Human immunodeficiency virus case detection and antiretroviral therapy enrollment among children below and above 18 months old: A comparative analysis from Cameroon

While pediatric human immunodeficiency virus (HIV) testing has been more focused on children below 18 months through prevention of mother to child transmission of HIV (PMTCT), the yield of this approach remains unclear comparatively to testing children above 18 months through routine provider-initiated testing and counselling (PITC). This study aimed at assessing and comparing the HIV case detection and antiretroviral therapy (ART) enrolment among children below and above 18 months of age in Cameroon. This information is required to guide the investments in HIV testing among children and adolescents.We conducted a cross-sectional study where we invited parents visiting or receiving HIV care in 3 hospitals to have their children tested for HIV. HIV testing was done using polymerase chain reaction (PCR) and antibody rapid tests for children <18 months and those ≥18 months, respectively. We compared HIV case detection and ART initiation between the 2 subgroups of children and this using Chi-square test at 5% significant level.A total of 4079 children aged 6 weeks to 15 years were included in the analysis. Compared with children <18 months, children group ≥18 months was 4-fold higher among those who enrolled in the study (80.3% vs 19.7%, P < .001); 3.5-fold higher among those who tested for HIV (77.6% vs 22.4%, P < .001); 6-fold higher among those who tested HIV+ (85.7% vs 14.3%, P = .24), and 11-fold higher among those who enrolled on ART (91.7% vs 8.3%, P = .02).Our results show that 4 out of 5 children who tested HIV+ and over 90% of ART enrolled cases were children ≥18 months. Thus, while rolling out PCR HIV testing technology for neonates and infants, committing adequate and proportionate resources in antibody rapid testing for older children is a sine quo none condition to achieve an acquired immunodeficiency syndrome (AIDS)-free generation.     

Isoxazolidine derivatives as corrosion inhibitors for low carbon steel in HCl solution: experimental,theoretical and effect of KI studies

Two isoxazolidine derivatives namely 5-(benzo[d][1,3]dioxol-5-ylmethyl)-2-tetradecyl isoxazolidine (BDMTI) and 5-(4-hydroxy-3-methoxybenzyl)-2-tetradecyl isoxazolidine (HMBTI) were synthesized and characterized using FTIR, C-NMR, H-NMR, and elemental analysis. The synthesized compounds were evaluated as corrosion inhibitors for API 5L X60 steel in 1 M HCl in the temperature range of 25–60 °C using gravimetric and electrochemical (Electrochemical Impedance Spectroscopy (EIS), Potentiodynamic Polarization (PDP) and Linear Polarization Resistance (LPR)) techniques. The effect of addition of a small amount of iodide ions on the corrosion inhibition performance of the compounds was also assessed. In addition, quantum chemical calculations and Monte Carlo simulations were employed to correlate the electronic properties of the compounds with the corrosion inhibition effect as well as to evaluate the adsorption/binding of the inhibitor molecules on the steel surface. Experimental results show that the two compounds inhibited the corrosion of carbon steel in an acid environment with HMBTI showing superior performance. The corrosion inhibition effect was found to be dependent on the inhibitors'' concentration and temperature. Addition of iodide ions improves the inhibition efficiency considerably due to co-adsorption of the iodide ions and the inhibitors on the steel surface which was competitive in nature as confirmed from the synergistic parameter (S₁) which was less than unity at higher temperature. Experimental and theoretical results are in good agreement.

Two isoxazolidine derivatives (BDMTI and HMBTI) were synthesized and characterized using FTIR, C-NMR, H-NMR and elemental analysis and evaluated as corrosion inhibitors for X60 steel in 1 M HCl solution.     

Antibiotic therapy in surgery of the Colon: Rationale and application

Summary Although intestinal antiseptics do have relative dangers, and although only 7 of 35 different intestinal antiseptics can be recommended for general use, the value of antibiotics in surgery of the colon has been experimentally demonstrated in protection of a colon anastomosis.Based upon clinical studies of 559 patients prepared for surgery with kanamycin, 79 who received postoperative intraluminal kanamycin, and 360 who received intraperitoneal antibiotic therapy at operation for some form of peritonitis, judicious use of antibiotics in conjunction with colon surgery is highly recommended.Presented at a postgraduate course, Advances in Gastroenterology—Enterocolonic Disease and Dysfunction (Oct. 22–24, 1964), sponsored by Louisiana State University School of Medicine, New Orleans, La.Supported in part by Grants Al-01600 and Al-00524 from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, U. S. Public Health Service.     

First-night effect in the chronic fatigue syndrome

Since the magnitude of the first-night effect has been shown to be a function of medical conditions and of settings in which polysomnographies are performed, it is essential to evaluate the habituation phenomenon in each case in order to determine the optimal recording methodology. A first-night effect was evidenced in certain cases of chronic fatigue syndrome, but not in others. To clarify this issue, a large group of patients with chronic fatigue syndrome who had no primary sleep disorders were selected and recorded for two consecutive nights in a hospital sleep unit. Several parameters, frequently associated with the first-night effect, were found to be influenced by the recording methodology: Total Sleep Time, Sleep Efficiency, Sleep Efficiency minus Sleep Onset, Sleep Onset Latency, Wake Time, Slow Wave Sleep, Rapid Eye Movement Sleep, Rapid Eye Movement Sleep Latency and Number of Sleep Cycles. Bland and Altman plots determined that the difference scores between the nights included a systematic bias linked to the order of recordings (first-night effect). Factorial analysis grouped the difference scores into three factors. No significant difference was observed between patients with generalized anxiety comorbidity and those with no psychiatric comorbidity, or between those with and without psychiatric comorbidity. Chronic fatigue syndrome must thus be added on the list of conditions where a clinically significant habituation effect takes place.     

Impaired emotional facial expression recognition in alcoholics,opiate dependence subjects,methadone maintained subjects and mixed alcohol-opiate antecedents subjects compared with normal controls

The present study aims to explore whether an impairment in emotional facial expressions (EFE) decoding is specific to alcoholism compared with opiate dependence. An EFE decoding test consisting of 16 photographs of EFE portraying happiness, anger, sadness and disgust was administered to five different groups of 30 subjects each: recently detoxified alcoholics (RA); opiate addicts under methadone maintenance treatment (OM); detoxified opiate addicts (OA); detoxified subjects with both alcohol and opiate dependence antecedents (DAO); and normal controls (NC). Repeated measures analysis of variance using a multivariate approach was conducted on EFE decoding accuracy scores with group as the between-subjects factor. Accuracy scores were significantly lower in RA and DAO than in OM and OA, which had significantly lower scores than NC. Low accuracy scores in RA and DAO confirm previous results indicating that alcoholism is associated with impaired EFE recognition. Results in OM and OA indicate that opiate dependence is also associated with an impaired EFE decoding but less than in alcoholism. Alcohol and opiate chronic consumption could both exercise a deleterious effect on EFE-decoding brain function, alcohol having the most severe impact. Alternatively, EFE-decoding problems could be present before the development of alcohol and opiate dependence, with an additional effect of chronic alcohol consumption on EFE decoding. In this context, EFE-decoding impairment could reflect a more general emotional intelligence deficit in addicted populations.     

Contribution of frontal cerebral blood flow measured by (99m)Tc-Bicisate spect and executive function deficits to predicting treatment outcome in alcohol-dependent patients

Aim: To determine whether inhibition and working memory deficits, and reduced regional cerebral blood flow (rCBF) (previously shown to be related), measured at the end of a detoxification programme, predict alcoholic relapse 2 months later. METHODS: Twenty uncomplicated alcoholic inpatients were investigated at the end of detoxification, at least 7 days since the last dose of diazepam, and a mean of 18.8 days since the last drink. Their performance was assessed on the inhibition (Hayling) test, working memory (Alpha-span task), episodic memory (California Verbal Learning Test) and abstract reasoning (Progressive Matrices). Frontal CBF was assessed at the same time with a semiquantitative (99m)Tc-Bicisate SPECT procedure. Patients were contacted 2 months later. Patients who abstained (n = 9) did not differ from those who relapsed (n = 11) on age, gender, smoking, duration of alcohol misuse, number of previous detoxifications, amount of ethanol consumed the month prior to admission to the detoxification programme, state anxiety, trait anxiety, or depression. RESULTS: Relapsed subjects had shown a lower uptake of (99m)Tc-Bicisate in the bilateral medial frontal gyrus (n = 9; mean ratio +/- SD = 0.69 +/- 0.006) than abstainers (n = 11; 0.85 +/- 0.19), and poorer performance on the Alpha-span task and the Hayling test. The other tests were not different. CONCLUSIONS: Inhibition and working memory deficits, associated with low levels of CBF in the medial frontal gyrus, are related to the difficulty of maintaining short-term abstinence from alcohol.