Antiretroviral therapy CNS penetration and HIV-1-associated CNS disease.

Objective: The impact of different antiretroviral agents on the risk of developing or surviving CNS disease remains unknown. The aim of this study was to investigate whether using antiretroviral regimens with higher CNS penetration effectiveness (CPE) scores was associated with reduced incidence of CNS disease and improved survival in the UK Collaborative HIV Cohort (CHIC) Study.

Methods: Adults without previous CNS disease, who commenced combination antiretroviral therapy (cART) between 1996 and 2008, were included (n = 22,356).

The impact of HIV drug resistance testing on changes to treatment.

Background: We investigate changes made to therapy after a resistance test result and identify factors associated with switching regimen.

Methods: Patients receiving antiretroviral therapy (ART) who had a resistance test performed during 1998-2007 were included in the analysis. A switch was defined as starting at least two drugs/starting a drug from a class not previously experienced within 4 months of the resistance test result.

[Pulmonary affection in advanced liver disease - hepatepulonary syndrome and portopulmonary hypertension].

Patients suffering from severe chronic liver disease, in particular cirrhosis, are at risk for pulmonary complications. The leading clinical symptom is shortness of breath, which can accompany the actual disease as indirect effect because of anemia, faint muscles or ascites. On the other hand, dyspnea can have multiple additive causes in case of accompanying cardial or pulmonary disease.

HIV-associated central nervous system diseases in the recent combination antiretroviral therapy era.

Background And Purpose: Data describing the incidence and survival of HIV-related central nervous system diseases (CNS-D) in recent years are sparse.

Methods: Between 1996 and 2007, adult subjects without previous CNS-D within a large UK cohort were included (n=30,954). CNS-D were HIV encephalopathy (HIVe), progressive multifocal leucoencephalopathy (PML), cerebral toxoplasmosis (TOXO) and cryptococcal meningitis (CRYP).

Biomarkers of impaired renal function.

Purpose Of Review: Renal disease is increasingly common as life expectancy of HIV-infected persons continues to improve. Several biomarkers are available for monitoring renal function, although no consensus exists on how best to apply these tools in HIV infection. This review describes recent findings for the more common renal biomarkers.

Articulated planar reformation for change visualization in small animal imaging.

The analysis of multi-timepoint whole-body small animal CT data is greatly complicated by the varying posture of the subject at different timepoints. Due to these variations, correctly relating and comparing corresponding regions of interest is challenging.In addition, occlusion may prevent effective visualization of these regions of interest.

[Patient satisfaction in acute coronary syndrome. Improvement through the establishment of a chest pain unit].

Background And Purpose: Chest pain units (CPUs) were established primarily in the United States with the aim of reducing hospital admissions and costs, whilst improving quality of life and patient care. Clinical trials have shown that these units are safe and practical; however, there was a need to investigate to what extent patients are satisfied with the care in CPUs. The aim of this study is to evaluate the experiences of patients receiving CPU care and routine emergency department (ED) treatment for acute chest pain.

Spatial navigation for context-aware video surveillance.

Interactive spatial navigation for video surveillance networks can be difficult. This is especially true for live tracking of complex events along many cameras, in which operators must make quick, accurate navigation decisions on the basis of the actual situation. The proposed spatial navigation interface facilitates such video surveillance tasks.

[Acute coronary syndrome. A diffuse diagnosis].

Acute coronary syndrome is one of the most common reasons for a presentation in an emergency room. The biggest component of the overall mortality in adults is acute coronary syndrome or in this context its complications. The term "acute coronary syndrome" comprises on one hand 3 entities--unstable angina pectoris, Non-ST-elevation myocardial infarction and ST-elevation myocardial infarction.

Immunodeficiency and renal impairment are risk factors for HIV-associated acute renal failure.

Objective: To identify risk factors for acute renal failure (ARF) in HIV-infected patients.

Design: Observational cohort study of HIV-infected patients attending a South London HIV centre between January 1999 and December 2008.

Methods: ARF was defined as a transient, more than 40% reduction in renal function as assessed by estimated glomerular filtration rate.

Efavirenz is associated with severe vitamin D deficiency and increased alkaline phosphatase.

Objective(s): To identify factors (including exposure to specific antiretroviral drugs) associated with severe vitamin D deficiency (VDD) in HIV-infected individuals and to explore the effects of severe VDD and antiretroviral drug exposure on serum alkaline phosphatase (ALP) as surrogate marker of bone turnover.

Design: Cross-sectional survey of vitamin D status among HIV-infected patients attending for routine clinical care at a large London HIV clinic.

Methods: Severe VDD was defined as 25(OH)D levels of less than 10 microg/l (<25 nmol/l).

Copeptin improves early diagnosis of acute myocardial infarction.

Objectives: Early identification of myocardial infarction in chest pain patients is crucial to identify patients at risk and to maintain a fast treatment initiation.

Background: The aim of the current investigation is to test whether determination of copeptin, an indirect marker for arginin-vasopressin, adds diagnostic information to cardiac troponin in early evaluation of patients with suspected myocardial infarction.

Methods: Between January 2007 and July 2008, patients with suspected acute coronary syndrome were consecutively enrolled in this multicenter study.

Randomized comparison of renal effects, efficacy, and safety with once-daily abacavir/lamivudine versus tenofovir/emtricitabine, administered with efavirenz, in antiretroviral-naive, HIV-1-infected adults: 48-week results from the ASSERT study.

Background: Abacavir/lamivudine and tenofovir/emtricitabine fixed-dose combinations are commonly used first-line antiretroviral therapies, yet few studies have comprehensively compared their safety profiles.

Methods: Forty-eight-week data are presented from this multicenter, randomized, open-label study comparing the safety profiles of abacavir/lamivudine and tenofovir/emtricitabine, both administered with efavirenz, in HLA-B*5701-negative HIV-1-infected adults.

Results: Three hundred eighty-five subjects were enrolled in the study.

Liver transplantation and combined liver-heart transplantation in patients with familial amyloid polyneuropathy: a single-center experience.

Liver transplantation (LT) is the only curative option for patients with familial amyloid polyneuropathy (FAP) at present. Twenty patients with FAP underwent LT between May 1998 and June 2007. Transthyretin mutations included predominantly the Val30Met mutation but also 10 other mutations.

Improved outcome in acute coronary syndrome by establishing a chest pain unit.

Aims: Chest pain units (CPUs) have been established to optimize treatment of patients with acute coronary syndrome (ACS) and to early and accurately discharge patients with non-coronary chest pain. The aim of this analysis was to elucidate whether treatment of ACS patients in the CPU versus emergency department (ED) has prognostic implications.

Methods And Results: Patients presenting with suspected ACS to either the ED between August 2004 and June 2005 or the CPU between July 2005 and May 2006 were retrospectively analyzed.

Combined surface and volume processing for fused joint segmentation.

Purpose: Segmentation of rheumatoid joints from CT images is a complicated task. The pathological state of the joint results in a non-uniform density of the bone tissue, with holes and irregularities complicating the segmentation process. For the specific case of the shoulder joint, existing segmentation techniques often fail and lead to poor results.

Evaluation of bone impingement prediction in pre-operative planning for shoulder arthroplasty.

In shoulder arthroplasty, malpositioning of prostheses often leads to reduced postoperative range of motion (ROM) and complications such as impingement, loosening, and dislocation. Furthermore, the risk of impingement complications increases when reverse total prostheses are used. For this purpose a pre-operative planning system was developed that enables surgeons to perform a virtual shoulder replacement procedure.

Mortality from HIV and TB coinfections is higher in Eastern Europe than in Western Europe and Argentina.

Background And Objectives: Tuberculosis (TB) is a leading cause of death in HIV-infected patients worldwide. We aimed to study clinical characteristics and outcome of 1075 consecutive patients diagnosed with HIV/TB from 2004 to 2006 in Europe and Argentina.

Methods: One-year mortality was assessed in patients stratified according to region of residence, and factors associated with death were evaluated in multivariable Cox models.

Smooth graphs for visual exploration of higher-order state transitions.

In this paper, we present a new visual way of exploring state sequences in large observational time-series. A key advantage of our method is that it can directly visualize higher-order state transitions. A standard first order state transition is a sequence of two states that are linked by a transition.

Tuberculosis among people with HIV infection in the United Kingdom: opportunities for prevention?

Objective: To investigate the incidence of, and risk factors for, tuberculosis among HIV clinic attendees in the United Kingdom.

Design And Methods: Observational cohort study of 27 868 individuals in the United Kingdom Collaborative HIV Cohort collaboration, 1996-2005.

Results: Among individuals not taking combination antiretroviral therapy (cART), tuberculosis incidence was considerably higher among individuals of black African vs.

Clinical epidemiology of HIV-associated end-stage renal failure in the UK.

Objective: To describe the clinical epidemiology of HIV-associated end-stage renal failure (HIV/ESRF) from 1998 to 2007 in the United Kingdom.

Design: Observational cohort study.

Setting: Seven leading HIV centres and affiliated renal clinics in the United Kingdom.

Sensitive troponin I assay in early diagnosis of acute myocardial infarction.

Background: Cardiac troponin testing is central to the diagnosis of acute myocardial infarction. We evaluated a sensitive troponin I assay for the early diagnosis and risk stratification of myocardial infarction.

Methods: In a multicenter study, we determined levels of troponin I as assessed by a sensitive assay, troponin T, and traditional myocardial necrosis markers in 1818 consecutive patients with suspected acute myocardial infarction, on admission and 3 hours and 6 hours after admission.