Effect of GB virus C co-infection on response to generic HAART in African patients with HIV-1 clade C infection

In 38 African AIDS patients initiating generic HAART, GB virus C (GBV-C) RNA-positive patients retained GBV-C viraemia during 52 weeks of HAART, had a faster decline in HIV viral load (P = 0.03), fewer opportunistic infections (14.3 versus 50%, P = 0.18), and suffered no serious adverse events (none versus 61%, P = 0.008) compared with patients without GBV-C. GBV-C co-infection may be associated with a beneficial effect on African AIDS patients treated with generic HAART.     

New-onset orthostatic intolerance following bariatric surgery

Background: As bariatric surgery has become an increasingly popular treatment for obesity, we have seen an increasing number of patients present after bariatric surgery with new-onset syncope, near-syncope, and lightheadedness.
Methods: We retrospectively reviewed patients who had had bariatric surgery referred to our institution for evaluation of orthostatic intolerance. We reviewed history, physical examination, type of bariatric surgery procedure, and tilt table test results in these patients. There were 14 women and one man with mean age 42 ± 6 years, preoperative body mass index was 49.3 ± 6.0 kg/m², and mean postoperative weight loss was 55.9 kg. Mean onset of symptoms was 5.2 ± 3.9 months after surgery. Presenting symptoms were lightheadedness in 15 (100%), near-syncope in 11 (73%), and syncope in nine (60%). All but one patient had a positive tilt table test with eight (53%) having a neurocardiogenic response, three (20%) having a dysautonomic response, and (20%) having a postural tachycardia response. The likely mechanism of orthostatic intolerance is autonomic insufficiency in combination with reverse course of obesity-related hypertension. The majority of the patients (12 out of 15) responded to standard therapy for autonomic insufficiency.
Conclusion: Some patients may develop significant orthostatic intolerance due to autonomic insufficiency following bariatric surgery, and awareness of the potential association between bariatric surgery and new orthostatic intolerance is important for providing timely care.     

Application of Confocal Raman Microscopy for the Characterization of Topical Semisolid Formulations and their Penetration into Human Skin Ex Vivo

Pharmaceutical Research - The quality testing and approval procedure for most pharmaceutical products is a streamlined process with standardized procedures for the determination of critical quality...     

Participatory development of a minimum dataset for the Khayelitsha district.

BACKGROUND: Traditional 'data-led' information systems have created excessive amounts of poor-quality and poorly utilised data. The Health Information Systems Pilot Project (HISPP), a Western Cape project that started in 1996, initiated a process in one of its three pilot sites to model an alternative approach to developing a district health information system. OBJECTIVE: To develop a minimum dataset for Khayelitsha as part of an action-led district health and management information system in a participatory 'bottom-up' process. METHOD: The HISPP, in conjunction with health workers in the proposed Khayelitsha district, developed a minimum dataset through a process of defining local goals, targets and indicators. This dataset was integrated with data requirements at regional and provincial levels. RESULTS: A minimum dataset was produced that defined all the data needed according to the frequency of reporting and the level at which it was required. CONCLUSION: The HISPP has demonstrated an alternative model for defining health information needs at district level. This participatory process has enabled health workers to appraise their own information needs critically and has encouraged local use of information for planning and action.