CRTA, 50 (27.9%) at LISP, and 18 (10.1%) at CRAS. the frequency of positive Cultures declined sharply from 22.6%, in 1995 to 6.9% in 1998, consistent with the decrease in opportunistic infections following the publicly funded distribution of highly active anti retroviral therapy. in 1995, mycobacteraemia was more frequently due to Mycobacterium avium complex (59.2%) than Mycobacterium tuberculosis (28.6%), whereas in 1998 the relative frequencies were reversed (28.6 vs. 64.3% respectively), probably justified by the increased virulence of M. tuberculosis and the greater risk of invasive infection in less-immunocompromised patients, including patients unaware they are infected with HIV.Univ Fed Espirito Santo, Ctr Biomed, BR-29040091 Vitoria, ES, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilInst Adolfo Lutz Registro, São Paulo, BrazilCtr Referencia & Treinamento AIDS, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilWeb of Scienc