Idiopathic AIDS enteropathy and treatment of gastrointestinal opportunistic pathogens.

Diarrhea in patients with acquired immune deficiency syndrome (AIDS) has proven to be both a diagnostic and treatment challenge since the discovery of the human immunodeficiency virus (HIV) virus more than 30 years ago. Among the main etiologies of diarrhea in this group of patients are infectious agents that span the array of viruses, bacteria, protozoa, parasites, and fungal organisms. In many instances, highly active antiretroviral therapy remains the cornerstone of therapy for both AIDS and AIDS-related diarrhea, but other targeted therapies have been developed as new pathogens are identified; however, some infections remain treatment challenges. Once identifiable infections as well as other causes of diarrhea are investigated and excluded, a unique entity known as AIDS enteropathy can be diagnosed. Known as an idiopathic, pathogen-negative diarrhea, this disease has been investigated extensively. Atypical viral pathogens, including HIV itself, as well as inflammatory and immunologic responses are potential leading causes of it. Although AIDS enteropathy can pose a diagnostic challenge so too does the treatment of it. Highly active antiretroviral therapy, nutritional supplementation, electrolyte replacements, targeted therapy for infection if indicated, and medications for symptom control all are key elements in the treatment regimen. Importantly, a multidisciplinary approach among the gastroenterologist, infectious disease physician, HIV specialists, oncology, and surgery is necessary for many patients

Structural properties of optimal coordinate-convex policies for CAC with nonlinearly-constrained feasibility regions

Necessary optimality conditions for Call Admission Control (CAC) problems with nonlinearly-constrained feasibility regions and two classes of users are derived. The policies are restricted to the class of coordinate-convex policies. Two kinds of structural properties of the optimal policies and their robustness with respect to changes of the feasibility region are investigated: 1) general properties not depending on the revenue ratio associated with the two classes of users and 2) more specific properties depending on such a ratio. The results allow one to narrow the search for the optimal policies to a suitable subset of the set of coordinate-convex policies

Escherichia coli K1 RS218 Interacts with Human Brain Microvascular Endothelial Cells via Type 1 Fimbria Bacteria in the Fimbriated State

Escherichia coli K1 is a major gram-negative organism causing neonatal meningitis. E. coli K1 binding to and invasion of human brain microvascular endothelial cells (HBMEC) are a prerequisite for E. coli penetration into the central nervous system in vivo. In the present study, we showed using DNA microarray analysis that E. coli K1 associated with HBMEC expressed significantly higher levels of the fim genes compared to nonassociated bacteria. We also showed that E. coli K1 binding to and invasion of HBMEC were significantly decreased with its fimH deletion mutant and type 1 fimbria locked-off mutant, while they were significantly increased with its type 1 fimbria locked-on mutant. E. coli K1 strains associated with HBMEC were predominantly type 1 fimbria phase-on (i.e., fimbriated) bacteria. Taken together, we showed for the first time that type 1 fimbriae play an important role in E. coli K1 binding to and invasion of HBMEC and that type 1 fimbria phase-on E. coli is the major population interacting with HBMEC

Pion distribution amplitudes within the instanton model of QCD vacuum

Pion transition form factor for the process $\gamma*\gamma*\to \pi^0$ at space-like values of photon momenta is calculated within the effective quark-meson model with the interaction induced by instanton exchange. The leading and next-to-leading order power asymptotics of the form factor and the relation between the light-cone pion distribution amplitudes of twists 2 and 4 and the dynamically generated quark mass are found.Comment: 5 pages, 4 eps figures. Revised version: references and figures adde

A case of primary Hodgkin's lymphoma of the parotid gland. Case report and differentian diagnosis from Kuttner's Syndrom

Abstract We report a rare case of primary Hodgkin’s lymphoma (HL) of the submandibular gland, with initially diagnosis of Kuttner’s Syndrom. A 48 years old man was referred to our hospital foe evaluation of a submandibular mass. Although the initial Fine Needle Aspiration and subsequent cytology was highly suggestive for a cronic sialadenitis with lymphoid cells. After surgical gland removal we obtained a definitive diagnosis of Hodgkin’s lymphoma in submandibular gland a seat where the most common lymphoma tipe is B

JCV-specific T-cells producing IFN-gamma are differently associated with PmL occurrence in HIV patients and liver transplant recipients

Aim of this work was to investigate a possible correlation between the frequency of JCV-specific T-cells and PML occurrence in HIV-infected subjects and in liver transplant recipients. A significant decrease of JCV-specific T-cells was observed in HIV-PML subjects, highlighting a close relation between JCV-specific T-cell immune impairment and PML occurrence in HIV-subjects. Interestingly, liver-transplant recipients (LTR) showed a low frequency of JCV-specific T-cells, similar to HIV-PML subjects. Nevertheless, none of the enrolled LTR developed PML, suggesting the existence of different immunological mechanisms involved in the maintenance of a protective immune response in LT

Which is the most accurate diagnostic procedure in Tamoxifen treated breast cancer patients

Purpose: The aim of this study was to evaluate the diagnostic accuracy of bi-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound (TVUS), hysterosonography (HSSG) and hysteroscopy in the detection of endometrial pathology in women treated with tamoxifen (TMX) for breast cancer. Methods: Forty-two patients, affected by breast cancer under treatment with TMX, underwent 2D-3D TVUS, HSSG and hysteroscopy completed by biopsy, after abnormal findings following a routine 2D TVUS examination. Results: 3D-TVUS was more accurate than 2D-TVUS in the detection of atrophic endometrium confirmed by biopsy and in the detection of endometrial polyps. HSSG and hysteroscopy detected atrophic endometrium and endometrial polyps significantly better than ultrasound scan. Endometrial carcinoma was detected in two cases, and in both HSSG and hysteroscopy were 100% diagnostic. Conclusion: In TMX treated breast cancer patients, HSSG and hysteroscopy provide more accurate diagnosis than 2D-3D ultrasound in the detection of treatment related endometrial lesions

Clinical predictive factors of pathologic complete response in locally advanced rectal cancer

Background: Predictive factors of pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) are still not identified. The purpose of this study was to define them. Materials and Methods: Data from consecutive LARC patients treated between January 2008 and June 2014 at our Institution were included in the analysis. All patients were treated with a long course of nCRT. Demographics, initial diagnosis and tumor extension details, as well as treatment modalities characteristics were included in the univariate and logistic regression analysis. Results: In total 99 patients received nCRT, of whom 23 patients (23.2%) achieved pCR. Patients with and without pCR were similar in term of age, sex, comobidities, BMI and tumor characteristics. Multivariate logistic regression indicated that pre-treatment tumor size <= 5 cm was a significant predictor for pCR (p = 0.035), whereas clinical N stage only showed a positive trend (p = 0.084). Conclusions: Tumor size at diagnosis could be used to predict pCR, and thus to individualize therapy in LARC patients management. Validation in other studies is needed

Loop electrosurgical excision procedure versus cryotherapy in the treatment of cervical intraepithelialneoplasia: A systematic review and meta-analysis of randomized controlled trials

AIM: Invasive cervical cancer is proceeded by a phase of preinvasive disease that is slow to progress and can be detected, treated, and collectively referred to as cervical intraepithelial neoplasia (CIN). Several excisional and ablative treatments for CIN have been studied, with loop electrosurgical excision procedure (LEEP) and cryotherapy being the two most commonly utilized. The objective of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to compare the compare harms and benefits of LEEP versus cryotherapy in women with CIN. METHODS: Electronic databases were searched from their inception until May 2018. We included all RCTs comparing cryotherapy versus LEEP in women with CIN. We included trials evaluating both HIV-seropositive and HIV-seronegative women. The primary outcome was the persistence of the disease at 6-month follow-up. Meta-analysis was performed using the random-effects model to produce summary treatment effects in terms of relative risk (RR) with 95% confidence interval (CI). RESULTS: Four trials, including 1035 women with CIN, were identified as relevant and included in the meta-analysis. Women who received LEEP for CIN had a significantly lower persistence at 6-month follow-up biopsy (RR: 0.87, 95% CI: 0.76-0.99) and significantly lower recurrence at 12-month follow-up biopsy (RR: 0.91, 95% CI: 0.84-0.99) compared to those who received cryotherapy. No between-group differences were found in the complications rate, but the analyses were not powered for these outcomes. CONCLUSIONS: In women with CIN, treatment with LEEP was associated with a significantly lower risk of persistence disease at 6 months and recurrence disease at 12 months compared to treatment with cryotherapy