HIV/STI co-infection among men who have sex with men in Spain

In Spain, neither the HIV nor the STI national surveillance systems collect information on HIV/STI co-infection. However, there are two networks based on HIV/STI clinics which gather this data. We describe HIV prevalence in men who have sex with men (MSM) diagnosed with infectious syphilis and/or gonorrhoea in 15 STI clinics; and concurrent diagnoses of STI in MSM newly diagnosed with HIV in 19 HIV/STI clinics. In total, 572 MSM were diagnosed with infectious syphilis and 580 with gonorrhoea during 2005-2007. HIV prevalence among syphilis and gonorrhoea cases was 29.8% and 15.2% respectively. In the multivariate analysis, HIV/syphilis co-infection was associated with being Latin American; having a history of STI; reporting exclusively anal intercourse; and having sex with casual or several types of partners. HIV and gonorrhoea co-infection was associated with age older than 45 years; having no education or only primary education completed; and having a history of STI. In total, 1,462 HIV infections were newly diagnosed among MSM during 2003-2007. Of these, 31.0% were diagnosed with other STI at the same time. Factors associated with STI co-infection among new HIV cases in MSM were being Latin American; and having sex with casual partners or with both steady and casual partners. In Spain, a considerable proportion of MSM are co-infected with HIV and STI.

Distinct mechanistic activity profile of pralatrexate in comparison to other antifolates in in vitro and in vivo models of human cancers

PURPOSE

This study evaluated mechanistic differences of pralatrexate, methotrexate, and pemetrexed.

METHODS

Inhibition of dihydrofolate reductase (DHFR) was quantified using recombinant human DHFR. Cellular uptake and folylpolyglutamate synthetase (FPGS) activity were determined using radiolabeled pralatrexate, methotrexate, and pemetrexed in NCI-H460 non-small cell lung cancer (NSCLC) cells. The tumor growth inhibition (TGI) was assessed using MV522 and NCI-H460 human NSCLC xenografts.

RESULTS

Apparent K ( i ) values for DHFR inhibition were 45, 26, and >200 nM for pralatrexate, methotrexate, and pemetrexed, respectively. A significantly greater percentage of radiolabeled pralatrexate entered the cells and was polyglutamylatated relative to methotrexate or pemetrexed. In vivo, pralatrexate showed superior anti-tumor activity in both NSCLC models, with more effective dose-dependent TGI in the more rapidly growing NCI-H460 xenografts.

CONCLUSIONS

Pralatrexate demonstrated a distinct mechanistic and anti-tumor activity profile relative to methotrexate and pemetrexed. Pralatrexate exhibited enhanced cellular uptake and increased polyglutamylation, which correlated with increased TGI in NSCLC xenograft models.

Experimental animal models of bullous pemphigoid

Bullous pemphigoid (BP) is a cutaneous autoimmune blistering disease characterized immunohistologically by dermal-epidermal junction separation, an inflammatory cell infiltrate in the upper dermis, and autoantibodies directed against the hemidesmosomal proteins BP230 and BP180. A passive transfer mouse model of BP that uses rabbit antibodies targeted against murine BP180 reproduces the key clinical and histological features of human BP. Using this model, it has been demonstrated that subepidermal blistering is initiated by anti-BP180 antibodies and mediated by complement activation, mast cell degranulation, neutrophil infiltration, and proteinase secretion. The rabbit-anti mouse IgG passive transfer model is not compatible with study of human pathogenic antibodies, as the human and murine antigenic epitopes are not cross-reactive. Two humanized mouse models in which the murine form of BP180 is replaced the human homologue have recently emerged. Autoantibodies isolated from human patients induce experimental BP in the humanized mice, and disease progression mirrors that observed in the rabbit-anti mouse IgG model. The humanized mouse models present ideal in vivo systems to test novel therapeutic strategies for disease management. In this review, we discuss the progress made in understanding the pathogenesis of BP, as well as the limits of using animal models to investigate human disease.

A feasibility study on the use of digital tomosynthesis with individually-acquired megavoltage portal images for target localization

PURPOSE

To determine the feasibility of using megavoltage (MV) images and digital tomosynthesis to determine the three dimensional (3D) localization of different objects.

MATERIALS AND METHODS

Different phantom geometries were imaged using an electronic portal imaging device and digital tomosynthesis was used to reconstruct tomograms. These were compared with corresponding computed tomography (CT) images.

RESULTS

While in-plane resolution of the tomograms was comparable as that of the CT images, definite out-of-plane (depth) localization was restricted to 5 mm.

CONCLUSION

The results confirm that it is possible to perform 3D localization of objects by using digital tomosynthesis for volumetric reconstructions from individually-acquired MV-quality portal images.

Structure of confined fluids by x-ray interferometry using diffraction gratings

We develop a novel method for structure determination of confined fluids using diffraction-grating-based x-ray interferometry.Within this approach, diffraction from a microfluidic array, which acts both as confinement and transmission diffraction grating, provides the reference wave, whereas the density modulations of the confined fluid, acting as a weak phase object, generate the object wave. The ensemble-averaged density profile of the fluid perpendicular to the confining channel is then unambiguously obtained from the interference between the reference and object waves by direct Fourier inversion.

Colloidal monolayer trapped near a charged wall: a synchrotron x-ray diffraction study

Using x-ray diffraction from microfluidic channel arrays, we have determined concentration profiles of charge-stabilized silica colloids (radius 60+/-2 nm) confined between two like-charged dielectric walls at a few hundred nanometer distance. In solutions of very low ionic strength, strongly repulsive Coulomb interactions drive the colloids toward the central region between the walls. The addition of a small quantity of salt ions (0.2 mM) causes a dense colloidal monolayer to be trapped near the walls.

Unusual productivity of Aedes aegypti in septic tanks and its implications for dengue control

Increased DEN-2 virus transmission in Puerto Rico during 2005 prompted the implementation of a rapid intervention programme to suppress Aedes aegypti (L.) (Diptera: Culicidae) emergence, which in turn lead to the discovery of previously unknown breeding sites underground. Initially, the following control measures were applied in Playa/Playita (PP), a town of 1,400 households, to all areas where the number of pupae per person exceeded the expected threshold for dengue transmission; all containers likely to be aquatic habitats were turned over and containers too large to turn were treated with 1 p.p.m. methoprene. The impact of these interventions was evaluated by comparing the number of resting adult mosquitoes (by backpack aspiration and sweepnetting in bedrooms) pre-intervention, with numbers at 3 and 5 weeks post-intervention, and by evaluating pupal density at 4 weeks post-intervention in PP and in a nearby town, Coqui (CO; 1500 households), which was not treated. The pre-intervention and post-intervention densities of resting Ae. aegypti adults were significantly larger in the intervention town, although the density of pupae in surface containers was low and similar in both towns at 4 weeks post-intervention. At 3 weeks post-intervention, the density of resting adults decreased by only 18% of pre-intervention levels, but returned to pre-intervention levels 5 weeks after treatment. By contrast, the density of resting adults in CO steadily decreased to 48% and 61%, at 3 and 5 weeks after the initial surveys, respectively. Geographical Information Systems identified significant clustering of adult mosquitoes, which led to the discovery of underground aquatic habitats (septic tanks) that were producing large numbers of Ae. aegypti and Culex quinquefasciatus (Say) in the treated town. We calculated that septic tanks could produce > 18 000 Ae. aegypti and approximately 170 000 Cx quinquefasciatus adults per day. Septic tanks are likely to be common and widespread in suburban and rural Puerto Rico, where, apparently, they can contribute significantly to the maintenance of island-wide dengue virus endemicity.

Prevalence of M. tuberculosis infection and tuberculosis disease among HIV-infected people in Spain

OBJECTIVE

To study the prevalence of Mycobacterium tuberculosis infection (MTBI) and past/current tuberculosis (TB) among human immunodeficiency virus (HIV) infected persons in Spain.

DESIGN

Longitudinal study conducted between 2000 and 2003 at 10 HIV hospital-based clinics. Data were drawn from clinical records. Associations were measured using odds ratios (ORs) and their 95% confidence intervals (95%CI).

RESULTS

Of the 1242 persons who met the eligibility criteria, most were male (75%), aged <40 years (75%) and unemployed (40%). HIV infection occurred through intravenous drug use (53%), heterosexual sex (29%) and sex between men (16%). In the initial evaluation, 315 subjects had evidence of MTBI: 84 (6.8%) had a history of TB, 23 (1.8%) current TB and 208 (16.8%) latent tuberculosis infection (LTBI). MTBI was associated with male sex, age 30-49 years, contact with a TB case, homelessness, poor education, and negatively with CD4 <100 cells/mm(3). Among subjects with MTBI, past/current TB was associated with retirement/disability (OR 6, 95%CI 1.6-22.5), CD4 <200 cells/mm(3) (OR 9.7, 95%CI 3.8-24.6), viral load >55,000 copies (OR 5.3, 95%CI 1.4-20.0), and negatively, with skilled work (OR 0.4, 95%CI 0.1-1.0) or administrative/managerial/professional work (OR 0.05, 95%CI 0.01-0.4).

CONCLUSION

Social context has an impact on the effectiveness of HIV and TB control programmes even in industrialised countries with free access to health care.