Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naive Mozambican patients

Seven hundred and four HIV-1/2-positive, antiretroviral therapy (ART) naïve patients were screened for HTLV-1 infection. Antibodies to HTLV-1 were found in 32/704 (4.5%) of the patients. Each co-infected individual was matched with two HIV mono-infected patients according to World Health Organization clinical stage, age +/-5 years and gender. Key clinical and laboratory characteristics were compared between the two groups. Mono-infected and co-infected patients displayed similar clinical characteristics. However, co-infected patients had higher absolute CD4+ T-cell counts (P = 0.001), higher percentage CD4+ T-cell counts (P < 0.001) and higher CD4/CD8 ratios (P < 0.001). Although HIV plasma RNA viral loads were inversely correlated with CD4+ T-cell-counts in mono-infected patients (P < 0.0001), a correlation was not found in co-infected individuals (P = 0.11). Patients with untreated HIV and HTLV-1 co-infection show a dissociation between immunological and HIV virological markers. Current recommendations for initiating ART and chemoprophylaxis against opportunistic infections in resource-poor settings rely on more readily available CD4+ T-cell counts without viral load parameters. These guidelines are not appropriate for co-infected individuals in whom high CD4+ T-cell counts persist despite high HIV viral load states. Thus, for co-infected patients, even in resource-poor settings, HIV viral loads are likely to contribute information crucial for the appropriate timing of ART introduction

Advanced Design and Fabrication of Microwave Components Based on Shape Optimization and 3D Ceramic Stereolithography Process

International audienceThe design of advanced components for space and terrestrial telecommunication systems requires both sophisticated design methodologies and manufacturing technologies for improving current component characteristics. In particular, optimizing the shape and the size of a component is a problem of primary importance for microwave engineers. Moreover, for designing RF and microwave components or antennas, the use of ceramic materials is preferable in order to satisfy both electrical and dimensional constraints. The main objective of this chapter is to demonstrate that it is possible to jointly improve the design and fabrication procedures of ceramic based advanced RF components. In this context, a ceramic 3D stereolithography based rapid prototyping technique is applied for fabricating 3D ceramic structures. As presented next, theoretical and experimental approaches are complementary and innovative components with excellent electrical performances have been designed, manufactured and characterized. Then the contribution demonstrates how an original CAD design approach based on shape optimization methods can be applied for improving electrical performance and integration of microwave and millimeter-wave devices

Coexistence of trisomy 12 and del(13)(q14.3) in two patients with chronic lymphocytic leukemia

We describe two patients with diagnosis of chronic lymphocytic leukemia (CLL) in whom interphase fluo­rescence in situ hybridization (FISH) analysis revealed trisomy 12 and del(13)(q14.3) occurring in the same clone. These abnormalities are rarely seen together and the prognostic relevance of their coexistence is still unclear. According to some data, a probable adverse prognosis for this group of patients is suggested. Our patients have been in a stable phase of the disease for more than one year since the given abnormalities were documented in their karyotypes. Further study is necessary to determine the prognostic significance of coexistence of these abnormalities in CLL patients

Surveillance of HIV Drug Resistance in Children Receiving Antiretroviral Therapy: A Pilot Study of the World Health Organization's Generic Protocol in Maputo, Mozambique

Between 2007 and 2008, the Mozambique Ministry of Health conducted an assessment of human immunodeficiency virus drug resistance (HIVDR) using World Health Organization (WHO) methods in a cohort of children initiating antiretroviral therapy (ART) at the main pediatric ART referral center in Mozambique. It was shown that prior to ART initiation 5.4% of children had HIVDR that was associated with nevirapine perinatal exposure (P < .001). Twelve months after ART initiation, 77% had viral load suppression (<1000 copies/mL), exceeding the WHO target of ≥70%; 10.3% had HIVDR at 12 months. Baseline HIVDR (P = .04), maternal prevention of mother-to-child transmission (P = .02), and estimated days of missed medication (P = .03) predicted HIVDR at 12 months. As efforts to eliminate pediatric AIDS are intensified, implementation of ritonavir-boosted protease inhibitor regimens in children with prevention of mother-to-child transmission exposure may reduce risk of virological failure in our settin

Renormalisation and fixed points in Hilbert Space

The energies of low-lying bound states of a microscopic quantum many-body system of particles can be worked out in a reduced Hilbert space. We present here and test a specific non-perturbative truncation procedure. We also show that real exceptional points which may be present in the spectrum can be identified as fixed points of coupling constants in the truncation procedure.Comment: 4 pages, 1 tabl

Improvement of the quality of treatment of the complicated maxillary dental caries due to the use of cone-beam tomography in the process of planning the endodontic treatment

Трудности, связанные с эндодонтическим лечением моляров верхней челюсти, очень распространены в современной стоматологии. В стоматологической практике, чаще всего, для определения количества корневых каналов используют внутриротовую рентгенографию или ортопантомографию. Некачественно проведенное эндодонтическое лечение моляров верхней челюсти приводит к осложнениям не только со стороны зубочелюстной системы, но и влечет за собой поражение рядом расположенных структур. Цель нашего исследования — профилактика осложнений, возникающих после эндодонтического лечения, за счет использования конусно-лучевой томографии во время его планирования. Согласно полученным результатам, второй мезиально-щечный корневой канал в первом моляре верхней челюсти встречается в 78 % случаев, а во втором моляре — в 43 %. Эти показатели отличаются от данных, приведенных в литературе.In the stages of planning of the endodontic treatment of teeth it is necessary to have a notion about the number and location of the root canals. It is especially important during the endodontic treatment of molars. According to different authors, it is known that the number and location of root canal molars of the upper jaw are individual for each person. Thus, the first upper molar has three roots of root canals, but 50% of the mesial buccal root has two root canals. The second maxillary molar has three root canals in 70% of cases, and four in 30%. Options for the location and structure of the root canals in these teeth are also quite diverse. Therefore, the difficulties associated with endodontic treatment of molars of the upper jaw, are very common in modern dentistry. In dental practice, most of all, to determine the number of root canals intraoral radiography or orthopantomography are used. Low quality of endodontic treatment of the maxillary molars causes complications not only of the dentition system, but also the loss of adjacent structures. The aim of our study is the prevention of complications that were caused by the endodontic treatment, by using cone-beam tomography during the process of planning. According to our research, the second mesio-buccal root canal in the first maxillary molar is found in 78% of cases, and in the second molar — in 43%. These data differ from those given in the literature. The overwhelming number of patients aged over 40 years is marked by the loss of the first molars of the upper jaw on the right or left side, or both sides at the same time, which is associated with ineffective endodontic treatment of these teeth

Odontogenic sinusitis as complication of chronic periodontitis

Статья посвящена обзору литературы, освещающей вопросы профилактики одонтогенного гайморита при лечении хронического периодонтита зубов верхней челюсти. В современной стоматологии эта проблема чрезвычайно актуальна, несмотря на многочисленные исследования отечественных и зарубежных ученых. Данная патология, согласно источникам литературы, составляет 15–30 % от общего числа стоматологических заболеваний. Учитывая особенности анатомо-гистологического строения верхнечелюстного синуса, осложнения, возникающие после эндодонтического лечения зубов верхней челюсти, часто протекают бессимптомно. Поэтому очень важны первичная профилактика и ранняя диагностика этого осложнения.Taking into account the nature of anatomical-histological structure of the maxillary sinus, complications occurring endodontic treatment of the upper jaw, are often asymptomatic. So it’s very important to prevent this complication and diagnose the disease at an early stage, when the pathological changes in the maxillary sinus are reversible

Conflicts about water in Lake Chad: are environmental, vulnerability and security issues linked?

This paper builds on the growing literature that explores the relations between environmental change and non-traditional security, defined as non-military threats that challenge the survival and well-being of peoples and states. The Lake Chad basin in Africa is used as a case study for analysis. Focusing on a set of questions that has dominated recent theoretical debates, the paper investigates if conflicts resulting from water scarcity are as much about the broader vulnerability of the Lake Chad region as they are about changes in the Lake system and its environment. It argues that conflict is a probable outcome only in locations that are already challenged by a multitude of other context-specific factors beside resource scarcity. In the Lake Chad context, the likelihood of scarcity-driven conflict depends on whether vulnerability increases or decreases in the face of a declining water supply. The paper provides perspectives for a nuanced understanding of how the receding Lake Chad has led to conflict and outlines an integrated, forward-looking research agenda for linking environmental change, vulnerability and security issues in integrated human-environment systems

The emergence of non-secretory multiple myeloma during the non-cytotoxic treatment of essential thrombocythemia: A case report

Introduction. The emergence of multiple myeloma as a second malignancy in patients with essential thrombocythemia is extremely rare. Several cases have been published so far, pointing out the impact of a cytotoxic effect during treatment of essential thrombocythemia on the development of multiple myeloma. Case presentation. We report the case of a 52-year-old Caucasian man who presented to our hospital because of leukocytosis, a slightly decreased hemoglobin level and thrombocytosis. After a complete hematological work-up, essential thrombocythemia was diagnosed. The patient was included in a multicenter clinical study, treated with anagrelide and his platelet counts were maintained in the normal range for more than 3 years. A sudden drop in his hemoglobin level with normal leukocyte and platelet count occurred at the same time as a back pain. Magnetic resonance imaging of his spine revealed the existence of a pathological fracture of Th4, the collapse of the upper edge of Th7 and osteolytic lesions of multiple thoracic vertebrae. Repeated hematological examinations, including bone biopsy with immunohistochemistry, disclosed diagnosis of multiple myeloma of the non-secretory type. Conclusions: To the best of our knowledge this is the first published case in which multiple myeloma developed during the treatment of essential thrombocythemia with the non-cytotoxic drug anagrelide. Our attempts to find a common origin for the coexistence of multiple myeloma and essential thrombocythemia have not confirmed the genetic basis of their appearance. Further studies are needed to determine the biological impact of this coexistence