Lipodystrophy syndrome in HIV-infected children on HAART

Lipodystrophy syndrome (LD) is common in HIV-infected children, particularly those taking didanosine, stavudine or zidovudine. Lipo-atrophy in particular causes major stigmatisation and interferes with adherence. In addition, LD may have significant long-term health consequences, particularly  cardiovascular. Since the stigmatising fat distribution changes of LD are largely permanent, the focus of management remains on early detection and arresting progression. Practical guidelines for surveillance and avoidance of LD in routine clinical practice are presented. The diagnosis of LD is described and therapeutic options are reviewed. The most important therapeutic intervention is to switch the most likely offending antiretroviral to a non-LD-inducing agent as soon as LD is recognised. Typically, when lipo-atrophy or lipohypertrophy is diagnosed the thymidine nucleoside reverse transcriptase inhibitor (NRTI) is switched to a non-thymidine agent such as abacavir (or tenofovir in adults).Where dyslipidaemia is predominant, a dietician review is helpful, and the clinician may consider switching to a protease inhibitor-sparing regimen or to atazanavir

Cavitation of the Ghon focus in an HIV-infected infant who acquired tuberculosis after the initiation of HAART

Tuberculosis immune reconstitution inflammatory syndrome (IRIS) may present as new or worsening cavitation. We present an HIV-infected infant in whom TB infection and subsequent cavitation of the Ghon focus appeared to coincide with immune reconstitution due to highly active antiretroviral therapy (HAART). TB-IRIS in response to infection that occurs after starting HAART has not previously been described

Algebraic treatment of PT\mathcal{PT}-symmetric coupled oscillators

The purpose of this paper is the discussion of a pair of coupled linear oscillators that has recently been proposed as a model of a system of two optical resonators. By means of an algebraic approach we show that the frequencies of the classical and quantum-mechanical interpretations of the optical phenomenon are exactly the same. Consequently, if the classical frequencies are real, then the quantum-mechanical eigenvalues are also real

Primary percutaneous coronary intervention for acute myocardial infarction in a patient with dextrocardia

Dextrocardia is a rare cardiac anomaly in which the heart is located in the right hemithorax. This developmental irregularity can occur in isolation as situs solitus, or in association with situs inversus or situs ambiguous. Although there are reports of coronary angiography in patients with dextrocardia, there are very few reported cases of mechanical intervention. We report a patient with dextrocardia and situs inversus who presented with an ST segment elevation myocardial infarction and was successfully treated with primary percutaneous coronary intervention

Submillimeter satellite radiometer first semiannual engineering progress report

Development of 560 GHz fourth harmonic mixer and 140 GHz third harmonic generator for use in radiomete

First Keck Nulling Observations of a Young Stellar Object: Probing the Circumstellar Environment of the Herbig Ae star MWC 325

We present the first N-band nulling plus K- and L-band V2 observations of a young stellar object, MWC325, taken with the 85 m baseline Keck Interferometer. The Keck nuller was designed for the study of faint dust signatures associated with debris disks, but it also has a unique capability for studying the temperature and density distribution of denser disks found around young stellar objects. Interferometric observations of MWC 325 at K, L and N encompass a factor of five in spectral range and thus, especially when spectrally dispersed within each band, enable characterization of the structure of the inner disk regions where planets form. Fitting our observations with geometric models such as a uniform disk or a Gaussian disk show that the apparent size increases monotonically with wavelength in the 2-12 um wavelength region, confirming the widely held assumption based on radiative transfer models, now with spatially resolved measurements over broad wavelength range, that disks are extended with a temperature gradient. The effective size is a factor of about 1.3 and 2 larger in the L-band and N-band, respectively, compared to that in the K-band. The existing interferometric measurements and the spectral energy distribution can be reproduced by a flat disk or a weakly-shadowed nearly flat-disk model, with only slight flaring in the outer regions of the disk, consisting of representative "sub-micron" (0.1 um) and "micron" (2 um) grains of a 50:50 ratio of silicate and graphite. This is marked contrast with the disks previously found in other Herbig Ae/Be stars suggesting a wide variety in the disk properties among Herbig Ae/Be stars.Comment: Accepted for publication in the Ap