Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women: Women's Interagency HIV Study

BACKGROUND: Anemia is common in HIV-infected individuals and may be associated with decreased survival. OBJECTIVE: To ascertain the impact of highly active antiretroviral therapy (HAART) on anemia and the relationship between anemia and overall survival in HIV-infected women. METHODS: A prospective multicenter study of HIV-1 infection in women. Visits occurred every 6 months, including a standardized history, physical examination, and comprehensive laboratory evaluation. The setting was a university-affiliated clinic at 6 sites in the United States. Participants were 2056 HIV-infected women from the Women's Interagency HIV Study (WIHS). The outcome measure was anemia, defined as hemoglobin (Hb) <12 g/dL. Survival analysis was based on overall mortality during the follow-up period. RESULTS: Among HIV-infected women who were not anemic at baseline, 47% became anemic by 3.5 years of follow-up. On multivariate analysis, the use of HAART was associated with resolution of anemia even when used for only 6 months (odds ratio [OR] = 1.45; P < 0.05). In the multivariate model, a CD4 cell count <200 cells/microL (OR = 0.56; P < 0.001); HIV-1 RNA level > or =50,000 copies/mL (OR = 0.65; P < 0.001), and mean corpuscular volume (MCV) value <80 fL (OR = 0.40; P < 0.001) were also associated with an inability to correct anemia. Similarly, use of HAART for 12 months or more was associated with a protective effect against development of anemia (OR = 0.71; P < 0.001). Among HIV-infected women, anemia was independently associated with decreased survival (hazard ratio [HR] = 2.58; P < 0.001). Other factors associated with decreased survival included a CD4 cell count <200 cells/microL (HR = 5.83; P < 0.001), HIV-1 RNA level > or = 50,000 copies/mL (HR = 2.12; P < 0.001), and clinical diagnosis of AIDS (HR = 2.83; P < 0.001). CONCLUSIONS: Anemia is an independent risk factor for decreased survival among HIV-infected women. HAART therapy for as little as 6 months is associated with resolution of anemia.     

Muscle architecture adaptations to knee extensor eccentric training: Rectus femoris vs. vastus lateralis

Introduction: Changes in muscle architecture induced by eccentric knee extensor training remain unclear, as well the adaptive responses of synergistic knee extensor muscles with different geometrical designs. Methods: Ultrasonography images were taken from rectus femoris (RF) and vastus lateralis (VL) of 20 male volunteers before and after a non‐training control period of 4 weeks, and additional evaluations were performed after 4, 8, and 12 weeks of isokinetic eccentric training. Results: RF and VL had significant changes in muscle architecture within the first 4 training weeks, and the adaptive response throughout the intervention was similar. Muscle thickness increased by around 7–10%, fascicle length increased 17–19%, and pennation angle was unchanged. Conclusions: Increased muscle thickness due to eccentric training was related to increased fascicle length and not to pennation angle changes. Although RF and VL have a different fascicular geometry, they had similar morphological adaptations to eccentric training. Muscle Nerve 48 : 498–506, 2013     

Prevalence of Orthohantavirus-Reactive Antibodies in Humans and Peri-Domestic Rodents in Northern Ethiopia

In 2012, Tigray orthohantavirus was discovered in Ethiopia, but its seasonal infection in small mammals, and whether it poses a risk to humans was unknown. The occurrence of small mammals, rodents and shrews, in human inhabitations in northern Ethiopia is affected by season and presence of stone bunds. We sampled small mammals in two seasons from low- and high-density stone bund fields adjacent to houses and community-protected semi-natural habitats in Atsbi and Hagere Selam, where Tigray orthohantavirus was first discovered. We collected blood samples from both small mammals and residents using filter paper. The presence of orthohantavirus-reactive antibodies in blood was then analyzed using immunofluorescence assay (human samples) and enzyme linked immunosorbent assays (small mammal samples) with Puumala orthohantavirus as antigen. Viral RNA was detected by RT-PCR using small mammal blood samples. Total orthohantavirus prevalence (antibodies or virus RNA) in the small mammals was 3.37%. The positive animals were three Stenocephalemys albipes rats (prevalence in this species = 13.04%). The low prevalence made it impossible to determine whether season and stone bunds were associated with orthohantavirus prevalence in the small mammals. In humans, we report the first detection of orthohantavirus-reactive IgG antibodies in Ethiopia (seroprevalence = 5.26%). S. albipes lives in close proximity to humans, likely increasing the risk of zoonotic transmission.     

Differences between measured and resultant joint moments during voluntary and artificially elicited isometric knee extension contractions

OBJECTIVE: Examine two hypotheses: (a) during isometric knee extension contractions the moment measured at the dynamometer is different from the resultant moment in the same plane around the knee joint and (b) during isometric contractions, at the same given resultant moment the knee angle while loading is different from the knee angle while unloading. DESIGN: Comparative study in which the geometrical and the kinetic differences between joint and dynamometer were determined. BACKGROUND: It is usually assumed that the moment measured by the dynamometer is equivalent to the resultant joint moment. The non-rigidity of the dynamometer-leg system can influence the equivalence of these two moments. METHOD: Twenty seven subjects performed isometric maximal knee extension contractions and contractions induced by electrostimulation on a dynamometer. The kinematics of the leg were recorded using 8 cameras (120 Hz). RESULTS: The resultant moment at the knee joint and the moment measured by the dynamometer are different. During a knee extension effort the knee angle changes significantly. At identical resultant knee joint moments the knee angles are different when comparing the loading and the unloading phases. CONCLUSIONS: The differences between the measured and the resultant joint moments might influence the estimation of parameters as: muscle forces, moment-angle relationship and strain and hysteresis of tendons and aponeuroses. RELEVANCE: Torque dynamometers have been often used to estimate muscle forces, to examine neuromuscular processes and to determine the mechanical properties of tendons and aponeuroses.     

Effects of ambient air pollutants on asthma medication use and wheezing among fourth-grade school children from 12 Southern California communities enrolled in The Children's Health Study

To investigate the effects of 12 monthly average air pollution levels on monthly prevalence of respiratory morbidity, the authors examined retrospective questionnaire data on 2034 4th-grade children from 12 Southern California communities that were enrolled in The Children's Health Study. Wheezing during the spring and summer months was associated with community levels of airborne particulate matter with a diameter < or = 10 microm (PM10) (odds ratio (OR) = 2.91; 95% confidence interval (CI) = 1.46-5.80), but was not associated with community levels of ozone, nitrogen dioxide, PM2.5 (diameter < or = 2.5), nitric acid, or formic acid. Logistic regression was performed on data stratified into two seasonal groups, spring/summer and fall/winter. Among asthmatics, the monthly prevalence of asthma medication use was associated with monthly levels of ozone, nitric acid, and acetic acid (OR = 1.80 [95%CI = 1.19-2.70]; OR = 1.80 [95%CI = 1.23-2.65]; OR = 1.57 [95% CI = 1.11-2.21]; respectively). Asthma medication use was more prevalent among children who spent more time outdoors--with consequential exposure to ozone--than among children who spent more time indoors (OR = 3.07 [95%CI = 1.61-5.86]; OR = 1.31 [95%CI = 0.47-2.71]; respectively). The authors concluded that monthly variations in some ambient air pollutants were associated with monthly respiratory morbidity among school children.     

Obesity and the risk of newly diagnosed asthma in school-age children

To determine the relation between obesity and new-onset asthma among school-age children, the authors examined longitudinal data from 3,792 participants in the Children's Health Study (Southern California) who were asthma-free at enrollment. New cases of physician-diagnosed asthma, height, weight, lung function, and risk factors for asthma were assessed annually at five school visits between 1993 and 1998. Incidence rates were calculated, and proportional hazards regression models were fitted to estimate the adjusted relative risks of new-onset asthma associated with percentile of body mass index (weight (kg)/height (m)(2)) and indicators of overweight (>85th body mass index percentile) and obesity (>95th body mass index percentile). The risk of new-onset asthma was higher among children who were overweight (relative risk (RR) = 1.52, 95% confidence interval (CI): 1.14, 2.03) or obese (RR = 1.60, 95% CI: 1.08, 2.36). Boys had an increased risk associated with being overweight (RR = 2.06, 95% 1.33, 3.18) in comparison with girls (RR = 1.25, 95% CI: 0.83, 1.88). The effect of being overweight was greater in nonallergic children (RR = 1.77, 95% CI: 1.26, 2.49) than in allergic children (RR = 1.16, 95% CI: 0.63, 2.15). The authors conclude that being overweight is associated with an increased risk of new-onset asthma in boys and in nonallergic children.     

An ovarian Sertoli-Leydig cell tumour in a 40 year old Ethiopian woman: case report

Sertoli-Leydig cell tumors of the ovary are uncommon ovarian tumors. They belong to the ovarian stromal neoplasm. The most striking mode of presentation of these tumours is virilization due to androgen secretion. But approximately 50% of patients with Sertoli-Leydig cell tumors have no endocrine manifestations and usually complain of abdominal pain or swelling. Occasional tumors have been associated with various estrogen syndromes. A forty year old Ethiopian lady with well differentiated Sertoli-Leydig cell tumor of the left ovary presenting with features of virilization is described with clinicopathological correlation and literature review.