Next-generation point-of-care testing in pediatric human immunodeficiency virus infection facilitates diagnosis and monitoring of treatment.

Point-of-care (PoC) testing facilitates early infant diagnosis (EID) and treatment initiation, which improves outcome. We present a field evaluation of a new PoC test (Cepheid Xpert® HIV-1 Qual XC RUO) to determine whether this test improves EID and assists the management of children living with human immunodeficiency virus (HIV) infection. We compared 2 PoC tests with the standard-of-care (SoC) test used to detect HIV infection from dry blood spots in newborn infants at high risk of in utero infection.

Author Correction: Sex-specific innate immune selection of HIV-1 in utero is associated with increased female susceptibility to infection.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Sex-specific innate immune selection of HIV-1 in utero is associated with increased female susceptibility to infection.

Female children and adults typically generate more efficacious immune responses to vaccines and infections than age-matched males, but also suffer greater immunopathology and autoimmune disease. We here describe, in a cohort of > 170 in utero HIV-infected infants from KwaZulu-Natal, South Africa, fetal immune sex differences resulting in a 1.5-2-fold increased female susceptibility to intrauterine HIV infection.

Unmet needs of high-risk mothers reduce success of antiretroviral treatment in HIV-infected infants.

In the era of effective prevention of mother-to-child transmission of HIV, the same psychosocioeconomic factors that predispose to mother-to-child transmission also substantially increase the likelihood of antiretroviral therapy failure in infected infants. For HIV-infected infants to benefit from early infant diagnosis and treatment initiation, into which much funding and effort is now invested, it is vital that these unmet needs of high-risk mothers are urgently attended to. From an ongoing study of early infant diagnosis and treatment following in utero transmission in KwaZulu-Natal, South Africa, we describe four cases to highlight these challenges facing transmitting mothers that contribute to treatment failure in their infants.

Modulation of the rhythmic patterns of expression of phosphoprotein phosphatases in human leukaemia cells.

Temporal variations in the expression of phosphoprotein phosphatase 1 (PP1), phosphoprotein phosphatase 2A (PP2A) and protein tyrosine phosphatase 1B (PTP1B) were monitored in the human acute, promyelocytic leukaemia cell line, HL60. Granulocytic differentiation was induced using all-trans retinoic acid (ATRA) and monocytic differentiation by phorbol-12-myristate-13-acetate (PMA). Expression of the enzyme proteins in cell extracts was determined by SDS-PAGE and Western immunoblotting using specific antibodies.

Correlation of kinin generating activity with Helicobacter pylori-associated gastric infection.

The kallikrein-kinin system involves a biologically complex set of interactive proteases that signal the first-line onset of inflammation and associated cellular processes. The basic enzymatic cleavage of kininogen substrate by the serine protease tissue kallikrein to liberate kinins is regulated by a number of factors. These may include the recently discovered bacterial involvement in the causation of gastritis.

The evaluation of tissue kallikrein in Helicobacter pylori-associated gastric ulcer disease.

Helicobacter pylori (Hp) associated ulcer disease is a common form of gastric disorder involving mucosal damage and invasion of the mucosa by polymorphic inflammatory cells with concomitant changes in the epithelial cell structure. The bacteria are thought to adhere by specific junction zones to the epithelial cell surface resulting in the degeneration of the mucosal layer. Our study was undertaken to examine the relative status of tissue kallikrein (TK) in antral and fundic biopsies, endoscopically obtained from 10 patients suspected of having gastric disorders.

Kinin receptor status in normal and inflammed gastric mucosa.

No documented studies have been reported on the presence of B1 and B2 kinin receptors in the mammalian gastric mucosa. This first study aimed to immunolocalise sites of B1 and B2 kinin receptors in the human pyloric gastric mucosa and to evaluate its role in gastritis. Biopsies were obtained from patients with dyspepsia during endoscopic examination of the patient.

Pirenzepine and cimetidine for duodenal ulcers. A comparative randomised double-blind controlled study.

A double-blind controlled trial was undertaken to compare the relative effectiveness of pirenzepine (Gastrozepin; Boehringer Ingelheim) and cimetidine (Tagamet; SK & F) in healing endoscopically proven duodenal ulcers. Thirty patients with duodenal ulcers were treated with pirenzepine 50 mg twice daily and 30 patients with cimetidine 400 mg twice daily. Endoscopy was repeated after 4 weeks.

Brainstem encephalitis or the Miller Fisher syndrome--a variant of acute idiopathic polyneuropathy. Case reports.

A syndrome comprising ophthalmoplegia, ataxia and areflexia was described by Miller Fisher in 1956. While some consider it to be a benign variety of acute idiopathic (Guillain-Barré) polyneuropathy, there are reports of the need for ventilatory support and of the benefits of plasmapheresis. Two further cases are described.

Bicitropeptide powder and placebo in the treatment of duodenal ulcers. A double-blind endoscopically controlled clinical trial.

In a double-blind study comprising 50 patients with endoscopically proven uncomplicated duodenal ulcers a powder formulation of bicitropeptide (BCP-Compound) was found to be superior to placebo. On endoscopic examination 19 patients (76%) treated with bicitropeptide powder had healed, while 3 (12%) showed some degree of healing, a total success rate of 88%. Only 5 patients (20%) on placebo had healed completely while 3 (12%) showed some degree of healing (chi 2 = 17,9667; P less than 0,0005).

Etiology of colonic strictures in South African black and Indian patients.

The etiology of colonic strictures in 263 South African black and Indian patients is presented. Nonmalignant lesions accounted for strictures in two-thirds of the patients and included amebiasis (27), tuberculosis (24), nonspecific colitis (30), ulcerative colitis/Crohn's colitis (11) and other lesions (36). Malignant lesions caused strictures in approximately a third of the black and Indian patients, which is higher than in other reported series in blacks.

Treatment of duodenal ulcers with cimetidine.

A total of 55 patients were treated with the histamine H2-receptor antagonist cimetidine (Tagamet: SKF) in an endoscopically controlled double-blind trial. Cimetide (200 or 300 mg every 6 hours) was administered to 36 patients, and placebo to 19 patients. Only patients who had been confirmed by endoscopy as having uncomplicated duodenal ulcers were admitted to the trial.

Prazosin alone and combined with a thiazide diuretic in the treatment of hypertension.

We conducted an uncontrolled study of the efficacy of prazosin in the treatment of hypertension in 45 patients. In 25 patients only prazosin was used and in 20 patients prazosin was combined with a thiazide diuretic. Control of blood pressure was obtained in 22 of the 25 patients (88%) on prazosin alone, and in all the patients on the combined treatment.

Prazosin combined with thiazide diuretic and beta-blocker in the treatment of hypertension.

In a study of 10 patients suffering from hypertension the results showed that combination treatment with prazosin, cyclopenthiazide and a beta-blocker produced a significant fall in blood pressure. Side-effects such as palpitations, headache, syncope and drowsiness which may occur with prazosin alone were obviated by combining prazosin with a beta-blocker.

Basal serum gastrin levels in normal subjects and in various gastro-intestinal conditions.

A total of 1 035 routine serum gastrin investigations was undertaken with a commercially available kit. Levels in 49 normal subjects were similar to those found in 200 patients with duodenal ulcertaion, in 42 patients with gastric ulcers, in 9 patients with carcinoma of the stomach, in 55 patients with chronic alcohol-induced pancreatitis, and in 27 with iron deficiency anaemia. Significantly raised levels of serum gastrin were found in 32 patients with megaloblastic anaemias, where the rise in serum gastrin concentration correlated with a fall in maximal acid output, and in 14 patients with complete vagotomies.

Probable chloroquine-resistant Plasmodium falciparum malaria from Mozambique A case report.

A female patient with Plasmodium falciparum malaria apparently resistant to chloroquine is descirbed. She had recently returned from Mozambique, which may prove to be a new endemic are with resistant strains. The infection was successfully treated with quinine.

Orthostatic hypotension due to Shy-Drager syndrome.

A case of orthostatic hypotension is presented, as well as postmortem neuropathological findings. The features of this case are consistent with those of the Shy-Drager syndrome, which comprises primary orthostatic hypotension and neurological manifestations caused by degenerative disease of the central nervous system.

A neonatal complication of maternal leukaemia treated with 6-mercaptopurine.

A 24-year-old African mother, who had received 6-mercaptopurine for acute leukaemia from before conception and throughout her pregnancy is described. The child, born prematurely, was anaemic at birth, with many features of a micro-angiopathic haemolytic anaemia. It is suggested that the mother's disease or treatment was involved in the aetiology of this anaemia.