Neutralizing antibodies as a potential secondary protective mechanism during chronic SHIV infection in CD8+ T-cell-depleted macaques

OBJECTIVE: To directly examine the role of CD8+ T cells in controlling viremia and disease during chronic, low-level primate immunodeficiency virus infection in DNA prime/protein boost-vaccinated macaques. BACKGROUND: A cohort of macaques, vaccinated with either a DNA prime/HIV-1 gp160 boost regimen or with gp160 alone was previously protected partially from sequential challenges with non-pathogenic and pathogenic strains of chimeric simian/human immunodeficiency virus (SHIV). In this study, the effect of temporary ablation of CD8+ T cells in these animals was examined. METHODS: Animals were treated with an anti-CD8 antibody and CD8+ T-cell levels in peripheral blood, plasma viral loads, peripheral blood mononuclear cell-associated virus levels, neutralizing antibody (nAb) titers and simian immunodeficiency virus Gag-specific CD8+ T-cell numbers were followed. RESULTS: Plasma viremia rose sharply in direct synchrony with a rapid but transient drop in CD8+ T cells. However, although levels of cell-associated virus also rose concomitantly, peak levels were much lower than those in virus-challenged, naive animals. In addition, despite a rise of pathogenic SHIV89.6P RNA levels in three animals, CD4+ T-cell counts remained unchanged. In each of these animals, neutralizing antibody titers against the pathogenic SHIV89.6P strain were high. CONCLUSIONS: The results indicate that CD8+ T cells play a key role in suppressing viremia in a chronically infected host. In addition, the results suggest that in the absence of CD8+ T cells, nAb may act as an effective second line of defense by limiting both the spread of infectious virus to new target cells and CD4+ T-cell loss.     

Appropriate use of antibiotics for respiratory infections: review of recent statements and position papers

Respiratory infections are among the most common reasons for prescribing antibiotics. The excessive use of antibiotics in ambulatory practice has contributed to the emergence and spread of antibiotic resistance. The appropriate use of antimicrobial agents for respiratory infections could potentially reduce the emergence of antibiotic resistance. This article reviews recent guidelines and position papers on the appropriate antibiotic treatment for respiratory infections. There is a wide consensus that antibiotics are not appropriate for the treatment of most cases of acute bronchitis, pharyngitis, and rhinosinusitis. The recently published community-acquired pneumonia guidelines emphasized the importance of selecting antibiotic regimens active against both typical and atypical pathogens. However, there is disagreement regarding the routine use of the new quinolones.     

Reversal of primary and pseudo-primary T wave abnormalities by ventricular pacing. A novel manifestation of cardiac memory

Aims  

“Cardiac memory” refers to abnormal T waves (TW) appearing after transient periods of altered ventricular depolarization. The aim of the study was to test the hypothesis that in the presence of abnormal TW, short periods of tailored ventricular pacing (VP) can be followed by normalization of ventricular repolarization.     

Pancreaticobiliary reflux in patients with a normal pancreaticobiliary junction: Pathologic implications

Knowledge on pancreaticobiliary reflux in normal pancreaticobiliary junction and its pathologic implications has experienced tremendous progress during the last few years.This editorial reviews the current knowledge on this condition and its pathological implications on gallbladder diseases.The following aspects were def ined appropriate for discussion:(1) Evidence of carcinogenesis associated with pancreaticobiliary reflux;(2) Evidence of pancreaticobiliary reflux in normal pancreaticobiliary junction;and(...     

Sleep disorders among undergraduate students in Southern Brazil

Purpose

Sleep disorders are very common in the young, being a result of the typical lifestyle lived by young people or a sleep disease that requires assistance and treatment. Furthermore, according to previous findings, sleep alterations can favor the development of depressive mood disorder. This survey aimed to assess the prevalence and characteristics of sleep disorders in a young population sample and their association with depressive symptoms.

Methods

With a cross-sectional study design, self-administered questionnaires were applied to 1,180 undergraduate students. The Mini-Sleep Questionnaire (MSQ) and the Beck Depression Inventory were used to evaluate sleep disturbances and depressive symptoms, respectively. Bivariate and multivariate analyses were conducted, with the main findings being the presence of disrupted sleep (MSQ?>?24), with an alpha error of 5%. The median point of the MSQ was 26 (P25?CP75, 21?C32 points).

Results

Sleep alterations were found in 59.6%. The prevalence of depression was 9.3% (n?=?110), mild depression being identified in 5.9% (n?=?62), moderate in 3.4% (n?=?40), and severe in 0.7% (n?=?8) of the students. In logistic regression, female gender (OR, 1.48; CI 95%, 1.09?C2.01; P?=?0.012) and being depressed (OR, 4.42; CI 95%, 2.30?C8.50; P?<?0.001) were independent factors for disrupted sleep.

Conclusions

Sleep alterations are prevalent complaints among young people, being present in nearly 60% of the students. Female gender and being depressed are independent factors for having some form of sleep disorder.     

Effects of different tidal volumes in pulmonary and extrapulmonary lung injury with or without intraabdominal hypertension

Purpose

We hypothesized that: (1) intraabdominal hypertension increases pulmonary inflammatory and fibrogenic responses in acute lung injury (ALI); (2) in the presence of intraabdominal hypertension, higher tidal volume reduces lung damage in extrapulmonary ALI, but not in pulmonary ALI.

Methods

Wistar rats were randomly allocated to receive Escherichia coli lipopolysaccharide intratracheally (pulmonary ALI) or intraperitoneally (extrapulmonary ALI). After 24?h, animals were randomized into subgroups without or with intraabdominal hypertension (15?mmHg) and ventilated with positive end expiratory pressure?=?5?cmH₂O and tidal volume of 6 or 10?ml/kg during 1?h. Lung and chest wall mechanics, arterial blood gases, lung and distal organ histology, and interleukin (IL)-1??, IL-6, caspase-3 and type III procollagen (PCIII) mRNA expressions in lung tissue were analyzed.

Results

With intraabdominal hypertension, (1) chest-wall static elastance increased, and PCIII, IL-1??, IL-6, and caspase-3 expressions were more pronounced than in animals with normal intraabdominal pressure in both ALI groups; (2) in extrapulmonary ALI, higher tidal volume was associated with decreased atelectasis, and lower IL-6 and caspase-3 expressions; (3) in pulmonary ALI, higher tidal volume led to higher IL-6 expression; and (4) in pulmonary ALI, liver, kidney, and villi cell apoptosis was increased, but not affected by tidal volume.

Conclusions

Intraabdominal hypertension increased inflammation and fibrogenesis in the lung independent of ALI etiology. In extrapulmonary ALI associated with intraabdominal hypertension, higher tidal volume improved lung morphometry with lower inflammation in lung tissue. Conversely, in pulmonary ALI associated with intraabdominal hypertension, higher tidal volume increased IL-6 expression.     

Prevalence and burden of headaches as assessed by the health family program

Background.— Unified health systems often have Family Health Programs (FHPs) as a core component of their preventive and early curative strategies. In Brazil, the FHP is established to proactively identify diseases such as diabetes and hypertension. Objective.— To use the FHP in order to assess the prevalence of primary headaches, as per the Second Edition of the International Classification of Headache Disorders in a Brazilian city covered by the program, and to document the burden of migraine and tension‐type headache (TTH) in this population. Methods.— FHP agents were trained on how to apply questionnaires that screened for the occurrence of headaches in the past year. Screening method had been previously validated. Respondents that screened positively were interviewed by a headache specialist, and all their headache types were classified. Additionally, disability (Migraine Disability Assessment Scale and Headache Impact Test) and health‐related quality of life were assessed. Results.— The 1‐year prevalence of migraine was 18.2% [95% confidence interval = 13.7; 23.5]. TTH occurred in 22.9% [18.0%; 28.6%]. Other primary headaches occurred in 10.8% of the participants. Idiopathic stabbing headache was significantly more common in individuals with migraine relative to those without migraine (44.7% vs 10.3%, P < .001). Contrasting with TTH, migraineurs had a mean of 3.1 headache types vs 1.9 in TTH (P < .001). Secondary headaches occurred in 21.7% of the participants over a 1‐year period [16.9%; 27.3%]. Most cases were headaches attributed to infection (mostly respiratory). The impact of migraine was bimodal. Most sufferers had little impact, but a sizable minority was severely impaired. Conclusions.— The FHP can be effectively used to bring individuals with headache to the attention of providers. Future investigations should assess whether this increased attention translates into improved outcomes. [Correction added after online publication 21‐Feb‐2012: The original publication contained an incorrect abstract. The above content replaces the abstract found in the originally published article.] (Headache 2012;52:483‐490)     

Photodynamic inactivation of Streptococcus mutans by curcumin in combination with EDTA

ObjectiveThis study aimed to test the efficacy of photodynamic inactivation (PDI) mediated by curcumin with EDTA against Streptococcus mutans in planktonic suspension using blue LED light.MethodsAntibacterial activity of curcumin and EDTA was evaluated by determination of their minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). The fractional inhibitory concentration index (FICI) was used to estimate the synergistic effect of various combination ratios of curcumin and EDTA against S. mutans. Cultures of S. mutans (18 h, 37 °C, 5% C0₂) were prepared to test the effect of curcumin-mediated PDI (50 μM and 500 μM) with or without 0.4% EDTA and 40 s of light-activation with blue light. EDTA and each concentration of curcumin were also tested individually. Chlorhexidine (0.2%), was used as positive control. Planktonic suspensions were also analyzed by viable colony counts (VCC), confocal laser scanning microscopy (CLSM), transmission electron microscopy (TEM), and polymerase chain reaction (PCR).ResultsThe MIC values of curcumin and EDTA were 5 mM and 0.125% respectively. FICI showed a synergistic interaction between curcumin and EDTA. All the combinations with curcumin and blue LED light resulted in a complete inactivation of the S. mutans and CLSM confirms these results, TEM showed morphological changes produced by the PDI. No damage on DNA structure was detected by PCR.SignificanceCurcumin-mediated PDI with EDTA using a blue light, shows a strong inhibitory effect against S. mutans in planktonic culture. Because of the unspecific target mechanism, it could be a promising technique for disinfection of dental tissues.     

Ileocolic intussusception due to a large B cell lymphoma in a patient with AIDS

Adult intussusception is rare. Here, we describe a case of an AIDS adult patient who developed an ileocolic intussusception secondary to a large B cell lymphoma of the cecum. Surgical findings included the ileon free of the tumor and invaginated within the cecum with infiltrating neoplasm. Surgical treatment included the resection of the right hemicolon because of the tumor, located in the cecum, causing intussusception. The English and Spanish literature is reviewed.