Ocularhaemodynamics parameters of asymptomatic HAART experienced HIV-infected under-five children

Objectives: Study aimed at evaluating the impacts of HAART on retinal blood flow of a symptomatic HAART - experienced HIV-infected underfive children.Method: Ethical approval and patient consents were obtained before commencement of the study in the selected hospitals. Thirty asymptomatic HAARTexperienced HIV-infected children and three seronegative children aged 0-5 year-old fulfilled conditions for ocular ultrasonography among 60 convenience sampled under-fives. Ocular ultrasonography was done on the patients in supine position with eyes closed as instructed by the radiologist. Maximum velocity (Vmax), pulsatility index (PI), resistive index (RI), optic nerve diameter, lens thickness and axial diameter were measured. Results of HAART-experienced children were not compared with the control children because of unequal size. Data were analysed by using ANOVA and level of significance was considered at p<0.05. Results: Vmax of blood flow in central retinal artery (CRA) of asymptomatic HAART - experienced HIV infected children was 12.2cm/s while that of seronegative children was 13.4 cm/s. The PI and RI of blood flow in CRA of asymptomatic HAARTexperienced HIV-infected children were 0.8 and 0.5 respectively while those of the seronegative children were 0.6 and 0.4 respectively. Reduced Vmax of blood flow of CRA was significantly associated with both increased PI and RI of asymptomatic HAARTexperienced HIV-infected underfive children.Discussion: Vmax of CRA of asymptomatic HAART-experienced HIV-infected children was reduced because of their increased PI and RI suggesting an increased resistance to blood flow in asymptomatic HAART experienced HIVinfected children.Conclusion: Reduced Vmax of blood flow to CRA was significantly associated with increased PI and RI of asymptomatic HAARTexperienced HIV-infected children.Keywords: Ophthalmic artery, Central retina artery, maximum velocity, Seropositive children, HAAR

Clozapine is associated with secondary antibody deficiency

Background: Schizophrenia affects 1% of the population. Clozapine is the only medication licensed for treatment-resistant schizophrenia and is intensively monitored to prevent harm from neutropenia. Clozapine is also associated with increased risk of pneumonia although the mechanism is poorly understood.AimsTo investigate the potential association between clozapine and antibody deficiency. Methods: Patients taking clozapine and patients who were clozapine-naive and receiving alternative antipsychotics were recruited and completed a lifestyle, medication and infection-burden questionnaire. Serum total immunoglobulins (immunoglobulin (Ig)G, IgA, IgM) and specific IgG antibodies to haemophilus influenzae type B, tetanus and IgG, IgA and IgM to pneumococcus were measured. Results: Immunoglobulins were all significantly reduced in the clozapine-treated group (n = 123) compared with the clozapine-naive group (n = 111). Odds ratios (ORs) for a reduction in clozapine:control immunoglobulin values below the fifth percentile were IgG, OR = 6.00 (95% CI 1.31-27.44); IgA, OR = 16.75 (95% CI 2.18-128.60); and IgM, OR = 3.26 (95% CI 1.75-6.08). These findings remained significant despite exclusion of other potential causes of hypogammaglobulinaemia. In addition, duration on clozapine was associated with decline in IgG. A higher proportion of the clozapine-treated group reported taking more than five courses of antibiotics in the preceding year (5.3% (n = 5) versus 1% (n = 1). Conclusions: Clozapine use was associated with significantly reduced immunoglobulin levels and an increased proportion of patients using more than five antibiotic courses in a year. Antibody testing is not included in existing clozapine monitoring programmes but may represent a mechanistic explanation and modifiable risk factor for the increased rates of pneumonia and sepsis-related mortality previously reported in this vulnerable cohort.Declaration of interestS.J. has received support from CSL Behring, Shire, LFB, Biotest, Binding Site, Sanofi, GSK, UCB Pharma, Grifols, BPL SOBI, Weatherden, Zarodex and Octapharma for projects, advisory boards, meetings, studies, speaker and clinical trials

Berry phase and quantum criticality in Yang--Baxter systems

Spin interaction Hamiltonians are obtained from the unitary Yang--Baxter $\breve{R}$-matrix. Based on which, we study Berry phase and quantum criticality in the Yang--Baxter systems.Comment: 7 pages, no figures. Accepted for publication in Annals of Physic

Clozapine is associated with secondary antibody deficiency

Background Schizophrenia affects 1% of the population. Clozapine is the only medication licensed for treatment-resistant schizophrenia and is intensively monitored to prevent harm from neutropenia. Clozapine is also associated with increased risk of pneumonia although the mechanism is poorly understood. Aims To investigate the potential association between clozapine and antibody deficiency. Methods Patients taking clozapine and patients who were clozapine-naive and receiving alternative antipsychotics were recruited and completed a lifestyle, medication and infection-burden questionnaire. Serum total immunoglobulins (immunoglobulin (Ig)G, IgA, IgM) and specific IgG antibodies to haemophilus influenzae type B, tetanus and IgG, IgA and IgM to pneumococcus were measured. Results Immunoglobulins were all significantly reduced in the clozapine-treated group (n = 123) compared with the clozapine-naive group (n = 111). Odds ratios (ORs) for a reduction in clozapine:control immunoglobulin values below the fifth percentile were IgG, OR = 6.00 (95% CI 1.31–27.44); IgA, OR = 16.75 (95% CI 2.18–128.60); and IgM, OR = 3.26 (95% CI 1.75–6.08). These findings remained significant despite exclusion of other potential causes of hypogammaglobulinaemia. In addition, duration on clozapine was associated with decline in IgG. A higher proportion of the clozapine-treated group reported taking more than five courses of antibiotics in the preceding year (5.3% (n = 5) versus 1% (n = 1). Conclusions Clozapine use was associated with significantly reduced immunoglobulin levels and an increased proportion of patients using more than five antibiotic courses in a year. Antibody testing is not included in existing clozapine monitoring programmes but may represent a mechanistic explanation and modifiable risk factor for the increased rates of pneumonia and sepsis-related mortality previously reported in this vulnerable cohort

Inhibition of tyrosine kinase receptors by SU6668 promotes abnormal stromal development at the periphery of carcinomas

Dynamic contrast-enhanced (albumin-Gd-DTPA) magnetic resonance imaging, performed during 2 weeks of daily administration of an inhibitor of tyrosine kinase receptors (SU6668) in an HT-29 colon carcinoma model, revealed the onset of a hyper-enhancing rim, not observed in untreated tumours. To account for tissue heterogeneity in the quantitative analysis, we segmented tumours into three subunits automatically identified by cluster analysis of the enhancement curves using a k-means algorithm. Transendothelial permeability (Kps) and fractional plasma volume (fPV) were calculated in each subunit. An avascular and necrotic region, an intermediate zone and a well-vascularised periphery were reliably identified. During untreated tumour growth, the identified sub-regions did not substantially change their enhancement pattern. Treatment with SU6668 induced major changes at tumour periphery where a significant increase of Kps and fPV was observed with respect to control tumours. Histology revealed a sub-capsular layer composed of hyper-dense viable tumour cells in the periphery of untreated tumours. The rim of viable neoplastic cells was reduced in treated tumours, and replaced by loose connective tissue characterised by numerous vessels, which explains the observed hyper-enhancement. The present data show a peripheral abnormal development of cancer-associated stroma, indicative of an adaptive response to anti-angiogenic treatment

Women gaze behaviour in assessing female bodies: the effects of clothing, body size, own body composition and body satisfaction

Often with minimally clothed figures depicting extreme body sizes, previous studies have shown women tend to gaze at evolutionary determinants of attractiveness when viewing female bodies, possibly for self-evaluation purposes, and their gaze distribution is modulated by own body dissatisfaction level. To explore to what extent women’s body-viewing gaze behaviour is affected by clothing type, dress size, subjective measurements of regional body satisfaction and objective measurements of own body composition (e.g., chest size, body mass index, waist-to-hip ratio), in this self-paced body attractiveness and body size judgement experiment, we compared healthy, young women’s gaze distributions when viewing female bodies in tight and loose clothing of different dress sizes. In contrast to tight clothing, loose clothing biased gaze away from the waist-hip to the leg region, and subsequently led to enhanced body attractiveness ratings and body size underestimation for larger female bodies, indicating the important role of clothing in mediating women’s body perception. When viewing preferred female bodies, women’s higher satisfaction of a specific body region was associated with an increased gaze towards neighbouring body areas, implying satisfaction might reduce the need for comparison of confident body parts; furthermore undesirable body composition measurements were correlated with a gaze avoidance process if the construct was less changeable (i.e. chest size) but a gaze comparison process if the region was more changeable (i.e. body mass index, dress size). Clearly, own body satisfaction and body composition measurements had an evident impact on women’s body-viewing gaze allocation, possibly through different cognitive processes

Evaluation of the current knowledge limitations in breast cancer research: a gap analysis

BACKGROUND A gap analysis was conducted to determine which areas of breast cancer research, if targeted by researchers and funding bodies, could produce the greatest impact on patients. METHODS Fifty-six Breast Cancer Campaign grant holders and prominent UK breast cancer researchers participated in a gap analysis of current breast cancer research. Before, during and following the meeting, groups in seven key research areas participated in cycles of presentation, literature review and discussion. Summary papers were prepared by each group and collated into this position paper highlighting the research gaps, with recommendations for action. RESULTS Gaps were identified in all seven themes. General barriers to progress were lack of financial and practical resources, and poor collaboration between disciplines. Critical gaps in each theme included: (1) genetics (knowledge of genetic changes, their effects and interactions); (2) initiation of breast cancer (how developmental signalling pathways cause ductal elongation and branching at the cellular level and influence stem cell dynamics, and how their disruption initiates tumour formation); (3) progression of breast cancer (deciphering the intracellular and extracellular regulators of early progression, tumour growth, angiogenesis and metastasis); (4) therapies and targets (understanding who develops advanced disease); (5) disease markers (incorporating intelligent trial design into all studies to ensure new treatments are tested in patient groups stratified using biomarkers); (6) prevention (strategies to prevent oestrogen-receptor negative tumours and the long-term effects of chemoprevention for oestrogen-receptor positive tumours); (7) psychosocial aspects of cancer (the use of appropriate psychosocial interventions, and the personal impact of all stages of the disease among patients from a range of ethnic and demographic backgrounds). CONCLUSION Through recommendations to address these gaps with future research, the long-term benefits to patients will include: better estimation of risk in families with breast cancer and strategies to reduce risk; better prediction of drug response and patient prognosis; improved tailoring of treatments to patient subgroups and development of new therapeutic approaches; earlier initiation of treatment; more effective use of resources for screening populations; and an enhanced experience for people with or at risk of breast cancer and their families. The challenge to funding bodies and researchers in all disciplines is to focus on these gaps and to drive advances in knowledge into improvements in patient care