Rhabdomyolysis in an HIV cohort: epidemiology, causes and outcomes.

BackgroundThe Literature on rhabdomyolysis in the HIV-positive population is sparse and limited. We aimed to explore the incidence, patient characteristics, etiologies and outcomes of rhabdomyolysis in a cohort of HIV-positive patients identified through the Johns Hopkins HIV clinical registry between June 1992 and April 2014.MethodsA retrospective analysis of 362 HIV-positive patients with non-cardiac CK elevation ≥1000 IU/L was performed. Both inpatients and outpatients were included. Incidence rate and potential etiologies for rhabdomyolysis were ascertained. The development of acute kidney injury (AKI, defined as doubling of serum creatinine), need for dialysis, and death in the setting of rhabdomyolysis were determined. Logistic regression was used to evaluate the association of peak CK level with the development of AKI.ResultsThree hundred sixty two cases of rhabdomyolysis were identified in a cohort of 7079 patients with a 38,382 person years follow-up time. The incidence rate was nine cases per 1000 person-years (95% CI: 8.5-10.5). Infection was the most common etiology followed by compression injury and drug/alcohol use. One-third of cases had multiple potential etiologies. AKI developed in 46% of cases; 20% of which required dialysis. Thirteen percent died during follow-up. After adjustment, AKI was associated with higher CK (OR 2.05 for each 1-log increase in CK [95% CI: 1.40-2.99]), infection (OR 5.48 [95% CI 2.65-11.31]) and higher HIV viral load (OR 1.22 per 1-log increase [95% CI: 1.03-1.45]).ConclusionRhabdomyolysis in the HIV-positive population has many possible causes and is frequently multifactorial. HIV-positive individuals with rhabdomyolysis have a high risk of AKI and mortality

Nivel de adherencia al tratamiento y calidad de vida relacionada a la salud en pacientes con VIH/sida, de un hospital MINSA nivel II-1 de Ferreñafe – Lambayeque, durante agosto – diciembre, 2017

Se ha observado que pacientes infectados por el virus de inmunodeficiencia humana y síndrome de inmunodeficiencia adquirida (VIH/SIDA) que no toman en cuenta las indicaciones del médico para su tratamiento, pueden generar una propagación constante y continua, dando paso a un problema de salud más grave a nivel mundial. Por ello se realizó una investigación no experimental - descriptiva, con el propósito de determinar los niveles de adherencia al tratamiento y calidad de vida relacionada a la salud según sexo y grado de instrucción, además de describir las dimensiones sociodemográficas en pacientes con VIH/SIDA, de un Hospital MINSA nivel II-1 de Ferreñafe - Lambayeque, durante agosto a diciembre del 2017. Se utilizó los cuestionarios CEAT-VIH para hallar los niveles de adherencia al tratamiento y MOS-SF 30 para determinar los niveles de calidad de vida relacionada a la salud, estimando su validez y confiabilidad en una población similar, siendo válidos y fiables. Además, en cuanto la variable sexo, se obtuvo que los varones tienen una adecuada adherencia al tratamiento, sin embargo para calidad de vida relacionada a la salud ambos sexos se encontraron en un nivel bajo. Por ende la población estudiada presenta baja adherencia al tratamiento y calidad de vida relacionada a la salud. Con respecto a los aspectos sociodemográficos, el 53% es de sexo masculino, el 62% es soltera, siendo la vía sexual (96%) la principal forma de transmisión del virus del VIH. Además el 75% lleva un tiempo mayor a 12 meses de tratamiento en el servicio de TARGA.Tesi

Tunable Oscillations in the Purkinje Neuron

In this paper, we study the dynamics of slow oscillations in Purkinje neurons in vitro, and derive a strong association with a forced parametric oscillator model. We demonstrate the precise rhythmicity of the oscillations in Purkinje neurons, as well as a dynamic tunability of this oscillation using a photo-switchable compound. We show that this slow oscillation can be induced in every Purkinje neuron, having periods ranging between 10-25 seconds. Starting from a Hodgkin-Huxley model, we also demonstrate that this oscillation can be externally modulated, and that the neurons will return to their intrinsic firing frequency after the forced oscillation is concluded. These results signify an additional functional role of tunable oscillations within the cerebellum, as well as a dynamic control of a time scale in the brain in the range of seconds.Comment: 12 pages, 5 figure

An FPGA based Efficient Fruit Recognition System Using Minimum Distance Classifier

The paper deals with a simple yet effective fruit identification system developed on an FPGA, SPARTAN 3(XC3S200-5PQ208) platform .The fruits under consideration were apple, banana, sapodilla and strawberry. Out of these selected fruits there were four different classes of apples, two different classes of sapodillas and one class each of the other two fruits. A total of 800 color images, 200 images of each fruit of size 64x64 were used for training. The fruit identification success rate mainly depends on the feature vector and the Classifier used. The 3D feature vector incorporates two first order statistical features and the shape feature. Using the 3D feature vector the MATLAB analysis of The Minimum Distance Classifier (MID) fetched a success rate of 85%.The Verilog coded Hardware platform was developed by burning the COE file of a Test image generated by JAVA ECLIPSE IDE onto the IP core. The MATLAB results were verified using the Hardware Platform. Keywords: RGB image, feature vector, MID, Verilog, FPGA, IP core, COE file

Neurodegeneration and Epilepsy in a Zebrafish Model of CLN3 Disease (Batten Disease)

The neuronal ceroid lipofuscinoses are a group of lysosomal storage disorders that comprise the most common, genetically heterogeneous, fatal neurodegenerative disorders of children. They are characterised by childhood onset, visual failure, epileptic seizures, psychomotor retardation and dementia. CLN3 disease, also known as Batten disease, is caused by autosomal recessive mutations in the CLN3 gene, 80–85% of which are a ~1 kb deletion. Currently no treatments exist, and after much suffering, the disease inevitably results in premature death. The aim of this study was to generate a zebrafish model of CLN3 disease using antisense morpholino injection, and characterise the pathological and functional consequences of Cln3 deficiency, thereby providing a tool for future drug discovery. The model was shown to faithfully recapitulate the pathological signs of CLN3 disease, including reduced survival, neuronal loss, retinopathy, axonopathy, loss of motor function, lysosomal storage of subunit c of mitochondrial ATP synthase, and epileptic seizures, albeit with an earlier onset and faster progression than the human disease. Our study provides proof of principle that the advantages of the zebrafish over other model systems can be utilised to further our understanding of the pathogenesis of CLN3 disease and accelerate drug discovery

Sebomic identification of sex- and ethnicity-specific variations in residual skin surface components (RSSC) for bio-monitoring or forensic applications

Background: “Residual skin surface components” (RSSC) is the collective term used for the superficial layer of sebum, residue of sweat, small quantities of intercellular lipids and components of natural moisturising factor present on the skin surface. Potential applications of RSSC include use as a sampling matrix for identifying biomarkers of disease, environmental exposure monitoring, and forensics (retrospective identification of exposure to toxic chemicals). However, it is essential to first define the composition of “normal” RSSC. Therefore, the aim of the current study was to characterise RSSC to determine commonalities and differences in RSSC composition in relation to sex and ethnicity. Methods: Samples of RSSC were acquired from volunteers using a previously validated method and analysed by high-pressure liquid chromatography–atmospheric pressure chemical ionisation–mass spectrometry (HPLC-APCI-MS). The resulting data underwent sebomic analysis. Results: The composition and abundance of RSSC components varied according to sex and ethnicity. The normalised abundance of free fatty acids, wax esters, diglycerides and triglycerides was significantly higher in males than females. Ethnicity-specific differences were observed in free fatty acids and a diglyceride. Conclusions: The HPLC-APCI-MS method developed in this study was successfully used to analyse the normal composition of RSSC. Compositional differences in the RSSC can be attributed to sex and ethnicity and may reflect underlying factors such as diet, hormonal levels and enzyme expression.Peer reviewedFinal Published versio

IL-4 alpha chain receptor (IL-4Rα) polymorphisms in allergic bronchopulmonary sspergillosis

BACKGROUND: Allergic bronchopulmonary aspergillosis occurs in 7–10% of cystic fibrosis (CF) and 1–2% of asthmatic patients. HLA-DR restriction and increased sensitivity to IL-4 stimulation have been proposed as risk factors in these populations. OBJECTIVE: We examined for the presence of IL-4 receptor alpha chain (IL-4Rα) single nucleotide polymorphisms (SNPs) in ABPA and whether these accounted for increased sensitivity to IL-4 stimulation. METHODS: One extracellular (ile75val) and four cytoplasmic IL-4Rα SNPs were analyzed in 40 CF and 22 asthmatic patients and in 56 non-ABPA CF and asthmatic patients. Sensitivity to IL-4 stimulation was measured by induction of CD23 expression on B cells. RESULTS: IL-4Rα SNPs were observed in 95% of ABPA patients. The predominant IL-4Rα SNP was the extracellular IL-4Rα SNP, ile75val, observed in 80% of ABPA patients. CONCLUSION: The presence of IL-4Rα SNPs, principally ile75val, appears to be a genetic risk for the development of ABPA

Identification of Novel Small RNAs and Characterization of the 6S RNA of \u3ci\u3eCoxiella burnetii\u3c/i\u3e

Coxiella burnetii, an obligate intracellular bacterial pathogen that causes Q fever, undergoes a biphasic developmental cycle that alternates between a metabolically-active large cell variant (LCV) and a dormant small cell variant (SCV). As such, the bacterium undoubtedly employs complex modes of regulating its lifecycle, metabolism and pathogenesis. Small RNAs (sRNAs) have been shown to play important regulatory roles in controlling metabolism and virulence in several pathogenic bacteria. We hypothesize that sRNAs are involved in regulating growth and development of C. burnetii and its infection of host cells. To address the hypothesis and identify potential sRNAs, we subjected total RNA isolated from Coxiella cultured axenically and in Vero host cells to deep-sequencing. Using this approach, we identified fifteen novel C. burnetii sRNAs (CbSRs). Fourteen CbSRs were validated by Northern blotting. Most CbSRs showed differential expression, with increased levels in LCVs. Eight CbSRs were upregulated ($2-fold) during intracellular growth as compared to growth in axenic medium. Along with the fifteen sRNAs, we also identified three sRNAs that have been previously described from other bacteria, including RNase P RNA, tmRNA and 6S RNA. The 6S regulatory sRNA of C. burnetii was found to accumulate over log phase-growth with a maximum level attained in the SCV stage. The 6S RNA-encoding gene (ssrS) was mapped to the 59 UTR of ygfA; a highly conserved linkage in eubacteria. The predicted secondary structure of the 6S RNA possesses three highly conserved domains found in 6S RNAs of other eubacteria. We also demonstrate that Coxiella’s 6S RNA interacts with RNA polymerase (RNAP) in a specific manner. Finally, transcript levels of 6S RNA were found to be at much higher levels when Coxiella was grown in host cells relative to axenic culture, indicating a potential role in regulating the bacterium’s intracellular stress response by interacting with RNAP during transcription

Optical determination of flexoelectric coefficients and surface polarization in a hybrid aligned nematic cell

A. Mazzulla, F. Ciuchi, and J. Roy Sambles, Physical Review E, Vol. 64, article 021708 (2001). "Copyright © 2001 by the American Physical Society."We present an optical study of the influence of both the flexoelectric effect and surface polarization on a hybrid-aligned nematic cell using the half-leaky guided mode technique. Tilt angle profiles, obtained from fits of experimental data (reflectivity curves) taken under applied voltages, are compared with the ones derived by a complete theoretical model. Measurements with an applied alternating voltage allow the evaluation of the anchoring energy by solving the torque balance equation at the planar surface. From measurements with static fields, the sum of flexoelectric coefficients and the surface polarization are determined by numerical solution of Euler-Lagrange equations