HIV infection and cardiovascular disease

Aims With the success of antiretroviral therapy (ART), non-human immunodeficiency virus (HIV)-related comorbidities like cardiovascular diseases (CVDs) are of increasing concern. We describe important recent research developments on the epidemiology of CVD in HIV infection, ART-related metabolic changes, and cardioprotective anti-inflammatory mechanisms, and summarize management strategies for CVD risk reduction. Methods and results We systematically identified and analysed systematic reviews and most cited literature published in the last 3 years and supplemented findings with selected evidence based on clinical expertise. Among HIV-infected individuals, the prevalence of CVD risk factors and the risk for CVD is higher compared with HIV negatives. Antiretroviral drugs may induce dyslipidaemia, reduce insulin sensitivity, and promote body fat redistribution that additionally contributes to CVD risk. Some antiretroviral drugs may increase risk for CVD events, but the absolute risk increase is moderate and has to be put into perspective with the massive HIV-related benefits. Sustained HIV suppression reduces systemic inflammatory markers and is associated with a moderate reduction in CVD events. Regular CVD risk assessment and counselling to stop smoking must be regularly done in all HIV-infected individuals. Statins are effective for the treatment of dyslipidaemia in HIV infection, but drug interactions with ART need to be considered. Conclusion Human immunodeficiency virus-infected individuals are at increased risk for CVD. Timely initiation of ART with consequent viral suppression is likely to reduce CVD events and to offset potential side effects from ART-induced metabolic changes. Reduction in smoking in HIV-infected individuals is a public health priorit

The initial conditions of the universe: how much isocurvature is allowed?

We investigate the constraints imposed by the current data on correlated mixtures of adiabatic and non-adiabatic primordial perturbations. We discover subtle flat directions in parameter space that tolerate large (~60%) contributions of non-adiabatic fluctuations. In particular, larger values of the baryon density and a spectral tilt are allowed. The cancellations in the degenerate directions are explored and the role of priors elucidated.Comment: 4 pages, 4 figures. Submitted to PR

Cosmological Perturbations Generated in the Colliding Bubble Braneworld Universe

We compute the cosmological perturbations generated in the colliding bubble braneworld universe in which bubbles filled with five-dimensional anti-de Sitter space (AdS5)expanding within a five dimensional de Sitter space (dS5) or Minkowski space (M5) collide to form a (3+1) dimensional local brane on which the cosmology is virtually identical to that of the Randall-Sundrum model. The perturbation calculation presented here is valid to linear order but treats the fluctuations of the expanding bubbles as (3+1) dimensional fields localized on the bubble wall. We find that for bubbles expanding in dS5 the dominant contribution to the power spectrum is `red' but very small except in certain cases where the fifth dimension is not large or the bubbles have expanded to far beyond the dS5 apparent horizon length. This paper supersedes a previous version titled "Exactly Scale-Invariant Cosmological Perturbations From a Colliding Bubble Braneworld Universe" in which we erroneously claimed that a scale-invariant spectrum results for the case of bubbles expanding in M5. This present paper corrects the errors of the previous version and extends the analysis to the more interesting and general case of bubbles expanding in dS5.Comment: 29 pages Latex with eps figures. Major errors in the original version of the paper corrected and analysis extended to bubbles expanding in dS

Local treatment with electrochemotherapy of superficial angiosarcomas: Efficacy and safety results from a multi-institutional retrospective study

Background: Angiosarcoma is an aggressive vascular neoplasm with a high propensity for local recurrence. Electrochemotherapy is an emerging skin-directed therapy, exerting prominent cytotoxic activity, and antivascular effects. Its efficacy in angiosarcoma has not been investigated. Methods: This multicenter retrospective analysis reviewed patients who underwent electrochemotherapy from 2007 to 2014 for superficial advanced angiosarcomas. Bleomycin was administered intravenously and delivered within tumors by means of percutaneously applied electric pulses, according to the European Standard Operating Procedures for Electrochemotherapy. Tumor assessment was performed using RECIST (version 1.1). Toxicity (CTCAE, v4.0) and local progression-free survival (LPFS) were also evaluated. Results: Nineteen patients (13 with locally advanced and 6 with metastatic angiosarcomas) were treated. Tumor sites were: scalp (n¼5), breast(n¼8), other skin sites (n¼3), and soft tissue (n¼3). Target lesions (n¼54) ranged in size from 1.5 to 2.5 cm (median, 2 cm). Treatment was well tolerated. After 2 months, an objective response was observed in 12/19 (63%) patients, complete in 8 (42%). One-year LPFS within treatment field was 68%. Local symptom improvement included palliation of bleeding (5/19 patients) and pain relief (6/19 patients). Conclusions: Electrochemotherapy may represent a new locoregional treatment for selected patients with superficial angiosarcomas

Singular behaviour of the electromagnetic field

The singularities of the electromagnetic field are derived to include all the point-like multipoles representing an electric charge and current distribution. Firstly derived in the static case, the result is generalized to the dynamic one. We establish a simple procedure for passing from the first, to the second case.Comment: Latex, 21.pages, no figure

Constraints on isocurvature models from the WMAP first-year data

We investigate the constraints imposed by the first-year WMAP CMB data extended to higher multipole by data from ACBAR, BOOMERANG, CBI and the VSA and by the LSS data from the 2dF galaxy redshift survey on the possible amplitude of primordial isocurvature modes. A flat universe with CDM and Lambda is assumed, and the baryon, CDM (CI), and neutrino density (NID) and velocity (NIV) isocurvature modes are considered. Constraints on the allowed isocurvature contributions are established from the data for various combinations of the adiabatic mode and one, two, and three isocurvature modes, with intermode cross-correlations allowed. Since baryon and CDM isocurvature are observationally virtually indistinguishable, these modes are not considered separately. We find that when just a single isocurvature mode is added, the present data allows an isocurvature fraction as large as 13+-6, 7+-4, and 13+-7 percent for adiabatic plus the CI, NID, and NIV modes, respectively. When two isocurvature modes plus the adiabatic mode and cross-correlations are allowed, these percentages rise to 47+-16, 34+-12, and 44+-12 for the combinations CI+NID, CI+NIV, and NID+NIV, respectively. Finally, when all three isocurvature modes and cross-correlations are allowed, the admissible isocurvature fraction rises to 57+-9 per cent. The sensitivity of the results to the choice of prior probability distribution is examined.Comment: 20 pages, 24 figures. Submitted to PR

Measuring the geometry of the Universe in the presence of isocurvature modes

The Cosmic Microwave Background (CMB) anisotropy constrains the geometry of the Universe because the positions of the acoustic peaks of the angular power spectrum depend strongly on the curvature of underlying three-dimensional space. In this Letter we exploit current observations to determine the spatial geometry of the Universe in the presence of isocurvature modes. Previous analyses have always assumed that the cosmological perturbations were initially adiabatic. A priori one might expect that allowing additional isocurvature modes would substantially degrade the constraints on the curvature of the Universe. We find, however, that if one considers additional data sets, the geometry remains well constrained. When the most general isocurvature perturbation is allowed, the CMB alone can only poorly constrain the geometry to Omega_0=1.6+-0.3. Including large-scale structure (LSS) data one obtains Omega_0=1.07+-0.03, and Omega_0=1.06+-0.02 when supplemented by the Hubble Space Telescope (HST) Key Project determination of H_0 and SNIa data.Comment: 4 pages, 5 figs. Submitted to PR

Thermo-mechanical behaviour of a compacted swelling clay

Compacted unsaturated swelling clay is often considered as a possible buffer material for deep nuclear waste disposal. An isotropic cell permitting simultaneous control of suction, temperature and pressure was used to study the thermo-mechanical behaviour of this clay. Tests were performed at total suctions ranging from 9 to 110 MPa, temperature from 25 to 80 degrees C, isotropic pressure from 0.1 to 60 MPa. It was observed that heating at constant suction and pressure induces either swelling or contraction. The results from compression tests at constant suction and temperature evidenced that at lower suction, the yield pressure was lower, the elastic compressibility parameter and the plastic compressibility parameter were higher. On the other hand, at a similar suction, the yield pressure was slightly influenced by the temperature; and the compressibility parameters were insensitive to temperature changes. The thermal hardening phenomenon was equally evidenced by following a thermo-mechanical path of loading-heating-cooling-reloading