HIV-1 seroconversion in a prospective study of female sex workers in northern Thailand: continued high incidence among brothel-based women

OBJECTIVES: To determine the incidence of HIV-1 infection, temporal trends in incidence, and risk factors for seroconversion in a cohort of female commercial sex workers (CSW) in upper northern Thailand, the region of Thailand with the highest rates of HIV-1 infection. METHODS: CSW were enrolled from 1991 through 1994 and evaluated prospectively with interviews, physical examination, testing for sexually transmitted diseases (STD), and serologic testing for HIV-1 infection. RESULTS: The incidence of HIV-1 seroconversion in the first year of follow-up was 20.3 per 100 person-years among 126 brothel-based CSW and 0.7 per 100 person-years among 159 other CSW who worked in other venues such as bars or massage parlors. Incidence remained elevated among brothel-based CSW who were enrolled later in the study compared with those who enrolled earlier. Through 1996, 30 women seroconverted. In a multivariable proportional hazards model, seroconversion was significantly associated (P < 0.05) with brothel-based sex work (adjusted risk ratio, 7.3) and Chlamydia trachomatis cervical infection (adjusted risk ratio, 3.3). CONCLUSION: Despite national HIV control efforts and declining rates of infection among young men in Thailand, brothel-based CSW may continue to be at high risk for HIV-1 infection. Additional efforts are needed to provide alternative economic choices for young women, to ensure universal condom use during commercial sex, and to develop new prevention technologies.     

Implications of a diagnosis of anorexia nervosa in a ballet school

A growth curve is presented, that using the Tanner and Whitehouse's 50th centile, plots the height versus weight, both for males and females. The age is gives as parameter on the curves. In this way, weight, height and age are merged on a single chart for every sex. After exemplifying its advantages, the simpler relief of deviation from the values of the height-weight medians on the various ages, because the values of weight refer to the real height (and back), not to the age. With the same rule, curves relating to 10th and 90th centiles are processed by Tanner and Whitehouse's values. Collating between them, curves allow some morphological relief. Moreover, for both referred to the 50th centile of Tanner and Whitehouse curves (for the male sex and the female one), is presented a simple mathematical expression of interpolation, which shows and excellent representation of the measured dates. This expression is composed of a third-degree polynomial (cubic), which is fitted to the dates by the method of least square. The result of the correlation height-weight allows both to synthesize the dates in a sole expression and a simpler relief of discordance in the growth.     

Effect of mannitol crystallization on the stability and aerosol performance of a spray-dried pharmaceutical protein, recombinant humanized anti-IgE monoclonal antibody

We have examined the stability and aerosol performance of the pharmaceutical protein recombinant humanized anti-IgE monoclonal antibody (rhuMAbE25) spray dried with mannitol. The aerosol performance was measured by the fine particle fraction (FPF), and stability was assessed by the formation of soluble aggregates. When mannitol was added to the spray-dried rhuMAbE25 formulation, its ability to stabilize the protein leveled off above about 20% (w/w, dry basis). The FPF of the spray-dried formulations was stable during storage for rhuMAbE25 containing 10% and 20% mannitol, but the 30% formulation exhibited a dramatic decrease upon storage at both 5 degreesC and 30 degreesC, due to mannitol crystallization. We tested the addition of sodium phosphate to a 60:40 rhuMAbE25:mannitol (w:w) mixture, which otherwise crystallized upon spray drying and yielded a nonrespirable powder. The presence of sodium phosphate was successful in inhibiting mannitol crystallization upon spray drying and dramatically lowering the rate of solid-state aggregation. However, over long-term storage some crystallization was observed even for the phosphate-containing samples, concomitantly with increased particle size and decreased suitability for aerosol delivery. Therefore, the physical state of mannitol (i.e., amorphous or crystalline) plays a role both in maintaining protein stability and providing suitable aerosol performance when used as an excipient for spray-dried powders. Agents which retard mannitol crystallization, e.g., sodium phosphate, may be useful in extending the utility of mannitol as an excipient in spray-dried protein formulations.     

Importance of protein kinase C for normal development of transmitter release properties in embryonic chick sympathetic neurons in culture

Three new dammarane-type triterpenoid saponins, bacopasaponins A, B and C, of biological interest have been isolated from the reputed Indian medicinal plant Bacopa monniera and identified as 3-O-alpha-L-arabinopyranosyl-20-O-alpha-L-arabinopyranosyl-+ ++jujubogenin, 3-O-[alpha-L-arabinofuranosyl (1--> 2)alpha-L-arabinopyranosyl]pseudojujubogenin and 3-O-[beta-D-glucopyranosyl (1 -->3)[alpha-L-arabinofuranosyl (1--> 2)]alpha-L-arabinopyranosyl]pseudojujubogenin by spectroscopic methods and some chemical transformations. The hitherto undetermined configurations at C-20 and C-22 of pseudojujubogenin were elucidated by phase-sensitive ROESY, and 1H and 13C signals of the saponins were assigned by DEPT, 1H-1H COSY, HSQC and HMBC techniques.     

Time of peak drug concentration after a single dose and a dose at steady state

The time of peak concentration after administration of oral drug is an often quoted and used pharmacokinetic parameter. It is not well appreciated, however, that the peak times after a single dose and a dose at steady state during a multiple administration regimen can differ significantly. This article derives the mathematical relationships that determine how a peak time at steady state differs from that after a single or first dose. These relationships are then evaluated using three different approaches: 1) graphic simulations of time courses of drug concentration for three hypothetical drugs; 2) comparisons of predicted and observed peak times using examples from the literature; and 3) comparisons of predicted and simulated peak times based on different sampling schedules for three hypothetical drugs. The key finding is that peak times after a dose at steady state can occur considerably earlier after administration than after a single dose. However, the manner by which peak times are usually determined, that is, the sampling time corresponding to the highest measured drug concentration, imposes significant limitations on the usefulness of this parameter.     

Clival chordoma

Chordomas are uncommon tumors arising from embryonic remnats of the fetal notochord. The spheno-occipital and sacrococcygeal regions account for over 90 per cent of cases, the remaining 10 per cent occurring anywhere along the vertebral axis. A case of chordoma arising from the clivus is presented with a view to discussing management. The ability to obtain reasonable survival times associated with a useful and meaningful quality of life is emphasized. This may be accomplished by repeated, judicious surgical intervention with surprising ease and little morbidity to the patient in spite of its intracranial location.     

Fecal long chain fatty acids and colon cancer risk

To determine whether excretion of high concentrations of long chain fatty acids might be associated with high colon cancer risk, we compared concentrations of major long chain fatty acids in the feces of four populations at different risk for colon cancer. Concentrations of C18:1 were found to be significantly higher (P less than 0.05) in the feces of the two high risk populations than in the feces of the two low risk populations.