The impact of human allelic variation on HIV-1 disease

Human allelic variants influence the susceptibility to HIV-1 infection and/or the subsequent rates of disease progression towards AIDS that average ten years, although they vary greatly among infected subjects. In this respect, studies involving multiply exposed persons who remain uninfected, long-term nonprogressors (who remain asymptomatic for fifteen years or more) or, in contrast, rapid progressors (who develop AIDS within two to three years post-infection) as well as seroincident cohorts of patients with defined seroconversion dates have contributed to our comprehension of the effects of different natural human polymorphisms on HIV-1 disease. The current article aims at providing an up-to-date review on these polymorphisms that may be broadly classified into three general categories: (1) those that control viral entry into susceptible cells (namely, chemokine and chemokine receptor polymorphisms), (2) mutational variants of genes involved in immune regulation, such as interleukin-10 (IL-10), interleukin-4 (IL-4), tumor necrosis factor-alpha (TNF-alpha), and mannose-binding lectin (MBL), and (3) polymorphisms in genes involved in the adaptive immune recognition by T cells, [human leukocyte antigen (HLA) type]. Particular emphasis has been placed on the state-of-the-art biotechnological methodologies, such as "spectral genotyping" that utilizes molecular beacons in conjunction with polymerase chain reaction in real-time (real-time-PCR), which were developed to assist with the characterization of some of these determinants. Elucidating the functional role of these factors via the application of such biotechnological assays is expected to further enhance our understanding of the pathogenesis of HIV-1 infection, and, eventually, to enrich our therapeutic arsenal with novel antiviral agents or strategic approaches.     

Nasal inflammation and chronic ear disease in Australian Aboriginal children

Objective : Chronic middle ear disease is common in Aboriginal children, and may be linked to nasal inflammation and Eustachian tube dysfunction. The pattern of nasal inflammation is unknown. The study reported here was performed to define the role of allergy and infection in causing nasal inflammation in Aboriginal children with chronic middle ear disease.
Methodology : Thirty-one Aboriginal children aged between 3 and 7 years underwent clinical assessment, audiometry and allergy skin tests. Nasal swabs for bacterial culture and cytology were performed during the winter and again in spring to identify any seasonal variation. A randomized trial of nasal beclomethasone for 8 weeks was conducted in children with abnormal tympanometry to identify the effect of therapy upon nasal cytology.
Results : Twenty-six of the 31 children had abnormal tympanograms. Average hearing levels were reduced in nine children. Pathogenic organisms were isolated from most children: Streptococcus pneumoniae (82%), Haemophilus influenzae (79%), Moraxella catarrhalis (39%) and Staphylococcus aureus (29%). Eight of the 31 children (26%) were atopic. Nasal cytology disclosed a marked neutrophil infiltrate (80% of cells) during the winter, which fell significantly in spring to 52% of cells. Only two subjects had nasal eosinophilia of >10%. There was no effect of beclomethasone on nasal cytology.
Conclusions : Chronic ear disease in Aboriginal children is associated with nasal inflammation, neutrophil infiltration and the presence of bacteria. These features suggest respiratory infection as the main cause of chronic nasal inflammation in Aboriginal children with middle ear disease. There is a seasonal variation in the severity of the nasal infiltrate, consistent with increased infections during winter. Despite a high prevalence of atopy, allergic nasal disease was uncommon.     

Viral correlates of HIV-1 disease

The transmission of HIV and the progression of HIV disease are influenced not only by a large number of human host factors, but also by certain correlates of the ever fluctuating virus quasispecies. The present review article aims at providing the current state of knowledge as well as an in-depth critical discussion of recent developments on the potential effects of HIV subtype, phenotype and attenuation on HIV disease. Despite the extensive research, several questions regarding the precise role that each of these correlates plays in human AIDS pathogenesis remain unanswered. Unraveling these roles is expected to aid the continued quest for truly effective antiretroviral drug regimens and preventive vaccines.     

Respiratory viral infection in lower airways of asymptomatic children

Aim: The aim of this study was to determine if asthmatic children have viruses more commonly detected in lower airways during asymptomatic periods than normal children. Methods: Fifty‐five asymptomatic children attending elective surgical procedures (14 with stable asthma, 41 normal controls) underwent non‐bronchoscopic bronchoalveolar lavage. Differential cell count and PCR for 13 common viruses were performed. Results: Nineteen (35%) children were positive for at least one virus, with adenovirus being most common. No differences in the proportion of viruses detected were seen between asthmatic and normal ‘control’ children. Viruses other than adenovirus were associated with higher neutrophil counts, suggesting that they caused an inflammatory response in both asthmatics and controls (median BAL neutrophil count, 6.9% for virus detected vs. 1.5% for virus not detected, p = 0.03). Conclusions: Over one‐third of asymptomatic children have a detectable virus (most commonly adenovirus) in the lower airway; however, this was not more common in asthmatics. Viruses other than adenovirus were associated with elevated neutrophils suggesting that viral infection can be present during relatively asymptomatic periods in asthmatic children.     

垂全催乳素瘤的诊断和治疗指南

3.男性:高催乳素血症通常导致阳痿、不孕和性功能低下.男性患者通常为大腺瘤,有神经系统症状.其原因可能是对症状认识的延误或者肿瘤生物学行为的差异.     

Kooperationsverträge zwischen Krankenhäusern und Vertragsärzten – Schnittstellenoptimierung oder Zuweisungsprovision?

Abstrakt  1. Eine Vereinbarung zwischen einem Krankenhaustr?ger und niedergelassenen ?rzten als potentiellen Zuweisern, die diesen ein Entgelt für Leistungen verspricht, die sie ohnehin im Rahmen ihrer (vertrags?rztlichen) Versorgung erbringen würden, ist rechts- und wettbewerbswidrig. 2. Eine in der Sache unzutreffende Bezeichnung dieser Zusammenarbeit als “sektorübergreifend” oder “pr?-/post” ?ndert an dieser Bewertung nichts, sondern verst?rkt eher den Verschleierungscharakter derartiger Vertr?ge. 3. Derartige Vertr?ge leisten in verantwortungsloser Weise sachwidrigen Erw?gungen bei der Wahl des geeigneten Arztes oder Krankenhauses Vorschub. (Leits?tze des Bearbeiters)     

Wettbewerbsrechtliche Zulässigkeit von Werbegaben an Ärzte im Wege einer nicht produktbezogenen Imagewerbungskampagne

Abstrakt  1. Das besondere Vertrauensverh?ltnis zwischen Arzt und Patient gebietet bei der Verschreibung von Medikamenten die ausschlie?liche Orientierung des Arztes an den Interessen des Patienten, die bereits durch den Verdacht der unsachlichen Beeinflussung seitens eines Herstellers von Medikamenten gef?hrdet w?re. 2. Sachzuwendungen von Pharmaunternehmen an ?rzte, die nicht mehr als geringwertig eingestuft werden k?nnen, stellen – auch wenn sie im Rahmen einer nicht produktbezogenen Imagewerbekampagne gew?hrt werden – sowohl einen sonstigen unangemessenen unsachlichen Einfluss i.S. von § 4 Nr. 1 UWG als auch einen Versto? gegen die “anst?ndigen Gepflogenheiten in Gewerbe und Handel” i.S. von § 3 UWG i.V. mit Art. 5 UGP-Richtlinie dar. 3. Das Anbringen von Werbelogos auf Praxiseinrichtungsgegenst?nden, die ?rzten zu erheblich vergünstigten Preisen angeboten werden, stellt keine Rechtfertigung für die in der Subventionierung der Gegenst?nde zu sehende unlautere Sachzuwendung dar. 4. Das Angebot eines Pharmaunternehmens an einen Arzt, kostenfreie Beratung durch eine Unternehmensberatung in Anspruch zu nehmen, stellt – jedenfalls wenn die Beratung sich nicht auf pharmakologische Fragestellungen bezieht, sondern auf solche der Organisation und des Praxismanagements – eine unlautere Zuwendung dar. Ein Ausschluss vom Zuwendungsverbot analog § 7 I Nr. 4 HWG scheidet daher aus. 5. Das Erfordernis einer “erheblichen Zahl von Unternehmen” i.S. von § 8 III Nr. 2 UWG bedeutet nicht, dass die dem klagenden Wettbewerbsverband angeh?renden Unternehmen einen exakten Querschnitt der sonstigen Marktteilnehmer der betreffenden Branche darstellen müssen. Etwa 10% der Unternehmen, die etwa 70% der Ums?tze einer Branche t?tigen, stellen.