Preferred antiretroviral drugs for the next decade of scale up

Global commitments aim to provide antiretroviral therapy (ART) to 15 million people living with HIV by 2015, and recent studies have demonstrated the potential for widespread ART to prevent HIV transmission. Increasingly, countries are adapting their national guidelines to start ART earlier, for both clinical and preventive benefits. To maximize the benefits of ART in resource-limited settings, six key principles need to guide ART choice: simplicity, tolerability and safety, durability, universal applicability, affordability and heat stability. Currently available drugs, combined with those in late-stage clinical development, hold great promise to simplify treatment in the short term. Over the longer-term, newer technologies, such as long-acting formulations and nanotechnology, could radically alter the treatment paradigm. This commentary reviews recommendations made in an expert consultation on treatment scale up in resource-limited settings

The influence of dairy consumption, sedentary behaviour and physical activity on bone mass in Flemish children : a cross-sectional study

Background: This cross-sectional study aimed to look for an association in young children between whole body bone mineral content (BMC) and areal bone mineral density (aBMD) and dairy consumption as well as sedentary behaviour (SB) and physical activity (PA). Moreover, we investigated whether there was an interaction effect between dairy consumption and SB or PA on BMC and aBMD. Methods: Healthy children (6-12 years) were recruited from primary schools. Body composition and whole body bone mass were measured with dual-energy X-ray absorptiometry (DXA), dairy consumption was assessed with a food frequency questionnaire (FFQ) and PA and SB with an accelerometer. In total, 272 children underwent a DXA scan. Complete FFQ data were available for 264 children and 210 children had matching data from accelerometry recordings. Regression analyses were used to study the associations between (1) BMC and aBMD and (2) dairy consumption, SB and PA, adjusting for age, gender, pubertal stage, height and body composition. Results: Dairy consumption was positively associated with whole body BMC and aBMD (absolute value as well as z-score), after correction for relevant confounders. SB was negatively associated with aBMD z-score and light PA was positively associated with both BMC and aBMD z-score. No gender differences were found. Moreover, an interaction effect between vigorous PA (VPA) and dairy consumption on aBMD (z-score) and BMC z-score was found, indicating that children with both high VPA and high dairy consumption had higher values for BMC and aBMD of the whole body minus the head. Conclusion: Already at young age, PA and dairy consumption positively influence whole body bone mass assessed by DXA. Moreover, this study indicates clearly that SB is negatively associated with whole body bone density. Promoting regular PA and sufficient dairy consumption in young children and limiting SB can be expected to positively influence their bone mass accumulation, which can help in the prevention of osteoporosis later in life

Effect of fat and sodium reduction on instrumental and sensory characteristics of liver paste

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Pediatric reference values for tibial trabecular bone mineral density and bone geometry parameters using peripheral quantitative computed tomography

The purpose of this study was to establish reference data, in relation to age and body height, for tibial trabecular and cortical volumetric bone mineral density, bone mineral content, and cross-sectional bone geometry in healthy children and adolescents using peripheral quantitative computed tomography (pQCT). Over a 2-year period, 432 (207 male and 225 female) healthy children, with an age range of 5 to 19 years, from 6 different geographic areas in Belgium were recruited. Multislice pQCT scanning (XCT2000(A (R)), Stratec Medizintechnik, Pforzheim, Germany) was performed at the distal metaphysis (at the 4 % site) and the distal diaphysis (14 and 38 % sites) of the tibia of the dominant leg. Gender-specific centile curves in relation to age and body height were generated with the LMS method for total and trabecular volumetric bone mineral density (at 4 % site), bone mineral content, total bone cross-sectional area, periosteal circumference (all at 4, 14, and 38 % site), cortical volumetric bone mineral density, endosteal circumference, and cortical thickness (at the 14 and the 38 % site). These centile curves can be used for the interpretation of pQCT results at the 4, 14, and 38 % site of the tibia in European children and adolescents, at least when a similar methodology is used

Ath “ Les Haleurs “, two villages lbk and blicquy/villeneuve-saint-germain: search for transition mechanisms through the integrated study of productions

At the turn of the sixth to the fifth millennium BC, a historical turning point occurred in continental neolithization of Europe as the Linear Pottery culture broke up into a mosaic of cultural entities. The northern half of France and Belgium were occupied by the Blic- quy/Villeneuve-Saint-Germain culture (BQY/VSG). The recently discovered site of Ath “Les Haleurs” in the west of Belgium (Hainaut Province) represents a key site for exploring in detail the mechanisms of the cultural transition between these two cultural spheres. Indeed, established along the eastern branch of the Dender river, the “Les Haleurs” site has the particularity of offering the remains of the two successive Early Neolithic cultures, i.e. Linear Pottery Culture (LBK) and Blicquy/Villeneuve-Saint-Germain. This proximity is exceptional: sites with houses of the two cultures are rare (three sites in Hainaut and two in Hesbaye, the Belgian Liège province) especially when they show such a high closeness (less than 3 meters). Thus, this communication will present the first results of the technological and integrated study of all the artifacts found at the site of Ath “Les Haleurs”. We propose to cross-reference the origin of raw materials, typo-technology, and use-wear analysis of ceramic productions, lithic industry, macrolithic tools, and stone ornaments. The rhythms of change in the different technical sub-systems will then be compared and questioned

Ath “ Les Haleurs “, two villages lbk and blicquy/villeneuve-saint-germain: search for transition mechanisms through the integrated study of productions

At the turn of the sixth to the fifth millennium BC, a historical turning point occurred in continental neolithization of Europe as the Linear Pottery culture broke up into a mosaic of cultural entities. The northern half of France and Belgium were occupied by the Blic- quy/Villeneuve-Saint-Germain culture (BQY/VSG). The recently discovered site of Ath “Les Haleurs” in the west of Belgium (Hainaut Province) represents a key site for exploring in detail the mechanisms of the cultural transition between these two cultural spheres. Indeed, established along the eastern branch of the Dender river, the “Les Haleurs” site has the particularity of offering the remains of the two successive Early Neolithic cultures, i.e. Linear Pottery Culture (LBK) and Blicquy/Villeneuve-Saint-Germain. This proximity is exceptional: sites with houses of the two cultures are rare (three sites in Hainaut and two in Hesbaye, the Belgian Liège province) especially when they show such a high closeness (less than 3 meters). Thus, this communication will present the first results of the technological and integrated study of all the artifacts found at the site of Ath “Les Haleurs”. We propose to cross-reference the origin of raw materials, typo-technology, and use-wear analysis of ceramic productions, lithic industry, macrolithic tools, and stone ornaments. The rhythms of change in the different technical sub-systems will then be compared and questioned

Asymmetric Intrastromal Corneal Ring Segments with Progressive Base Width and Thickness for Keratoconus: Evaluation of Efficacy and Analysis of Epithelial Remodeling

Purpose: The aim of this study is to describe visual outcomes and epithelial remodeling following the implantation of asymmetric intracorneal ring segments (ICRSs) of variable thickness and base width for the management of duck-type keratoconus. Methods: A prospective observational study of patients with duck-type keratoconus was conducted. All patients received one ICRS AJL PRO + implant (AJL Ophthalmic). We analyzed demographic and clinical data, anterior segment optical coherence tomography (AS-OCT) data and Scheimpflug camera images obtained with a Placido disc MS-39 (CSO, Firenze, Italy) one and six months after surgery to determine keratometric and aberrometric outcomes and epithelial remodeling. Results: We studied 33 keratoconic eyes. ICRS implantation significantly improved both corrected distance visual acuity (CDVA) and uncorrected distance visual acuity at six months, as assessed with the logMAR (minimum angle of resolution) system, from 0.32 ± 0.19 to 0.12 ± 0.12 (p p n = 1) lost one line of CDVA; 55% of eyes attained a manifest refraction spherical equivalent between +1.50 and −1.50 D. Epithelial remodeling was greater at the wider and thicker end (+11.33 µm ± 12.95; p p = 0.01). Coma aberration was significantly reduced from 1.62 ± 0.81 µm to 0.99 ± 0.59 µm (p Conclusions: AJL-PRO + ICRS implantation for duck-type keratoconus improves refractive, topographic, aberrometric and visual parameters and induces progressive epithelial thickening along the segment

Why it’s time to say goodbye to stavudine ... everywhere

The previous issue of the SAJHIV (December 2011) carried an Opinion piece by Innes, Cotton and Venter regarding the potential value of low-dose of stavudine (20 mg twice a day). They suggested that reduced dosing of stavudine may lead to levels of viral suppression comparable with those achieved with stavudine 30 mg bd but with a lower risk of toxicity and side-effects, and at a fraction of the cost of tenofovir. The Opinion was related to a larger proposal, led by Venter, to conduct a head-to-head trial comparing low-dose stavudine with tenofovir (both in a regimen including lamivudine and efavirenz) on viral suppression and other treatment outcomes over 24 months. There has been considerable debate regarding the advantages and disadvantages of low-dose stavudine, and in turn the value of any such trial. Here the debate continues with a commentary by Isabelle Andrieux-Meyer et al. and a rebuttal by Venter and colleagues