Long-lasting remission of cytomegalovirus retinitis without maintenance therapy in human immunodeficiency virus-infected patients

Seven AIDS patients who were receiving suppressive therapy for previously diagnosed cytomegalovirus (CMV) retinitis were offered treatment with protease inhibitors (PIs). Secondary prophylaxis for CMV was discontinued after 3 months of therapy with PIs if patients had >150 CD4 cells/mm3 and a human immunodeficiency virus (HIV) load of <200 copies/mL and if they were negative for CMV as determined by qualitative CMV polymerase chain reaction (PCR). Ophthalmologic exams were done periodically. After a median follow-up of 9 months (range, 9-12), no new episodes of CMV retinitis were observed. CD4 cell counts were >150 cells/mm3 in all cases, HIV loads were <200 copies/mL, and results for qualitative CMV PCRs remained negative. These observations suggest that for selected patients with healed CMV retinitis who have immunologic and virologic evidence of a clinical response to potent combination antiretroviral therapy, temporary discontinuation of a chronic anti-CMV suppressive therapy may not result in further retinal necrosis. However, the long-term immunologic benefit of PIs and hence the safety of prolonged withdrawal of anti-CMV therapy is unknown.     

Osteoporosis screening: from clinical history to physical examination before complementary examinations

An initial survey of the construction needs of the health care industry was conducted in 1989, and this paper reports on the results of the follow-up study that was completed in late 1996. In the 1996 study, questionnaires were sent to 2,600 large hospitals, both public and private, throughout the United States. Information was compiled on new construction, renovation, and maintenance expenditures. Analyses of expenditures, contracting methods, and forms of solicitation are presented. Respondents were also asked to identify their top construction-related problem and to list future trends impacting health care facilities over the next 5–10 years. The findings conclude that sweeping changes in managed health care have caused a major shift away from new construction and toward renovation of existing facilities to meet the state-of-the-art outpatient services demanded by health care customers.     

Eosinophilic esophagitis as a cause of dysphagia with a 10-year history

A new case of eosinophilic esophagitis is reported in a young male with a 10-year history of dysphagia who did not present manifestations of allergy, reflux or other involvement of the digestive tract by eosinophilic infiltration. A review of the literature up to the present is provided with emphasis on the fact that this is an entity to take into account in the differential diagnosis of dysphagia, especially in young people and that this disease is probably underdiagnosed.     

Enhancement of intramammary lymph nodes with lymphoid hyperplasia: a potential pitfall in breast MRI

We present three cases of breast lesions labeled as probable intramammary lymph nodes that showed an increase in size on follow-up mammography. Contrast-enhanced MRI was performed and the three lesions showed strong and rapid uptake of the intravenous contrast. Core needle biopsy established the diagnosis of lymphoid hyperplasia in all three patients. Because intramammary lymph nodes affected by benign processes can present findings similar to malignant lesions, the usefulness of contrast-enhanced MRI in these cases is controversial.     

Macrophage triggering with cecropin A and melittin-derived peptides induces type II nitric oxide synthase expression

Triggering of RAW 264.7 cells with a cecropin A-melittin hybrid peptide (CA(1-8)M(1-18)) promoted a rapid rise in the intracellular calcium concentration that was followed, after a lag period of 6 h, by nitric oxide synthesis through the expression of the cytokine-inducible form of nitric oxide synthase (type II NOS or iNOS). The maximal effect was obtained at peptide concentrations in the 2 to 5-microM range. Simultaneous incubation with the peptide and LPS abrogated the nitric oxide synthesis elicited after LPS treatment of the cells. CA(1-8)M(1-18) induced a rapid activation of nuclear factor kappaB as evidenced by the presence of p50/p65 heterodimers of the nuclear factor kappaB/c-Rel family in the nuclei of activated cells. This peptide also activated the reporter activity of cells transfected with a plasmid harboring a 1-kb fragment corresponding to the 5'-flanking region of the murine iNOS gene. CA(1-8)M(1-18) promoted apoptotic cell death at concentrations below 1 to 2 microM, whereas higher concentrations altered the plasma membrane integrity. These results suggest the involvement of multiple intracellular signaling pathways in the mechanism by which this peptide elicits macrophage triggering.     

Deploying Wide-Area Applications Is a Snap

The Structured overlay Networks Application Platform (Snap) is a J2EE-compatible wide-area Web application deployment infrastructure. Due to its structured peer-to-peer overlay network substrate, Snap offers three benefits to wide-area Web application deployment: easy adaptation of existent J2EE applications to a scalable network, a secure and decentralized deployment environment, and transparent embedded services, such as persistence, load balancing, fault tolerance, and edge computing     

SVM-based posture identification with a single waist-located triaxial accelerometer

Analysis of human body movement is an important research area, specially for health applications. In order to assess the quality of life of people with mobility problems like Parkinson’s disease o stroke patients, it is crucial to monitor and assess their daily life activities. The main goal of this work is the characterization of basic activities using a single triaxial accelerometer located at the waist. This paper presents a novel postural detection algorithm based in SVM methods which is able to detect and identify Walking, Stand, Sit, Lying, Sit to Stand, Stand to sit, Bending up/down, Lying from Sit and Sit from Lying transitions with a sensitivity of 97% and specificity of 84% with 2884 postures analyzed from 31 healthy volunteers. Parameters and models found have been tested in another dataset from Parkinson’s disease patients, achieving results of 98% of sensitivity and 78% of specificity in postural transitions. The proposed algorithm has been optimized to be easily implemented in real-time system for on-line monitoring applications.     

A polymeric micro-optical system for the spatial monitoring in two-phase microfluidics

This article presents a polymeric micro-optical system that consists of two coupled miniaturized devices for spatially distributed characterization of microfluidic two-phase phenomena exploiting multiwavelength optical signals. The input device implements four optical windows (slits) which are superimposed on the centerline of a microfluidic serpentine channel and illuminate specific locations of the microchannel. The flow-related information is then collected by an ad hoc polymeric micro-optical output device that guides and merges the spatially distributed information into a single output signal, which maintains memory of the spatial coordinates by using the wavelengths as fingerprints of the slits’ position in the microfluidic channel. Both micro-optical devices were designed, simulated, and characterized in static and dynamic conditions. Experiments on two-phase (air and ethanol) flow were carried out by applying constant and periodic flow rate functions. In both cases, the system was proved to be efficient in capturing the spatial–temporal dynamics of flow profiles.     

Determination of the potential of zero charge of Au(111) modified with thiol monolayers

A new method is proposed for the determination of the potential of zero charge of gold electrodes modified with thiol monolayers. It makes use of the immersion technique, in combination with a vapor deposition protocol to build the thiol monolayers. As compared to previous methods, the present approach provides more accurate results, particularly in the case of long-chain alkanethiol monolayers, and it is applicable to any monolayer irrespective of its degree of hydrophilicity. Results are presented for a series of 12 alkanethiol monolayers and for 11-mercaptoundecanol and 11-mercaptoundecanoic acid monolayers. Good agreement is found between the variation of the potential of zero charge along the alkanethiol series with the corresponding change of the surface work function. The potential of zero charge of the 11-mercaptoundecanoic acid monolayer is shown to depend on the extent of dissociation of the acid, thus opening the possibility of applying this type of measurements to the study of surface ionization processes.     

Biomimetic Architectures for the Impedimetric Discrimination of Influenza Virus Phenotypes

Rapid discrimination of avian vs. human phenotypes of emerging influenza A virus isolates with pandemic potential is an important issue in pathogenesis and epidemiology studies of the infection. In this work, functional architectures are tailored on the surface of a gold electrode, introducing receptor molecules as a sensing entity that mimics those found in the membrane of target cells of the influenza A virus and with the aim of developing an impedimetric‐based detector for influenza A virus phenotyping. In a bottom‐up approach, the artificial receptors are built by sequential assembly of a 1‐octanethiol/octyl‐galactoside hybrid bilayer, followed by an enzyme‐mediated functionalization of the terminal galactoside groups with sialic acid molecules. The detection mechanism relies hence on the specific affinity between the sialic acid‐galactose receptor moieties anchored on the modified electrode surface and the hemagglutinin (HA) viral surface protein. By using the appropriate type of sialyltransferase enzyme, sialylation of galactose residues is made through α‐2,3 or α‐2,6 linkages. This permits the envisaged impedimetric detector to discriminate rapidly between avian vs. human strains of influenza A virus with the absence of elaborate sample preparation steps. In contrast to immunosensors based on antibodies as bioreceptor, the sialylated modified gold electrode is also able to distinguish among influenza phenotypes, which could make the here presented detector a reagentless, label‐free diagnostic device for influenza phenotyping.