Predictors of HIV Antiretroviral Treatment Failure among Patients Attending a Semi - Urban HIV Clinic– Kenya, 2012: Can Social Support Help?

Background: HIV antiretroviral treatment [ART] failure increases morbidity and mortality. In Kenya, use of treatment supporter, HIV serostatus disclosure, and support groups are believed to reduce the risk of treatment failure by improving adherence. Methods: We conducted a case-control study to identify factors associated with clinical or immunologic indicators of treatment failures. Cases and controls were adult patients attending a semi-urban HIV clinic who initiated ART at least six months prior to the study. Cases were patients who had a] a decline in CD4 count [below baseline or 30% from highest value since ART initiation] or b] unimproved CD4 counts or c] a World Health Organization [WHO] stage III or IV opportunistic infection. Controls did not meet either immunologic or clinical criteria for treatment failure. Information was obtained through face-to-face interviews medical chart reviews. Results: We enrolled 52 cases and 104 controls. Twenty-eight [53%] cases and 71 [70%] controls were women, and median age was 44 years [range: 38-50 years] among cases and 43 years [range: 38-49 years] among controls. Discontinued ART for 2 weeks or more [adjusted odds ratio [AOR] 8.9, 95% confidence interval [CI] 1.4-57.4] and alcohol use [AOR 7.2, 95% CI 1.1-45.5] were found to significantly increase the risk of ART failure. Compared to men who discontinued ART for less than 2 weeks, women who discontinued ART for less than 2 weeks had reduced risk [AOR 0.4, 95% CI 0.2-0.9] while those who discontinued for two weeks or more had a greater risk [AOR 12.97, 95% CI 1.5-111.8] of developing ART failure. Social support factors were not associated with treatment failure. Conclusions: Discontinuing ART and alcohol use were identified to be modifiable factors associated with clinical or immunologic criteria of ART failure. Interventions with proven efficacy at reducing alcohol use and increasing continuous ART should be implemented.Key words: Antiretroviral treatment failure, HIV, AIDS, adherence, alcohol, Keny

ASSESSORIA EM PSICOLOGIA JURÍDICA: ANÁLISE DE DEMANDAS A PARTIR DE UMA EXPERIÊNCIA DE EXTENSÃO UNIVERSITÁRIA

O presente trabalho buscou analisar a demanda de atendimentos realizados através da assessoria da equipe de Psicologia Jurídica do Centro Integrado de Psicologia da Universidade Feevale (CIP)3 ao Núcleo de Práticas Jurídicas (NPJ) da Instituição, que tem como objetivo assessorar os operadores do Direito nos conhecimentos da Psicologia, no sentido de aliviar a ansiedade dos seus clientes, promovendo espaços que viabilizem, sempre que possível, processos de mediação. Buscou-se investigar, a partir das fichas de atendimentos, os tipos de atendimentos que mais foram realizados pela equipe de Psicologia Jurídica durante o período de março/2009 a junho/2011, para, com base nesses dados, mapear a demanda existente e avaliar as possibilidades de atendimento de forma mais condizente com as necessidades de seu público-alvo. Conclui-se, a partir dos dados levantados, que as intervenções da assessoria em Psicologia Jurídica devem se manter voltadas às questões de família, reforçando suas intervenções no sentido de auxiliar estas em sua organização, a fim de contribuir para que esses momentos despertem o potencial transformador que as crises podem gerar nas famílias. Palavras Chave: Psicologia Jurídica. Mediação. Análise de demanda

ASSESSORIA EM PSICOLOGIA JURÍDICA: ANÁLISE DE DEMANDAS A PARTIR DE UMA EXPERIÊNCIA DE EXTENSÃO UNIVERSITÁRIA

O presente trabalho buscou analisar a demanda de atendimentos realizados através da assessoria da equipe de Psicologia Jurídica do Centro Integrado de Psicologia da Universidade Feevale (CIP)3 ao Núcleo de Práticas Jurídicas (NPJ) da Instituição, que tem como objetivo assessorar os operadores do Direito nos conhecimentos da Psicologia, no sentido de aliviar a ansiedade dos seus clientes, promovendo espaços que viabilizem, sempre que possível, processos de mediação. Buscou-se investigar, a partir das fichas de atendimentos, os tipos de atendimentos que mais foram realizados pela equipe de Psicologia Jurídica durante o período de março/2009 a junho/2011, para, com base nesses dados, mapear a demanda existente e avaliar as possibilidades de atendimento de forma mais condizente com as necessidades de seu público-alvo. Conclui-se, a partir dos dados levantados, que as intervenções da assessoria em Psicologia Jurídica devem se manter voltadas às questões de família, reforçando suas intervenções no sentido de auxiliar estas em sua organização, a fim de contribuir para que esses momentos despertem o potencial transformador que as crises podem gerar nas famílias.Palavras Chave: Psicologia Jurídica. Mediação. Análise de demanda

Elevated osteoprotegerin is associated with abnormal ankle brachial indices in patients infected with HIV: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Patients infected with HIV have an increased risk for accelerated atherosclerosis. Elevated levels of osteoprotegerin, an inflammatory cytokine receptor, have been associated with a high incidence of cardiovascular disease (including peripheral arterial disease, or PAD), acute coronary syndrome, and cardiovascular mortality. The objective of this study was to determine whether PAD is prevalent in an HIV-infected population, and to identify an association with HIV-specific and traditional cardiovascular risk factors, as well as levels of osteoprotegerin.</p> <p>Methods</p> <p>One hundred and two patients infected with HIV were recruited in a cross-sectional study. To identify the prevalence of PAD, ankle-brachial indices (ABIs) were measured. Four standard ABI categories were utilized: ≤ 0.90 (definite PAD); 0.91-0.99 (borderline); 1.00-1.30 (normal); and >1.30 (high). Medical history and laboratory measurements were obtained to determine possible risk factors associated with PAD in HIV-infected patients.</p> <p>Results</p> <p>The prevalence of PAD (ABI ≤ 0.90) in a young HIV-infected population (mean age: 48 years) was 11%. Traditional cardiovascular risk factors, including advanced age and previous cardiovascular history, as well as elevated C-reactive protein levels, were associated with PAD. Compared with patients with normal ABIs, patients with high ABIs had significantly elevated levels of osteoprotegerin [1428.9 (713.1) pg/ml vs. 3088.6 (3565.9) pg/ml, respectively, p = 0.03].</p> <p>Conclusions</p> <p>There is a high prevalence of PAD in young HIV-infected patients. A number of traditional cardiovascular risk factors and increased osteoprotegerin concentrations are associated with abnormal ABIs. Thus, early screening and aggressive medical management for PAD may be warranted in HIV-infected patients.</p

Volatiles in the Desert: Subtle Remote-sensing Signatures of the Dakhleh Oasis Catastrophic Event, Western Desert, Egypt

Over the past decade members of the Dakhleh Oasis Project have studied enigmatic signatures in the Pleistocene geologic record of portions of the Dakhleh oasis and palaeo-oasis in Egypt's Western Desert [1,2]. In particular, Si-Ca-Al rich glass melt (Dakhleh Glass, Fig. 1) points to a catastrophic event between c.100,000-200,000 years ago [3] in this well-studied African savannah and freshwater lake Middle Stone Age environment [4,5]

Kynurenine pathway inhibition reduces central nervous system inflammation in a model of human African trypanosomiasis

Human African trypanosomiasis, or sleeping sickness, is caused by the protozoan parasites &lt;i&gt;Trypanosoma brucei rhodesiense&lt;/i&gt; or &lt;i&gt;Trypanosoma brucei gambiense&lt;/i&gt;, and is a major cause of systemic and neurological disability throughout sub-Saharan Africa. Following early-stage disease, the trypanosomes cross the blood-brain barrier to invade the central nervous system leading to the encephalitic, or late stage, infection. Treatment of human African trypanosomiasis currently relies on a limited number of highly toxic drugs, but untreated, is invariably fatal. Melarsoprol, a trivalent arsenical, is the only drug that can be used to cure both forms of the infection once the central nervous system has become involved, but unfortunately, this drug induces an extremely severe post-treatment reactive encephalopathy (PTRE) in up to 10% of treated patients, half of whom die from this complication. Since it is unlikely that any new and less toxic drug will be developed for treatment of human African trypanosomiasis in the near future, increasing attention is now being focussed on the potential use of existing compounds, either alone or in combination chemotherapy, for improved efficacy and safety. The kynurenine pathway is the major pathway in the metabolism of tryptophan. A number of the catabolites produced along this pathway show neurotoxic or neuroprotective activities, and their role in the generation of central nervous system inflammation is well documented. In the current study, Ro-61-8048, a high affinity kynurenine-3-monooxygenase inhibitor, was used to determine the effect of manipulating the kynurenine pathway in a highly reproducible mouse model of human African trypanosomiasis. It was found that Ro-61-8048 treatment had no significant effect (P = 0.4445) on the severity of the neuroinflammatory pathology in mice during the early central nervous system stage of the disease when only a low level of inflammation was present. However, a significant (P = 0.0284) reduction in the severity of the neuroinflammatory response was detected when the inhibitor was administered in animals exhibiting the more severe, late central nervous system stage, of the infection. &lt;i&gt;In vitro&lt;/i&gt; assays showed that Ro-61-8048 had no direct effect on trypanosome proliferation suggesting that the anti-inflammatory action is due to a direct effect of the inhibitor on the host cells and not a secondary response to parasite destruction. These findings demonstrate that kynurenine pathway catabolites are involved in the generation of the more severe inflammatory reaction associated with the late central nervous system stages of the disease and suggest that Ro-61-8048 or a similar drug may prove to be beneficial in preventing or ameliorating the PTRE when administered as an adjunct to conventional trypanocidal chemotherap

Large-scale synchrony of gap dynamics and the distribution of understory tree species in maple-beech forests

Large-scale synchronous variations in community dynamics are well documented for a vast array of organisms, but are considerably less understood for forest trees. Because of temporal variations in canopy gap dynamics, forest communities—even old-growth ones—are never at equilibrium at the stand scale. This paucity of equilibrium may also be true at the regional scale. Our objectives were to determine (1) if nonequilibrium dynamics caused by temporal variations in the formation of canopy gaps are regionally synchronized, and (2) if spatiotemporal variations in canopy gap formation aVect the relative abundance of tree species in the understory. We examined these questions by analyzing variations in the suppression and release history of Acer saccharum Marsh. and Fagus grandifolia Ehrh. from 481 growth series of understory saplings taken from 34 mature stands. We observed that (1) the proportion of stems in release as a function of time exhibited a U-shaped pattern over the last 35 years, with the lowest levels occurring during 1975–1985, and that (2) the response to this in terms of species composition was that A. saccharum became more abundant at sites that had the highest proportion of stems in release during 1975–1985. We concluded that the understory dynamics, typically thought of as a stand-scale process, may be regionally synchronized

Microsatellite markers for the Cabreúva tree, Myroxylon peruiferum (Fabaceae), an endangered medicinal species from the Brazilian Atlantic Forest

The Cabreúva tree, Myroxylon peruiferum, is an endangered tropical species from Brazil used in forest restoration projects. It is known for its medicinal properties. Eleven microsatellite markers were developed for this species, from a microsatellite-enriched library. Nine of these markers, characterized in 30 individuals from a semideciduous forest remnant population in southeast Brazil, were polymorphic, with allele numbers ranging from 2 to 8 per locus; expected and observed heterozygosities ranged from 0.103 to 0.757 and 0.107 to 0.704, respectively. One locus (Mpe-C04) showed significant deviation from Hardy-Weinberg equilibrium, probably due to null alleles. Two other loci (Mpe-E09 and Mpe-H07) were monomorphic in this population. These microsatellite loci should be useful for future population genetic studies of this species. The Cabreúva tree, Myroxylon peruiferum, is an endangered tropical species from Brazil used in forest restoration projects. It is known for its medicinal properties. Eleven microsatellite markers were developed for this species, from a microsatellite-enriched library. Nine of these markers, characterized in 30 individuals from a semideciduous forest remnant population in southeast Brazil, were polymorphic, with allele numbers ranging from 2 to 8 per locus; expected and observed heterozygosities ranged from 0.103 to 0.757 and 0.107 to 0.704, respectively. One locus (Mpe-C04) showed significant deviation from Hardy-Weinberg equilibrium, probably due to null alleles. Two other loci (Mpe-E09 and Mpe-H07) were monomorphic in this population. These microsatellite loci should be useful for future population genetic studies of this species13369206925CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPsem informaçã

Microsatellite Markers For The Cabreúva Tree, Myroxylon Peruiferum (fabaceae), An Endangered Medicinal Species From The Brazilian Atlantic Forest.

The Cabreúva tree, Myroxylon peruiferum, is an endangered tropical species from Brazil used in forest restoration projects. It is known for its medicinal properties. Eleven microsatellite markers were developed for this species, from a microsatellite-enriched library. Nine of these markers, characterized in 30 individuals from a semideciduous forest remnant population in southeast Brazil, were polymorphic, with allele numbers ranging from 2 to 8 per locus; expected and observed heterozygosities ranged from 0.103 to 0.757 and 0.107 to 0.704, respectively. One locus (Mpe-C04) showed significant deviation from Hardy-Weinberg equilibrium, probably due to null alleles. Two other loci (Mpe-E09 and Mpe-H07) were monomorphic in this population. These microsatellite loci should be useful for future population genetic studies of this species.136920-