Estudio transversal sobre conductas sexuales asociadas a la transmisión del VIH entre hombres homosexuales de Cataluña

ResumenEn 1993, se realizó un estudio transversal sobre los comportamientos sexuales de una muestra de hombres homosexuales reclutados en saunas, sex-shops y una organización comunitaria de base gay de Cataluña. Un total de 551 hombres de 34 años de edad media y alto nivel educativo devolvieron por correo un cuestionario anónimo. En los últimos seis meses, la mediana de parejas sexuales masculinas fue de seis y la de parejas con penetración de tres. En el último mes, el 94% habían realizado sexo oro-genital (22% con eyaculación) y el 76% sexo ano-genital (38% sin preservativo y 21% con eyaculación). El 51 % declaraba consumir alcohol durante las relaciones sexuales; el 34%, nitritos inhalados; el 20%, haschis y el 10%, cocaína. El 61% se había realizado la prueba de detección de anticuerpos anti-VIH, notificando una prevalencia de infección del 21 %. El 86% declaró conocer alguna persona infectada por el VIH o con SIDA. El alto porcentaje de hombres que practican el sexo ano-genital sin preservativo y la alta seroprevalencia auto-declarada de infección por VIH ponen de manifiesto la necesidad de aumentar los esfuerzos de prevención y la investigación en este colectivo. La monitorización de conductas relacionadas con la transmisión del VIH proporciona indicadores de utilidad, para el seguimiento de la evolución de la epidemia y para el diseño y evaluación de las intervenciones preventivas.SummaryIn 1993, a cross sectional study was carried out on the sexual behaviour of a sample of homosexual men recruited in saunas, sex shops and a gay community-beased organisation of Catalonia. A total of 551 men with an average age of 34 years and a high educational level sent in an anonymous questionnaire. In the previous 6 months the mean number of male sexual partners was 6 and for penetrative partners 3. In the previous month, 94% had had oral sex (22% with ejaculation) and 76% anal intercourse (38% without a condom and 21% with ejaculation). During sex, 51% used alcohol, 34% nitrite inhalants, 20% hashish and 10% cocaine. 61% had had the HIV test, with a self-reported HIV prevalence of 21%. 86% stated that they knew of one or more people infected by HIV or with AIDS. The high percentage of men who had unprotected anal intercourse and the high self-reported HIV prevalence highlights the need to increase efforts in AIDS prevention and research in this group. Monitoring HIV associated sexual behaviours provides valuable indicators of the evolution of the epidemic, useful for designing and evaluating preventive interventions

Association of the tumour necrosis factor alpha -308 but not the interleukin 10 -627 promoter polymorphism with genetic susceptibility to primary sclerosing cholangitis

BACKGROUND AND AIMS Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown aetiology. Abnormalities in immune regulation and genetic associations suggest that PSC is an immune mediated disease. Several polymorphisms within the tumour necrosis factor α (TNF-α) and interleukin 10 (IL-10) promoter genes have been described which influence expression of these cytokines. This study examines the possible association between polymorphisms at the −308 and −627 positions in the TNF-α and IL-10 promoter genes, respectively, and susceptibility to PSC. METHODS TNF-α −308 genotypes were studied by polymerase chain reaction (PCR) in 160 PSC patients from Norway and the UK compared with 145 ethnically matched controls. IL-10 −627 genotypes were studied by PCR in 90 PSC patients compared with 84 ethnically matched controls. RESULTS A total of 16% of Norwegian PSC patients and 12% of British PSC patients were homozygous for the TNF2 allele compared with 3% and 6% of respective controls. The TNF2 allele was present in 60% of PSC patients versus 30% of controls (ORcombined data=3.2 (95% confidence intervals (CI) 1.8–4.5); pcorr=10−5). The association between the TNF2 allele and susceptibility to PSC was independent of the presence of concurrent inflammatory bowel disease (IBD) in the PSC patients; 61% of PSC patients without IBD had TNF2 compared with 30% of controls (ORcombined data=3.2 (95% CI 1.2–9.0); pcorr=0.006 ). There was no difference in the −627 IL-10 polymorphism distributions between patients and controls in either population. The increase in TNF2 allele in PSC patients only occurs in the presence of DRB1*0301 (DR3) and B8. In the combined population data, DRB1*0301 showed a stronger association with susceptibility to PSC than both the TNF2 and B8 alleles (ORcombined data=3.8, pcorr=10−6 v ORcombined data=3.2, pcorr=10−5 vORcombined data =3.41, pcorr=10−4, respectively). CONCLUSIONS This study identified a significant association between possession of the TNF2 allele, a G→A substitution at position −308 in the TNF-α promoter, and susceptibility to PSC. This association was secondary to the association of PSC with the A1-B8-DRB1*0301-DQA1*0501-DQB1*0201 haplotype. No association was found between the IL-10 −627 promoter polymorphism and PSC

Controls upon the Last Glacial Maximum deglaciation of the northern Uummannaq Ice Stream System, West Greenland

The Uummannaq Ice Stream System (UISS) was a convergent cross-shelf ice stream system that operated in West Greenland during the Last Glacial Maximum (LGM). This paper presents new evidence constraining the geometry and evolution of the northern sector of the UISS and considers the factors controlling its dynamic behaviour. Geomorphological mapping, 21 new terrestrial cosmogenic nuclide (TCN) exposure ages, and radiocarbon dating constrain LGM warm-based ice stream activity in the north of the system up to 1400 m a.s.l. Intervening plateaux areas either remained ice free, or were covered by cold-based icefields. Beyond the inner fjords, topography and bathymetry forced ice flow southwards into the Uummannaq Trough, where it coalesced with ice from the south, and formed the trunk zone of the UISS. Deglaciation of the UISS began at 14.9 cal. ka BP. Rapid retreat from the LGM limit was forced by an increase in air temperatures and rising sea level, enhanced by the bathymetric over-deepening of the Uummannaq and Igdlorssuit Sund troughs. Ice reached the inner fjord confines in the northern Uummannaq area by 11.6 ka and experienced an ice marginal stabilisation in Rink–Karrat Fjord for up to 5 ka. This was a function of topographic constriction and bathymetric shallowing, and occurred despite continued climatic forcing. In the neighbouring Ingia Fjord this did not occur. Following this period of stability, ice within Rink–Karrat Fjord retreated, reaching the present ice margin or beyond after 5 ka. The presence of a major ice stream within a mid-fjord setting, during the mid-Holocene and the Holocene Thermal Maximum (∼11–5 ka) is in direct contrast to records of other ice streams throughout West Greenland, which suggest ice had retreated beyond its present margin by 9–7 ka. This demonstrates the potential importance of topographic control on calving margin stability, and its ability to override climatic forcing

Endoplasmic reticulum stress inhibition protects steatotic and non-steatotic livers in partial hepatectomy under ischemia-reperfusion

During partial hepatectomy, ischemia-reperfusion (I/R) is commonly applied in clinical practice to reduce blood flow. Steatotic livers show impaired regenerative response and reduced tolerance to hepatic injury. We examined the effects of tauroursodeoxycholic acid (TUDCA) and 4-phenyl butyric acid (PBA) in steatotic and non-steatotic livers during partial hepatectomy under I/R (PH + I/R). Their effects on the induction of unfolded protein response (UPR) and endoplasmic reticulum (ER) stress were also evaluated. We report that PBA, and especially TUDCA, reduced inflammation, apoptosis and necrosis, and improved liver regeneration in both liver types. Both compounds, especially TUDCA, protected both liver types against ER damage, as they reduced the activation of two of the three pathways of UPR (namely inositol-requiring enzyme and PKR-like ER kinase) and their target molecules caspase 12, c-Jun N-terminal kinase and C/EBP homologous protein-10. Only TUDCA, possibly mediated by extracellular signal-regulated kinase upregulation, inactivated glycogen synthase kinase-3β. This is turn, inactivated mitochondrial voltage-dependent anion channel, reduced cytochrome c release from the mitochondria and caspase 9 activation and protected both liver types against mitochondrial damage. These findings indicate that chemical chaperones, especially TUDCA, could protect steatotic and non-steatotic livers against injury and regeneration failure after PH + I/R. © 2010 Macmillan Publishers Limited.This work was supported by the Ministerio de Educación y Ciencia (project grant SAF 2005-00385; project grant manager BFU2009-07410) (Madrid, Spain) and the Ministerio de Sanidad y Consumo (project grant PIO60021) (Madrid, Spain). Centro de Investigaciones Biomédicas Esther Koplowitz, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas is supported by the Instituto de Salud Carlos III (Spain).Peer Reviewe

Expression profiling of chromatin-modifying enzymes and global DNA methylation in CD4+ T cells from patients with chronic HIV infection at different HIV control and progression states

Abstract Background Integration of human immunodeficiency virus type 1 (HIV-1) into the host genome causes global disruption of the chromatin environment. The abundance level of various chromatin-modifying enzymes produces these alterations and affects both the provirus and cellular gene expression. Here, we investigated potential changes in enzyme expression and global DNA methylation in chronically infected individuals with HIV-1 and compared these changes with non-HIV infected individuals. We also evaluated the effect of viral replication and degree of disease progression over these changes. Results Individuals with HIV-1 had a significant surge in the expression of DNA and histone methyltransferases (DNMT3A and DNMT3B, SETDB1, SUV39H1) compared with non-infected individuals, with the exception of PRMT6, which was downregulated. Some histone deacetylases (HDAC2 and HDAC3) were also upregulated in patients with HIV. Among individuals with HIV-1 with various degrees of progression and HIV control, the group of treated patients with undetectable viremia showed greater differences with the other two groups (untreated HIV-1 controllers and non-controllers). These latter two groups exhibited a similar behavior between them. Of interest, the overexpression of genes that associate with viral protein Tat (such as SETDB1 along with DNMT3A and HDAC1, and SIRT-1) was more prevalent in treated patients. We also observed elevated levels of global DNA methylation in individuals with HIV-1 in an inverse correlation with the CD4/CD8 ratio. Conclusions The current study shows an increase in chromatin-modifying enzymes and remodelers and in global DNA methylation in patients with chronic HIV-1 infection, modulated by various levels of viral control and progression

Piscicultura

Conté: Crónica piscatoria - Cría industrial de la trucha - Variedades piscícolas - Piscicultura fluvial y doméstica en China - Les escales per a peixos - Reproducció de la truita - Enemics d'els peixos, La lludria

Pseudoaneurysm of the left ventricle following apical approach TAVI

Symptomatic severe aortic stenosis carries a two year survival of only 50%. However many patients are unsuitable for conventional aortic valve replacement as they are considered too high risk due to significant co-morbidities. Transcatheter Aortic Valve Implantation (TAVI) offers a viable alternative for this high risk patient group, either by the femoral or apical route. This article reports a case of a pseudoaneurysm of the left ventricle following an apical approach TAVI in an elderly lady with severe aortic stenosis. To our knowledge pseduoaneuryms of the left ventricle have been reported infrequently in the literature and has yet to be established as a recognised complication of TAVI

Early outcomes of percutaneous pulmonary valve implantation using the Edwards SAPIEN XT transcatheter heart valve system

BACKGROUND: Patients with congenital or acquired heart defects affecting the pulmonary valve and right ventricular outflow tract (RVOT) commonly require multiple surgical interventions, resulting in significant morbidity. A less invasive alternative is percutaneous pulmonary valve implantation (PPVI). Though studies have previously reported the safety and efficacy of the early generation transcatheter heart valves (THVs), data on more recent devices are severely lacking. METHODS AND RESULTS: We performed a multinational, multicentre, retrospective, observational registry analysis of patients who underwent PPVI using the Edwards SAPIEN XT THV. Of the 46 patients that were enrolled, the majority had tetralogy of Fallot as the underlying diagnosis (58.7%), and stentless xenograft as the most common RVOT anatomy (34.8%). Procedural success rate was high (93.5%), with a low frequency of periprocedural complications and adverse events (6.5% and 10.9%, respectively). At 30days post-procedure, NYHA class had improved significantly (90.6% were at NYHA I or II). The rate of moderate/severe pulmonary regurgitation had decreased from 76.1% at baseline to 5.0% at 30days, and the calculated peak systolic gradient had decreased from 45.2 (SD±21.3) mmHg to 16.4 (SD±8.0) mmHg, with these values remaining low up to 2years. CONCLUSIONS: The data suggest the efficacy and safety of the SAPIEN XT THV in PPVI in common anatomies in patients with conduits, as well as those with native pulmonary valves or transannular patches. Continued data collection is necessary to verify long-term findings

Transmitted drug resistance, selection of resistance mutations and moderate antiretroviral efficacy in HIV-2: Analysis of the HIV-2 Belgium and Luxembourg database

BACKGROUND: Guidelines established for the treatment of HIV-1 infection and genotype interpretation do not apply for HIV-2. Data about antiretroviral (ARV) drug efficacy and resistance mutations is scarce. METHODS: Clinical data about HIV-2 infected patients in Belgium and Luxembourg were collected and the effect of ARV therapy on plasma viral load and CD4 counts were analysed. Viral RNA encoding for protease (PR) and reverse transcriptase (RT) from ARV-naive and treated patients were sequenced. RESULTS: Sixty-five HIV-2 infected patients were included in this cohort. Twenty patients were treated with 25 different ARV combinations in a total of 34 regimens and six months after the start of ARV therapy, only one third achieved viral load suppression. All of these successful regimens bar one contained protease inhibitors (PIs). Mean CD4 gains in the group of viral load suppressors and the group of patients treated with PI-containing regimens were respectively significantly higher than in the group of non-suppressors and the group of PI-sparing regimens. The most frequent mutations selected under therapy (compared to HIV-2 ROD) were V71I, L90M and I89V within PR. Within RT, they were M184V, Q151M, V111I and K65R. All of these mutations, except K65R and M184V, were also found in variable proportions in ARV-naive patients. CONCLUSION: Despite a high rate of ARV treatment failure, better virological and immunological results were achieved with PI-containing regimens. The analysis of polymorphic positions and HIV-2 specific mutations selected during therapy showed for the first time that transmission of drug resistant viruses has occurred in Belgium and Luxembourg. The high heterogeneity in ARV combinations reflects a lack of guidelines for the treatment of HIV-2 infection