Analysis of serious non‐AIDS events among HIV‐infected adults at Latin American sites

Objective

Acquired immune deficiency appears to be associated with serious non‐AIDS (SNA)‐defining conditions such as cardiovascular disease, liver and renal insufficiency and non‐AIDS‐related malignancies. We analysed the incidence of, and factors associated with, several SNA events in the LATINA retrospective cohort.

Materials and methods

Cases of SNA events were recorded among cohort patients. Three controls were selected for each case from cohort members at risk. Conditional logistic models were fitted to estimate the effect of traditional risk factors as well as HIV‐associated factors on non‐AIDS‐defining conditions.

Results

Among 6007 patients in follow‐up, 130 had an SNA event (0.86 events/100 person‐years of follow‐up) and were defined as cases (40 with cardiovascular events, 54 with serious liver failure, 35 with non‐AIDS‐defining malignancies and two with renal insufficiency). Risk factors such as diabetes, hepatitis B and C virus coinfections and alcohol abuse showed an association with events, as expected. The last recorded CD4 T‐cell count prior to index date (P=0.0056, with an average difference of more than 100 cells/μL) and area under the CD4 cell curve in the year previous to index date (P=0.0081) were significantly lower in cases than in controls. CD4 cell count at index date was significantly associated with the outcome after adjusting for risk factors.

Conclusions

The incidence and type of SNA events found in this Latin American cohort are similar to those reported in other regions. We found a significant association between immune deficiency and the risk of SNA events, even in patients under antiretroviral treatment.     

Antioxidant and membranoprotector treatment of chronic pyelonephritis

The results of investigation of the clinical efficiency of using the antioxidant drug cytoflavin in a complex therapy of patients with chronic pyelonephritis prior to development of azotemia are presented. It is shown that cytoflavin in combination with basic therapy reduces the intensity of lipid peroxidation processes (as monitored using diene conjugates, malonic dialdehyde, and Schiffbase metabolites) with retention of the antioxidant status. The proposed treatment normalizes the ratio of blood plasma phospholipid fractions and erythrocytes membranes.     

Erwerb der Zusatzbezeichnung Notfallmedizin nach Übergangsbestimmungen

Ohne Zusammenfassung     

Isovolemic relaxation of the intact left ventricle and the energy efficiency of the cardiac cycle

To compare left ventricle (LV) function during isometric relaxation (IR) and energy parameters of LV contraction, 22 patients with a rejected diagnosis of coronary heart disease (CHD) were examined. All the test subjects underwent coronary angiography, direct left ventriculography by means of a special catheter equipped at the end with a pressure microtransducer, and intravenous biventriculography with injection of a radiocontrast substance to the right atrium coupled with continuous monitoring of the pressure in the LV. All the ventriculograms were subjected to multipicture analysis using computer. It has been established that the energy effectiveness of the cycle of LV contraction is in a reverse agreement with the volume of ventricle filling during IR. Therefore, the assessment of LV function during IR (that can be performed by noninvasive technique either) allows one to form a judgement about the energy of pump heart function in a real clinical situation.     

Cystatin C: a biological role and impaired secretion in viral hepatitis c and hepatic cirrhosis

Cystatin C is a non-glycated cationic protein with a molecular weight of 13.3 kD, which belongs to the superfamily of cystatins; its basic function is to inhibit and regulate the activity of cysteine proteinase. In apparently healthy individuals, the extracellular concentration of cystatin C is shown to be substantially higher in serum than in urine and bile. The increased serum concentration of cystatin C has been found in the development of chronic viral hepatitis C, and hepatic cirrhosis in particular, which reflects the development of an inflammatory process and, evidently, the higher secretion of cystatin C by stimulated macrophages.     

Three-dimensional structure of a halotolerant algal carbonic anhydrase predicts halotolerance of a mammalian homolog

Protein molecular adaptation to drastically shifting salinities was studied in dCA II, an alpha-type carbonic anhydrase (EC 4.2.1.1) from the exceptionally salt-tolerant unicellular green alga Dunaliella salina. The salt-inducible, extracellular dCA II is highly salt-tolerant and thus differs from its mesophilic homologs. The crystal structure of dCA II, determined at 1.86-A resolution, is globally similar to other alpha-type carbonic anhydrases except for two extended alpha-helices and an added Na-binding loop. Its unusual electrostatic properties include a uniformly negative surface electrostatic potential of lower magnitude than that observed in the highly acidic halophilic proteins and an exceptionally low positive potential at a site adjoining the catalytic Zn(2+) compared with mesophilic homologs. The halotolerant dCA II also differs from typical halophilic proteins in retaining conformational stability and solubility in low to high salt concentrations. The crucial role of electrostatic features in dCA II halotolerance is strongly supported by the ability to predict the unanticipated halotolerance of the murine CA XIV isozyme, which was confirmed biochemically. A proposal for the functional significance of the halotolerance of CA XIV in the kidney is presented.