Amprenavir and efavirenz pharmacokinetics before and after the addition of nelfinavir, indinavir, ritonavir, or saquinavir in seronegative individuals

Adult AIDS Clinical Trials Group 5043 examined pharmacokinetic (PK) interactions between amprenavir (APV) and efavirenz (EFV) both by themselves and when nelfinavir (NFV), indinavir (IDV), ritonavir (RTV), or saquinavir (SQV) is added. A PK study was conducted after the administration of single doses of APV (day 0). Subjects (n = 56) received 600 mg of EFV every 24 h (q24h) for 10 days and restarted APV with EFV for days 11 to 13 with a PK study on day 14. A second protease inhibitor (PI) (NFV, 1,250 mg, q12h; IDV, 1,200 mg, q12h; RTV, 100 mg, q12h; or SQV, 1,600 mg, q12h) was added to APV and EFV on day 15, and a PK study was conducted on day 21. Controls continued APV and EFV without a second PI. Among subjects, the APV areas under the curve (AUCs) on days 0, 14, and 21 were compared using the Wilcoxon signed-rank test. Ninety-percent confidence intervals around the geometric mean ratios (GMR) were calculated. APV AUCs were 46% to 61% lower (median percentage of AUC) with EFV (day 14 versus day 0; P values of <0.05). In the NFV, IDV, and RTV groups, day 21 APV AUCs with EFV were higher than AUCs for EFV alone. Ninety-percent confidence intervals around the GMR were 3.5 to 5.3 for NFV (P < 0.001), 2.8 to 4.5 for IDV (P < 0.001), and 7.8 to 11.5 for RTV (P = 0.004). Saquinavir modestly increased the APV AUCs (GMR, 1.0 to 1.4; P = 0.106). Control group AUCs were lower on day 21 compared to those on day 14 (GMR, 0.7 to 1.0; P = 0.042). African-American non-Hispanics had higher day 14 efavirenz AUCs than white non-Hispanics. We conclude that EFV lowered APV AUCs, but nelfinavir, indinavir, or ritonavir compensated for EFV induction

No Evidence for Decay of the Latent Reservoir in HIV‐1–Infected Patients Receiving Intensive Enfuvirtide‐Containing Antiretroviral Therapy

Human immunodeficiency virus type 1 (HIV-1) persists in a latent reservoir of infected resting memory CD4 cells in patients receiving antiretroviral therapy. We assessed whether multitarget therapy with enfuvirtide, 2 reverse-transcriptase inhibitors, and a ritonavir-boosted protease inhibitor leads to decay of this reservoir. Nineteen treatment-naive patients initiated this regimen; 9 experienced virologic suppression and continued enfuvirtide-containing therapy for at least 48 weeks. In enfuvirtide-treated patients with virological suppression, there was no decay of the latent reservoir (95% confidence interval for half-life, 11 months to infinity). The stability of the latent reservoir despite intensive therapy suggests that new strategies are needed to eradicate HIV-1 from this reservoir

Phase I/II Trial of the Anti-HIV Activity of Mifepristone in HIV-Infected Subjects ACTG 5200

Mifepristone is a glucocorticoid receptor inhibitor shown in vitro to have anti-HIV activity and anti-simian immunodeficiency virus activity in a macaque model. A phase I/II trial was performed to assess the drug’s safety and anti-HIV activity

Women in (Dis)placement: The Field of Studies on Migrations, Social Remittances, Care and Gender in Chile

This article presents current perspectives on the gender approach to the study of migration in Chile between 1990 and 2018, contextualizing it in light of international debates in the social sciences. We will discuss how the feminization and the growth of Latin American migrations have given rise to a prolific field of research, as exemplified by studies conducted in central and northern Chile. We will show how the concepts of social remittances and caregiving permeate the Chilean debate on migrant women. We conclude with reflections on topics and perspectives to be incorporated into the Chilean research agenda on gender and migration.Se presenta un estado del arte sobre el enfoque de género en los estudios de la migración en Chile entre 1990 y 2018, contextualizándolo a la luz de debates internacionales de las ciencias sociales. Abordaremos cómo la feminización y el incremento de las migraciones latinoamericanas inauguran un prolijo campo de investigaciones, articulado a través de estudios desarrollados en el centro y en el norte de Chile. Señalaremos cómo los conceptos de remesas sociales y cuidados permean el debate chileno sobre las mujeres migrantes. Finalizamos con reflexiones sobre temas y perspectivas a ser incorporados en la agenda chilena de investigaciones sobre género y migración.The authors would like to thank the Chilean National Commission for Scientific and Technological Research (CONICYT) for funding the study that led to this article through Fondecyt Regular Project number 1160683: “Ser Mujer Mayor en Santiago. Organización social de los cuidados, feminización del envejecimiento y desigualdades acumuladas” (“Being an older woman in Santiago. Social organization of care, feminization of ageing and accumulated inequalities”), led by Herminia Gonzálvez Torralbo and Fondecyt Regular Project number 1190056: “The Boundaries of Gender Violence: Migrant Women’s Experiences in South American Border Territories” led by Menara Lube Guizardi

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Wpływ czynników psychosomatycznych na długość wybranych mięśni posturalnych i postawę ciała

Wstęp: Psychosomatyka to dwustronna współzależność między psychiką a somatycznymi funkcjami organizmu. Długotrwałe stany emocjonalne doprowadzają do zaburzenia homeostazy w organiźmie, co może być odpowiedzialne za zaburzenia czynnościowe w narządach człowieka. Problemem jest odpowiedni dobór czynników psychosomatycznych mający wpływ na zaburzenia czynnościowe w układzie mięśniowym. Analiza ta musi uwzględniać wiele aspektów, dlatego nie możemy stwierdzić jednoznacznie wpływu na postawę ciała.Cel: Celem pracy była analiza wpływu czynników psychosomatycznych na zmianę długości mięśni piersiowych większych, mięśnia biodrowo-lędźwiowego i postawę człowieka uwzględniającą kryteria oceny postawy według Kasperczyka. Materiał i metody: Badania zostały przeprowadzone w dwóch etapach. W pierwszej ich części udział wzięło 84 kobiet i 78 mężczyzn w wieku od 17-19lat którzy zgłosiły się do badania spontanicznie. Każda z tych osób została poddana ocenie postawy ciała opracowanej według metody Kasperczyka. Do drugiego etapu zakwalifikowano 82 kobiety i 68 mężczyzn którzy dodatkowo podlegali ocenie zakresu długości wybranych mięśni posturalnych oraz uczestniczyli w badaniach psychologicznych oceniający wskaźnik kontroli emocji, radzenie sobie ze stresem, kompetencje osobiste na podstawie testów oraz skal psychologicznych.Wyniki: Uzyskane wyniki pozwalają stwierdzić iż nie wykazano silnych korelacji pomiędzy czynnikami psychosomatycznymi a zmianą długości wybranych mięśni posturalnych. Na postawę ciała ma jedynie negatywny wpływ zmienna psychologiczna świadcząca o wyuczonej bezradności osoby badanej.Wnioski: Stwierdzamy brak korelacji pomiędzy wybranymi czynnikami psychosomatyczni a układem mięśniowym i postawą ciała oraz słabą korelację pomiędzy nieprawidłową postawą ciała a kompetencją osobistą jaką jest wyuczona bezradność.Introduction: Psychosomatics is a way of recognizing the bilateral relationship between the psyche and the somatic functions of the body. Long-term emotional states lead to the disruption of homeostasis in the body which may be responsible for functional disorders in human organs and systems. The problem is the proper selection of psychosomatic factors affecting the functional disorders of the muscular system. This analysis must take into account many aspects, that is why we can’t tell if they have any influence on the body posture.Objective: The aim of this study was to analyze the influence of psychosomatic factors on the selected length’s changes of muscles: pectoralis-major and ilio-lumbar and the human’s posture taking into account the criteria for assessing the attitudes according to Kasperczyk.Material and Methods: The study was conducted in two stages. In the first part thereof it was attended by 84 women and 78 men aged between 17-19years old. Each of these individuals has been assessed body posture scoring with the method developed by Kasperczyk. The second stage group consisted of 82 women and 68 men which was subject to further assessment of the extent length of postural muscles and participated in psychological research evaluating the rate of controls emotions coping with stress, personal competence based on psychological tests.Results: The obtained results allow to conclude that there was a strong correlation between psychosomatic factors and the variation of some postural muscles. At posture it has only a negative psychological impact variable testifying to the helplessness of a subject.Conclusions: We find no correlation between selected psychosomatical factors,the muscular system and the overall body posture and a weak correlation between abnormal body posture and personal competence like helplessness