Women's health. The role of gender in HIV progression

Recent studies have examined the experience of women and the potential for gender differences with respect to HIV progression and the acceptance, tolerance, adherence, and response regarding HAART. Differences in CD4 cell count and viral load have not been reported in all studies. For any given CD4 cell count, women may be at a higher risk of HIV progression. Women appear to have an increased risk of progression to AIDS compared with men with the same viral load. They have lower initial viral loads than men in early-stage disease, but these catch up in advanced-stage disease. Because of depression and other psychological factors, women may be in greater need of supportive services, and this can affect the success of antiretroviral therapy. Women also have an increased risk of adverse drug reactions from HAART. Gender should be considered when prescribing therapy.     

Pancreas Acinar Cell Differentiation: VII. Autoradiographic Demonstration of Intracellular Radioactivity with S-Adenosyl-L-(C3H3) Methionine

After rat pancreas anlagen were grown in an organ culture medium for 9 days and further incubated for 15, 30 or 60 minutes in media to which C³H₃-Sadenosyl-L-methionine (C³H₃-SAM) was added, autoradiography demonstrated radioactivity in the nucleolus, nucleus and cytoplasm of the acinar cell. Under similar circumstances, except that the anlagen were grown in a methionine-deficient (CD-MD) medium prior to incubation with C³H₃-SAM, much greater concentrations of radioactivity were present in the nucleolus, nucleus and cytoplasm of the acinar cell than in the respective compartments of anlagen grown in control medium. The nucleolus showed the highest concentration of radioactivity in anlagen grown in either control or methionine-deficient medium. The nucleolus of the acinar cell of anlagen grown in CD-MD medium appeared to be the most undermethylated cellular compartment and was larger than the nucleolus of the acinar cell grown in the control CD medium, so it is possible that a deficient methylation of ribosomal RNA precursors led to a piling up of RNA in the nucleolus and a decrease in the flow of ribosomal precursors to the cytoplasm. Other substance might have been undermethylated and thereby have inhibited differentiation.     

The validity and reliability of the Persian version of the Revised Fibromyalgia Impact Questionnaire

The Revised Fibromyalgia Impact Questionnaire (FIQR), an updated version of the Fibromyalgia Impact Questionnaire (FIQ) achieved a better balance among different domains (i.e., function, overall impact, and symptom severity) and attempts to address the limitations of FIQ. As there is no Persian version of the FIQR available, we aimed to investigate the validity and reliability of a Persian translation of the FIQR in Iranian patients. After translating the FIQR into Persian, it was administered to 77 female patients with fibromyalgia syndrome. All of the patients filled out the questionnaire together with a Persian version of the FIQ, short form-12 (SF-12). The tender-point count was also calculated. One week later, FM patients filled out the Persian FIQR at their second visit. Reliability was analyzed by internal consistency and reproducibility including Cronbach’s α coefficient and intra-class correlation coefficient. Construct validity was evaluated by Spearman’s correlation coefficient and Pearson’s correlation coefficient. Statistical analysis was performed using SPSS for Windows version 17.0. All patients included in this study were female, and the mean age was 38.23 ± 10.68 years. The total scores of the FIQR and FIQ were 49.77 ± 18.27 and 54.05 ± 14.00 that were closely correlated (r = 0.63, p < 0.01), and each of the three domains of the Persian FIQR was also correlated well with the three related FIQ domains (r = 0.36–0.63, p < 0.01). Also some significant inverse correlations of FIQR with quality-of-life (assessed by SF-12) domains and items were found. Cronbach’s α was 0.87 for FIQR in the first visit. The Persian FIQR showed adequate reliability and validity. This instrument can be used in the clinical evaluation of Iranian patients with fibromyalgia.     

A Comparison Between Polymeric Microsphere and Bacterial Vectors for Macrophage P388D1 Gene Delivery

Purpose The purpose of this study was to compare bacterial and polymeric gene delivery devices for the ability to deliver plasmid DNA to a murine macrophage P388D1 cell line. Methods An 85:15 ratio of poly(lactic-co-glycolic acid) (PLGA) and poly(β-amino ester) polymers were formulated into microspheres that physically entrapped plasmid DNA encoding for the firefly luciferase reporter gene; whereas, the same plasmid was biologically transformed into a strain of Escherichia coli engineered to produce recombinant listeriolysin O. The two delivery devices were then tested for gene delivery and dosage effects using a macrophage cell line with both assays taking advantage of a 96-well high throughput format to quantify and compare each vector type. Results Gene delivery was comparable for both vectors at higher vector dosages while lower dosages showed an improved delivery for the microsphere vectors. Delivery efficiency (defined as luciferase measurement/mg cellular protein/ng DNA delivered) was 881 luminescence mg⁻¹ ng⁻¹ for polymeric microspheres compared to 171 luminescence mg⁻¹ ng⁻¹ for the bacterial vectors. Conclusion A first head-to-head comparison between polymeric and bacterial gene delivery vectors shows a delivery advantage for polymeric microspheres that must also be evaluated in light of vector production, storage, and future potential. Saba Parsa and Yong Wang contributed equally to this work.     

An in vitro comparison of tensile bond strengths of noble and base metal alloys to enamel

STATEMENT OF PURPOSE: Many different surface treatments have been used to increase the bond strength of noble and base metal alloys to enamel, but only a few have been studied. PURPOSE: The purpose of this in vitro study was to compare the tensile bond strength of a tin-plated noble alloy, an Alloy Primer-treated noble alloy, and an airborne particle-abraded base metal alloy, all bonded to enamel with a phosphate-methacrylate resin luting agent. MATERIAL AND METHODS: Seventy noncarious molar teeth were extracted, cleaned, and embedded in autopolymerizing acrylic resin with the buccal surface of the teeth exposed. Seventy wax patterns (4-mm diameter x 2-mm thickness) were waxed, invested, and cast-50 with a noble alloy (Argedent 52) and 20 with a base metal alloy (Argeloy N.P.). Twenty of the noble alloy specimens were tin-plated (TP), 20 noble alloy specimens were treated with Alloy Primer (AP), and 20 base metal alloy specimens were airborne particle abraded (AA). All specimens were luted with a phosphate-methacrylate resin luting agent (Panavia F) and stored in 100% humidity at 37 degrees C, half for 24 hours and half for 7 days. Ten noble alloy specimens were tin-plated and stored in water for 48 hours (aged) before cementation and then stored in water for 24 hours after cementation. These specimens were used to test whether there is an advantage to aging the tin-plated surface in water before cementation. All specimens were thermocycled (5 degrees to 55 degrees C) for 500 cycles and then tested for tensile bond strength (TBS), measured in MPa, with a universal testing machine at a crosshead speed of 0.5mm/min. Various castings (n=6 per test group) were randomly selected from each group and inspected under a scanning electronic microscope to determine mode of failure. The mean values and standard deviations of all specimens were calculated for each group. A 2-way analysis of variance (ANOVA) was performed, and multiple pairwise comparisons were then completed with post hoc Tukey test (alpha=.05). RESULTS: The TBS of the tin-plated noble alloy specimens bonded to enamel (24 hours: 9.33 +/- 1.31 MPa; 7 days: 11.65 +/- 1.55 MPa) was significantly greater than the Alloy Primer noble alloy specimens (24 hours: 6.11 +/- 1.01 MPa; 7 days: 5.45 +/- 1.22 MPa) (P <.001). The Alloy Primer noble alloy group showed the lowest TBS compared with the tin-plated noble alloy and airborne particle-abraded base metal alloy group (24 hours: 10.61 +/- 1.41 MPa; 7 days: 6.94 +/- 1.40 MPa). The tin-plated noble alloy specimens showed greater TBS after storage for 7 days in distilled water compared with storage for 24 hours (24 hours: 9.33 +/- 1.31 MPa; 7 days: 11.65 +/- 1.55 MPa). Aging the tin-plated noble alloy for 48 hours in 37 degrees C (9.17 +/- 1.68 MPa) prior to cementation did not increase the TBS to enamel. The airborne particle-abraded base metal alloy showed significantly lower TBS at the 7-day storage time compared to the 24-hour storage time (24 hours: 10.61 +/- 1.41 MPa; 7 days: 6.94 +/- 1.40 MPa) (P <.001). SEM examination of the debonded metal and enamel surfaces showed mixed (adhesive and cohesive) failures for all groups. CONCLUSION: Tin-plating a noble alloy produced the highest bond strength to enamel. Storing the tin-plated noble alloy in 37 degrees C distilled water for 48 hours before cementation did not result in a change in TBS. Using an Alloy Primer with a noble alloy resulted in statistically significant lower TBS than tin-plating.     

Using the internal thoracic artery of patients with reduced left ventricular function

Todate internal mammary artery (IMA) is routinely used in coronary artery bypass grafting even in elder patients. However in patients with poor left ventricular function use of the IMA is discussed controversely in Germany. Main arguments against IMA are an increased operation time, initially lower blood flow, higher rates of reoperation for bleeding and more perioperative complications. In this study we investigated use of the IMA in patients with poor left ventricular function (LVEF < 40%) compared to exclusively veingraft bypass surgery. 137 patients (105 m/32 f) suffering from coronary artery disease with reduced LVEF (12-40%) were randomized in the study. 67 patients received exclusively vein grafts (group I), 70 patients routinely obtained an IMA graft. Criteria used for evaluation of IMA graft were operation time, postoperative bleeding, need for catecholamines, requirement of intensive care, perioperative myocardial infarction and mortality. The number of distal anastomoses in each group was 3.1 (2-5). The operation time varied in compliance with the number of distal anastomoses, but there were no significant differences between both groups. Postoperative bleeding until the second postoperative day was 905 ml in group II versus 569 ml in group I; the difference was significant (p < 0.05). The need of catecholamines after operation and hemodynamic parameters were comparable in both groups, there were no significant differences. Intensive care was required for a mean of 1.6 days in both groups, postoperative ventilation was 5.8 hours in group I versus 7.9 hours in group II, differences not significant. Ischemia or myocardial infarction could be demonstrated in 2 patients of group I (3%) versus 4 patients of group II (5.7%). The differences between the groups were not significant. Cardiac low output syndromes without sights of myocardial infarction were apparent in 9 patients of group I (13.5%) versus 2 patients of group II (2.9%), this difference being significant (p < 0.05). Mortality after operation in both groups was higher than in patients with normal ventricular function, however the differences between the evaluated groups were not significant (5.9% in group I versus 4.3% in group II). Summarizing the above it can be concluded that patients with poor left ventricular function are at a higher risk when subjected to bypass operation; the use of IMA did not show any disadvantages in comparison to exclusively veingraft surgery, except of a higher perioperative bleeding risk. Due to better long term results IMA should be used routinely also in bypass-patients with poor left ventricular function.     

Genetic African Ancestry and Markers of Mineral Metabolism in CKD

Background and objectives

Disorders of mineral metabolism are more common in African Americans with CKD than in European Americans with CKD. Previous studies have focused on the differences in mineral metabolism by self-reported race, making it difficult to delineate the importance of environmental compared with biologic factors.

Design, setting, participants, & measurements

In a cross-sectional analysis of 3013 participants of the Chronic Renal Insufficiency Cohort study with complete data, we compared markers of mineral metabolism (phosphorus, calcium, alkaline phosphatase, parathyroid hormone, fibroblast growth factor 23, and urine calcium and phosphorus excretion) in European Americans versus African Americans and separately, across quartiles of genetic African ancestry in African Americans (n=1490).

Results

Compared with European Americans, African Americans had higher blood concentrations of phosphorus, alkaline phosphatase, fibroblast growth factor 23, and parathyroid hormone, lower 24-hour urinary excretion of calcium and phosphorus, and lower urinary fractional excretion of calcium and phosphorus at baseline (P<0.001 for all). Among African Americans, a higher percentage of African ancestry was associated with lower 24-hour urinary excretion of phosphorus (P_trend<0.01) in unadjusted analyses. In linear regression models adjusted for socio-demographic characteristics, kidney function, serum phosphorus, and dietary phosphorus intake, higher percentage of African ancestry was significantly associated with lower 24-hour urinary phosphorus excretion (each 10% higher African ancestry was associated with 39.6 mg lower 24-hour urinary phosphorus, P<0.001) and fractional excretion of phosphorus (each 10% higher African ancestry was associated with an absolute 1.1% lower fractional excretion of phosphorus, P=0.01).

Conclusions

A higher percentage of African ancestry was independently associated with lower 24-hour urinary phosphorus excretion and lower fractional excretion of phosphorus among African Americans with CKD. These findings suggest that genetic variability might contribute to racial differences in urinary phosphorus excretion in CKD.     

Full hematopoietic engraftment after allogeneic bone marrow transplantation without cytoreduction in a child with severe combined immunodeficiency

Bone marrow transplantation (BMT) for severe combined immunodeficiency (SCID) with human leukocyte antigen (HLA)-identical sibling donors but no pretransplantation cytoreduction results in T-lymphocyte engraftment and correction of immune dysfunction but not in full hematopoietic engraftment. A case of a 17-month-old girl with adenosine deaminase (ADA) deficiency SCID in whom full hematopoietic engraftment developed after BMT from her HLA-identical sister is reported. No myeloablative or immunosuppressive therapy or graft-versus-host disease (GVHD) prophylaxis was given. Mild acute and chronic GVHD developed, her B- and T-cell functions became reconstituted, and she is well almost 11 years after BMT. After BMT, repeated studies demonstrated: (1) Loss of a recipient-specific chromosomal marker in peripheral blood leukocytes (PBLs) and bone marrow, (2) conversion of recipient red blood cell antigens to donor type, (3) conversion of recipient T-cell, B-cell, and granulocyte lineages to donor origin by DNA analysis, and (4) increased ADA activity and metabolic correction in red blood cells and PBLs.