Use of assisted reproductive technology to separate sperm from human immunodeficiency virus infected men resulting in pregnancy among serodiscordant couples

Due to HIV care improvement, discordant couples more frequently seek help in order to conceive their own biological child. Besides the advance of antiretroviral therapy, unprotected intercourse is not a complete safe option, carrying a low but still present risk of HIV transmission. We report 10 serodiscordant couples in whom the male partner is HIV positive, submitted to sperm washing and intrauterine insemination. The procedure resulted in four pregnancies and no HIV transmission to mother or child was observed. Techniques of assisted reproduction can help HIV discordant couples to conceive biological offspring and is a safer option than unprotected intercourse.     

Correlation between Electrocardiographic Features and Mechanical Dyssynchrony in Heart Failure Patients with Left Bundle Branch Block

Background: Few electrocardiographic parameters beyond the QRS duration were studied with regard to the correlation with mechanical dyssynchrony. This study aims to analyze the correlation between electrocardiographic parameters and mechanical dyssynchrony in patients with symptomatic heart failure (HF) and left bundle branch block (LBBB). Methods: Patients with HF, ejection fraction ≤ 35%, and QRS interval ≥ 120 ms with a LBBB were prospectively studied. We analyzed the correlation between electrocardiographic parameters (QRS duration, R voltage in limb leads, S voltage in precordial leads, Sokolow and Cornell indexes, QRS axis deviation, and QRS notches in lateral and inferior leads) and mechanical dyssynchrony measured by tissue Doppler imaging (TDI). Results: A group of 50 patients were studied, 60% male, 78% with nonischemic cardiomyopathy, NYHA Class III–IV (86%), and ejection fraction of 0.22 ± 0.6. Intra‐ and interventricular dyssynchrony occurred in 68% and 74% of patients, respectively. The S amplitude in precordial leads and the Sokolow and Cornel indexes show a weak correlation with the degree of dyssynchrony. In the patients with QRS notching in the lateral and inferior leads, we observed significantly greater prevalence of intraventricular dyssynchrony, with sensitivity and specificity of 85% and 56%, respectively, for notches in lateral leads. The QRS duration presents moderate correlation with the degree of both intraventricular (r = 0.48) and interventricular dyssynchrony (r = 0.46). Conclusion: The following electrocardiographic parameters were related to the degree of mechanical dyssynchrony: QRS duration and notches in QRS. In addition, the patients tend to have highest S amplitude in precordial leads. Ann Noninvasive Electrocardiol 2011;16(1):41–48     

Non-Alpine thyroid angiosarcoma

INTRODUCTIONAngiosarcoma is a very rare entity of soft tissue neoplasm with an aggressive and destructive biological behavior. Thyroid angiosarcoma is usually reported in Alpine regions, with only exceptionally rare cases arising in non-mountainous areas. In the Alpine regions it constitutes 2–10% of all malignant thyroid tumors.PRESENTATION OF CASEWe report a case of a thyroid non-Alpine angiosarcoma in a 71-year-old female with a 10 years old multinodular goiter. The cervical mass underwent rapid growth in the last year, and she was referred for surgical treatment. A 15 cm mass was found on the right side of the neck invading adjacent tissues and displacing the trachea without obvious invasion of this organ. Fine needle aspiration cytology showed “carcinoma”. Lung metastasis were present. Although difficult, total thyroidectomy was possible with resection of an esophageal implant. Post-operatively, she had respiratory failure that eventually recovered, but, on 39th post-operative day, she died of violent hemoptysis, probably due to invasion by mediastinal metastasis.DISCUSSIONA clear distinction between angiosarcoma and anaplastic carcinoma of the thyroid is considerably difficult, despite treatments and prognosis are practically the same. However, in recent years, a thyroid malignancy exhibiting phenotypical features of endothelial differentiation was described. Keratin positivity cannot be reported as necessarily indicative of epithelial differentiation.CONCLUSIONOptimal treatment for thyroid angiosarcoma remains unclear, not only because the prognosis is poor, despite multimodal therapeutic efforts, but also because it is a very rare entity.     

Rational and Experiential Decision-Making Preferences of Third-Year Student Pharmacists

Objective. To examine the rational (systematic and rule-based) and experiential (fast and intuitive) decision-making preferences of student pharmacists, and to compare these preferences to the preferences of other health professionals and student populations.Methods. The Rational-Experiential Inventory (REI-40), a validated psychometric tool, was administered electronically to 114 third-year (P3) student pharmacists. Student demographics and preadmission data were collected. The REI-40 results were compared with student demographics and admissions data to identify possible correlations between these factors.Results. Mean REI-40 rational scores were higher than experiential scores. Rational scores for younger students were significantly higher than students aged 30 years and older (p<0.05). No significant differences were found based on gender, race, or the presence of a prior degree. All correlations between REI-40 scores and incoming grade point average (GPA) and Pharmacy College Admission Test (PCAT) scores were weak.Conclusion. Student pharmacists favored rational decision making over experiential decision making, which was similar to results of studies done of other health professions.     

Biological therapy in rheumatoid vasculitis: a systematic review

Clinical Rheumatology - Rheumatoid vasculitis (RV) is one of the most severe extra-articular manifestations of rheumatoid arthritis, with significant morbidity and mortality, requiring aggressive...     

Knowledge and Attitudes About Pre-Exposure Prophylaxis Among Young Adults Experiencing Homelessness in Seven U.S. Cities

Purpose

Evidence suggests that young adults experiencing homelessness (YEH) are at elevated risk of HIV compared to housed youth. Given the limited research on pre-exposure prophylaxis (PrEP) awareness among YEH, this study examined their PrEP knowledge and attitudes.

Characterization and induction of cementoblast cell proliferation by bioactive glass nanoparticles

Cementum is a mineralized tissue that lines the surface of the tooth root enabling attachment of the periodontal ligament to the root and surrounding alveolar bone. Studies examining the mechanisms involved in the formation of root cementum have been hindered by an inability to isolate and culture the cells required for cementum production (cementoblasts). This study isolated and characterized cementoblast cells derived from rat molar periodontal ligament. It was observed that the isolated cells expressed F‐Spondin, a cementoblast marker, while F‐Spondin expression was not observed in the cells of other tissues such as gingival fibroblasts and osteoblasts. As expected, the isolated cementoblast cells also expressed osteocalcin (OC), bone sialoprotein (BSP), alkaline phosphatase (ALP), and type I collagen, demonstrating the presence of mineralized tissues genes in cementoblast cells. These cells showed high ALP activity and calcified nodule formation in vitro. Since cementogenesis could be a critical event for regeneration of periodontal tissues, this study investigated whether bioactive glass particles could affect the proliferation of cementoblasts since they are known to enhance osteoblast proliferation. It was found that the ionic products from bioactive glass nanoparticles increased cementoblast viability, mitochondrial activity, and induced cell proliferation. Together, these results show the characterization of cementoblast cells from rat molar periodontal ligament. Additionally, it was shown that bioactive glass nanoparticles induced cementoblast to proliferate, indicating that they could be a potential material for use in cement regeneration through tissue engineering. Copyright © 2011 John Wiley & Sons, Ltd.