Evaluation of endothelial function and subclinical atherosclerosis in patients with HIV infection

The aim of this study was to analyse the association between human immunodeficiency virus (HIV) related clinical and analytical parameters and the presence of subclinical atherosclerosis as well as endothelial dysfunction. This was a prospective cohort study of HIV-positive patients who underwent intima media thickness (IMT) determination and coronary artery calcium scoring to determine subclinical atherosclerosis. To detect endothelial dysfunction, the breath holding index, flow-mediated dilation and the concentration of endothelial progenitor cells (EPCs) were measured. Patients with an IMT ≥ 0.9 mm had an average of 559.3 ± 283.34 CD4/μl, and those with an IMT < 0.9 mm had an average of 715.4 ± 389.92 CD4/μl (p = 0.04). Patients with a low calcium score had a significantly higher average CD4 cell value and lower zenith viral load (VL) than those with a higher score (707.7 ± 377.5 CD4/μl vs 477.23 ± 235.7 CD4/μl (p = 0.01) and 7 × 10⁴ ± 5 × 10⁴ copies/ml vs 23.4 × 104 ± 19 × 104 copies/ml (p = 0.02)). The number of early EPCs in patients with a CD4 nadir < 350/µl was lower than that in those with a CD4 nadir ≥ 350 (p = 0.03). In HIV-positive patients, low CD4 cell levels and high VL were associated with risk of developing subclinical atherosclerosis. HIV patients with CD4 cell nadir < 350/µl may have fewer early EPCs.

Effect of marine by-product meals on hen egg production parameters, yolk lipid composition and sensory quality

The effect of including 5% marine by-product meals in feeds of laying hens on egg production, composition and sensory characteristics was tested. Marine by-product meals were prepared using two methods: (i) cooking (100°C/10 min) followed by drying (60°C/24 hr) or (ii) grinding followed by drying. The raw materials used for meal production were scallop or squid viscera, shrimp heads or whole mackerel. A total of 108 laying hens were allocated to nine diet treatments; one control diet (corn and soya bean based) and eight experimental diets, containing 95% of the control feed and 5% of the experimental meal for three weeks. Daily intake was higher in hens fed the dried mackerel and cooked shrimp meals. All the experimental treatments showed significantly higher concentration of n-3 HUFA in yolk reserves and phospholipids compared to the control (0.12-0.13 g per 100 g), especially those with scallop or squid prepared by both methods (0.53-0.95 g per 100 g). Scallop, squid and shrimp meal inclusion in the feed produced eggs with more astaxanthin (0.22 mg per 100 g) while this carotenoid was absent in the control and mackerel treatments. Visual evaluation of raw yolk colour increased with the inclusion of marine by-product meals with higher values in hens fed shrimp heads (13), followed by scallop viscera (11), squid viscera (9), and with similar values for mackerel and control (4). The taste, aroma, texture and colour of cooked eggs from different treatments were not statically different when evaluated by a panel of 60 untrained people. These results suggest that meals from marine by-products are a better alternative for improving egg yolk composition by increasing n-3 HUFA when compared to fishmeal as they also increase astaxanthin and yolk pigmentation without affecting egg sensory characteristics.

[MIII2MII3] n+ trigonal bipyramidal cages based on diamagnetic and paramagnetic metalloligands

A family of five [MIII2MII3] n+ trigonal bipyramidal cages (MIII = Fe, Cr and Al; MII = Co, Zn and Pd; n = 0 for 1-3 and n = 6 for 4-5) of formulae [Fe2Co3L6Cl6] (1), [Fe2Zn3L6Br6] (2), [Cr2Zn3L6Br6] (3), [Cr2Pd3L6(dppp)3](OTf)6 (4) and [Al2Pd3L6(dppp)3](OTf)6 (5) (where HL is 1-(4-pyridyl)butane-1,3-dione and dppp is 1,3-bis(diphenylphosphino)propane) are reported. Neutral cages 1-3 were synthesised using the tritopic [MIIIL3] metalloligand in combination with the salts CoIICl2 and ZnIIBr2, which both act as tetrahedral linkers. The assembly of the cis-protected [PdII(dppp)(OTf)2] with [MIIIL3] afforded the anionic cages 4-5 of general formula [MIII2PdII3](OTf)6. The metallic skeleton of all cages describes a trigonal bipyramid with the MIII ions occupying the two axial sites and the MII ions sitting in the three equatorial positions. Direct current (DC) magnetic susceptibility, magnetisation and heat capacity measurements on 1 reveal weak antiferromagnetic exchange between the FeIII and CoII ions. EPR spectroscopy demonstrates that the distortion imposed on the {MO6} coordination sphere of [MIIIL3] by complexation in the {MIII2MII3} supramolecules results in a small, but measurable, increase of the zero field splitting at MIII. Complete active space self-consistent field (CASSCF) calculations on the three unique CoII sites of 1 suggest DCo ≈ -14 cm-1 and E/D ≈ 0.1, consistent with the magnetothermal and spectroscopic data.

Modulation of Postnatal Neurogenesis by Perinatal Asphyxia: Effect of D1 and D2 Dopamine Receptor Agonists

Perinatal asphyxia (PA) is associated to delayed cell death, affecting neurocircuitries of basal ganglia and hippocampus, and long-term neuropsychiatric disabilities. Several compensatory mechanisms have been suggested to take place, including cell proliferation and neurogenesis. There is evidence that PA can increase postnatal neurogenesis in hippocampus and subventricular zone (SVZ), modulated by dopamine, by still unclear mechanisms. We have studied here the effect of selective dopamine receptor agonists on cell death, cell proliferation and neurogenesis in organotypic cultures from control and asphyxia-exposed rats. Hippocampus and SVZ sampled at 1-3 postnatal days were cultured for 20-21 days. At day in vitro (DIV) 19, cultures were treated either with SKF38393 (10 and 100 µM, a D₁ agonist), quinpirole (10 µM, a D₂ agonist) or sulpiride (10 μM, a D₂ antagonist) + quinpirole (10 μM) and BrdU (10 μM, a mitosis marker) for 24 h. At DIV 20-21, cultures were processed for immunocytochemistry for microtubule-associated protein-2 (MAP-2, a neuronal marker), and BrdU, evaluated by confocal microscopy. Some cultures were analysed for cell viability at DIV 20-21 (LIVE/DEAD kit). PA increased cell death, cell proliferation and neurogenesis in hippocampus and SVZ cultures. The increase in cell death, but not in cell proliferation, was inhibited by both SKF38393 and quinpirole treatment. Neurogenesis was increased by quinpirole, but only in hippocampus, in cultures from both asphyxia-exposed and control-animals, effect that was antagonised by sulpiride, leading to the conclusion that dopamine modulates neurogenesis in hippocampus, mainly via D₂ receptors.

Diversidad genética de la gallina criolla del Suroccidente Colombiano

En Colombia, la gallina Criolla es socialmente importante por su aporte nutricional, fácil reproducción, adaptabilidad y rusticidad. Por lo tanto, ha sido necesario conocer cómo es su diversidad, relaciones y estructura genética. El objetivo de este estudio fue ccontribuir al conocimiento de la biodiversidad del país y al desarrollo agropecuario sostenible, mediante el estudio de la diversidad genética de aves criollas. Se analizaron 224 muestras de ADN de gallina Criolla colombiana provenientes de los departamentos del Cauca, Caldas, Chocó, Nariño y Valle del Cauca, y 20 de líneas comerciales, mediante 17 marcadores microsatélites, realizándoles extracción de ADN por el método de Salting Out y posteriormente amplificando por reacción en cadena de la polimerasa (PCR). El análisis estadístico para evaluar la diversidad genética se realizó a través de los programas ARLEQUIN v. 3.5, GENALEX v. 6.5, Microsatellite Toolkit y FSTAT. La estructura de las poblaciones se determinó por el programa STRUCTURE v. 2.3.4. Se encontraron 79 alelos para las poblaciones. El número promedio de alelos para la gallina Criolla fue de 4,65±1,66. La heterocigosidad esperada fue mayor que la observada y varió de 0,59 en Chocó a 0,62 en el Valle del Cauca. El FIS fue de 0,40 (p

Computed axial tomography in otorhinolaryngology

The value of computed tomography in ORL and its applications have been briefly discussed. Better soft tissue detail and its relationship to bony structures is obtained. At the present time this modality may be utilized as a screening test in some suspected cases or as an adjunct of conventional methods. With the technical refinements that are constantly being made, better diagnostic information will be obtained in CT scanning.

Thermal properties of the stationary current in mesoporous Pt/TiO2 structures in an oxyhydrogen atmosphere

We report on the effect of temperature on the electric current induced in the mesoporous Pt/TiO2 structure by the room temperature surface chemical reaction of hydrogen and oxygen,13,14 which helps to unveil the physical origin of this current and the related electromotive force (chemi-EMF). We found that the temperature dependence of this reaction current has a clear multipeak structure, suggesting that at least two distinct processes contribute to the current generation. We suggest that the output current represents the interplay of both chemical and electrical processes, evidenced by the metastability of the room temperature reaction and by matching one of the current peaks with a water desorption peak for TiO2.

Influenza-like illness surveillance on the California-Mexico border, 2004-2009

BACKGROUND

Since 2004, the Naval Health Research Center, with San Diego and Imperial counties, has collaborated with the US Centers for Disease Control and Prevention to conduct respiratory disease surveillance in the US-Mexico border region. In 2007, the Secretariat of Health, Mexico and the Institute of Public Health of Baja California joined the collaboration.

OBJECTIVES

The identification of circulating respiratory pathogens in respiratory specimens from patients with influenza-like illness (ILI).

METHODS

Demographic, symptom information and respiratory swabs were collected from enrollees who met the case definition for ILI. Specimens underwent PCR testing and culture in virology and bacteriology.

RESULTS

From 2004 through 2009, 1855 persons were sampled. Overall, 36% of the participants had a pathogen identified. The most frequent pathogen was influenza (25%), with those aged 6-15 years the most frequently affected. In April 2009, a young female participant from Imperial County, California, was among the first documented cases of 2009 H1N1. Additional pathogens included influenza B, adenovirus, parainfluenza virus, respiratory syncytial virus, enterovirus, herpes simplex virus, Streptococcus pneumoniae, and Streptococcus pyogenes.

CONCLUSIONS

The US-Mexico border is one of the busiest in the world, with a large number of daily crossings. Due to its traffic, this area is an ideal location for surveillance sites. We identified a pathogen in 36% of the specimens tested, with influenza A the most common pathogen. A number of other viral and bacterial respiratory pathogens were identified. An understanding of the incidence of respiratory pathogens in border populations is useful for development of regional vaccination and disease prevention responses.

Magnetic structure of Gd5Si2Ge2 and Gd5Si2Ge1.9M0.1 (M = Ga, Cu)

Powder x-ray diffraction patterns of the doped compounds Gd(5)Si(2)Ge(1.9)M(0.1) (M = Ga, Cu) show the same crystal structure, orthorhombic Gd(5)Si(4)-type, in the ferromagnetic and paramagnetic phases. This is different from Gd(5)Si(2)Ge(2), whose paramagnetic phase is monoclinic. The magnetic structure at low temperature, solved from diffraction experiments with hot neutrons, is the same in all the three compounds, collinear ferromagnetic with moments along the crystal b-axis, or F(y)F(By) according to Bertaut's notation. These results, combined with those of heat capacity and magnetocaloric effect, indicate, similarly to Gd(5)Si(4), a second-order, purely magnetic, transition in the doped compounds explaining the absence of hysteresis.

An Atlas of Infectious and Parasitic Diseases of the Central Nervous System. A Cooperative Study of SILAN (Sociedad Iberolatinoamericana de Neurorradiologia)

Infectious diseases of the central nervous system vary in frequency in different locations in America and Europe. What is common in Brazil can be a sporadic presentation in Europe. Cooperative work gathering experiences from neuroradiologists working in various places can be achieved and will help to identify uncommon cases that can present in our daily practice.

Imaging of isolated cerebral mucormycosis. A report of three cases

Mucormycosis is a rare infection in immunosupressed patients caused by fungi from the family Mucoraceae. Three types of disease spread have been described: rhinocerebral, systemic and isolated. Isolated spread is the most uncommon form, usually resulting in death. It has been described in diabetics, immunosupressed patients and intravenous drug abusers. Neuroimaging can aid the diagnosis of this entity, but biopsy remains the only reliable method. Imaging findings of Mucormycosis include abscesses and hemorrhagic or ischemic infarcts, usually in the basal ganglia and frontal lobes. Single or multiple lesions have been described as well as meningoencephalitis. Understanding these findings can help to detect the infection in an early stage. We describe three cases of isolated cerebral mucormycosis; all of them were intravenous drug abusers with one patient also being HIV positive.

Effect of hypo- and hypersaline conditions on osmolality and Na+/K+-ATPase activity in juvenile shrimp (Litopenaeus vannamei) fed low- and high-HUFA diets

Fatty acid composition of cellular membranes can modify permeability and can modulate the activity of Na(+)/K(+)-ATPase. Although highly unsaturated fatty acids (HUFA) improve survival and osmoregulatory capacity to low salinities in penaeid shrimp, the possible mechanisms have not been established. For this purpose the influence of HUFA supplementation in diet (2.9 vs. 34% HUFA proportion to total fatty acids) on osmoregulatory responses of juvenile Litopenaeus vannamei submitted to an acute (15 h) or chronic exposure (21 days), to low (5 g L(-1)) and high salinities (50 g L(-1)) was analyzed. Shrimp fed the high-HUFA diet, had higher concentration of main HUFA (20:5n-3 and 22:6n-3) in polar lipids of gills. Osmotic pressure in hemolymph was significantly affected by salinity in acute (640, 751, 847 mOsm/kg for 5, 30 and 50 g L(-1), respectively), and chronic exposure (645, 713, 814 mOsm/kg), but variations between them were small compared to environmental salinity (206, 832, 1547 mOsm/kg), indicating that osmoregulation was achieved in a matter of hours. An increase in Na(+)/K(+)-ATPase activity was observed only after a chronic exposure to low salinity. Free amino acids (FAA), mainly alanine and arginine, were higher at 30 (control) and 50 g L(-1) in accordance to their role as organic osmolites. Neither osmotic pressure, Na(+)/K(+)-ATPase activity, nor FAA was affected by HUFA supplementation. However, higher water content in gills of shrimp exposed to low salinities was counteracted by increased HUFA content, which could be a result of changes in water permeability of gills. The osmoregulatory capacity of penaeid shrimp to low and high salinities was achieved within 15 h of acclimation and did not depend on HUFA supplementation in the diet.

[Recommendations for optimising the treatment of multiple sclerosis in Latin America]

INTRODUCTION

Multiple sclerosis (MS) is the most common primary demyelinating disease affecting the central nervous system. In recent years the development of new drugs that have been shown to modify the natural history of MS have had a substantial impact on the treatment of the disease.

AIMS

To harmonise and integrate the evidence available on optimising the treatment of patients with MS.

DEVELOPMENT

In order to fulfil our main aim, a group of experts from different Latin American countries drew up a list of statements related to the use of immunomodulatory agents in the different clinical forms of the disease and the strategies that should be considered in cases in which the therapeutic response was suboptimal. Each of the participants used a structured scale to express the extent to which he or she agreed or disagreed, and a consensus was considered to have been reached when acceptance of each of the statements was equal to or higher than 80%.

CONCLUSIONS

These recommendations will provide neurologists with the tools needed to make decisions that optimise the treatment of MS patients.

Nurses as providers of emotional support to patients with MDR-TB

AIM

To identify the forms and means of emotional support that nurses provide to patients living with multidrug-resistant tuberculosis (MTR-TB) in Lima, Peru.

BACKGROUND

A fundamental role of nurses is to provide emotional support, defined as all the strategies that a health team employs to assure the psychosocial well-being of the patient. However, neither the forms of emotional support nor the means used by nurses in resource-poor settings have been much written about. This paper describes a qualitative study of a team of seven nurses working in a programme that provides individualized MDR-TB treatment to patients in Lima, Peru. It describes the various forms of support that facilitated the ability of patients to adhere to treatment despite socio-economic difficulties, social stigma, drug side effects, problems related to different stages of treatment and concurrent illnesses/special situations.

METHODS

Qualitative study methods were employed over the course of 8 years to observe nurses and patients in an MDR-TB treatment programme. These included participant observation, structured observation sessions of nurses with their patients and focus groups with seven nurses.

CONCLUSION

Through theme and content analyses of qualitative data, ten situations related to MDR-TB treatment were found. These ten issues served as an analytical framework used to identify and discuss the various types of emotional support provided by both formal and informal means. This type of support focused on problems related to different stages of treatment, social stigma of the illness, treatment adherence, side effects, socio-economic difficulties, death and concurrent illnesses/special situations.

PRACTICE IMPLICATIONS

The essential role of the nurse as a provider of emotional support in the development or implementation of similar programmes with MDR-TB should, in future, be taken into account.

Contact investigations as a means of detection and timely treatment of persons with infectious multidrug-resistant tuberculosis

SETTING

Two regions of metropolitan Lima, Peru.

OBJECTIVE

To determine the outcomes of two contact investigation strategies used in therapy enrollment cohorts of patients with multidrug-resistant tuberculosis (MDR-TB).

DESIGN

From 28 August 1996 to 31 December 1999, 91 index patients received individualized MDR-TB therapy (Group A), and from 1 October 1997 to 31 December 1999, another 101 index patients received a standardized MDR-TB regimen (Group B). We conducted a retrospective chart review and home visits to identify secondary cases among close contacts of both of these groups. Group A secondary cases with MDR-TB received therapy based on the drug susceptibility profile of their infecting strain, while Group B secondary cases received standard short-course therapy.

RESULTS

Among 945 close contacts, 72 secondary TB cases (8%) were found. Of 42 who had drug-susceptibility testing, 35 (84%) were MDR-TB, but only seven (17%) had the same drug susceptibility profile as the index case. Cure exceeded 80% in Group A secondary cases, while only half of Group B secondary cases were cured (RR 1.6, 95%CI 1.1-2.2).

CONCLUSION

Contact investigation protocols coupled with enrollment in MDR-TB therapy are a useful means of detecting and promptly treating persons with infectious MDR-TB. In settings with endemic MDR strains of Mycobacterium tuberculosis, effective therapy of contacts of MDR-TB patients requires knowledge of drug susceptibility for each contact with active disease.

Clinical and programmatic considerations in the treatment of MDR-TB in children: a series of 16 patients from Lima, Peru

SETTING

Since 2000, the directly observed treatment, short-course (DOTS) strategy has been expanded in several countries to include treatment of multidrug-resistant tuberculosis (MDR-TB). This strategy is known as DOTS-Plus. Tuberculosis is a common cause of morbidity and mortality for children throughout the developing world. Children may also be infected with MDR-TB, yet most developing countries do not specifically address pediatric MDR-TB.

OBJECTIVE

To present the intermediate outcomes of the first 16 children enrolled in the Peruvian DOTS-Plus program and to demonstrate the tolerability of second-line anti-tuberculosis drugs.

RESULTS

Three children completed therapy and are cured, one child had bacteriologic and clinical failure after 12 months of therapy and died of respiratory insufficiency, and 12 have intermediate outcomes demonstrating favorable clinical, bacteriologic, and radiographic evidence of improvement after 9-19 months of therapy.

CONCLUSIONS

Of the 16 pediatric DOTS-Plus patients, 15 have tolerated therapy well and have had favorable clinical evolution. However, the diagnosis of pediatric MDR-TB is often extremely delayed due to reliance on the adult case definition and should be changed to prevent progressive, chronic illness in such children. Programmatic changes could facilitate earlier diagnosis and treatment of pediatric MDR-TB in Peru and in other DOTS-Plus programs.

The role of the nurse in the community-based treatment of multidrug-resistant tuberculosis (MDR-TB)

SETTING

A community-based treatment program for multidrug-resistant tuberculosis (MDR-TB) in Lima, Peru.

OBJECTIVES

To describe the activities carried out by the nurses working with the program.

DESIGN

A qualitative study using a variety of ethnographic methods, including participant observation, focus groups, and key informant interviews over a 5-year period.

RESULTS

Nurses were responsible for carrying out a wide variety of activities within the program. These included patient-focused activities such as identifying patients, evaluating patients prior to starting and during therapy, and managing emergencies; educational activities for both patients and health professionals managing MDR-TB; and coordination activities, including over-seeing health workers and communicating between team members.

CONCLUSION

Nurses play a key role in the community-based management of MDR-TB.

Ranging pattern and use of space in a group of red howler monkeys (Alouatta seniculus) in a southeastern Colombian rainforest

We studied a group of red howler monkeys (Alouatta seniculus) bordering a lake in an eastern Colombian Amazon rainforest for 10 months. The group used an area of 182 ha located mainly on Pleistocene terrace forest and had no overlap with other howler home ranges. Home range use varied through the year as a consequence of fruit and leaf abundance. For example, during the fruit scarcity season the group used an area of flooded forest nearly exclusively, indicating that at least for a portion of the year they are habitat specialists. Two areas intensively used by the group were identified, representing 17.6 % of the home range, and within which 56.9 % of the feeding trees were located. Overall density of feeding trees within the group's home range was very low (1.12 trees/ha). Home range size, as well as mean length of daily ranges (1,150 m), is the largest reported for this species to date, and it is likely a consequence of the diminished productivity of the plant communities on poor soil. Our results give an interesting example of the ranging behavior of this primate, which clearly differs from previous descriptions of red howlers.