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Sample records for hiv-associated cryptococcosis status

  1. The status of cryptococcosis in Latin America

    Directory of Open Access Journals (Sweden)

    Carolina Firacative

    2018-04-01

    Full Text Available Cryptococcosis is a life-threatening fungal infection caused by the encapsulated yeasts Cryptococcus neoformans and C. gattii, acquired from the environment. In Latin America, as occurring worldwide, C. neoformans causes more than 90% of the cases of cryptococcosis, affecting predominantly patients with HIV, while C. gattii generally affects otherwise healthy individuals. In this region, cryptococcal meningitis is the most common presentation, with amphotericin B and fluconazole being the antifungal drugs of choice. Avian droppings are the predominant environmental reservoir of C. neoformans, while C. gattii is associated with several arboreal species. Importantly, C. gattii has a high prevalence in Latin America and has been proposed to be the likely origin of some C. gattii populations in North America. Thus, in the recent years, significant progress has been made with the study of the basic biology and laboratory identification of cryptococcal strains, in understanding their ecology, population genetics, host-pathogen interactions, and the clinical epidemiology of this important mycosis in Latin America.

  2. Cryptococcosis (C. gattii)

    Science.gov (United States)

    ... Foodborne, Waterborne, and Environmental Diseases Mycotic Diseases Branch C. gattii Infection Recommend on Facebook Tweet Share Compartir ... as British Columbia and the U.S. Pacific Northwest. C. gattii cryptococcosis is a rare infection that people ...

  3. HIV-associated opportunistic fungal infections: a guide to using the ...

    African Journals Online (AJOL)

    This review aims to provide a guide for clinicians to using the clinical microbiology laboratory for management of common HIV-associated opportunistic fungal infections, e.g. mucosal candidiasis, cryptococcosis, Pneumocystis jirovecii pneumonia (PCP), histoplasmosis, etc. Laboratory tests provide valuable guidance at ...

  4. Focus on Cryptococcosis

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    S Bilimoria

    1980-01-01

    Full Text Available A case report of disseminated cutaneous cryptococcosis with Hodgkin′s disease is presented. No foci in the lungs, central nervous system, bones, gastro-intestinal tract, liver, kidneys or heart were detected. C.neoformans was cultured, identified by its capsule, growth at 37′C ability to produce urease, specific nitrate and sugar assimilation and pathogenicity for the mouse. Histo-pathologically the organism was demonstrated in the tissue sections. Clinical subsidence was seen with amphotericin B 0.5 mg/kg. for 22 days. The fact that present day use of steroids, immuno-suppressives and anti-neoplastic agents are known to predispose to this infection is emphasised.

  5. Cryptococcosis infection among HIV patients

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    Zineb Tlamcani

    2016-06-01

    Full Text Available Cryptococcosis is commonly known as a central nervous system infection due to Cryptococcus neoformans. It is one of the most frequent infections in AIDS patients. Disseminated cryptococcosis appears in almost one third of these patients. In this review, we will discuss the clinical presentation of cryptococcal infections among HIV patients and various methods of diagnosis, such as India ink, latex agglutination test and culture.

  6. AIDS defining disease: Disseminated cryptococcosis

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    Roshan Anupama

    2006-01-01

    Full Text Available Disseminated cryptococcosis is one of the acquired immune deficiency syndrome defining criteria and the most common cause of life threatening meningitis. Disseminated lesions in the skin manifest as papules or nodules that mimic molluscum contagiosum (MC. We report here a human immunodeficiency virus positive patient who presented with MC like lesions. Disseminated cryptococcosis was confirmed by India ink preparation and histopathology. The condition of the patient improved with amphotercin B.

  7. Cryptococcosis

    Science.gov (United States)

    C. neoformans var. neoformans infection; C. neoformans var. gatti infection; C. neoformans var. grubii infection ... C. neoformans and C. gattii are the fungi that cause this disease. Infection with C. neoformans is ...

  8. Cryptococcosis with bird's eye manifestation: A case report

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    H S Suhas

    2018-01-01

    Full Text Available Cryptococcosis is a menacing opportunistic infection most commonly affecting immunocompromised individuals. Its occurrence in immunocompetant individuals is uncustomary. Disseminated cryptococcosis is subtile in immunocompetent individuals. Cryptococcosis presenting with myriad of symptoms with involvement of lung, meninges, hematological system is rare. We present to you a unique case of disseminated cryptococcosis presenting as bilateral pulmonary nodular opacities with peripheral eosinophilia and meningitis along with a narration of the enthralling diagnostic process.

  9. Colliding Epidemics and the Rise of Cryptococcosis

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    Christina C. Chang

    2015-12-01

    Full Text Available Discovered more than 100 years ago as a human pathogen, the Cryptococcus neoformans–Cryptococcus gattii (C. neoformans–C. gattii complex has seen a large global resurgence in its association with clinical disease in the last 30 years. First isolated in fermenting peach juice, and identified as a human pathogen in 1894 in a patient with bone lesions, this environmental pathogen has now found niches in soil, trees, birds, and domestic pets. Cryptococcosis is well recognized as an opportunistic infection and was first noted to be associated with reticuloendothelial cancers in the 1950s. Since then, advances in transplant immunology, medical science and surgical techniques have led to increasing numbers of solid organ transplantations (SOT and hematological stem cell transplantations being performed, and the use of biological immunotherapeutics in increasingly high-risk and older individuals, have contributed to the further rise in cryptococcosis. Globally, however, the major driver for revivification of cryptococcosis is undoubtedly the HIV epidemic, particularly in Sub-Saharan Africa where access to care and antiretroviral therapy remains limited and advanced immunodeficiency, poverty and malnutrition remains the norm. As a zoonotic disease, environmental outbreaks of both human and animal cryptococcosis have been reported, possibly driven by climate change. This is best exemplified by the resurgence of C. gattii infection in Vancouver Island, Canada, and the Pacific Northwest of the United States since 1999. Here we describe how the colliding epidemics of HIV, transplantation and immunologics, climate change and migration have contributed to the rise of cryptococcosis.

  10. Criptococose em felino Cryptococcosis in cat

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    F.J.F. Sant’Ana

    1999-08-01

    Full Text Available A case of cryptococcosis in a cat refferred to the Hospital Veterinário da Universidade Federal Rural de Pernambuco is described. The cat was euthanized and the microscopic examination of a firm mass observed in the nasal cavity was accomplished. Cryptococcus sp. and a chronic inflammatory process was observed throughout the tissue.

  11. Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography in Disseminated Cryptococcosis

    Science.gov (United States)

    Tripathy, Sarthak; Parida, Girish Kumar; Roy, Shambo Guha; Singhal, Abhinav; Mallick, Saumya Ranjan; Tripathi, Madhavi; Shamim, Shamim Ahmed

    2017-01-01

    Disseminated cryptococcosis without pulmonary involvement is a very rare phenomenon. Patterns of organ involvement in cryptococcosis resemble various other infective conditions as well as malignant conditions on fluorodeoxyglucose positron emission tomography–computed tomography. We present a case of a 43-year-old male patient who had disseminated cryptococcosis. The rarity of the case being noninvolvement of lungs and meninges and resembling more like lymphoma due to the diffuse involvement of the lymph nodes on both sides of the diaphragm. PMID:29142368

  12. Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Disseminated Cryptococcosis.

    Science.gov (United States)

    Tripathy, Sarthak; Parida, Girish Kumar; Roy, Shambo Guha; Singhal, Abhinav; Mallick, Saumya Ranjan; Tripathi, Madhavi; Shamim, Shamim Ahmed

    2017-01-01

    Disseminated cryptococcosis without pulmonary involvement is a very rare phenomenon. Patterns of organ involvement in cryptococcosis resemble various other infective conditions as well as malignant conditions on fluorodeoxyglucose positron emission tomography-computed tomography. We present a case of a 43-year-old male patient who had disseminated cryptococcosis. The rarity of the case being noninvolvement of lungs and meninges and resembling more like lymphoma due to the diffuse involvement of the lymph nodes on both sides of the diaphragm.

  13. An radiography study of pediatric pulmonary cryptococcosis

    International Nuclear Information System (INIS)

    Yeon, Kyung Mo; Kim, In One

    1981-01-01

    Cryptococcosis is a cosmopolitan mycotic disease caused by a yeast like fungus, Cryptococcus neoformans. Respiratory tract, as portal of entry, is the initial focus of infection. Initial pulmonary lesion may heal with or without dissemination of the disease. Authors reviewed 8 cases of confirmed cryptococcosis during Jan. 1973 to June 1981 at Seoul National University Hospital. The results are as follows: Majority of the cases are below 5 years old. The most common symptoms are fever, abdominal pain and distension, and respiratory symptoms in only 2 cases. The involved organs are liver, lymph node, spleen, meninges, and skin in the order of frequency. Chest P-A roentgenograms show both hilar enlargement with perihilar and basilar, linear and small nodular infiltrations. Miliary nodular lesions and mediastinal lymphadenopathy were also noted

  14. Disseminated cryptococcosis in an immunocompetent patient.

    Science.gov (United States)

    Mada, Pradeep; Nowack, Brad; Cady, Beth; Joel Chandranesan, Andrew Stevenson

    2017-07-18

    Cryptococcosis is a fungal infection which is commonly associated with immune-compromised state. Disseminated infection in immunocompetent individuals is extremely rare. We present a case of a 56-year-old African American patient who presented with unilateral knee pain and swelling and was subsequently diagnosed with cryptococcal bone mass with dissemination of infection. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. [Disseminated cryptococcosis in an immunocompetent patient].

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    Elkhihal, B; Hasnaoui, A; Ghfir, I; Moustachi, A; Aoufi, S; Lyagoubi, M

    2015-09-01

    Disseminated cryptococcosis is a serious opportunistic fungal infection caused by a yeast-encapsulated fungus of the genus Cryptococcus neoformans. It occurs most often in patients with a significant deficit of cellular immunity and preferentially affects the central nervous system. The skin and the lungs are the most commonly affected sites outside the neuro-subarachnoid location. We report the case of a patient apparently immunocompetent who had a disseminated cryptococcosis. The disease started with the multiple purplish skin lesions, large umbilicated on the face, groin, forearm and leg with progressively increasing volume. This symptomatology had evolved in the context of weight loss and poor general condition. The diagnosis was established by the presence of cryptococcal at the skin biopsy and cerebrospinal fluid. Research of immunosuppression common pathologies were negative. Treatment was initiated based on amphotericin B for 40 days. The patient's condition deteriorates onset of paraplegia and swallowing disorders causing death in an array of cachexia. This observation points out that disseminated cryptococcosis can occur in an immunocompetent patient. The skin lesions may be the first sign of the disease. Copyright © 2015. Published by Elsevier Masson SAS.

  16. Prevalence of cryptococcosis among HIV-infected patients in ...

    African Journals Online (AJOL)

    Objective: To investigate the prevalence of cryptococcosis among HIV infected patients in Yaounde. Methods: In a hospital-based surveillance study of cryptococcosis, the colonization of Cerebrospinal Fluid (CSF), urine and blood sample by C. neoformans was evaluated by direct microscopic examination and culture ...

  17. HIV-associated anal cancer

    OpenAIRE

    Newsom-Davis, T; Bower, M

    2010-01-01

    HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes. The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50. Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings. Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiqui...

  18. Cryptococcosis outbreak in psittacine birds in Brazil.

    Science.gov (United States)

    Raso, T F; Werther, K; Miranda, E T; Mendes-Giannini, M J S

    2004-08-01

    An outbreak of cryptococcosis occurred in a breeding aviary in São Paulo, Brazil. Seven psittacine birds (of species Charmosyna papou, Lorius lory, Trichoglossus goldiei, Psittacula krameri and Psittacus erithacus) died of disseminated cryptococcosis. Incoordination, progressive paralysis and difficulty in flying were seen in five birds, whereas superficial lesions coincident with respiratory alterations were seen in two birds. Encapsulated yeasts suggestive of Cryptococcus sp. were seen in faecal smears stained with India ink in two cases. Histological examination of the birds showed cryptococcal cells in various tissues, including the beak, choana, sinus, lungs, air sacs, heart, liver, spleen, kidneys, intestines and central nervous system. High titres of cryptococcal antigen were observed in the serum of an affected bird. In this case, titres increased during treatment and the bird eventually died. Yeasts were isolated from the nasal mass, faeces and liver of one bird. Cryptococcus neoformans var. gattii serovar B was identified based on biochemical, physiological and serological tests. These strains were resistant (minimum inhibitory concentration 64 microg/ml) to fluconazole. This is the first report of C. neoformans var. gattii occurring in psittacine birds in Brazil.

  19. HIV-associated neurocognitive disorders

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    Zahir Vally

    2011-12-01

    Full Text Available HIV infection is associated with disturbances in brain function referred to as HIV-associated neurocognitive disorders (HAND. This literature review outlines the recently revised diagnostic criteria for the range of HAND from the earliest to the more advanced stages: (i asymptomatic neurocognitive impairment; (ii mild neurocognitive disorder; and (iii HIV-associated dementia. Relevant literature is also reviewed regarding the differential impact upon component cognitive domains known to be affected in HAND, which in turn should ideally be targeted during clinical and neuropsychological assessments: psychomotor and information processing speed, learning and memory, attention and working memory, speech and language, executive functioning and visuospatial functioning. A discussion outlining the neuropsychological tools used in the diagnostic screening of HAND is also included. The central mechanisms of HAND appear to revolve primarily around psychomotor slowing and cognitive control over mental operations, possibly reflecting the influence of disrupted fronto-striatal circuits on distributed neural networks critical to cognitive functions. The accurate assessment and diagnosis of HAND depends on meeting the need for statistically sound neuropsychological assessment techniques that may be used confidently in assessing South African populations, as well as the development of relevant norms for comparison of test performance data.

  20. Intra-abdominal cryptococcosis in two dogs.

    Science.gov (United States)

    Malik, R; Hunt, G B; Bellenger, C R; Allan, G S; Martin, P; Canfield, P J; Love, D N

    1999-08-01

    Intra-abdominal cryptococcosis was diagnosed in two young dogs. The first, an entire male border collie, was presented with vomiting. An abdominal mass detected during physical examination proved to be cryptococcal mesenteric lymphadenitis on exploratory laparotomy. The second dog, a female neutered giant schnauzer, was presented with neurological signs suggestive of encephalopathy. Intestinal cryptococcal granulomas were detected in an extensive diagnostic investigation which included abdominal ultrasonography. The gastrointestinal tract was considered the most likely portal of entry for cryptococcal organisms in both cases. Both dogs were treated using surgery and multiagent antifungal chemotherapy. The first case succumbed despite therapy, while the second dog was treated successfully as gauged by return to clinical normality and a substantial decline in the cryptococcal antigen titre which continued to fall after cessation of treatment.

  1. Abdominal cryptococcosis in two dogs: diagnosis and medical management.

    Science.gov (United States)

    Tangeman, Lindsay; Davignon, Danielle; Patel, Reema; Littman, Meryl

    2015-01-01

    Canine cryptococcosis cases are typically reported as neurologic, disseminated, or both. There have been few reports of other parenchymal organ involvement. Dogs infected with Cryptococcus spp. are likely to develop central nervous system involvement, and those that are severely affected are treated aggressively with surgery and/or amphotericin B. This report describes two cases of canine abdominal cryptococcosis: one boxer with primary alimentary cryptococcosis alone and one miniature schnauzer with pancreatic and disseminated cryptococcosis. The boxer is unique in that the dog suffered from primary alimentary cryptococcosis without dissemination, secondary anemia due to gastrointestinal losses, and is the second case to have Cryptococcus spp. identified on fecal examination as part of the diagnostic workup. Unlike previous reports, surgery was not performed in either case, and both dogs were treated with fluconazole alone. Currently, both dogs are free from clinical signs, and Cryptococcus spp. antigen titers are negative at 17 and 15 mo after initial presentation. These cases suggest fluconazole may be effective therapy alone for canine abdominal cryptococcosis, negating the need for high-risk therapy options such as surgery and/or amphotericin B in some cases.

  2. Disturbed amino acid metabolism in HIV: association with neuropsychiatric symptoms

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    Johanna M Gostner

    2015-07-01

    Full Text Available Blood levels of the amino acid phenylalanine, as well as of the tryptophan breakdown product kynurenine, are found to be elevated in human immunodeficiency virus type 1 (HIV-1-infected patients. Both essential amino acids, tryptophan and phenylalanine are important precursor molecules for neurotransmitter biosynthesis. Thus, dysregulated amino acid metabolism may be related to disease-associated neuropsychiatric symptoms such as development of depression, fatigue, and cognitive impairment.Increased phenylalanine/tyrosine and kynurenine/tryptophan ratios are associated with immune activation in patients with HIV-1 infection and decrease upon effective antiretroviral therapy. Recent large-scale metabolic studies have confirmed the crucial involvement of tryptophan and phenylalanine metabolism in HIV-associated disease. Herein, we summarize the current status of the role of tryptophan and phenylalanine metabolism in HIV disease and discuss how inflammatory stress-associated dysregulation of amino acid metabolism may be part of the pathophysiology of common HIV-associated neuropsychiatric conditions.

  3. Pulmonary cryptococcosis in rheumatoid arthritis (RA) patients: Comparison of imaging characteristics among RA, acquired immunodeficiency syndrome, and immunocompetent patients

    International Nuclear Information System (INIS)

    Yanagawa, Noriyo; Sakai, Fumikazu; Takemura, Tamiko; Ishikawa, Satoru; Takaki, Yasunobu; Hishima, Tsunekazu; Kamata, Noriko

    2013-01-01

    Purpose: The imaging characteristics of cryptococcosis in rheumatoid arthritis (RA) patients were analyzed by comparing them with those of acquired immunodeficiency syndrome (AIDS) and immunocompetent patients, and the imaging findings were correlated with pathological findings. Methods: Two radiologists retrospectively compared the computed tomographic (CT) findings of 35 episodes of pulmonary cryptococcosis in 31 patients with 3 kinds of underlying states (10 RA, 12 AIDS, 13 immunocompetent), focusing on the nature, number, and distribution of lesions. The pathological findings of 18 patients (8 RA, 2 AIDS, 8 immunocompetent) were analyzed by two pathologists, and then correlated with imaging findings. Results: The frequencies of consolidation and ground glass attenuation (GGA) were significantly higher, and the frequency of peripheral distribution was significantly lower in the RA group than in the immunocompetent group. Peripheral distribution was less common and generalized distribution was more frequent in the RA group than in the AIDS group. The pathological findings of the AIDS and immunocompetent groups reflected their immune status: There was lack of a granuloma reaction in the AIDS group, and a complete granuloma reaction in the immunocompetent group, while the findings of the RA group varied, including a complete granuloma reaction, a loose granuloma reaction and a hyper-immune reaction. Cases with the last two pathologic findings were symptomatic and showed generalized or central distribution on CT. Conclusion: Cryptococcosis in the RA group showed characteristic radiological and pathological findings compared with the other 2 groups

  4. Pulmonary cryptococcosis in rheumatoid arthritis (RA) patients: Comparison of imaging characteristics among RA, acquired immunodeficiency syndrome, and immunocompetent patients

    Energy Technology Data Exchange (ETDEWEB)

    Yanagawa, Noriyo, E-mail: noriyo_yana@ybb.ne.jp [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Sakai, Fumikazu [Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298 (Japan); Takemura, Tamiko [Department of Pathology, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935 (Japan); Ishikawa, Satoru [Department of Respiratory Medicine, National Hospital Organization Chiba-East-Hospital, 673 Nitona-cho, Chuo-ku, Chiba-shi, Chiba 260-8712 (Japan); Takaki, Yasunobu [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Hishima, Tsunekazu [Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan); Kamata, Noriko [Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677 (Japan)

    2013-11-01

    Purpose: The imaging characteristics of cryptococcosis in rheumatoid arthritis (RA) patients were analyzed by comparing them with those of acquired immunodeficiency syndrome (AIDS) and immunocompetent patients, and the imaging findings were correlated with pathological findings. Methods: Two radiologists retrospectively compared the computed tomographic (CT) findings of 35 episodes of pulmonary cryptococcosis in 31 patients with 3 kinds of underlying states (10 RA, 12 AIDS, 13 immunocompetent), focusing on the nature, number, and distribution of lesions. The pathological findings of 18 patients (8 RA, 2 AIDS, 8 immunocompetent) were analyzed by two pathologists, and then correlated with imaging findings. Results: The frequencies of consolidation and ground glass attenuation (GGA) were significantly higher, and the frequency of peripheral distribution was significantly lower in the RA group than in the immunocompetent group. Peripheral distribution was less common and generalized distribution was more frequent in the RA group than in the AIDS group. The pathological findings of the AIDS and immunocompetent groups reflected their immune status: There was lack of a granuloma reaction in the AIDS group, and a complete granuloma reaction in the immunocompetent group, while the findings of the RA group varied, including a complete granuloma reaction, a loose granuloma reaction and a hyper-immune reaction. Cases with the last two pathologic findings were symptomatic and showed generalized or central distribution on CT. Conclusion: Cryptococcosis in the RA group showed characteristic radiological and pathological findings compared with the other 2 groups.

  5. Normalization of Bilateral Adrenal Gland Enlargement after Treatment for Cryptococcosis

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    Yuka Muraoka

    2017-01-01

    Full Text Available Cryptococcosis usually occurs in immunocompromised patients and can cause enlargement of the adrenal glands, although the morphologic changes after treatment have not been reported in detail. We report the case of 24-year-old man with fevers, headaches, and impaired consciousness who had been treated with glucocorticoids for a protein-losing gastroenteropathy. The cerebrospinal fluid analysis revealed cryptococcal meningitis. Computed tomography showed bilateral adrenal enlargement. A retrospective analysis revealed that the enlargement had been detected 5 months before admission and gradually increased. The enlargement was improved with antifungal therapy and normalized 6 months later. This is the first report describing morphological changes in the adrenal glands associated with cryptococcal meningitis. Adrenal enlargement by cryptococcosis can be improved without any abnormal findings, including calcifications, which may be a unique characteristic from other diseases, including tuberculosis.

  6. What's in a Name? AIDS Dementia Complex, HIV-associated ...

    African Journals Online (AJOL)

    Key words: HIV; AIDS; HIV-associated dementia (HAD); HIV-associated neurocognitive disorder (HAND) .... increased survival a mixed picture is becoming more common. ... alternating sequence and memory recall of the four objects.

  7. CT findings of pulmonary cryptococcosis in immunocompetent children

    International Nuclear Information System (INIS)

    Wang Bei; Peng Yun; Zhou Chunjun; Zhao Shunying

    2012-01-01

    Objective: The aim of our study was to study the CT findings of cryptococcosis in immunocompetent children. Methods: CT scan and clinical data of 21 immunocompetent children with proven pulmonary cryptococcosis were retrospectively collected and analyzed. Results: The CT scans demonstrated 1 mm subpleural nodule in the lingula of left lung in 1 patient and multiple nodules in 20 patients.Of 20 patients with multiple nodules, peripheral or subpleural distribution was found in 12 patients,and diffuse distribution in 8 patients. Of 20 patients with multiple nodules,Nodules of < 10 mm was found in 18 patients,< 3 mm in 14 patients, and > 10 mm in 2 patients. Round nodular with smooth margin was detected in 15 of 20 patients with multiple nodules. Lymphadenopathy was found in 17 patients including 3 patients with mild contrast enhancement and 2 patients with circular enhancement. Extrapulmonary lesions distributing in liver, spleen, kidney, and the nervous system were found in 14 patients. In follow-up, 1 patient died and 20 patients fully recovered. Conclusions: Pulmonary multiple nodules with lymphadenopathy is the characteristic CT findings in immunocompetent children with pulmonary cryptococcosis which is prone to involve multiple extra-pulmonary organs. (authors)

  8. Pulmonary Cryptococcosis: Imaging Findings in 23 Non-AIDS Patients

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    Song, Kyoung Doo; Lee, Kyung Soo; Kim, Tae Sung; Yi, Chin A; Chung, Myung Jin [Samsung Medical Center, Seoul (Korea, Republic of); Man Pyo Chung; O Jung Kwon [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    We aimed to review the patterns of lung abnormalities of pulmonary cryptococcosis on CT images, position emission tomography (PET) findings of the disease, and the response of lung abnormalities to the therapies in non-AIDS patients. We evaluated the initial CT (n = 23) and 18F-fluorodeoxyglucose (FDG) PET (n = 10), and follow-up (n = 23) imaging findings of pulmonary cryptococcosis in 23 non-AIDS patients. Lung lesions were classified into five patterns at CT: single nodular, multiple clustered nodular, multiple scattered nodular, mass-like, and bronchopneumonic patterns. The CT pattern analyses, PET findings, and therapeutic responses were recorded. A clustered nodular pattern was the most prevalent and was observed in 10 (43%) patients. This pattern was followed by solitary pulmonary nodular (n = 4, 17%), scattered nodular (n = 3, 13%), bronchopneumonic (n = 2, 9%), and single mass (n = 1, 4%) patterns. On PET scans, six (60%) of 10 patients showed higher FDG uptake and four (40%) demonstrated lower FDG uptake than the mediastinal blood pool. With specific treatment of the disease, a complete clearance of lung abnormalities was noted in 15 patients, whereas a partial response was noted in seven patients. In one patient where treatment was not performed, the disease showed progression. Pulmonary cryptococcosis most commonly appears as clustered nodules and is a slowly progressive and slowly resolving pulmonary infection. In two-thirds of patients, lung lesions show high FDG uptake, thus simulating a possible malignant condition

  9. Clinical and microbiological characteristics of cryptococcosis in Singapore: predominance of Cryptococcus neoformans compared with Cryptococcus gattii.

    Science.gov (United States)

    Chan, Monica; Lye, David; Win, Mar Kyaw; Chow, Angela; Barkham, Tim

    2014-09-01

    To describe the clinical features, treatments, outcomes, and subtype prevalence of cryptococcosis in Singapore. All patients with laboratory confirmed cryptococcal infections admitted from 1999 to 2007 to a teaching hospital in Singapore were reviewed retrospectively. Identification and molecular types of Cryptococcus neoformans variants and Cryptococcus gattii were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Serotypes were inferred with a multiplex PCR method. Of 62 patients with cryptococcosis, C. neoformans var. grubii was the predominant subtype (in 95%), affecting mainly immunocompromised hosts (91%) with HIV infection (80%). Patients with HIV were younger (median age 36.5 vs. 49.5 years, p=0.006) and less likely to present with an altered mental status (14% vs. 50%, p=0.013). In contrast, delayed treatment (median 7 days vs. 2 days, p=0.03), pulmonary involvement (58% vs. 14%, p=0.03), and initial treatment with fluconazole (25% vs. 2%, p=0.02) were more common in HIV-negative patients. C. gattii was uncommon, affecting only three patients, all of whom were immunocompetent and had disseminated disease with pulmonary and neurological involvement. All C. gattii were RFLP type VG II, serotype B and all C. neoformans var. grubii were RFLP type VN I, serotype A, except for one that was RFLP type VN II. C. neoformans var. grubii, subtype VN I, was the predominant subtype in Singapore, infecting younger, mainly immunocompromised hosts with HIV. C. gattii was uncommon, causing pulmonary manifestations in older, immunocompetent patients and were RFLP type VG II. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Cryptococcosis in captive cheetah (Acinonyx jubatus : two cases : case report

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    L.A. Bolton

    1999-07-01

    Full Text Available Cryptococcus neoformans is a yeast-like organism associated with pulmonary, meningoencephalitic, or systemic disease. This case report documents 2 cases of cryptococcosis with central nervous system involvement in captive cheetah (Acinonyx jubatus. In both cases the predominant post mortal lesions were pulmonary cryptococcomas and extensive meningoencephalomyelitis. Both cheetahs tested negative for feline immunodeficiency virus and feline leukaemia virus. The organism isolated in Case 2 was classified as Cryptococcus neoformans var. gattii, which is mainly associated with disease in immunocompetent hosts.

  11. Disseminated Cryptococcosis presenting as cellulitis in a renal transplant recipient.

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    Chaya, Ramachandraiah; Padmanabhan, Srinivasan; Anandaswamy, Venugopal; Moin, Aumir

    2013-01-15

    Cellulitis is an unusual presentation of cryptococcal infection in renal allograft recipients. In such patients, disseminated cryptococcal infection can result in significant morbidity and mortality. Patients are often treated with antibiotics before a definitive diagnosis is made, delaying appropriate therapy. We describe the case of a 43-year-old post renal transplant recipient presenting with fever and swelling in the right thigh. On physical examination, the patient was found to have features suggestive of cellulitis with minimal slurring of speech. Material obtained from incision and drainage of the wound showed yeast cells resembling Cryptococcus spp. Blood culture and cerebrospinal fluid culture were also found to have growth of Cryptococcus neoformans. He received treatment with amphotericin B 6 mg/kg daily intravenously for two weeks, then continued with fluconazole 400 mg daily for three months. The patient showed a remarkable improvement. There was no recurrence of cryptococcosis after four months of follow-up. The diagnosis of disseminated cryptococcosis should be considered in differential diagnosis of cellulitis among non HIV immunocompromised hosts. A high clinical suspicion and early initiation of therapy is needed to recognize and treat patients effectively.

  12. Research progress of HIV-associated myelopathy

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    Kun HONG

    2016-08-01

    Full Text Available The wide usage of highly active antiretroviral therapy (HAART leads to reduction of the occurence rate of focal or diffuse neurological damage caused by human immunodeficiency virus (HIV infection, which prominently improves the living quality of HIV-infected patients. Despite this progress, about 70% of HIV-infected patients develop neurological complications. Although neurological disease typically occurs in the advanced stage of the disease or after severe damage of immune functions, it may also occur during early stage of the infection. HIV-associated myelopathy is a common complication of immunodeficiency syndrome and its typical pathological appearence is vacuolar degeneration. In many patients the clinical manifestations of vacuolar myelopathy are in fact limited to non-specific sphincter or sexual dysfunction, and may remain completely asymptomatic. Even when motor and sensory symptoms become evident, the diagnosis is often complicated by a concomitant peripheral neuropathy. The purpose of this study is to summarize pathogenesis, clinical manifestations, pathological features, diagnosis and treatment of HIV-associated myelopathy. DOI: 10.3969/j.issn.1672-6731.2016.08.004

  13. Radiological features of AIDS complicated by pulmonary cryptococcosis: Literature review and a report of 10 cases

    Directory of Open Access Journals (Sweden)

    Xiao Yu

    2016-03-01

    Conclusion: The radiological signs featured AIDS complicated by pulmonary cryptococcosis such as singular or multiple nodules with cavity and “halo sign” can facilitate its diagnosis. But the diagnosis should be made in combination to the clinical history.

  14. Antiretroviral treatment uptake in patients with HIV associated TB ...

    African Journals Online (AJOL)

    Background. Delivery of integrated care for patients with HIV-associated TB is challenging. We assessed the uptake and timing of antiretroviral treatment (ART) among eligible patients attending a primary care service with co-located ART and TB clinics. Methods. In a retrospective cohort study, all HIV-associated TB patients ...

  15. Acute lethal toxicity following passive immunization for treatment of murine cryptococcosis.

    OpenAIRE

    Savoy, A C; Lupan, D M; Manalo, P B; Roberts, J S; Schlageter, A M; Weinhold, L C; Kozel, T R

    1997-01-01

    Passive immunization with monoclonal antibodies (MAbs) specific for the major capsular polysaccharide of Cryptococcus neoformans alters the course of murine cryptococcosis. During studies of passive immunization for treatment of murine cryptococcosis, we noted the occurrence of an acute, lethal toxicity. Toxicity was characterized by scratching, lethargy, respiratory distress, collapse, and death within 20 to 60 min after injection of antibody. The toxic effect was observed only in mice with ...

  16. Evidence of Cryptococcosis in cattle in Zaria Kaduna state, Nigeria

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    Emmanuella N. Akange

    2013-04-01

    Full Text Available Aim: Cryptococcosis is azoonotic infection caused by fungal of the Cryptococcus neoformans complex comprising of C. neoformans and C. gattii.The disease affects humans and animals worldwide causing morbidity and mortality. This work was carried out to determine the occurrence of cryptococcal antigens and factors associated with presence of antigens in cattle in Zaria, Nigeria. Materials and Methods: Three hundred and ninety (390 serum samples from cattle of various ages were collected from 11 farms in Zaria, Nigeria. The samples were analysed using alatex agglutination test and lateral flow assay kit which detectsthe polysaccharide capsular antigens of Cryptococcus species. Results:Out of the 390 samples tested 28 (7.17% were found to be positive using the latex agglutination test while only of these 22 (5.64% were positive using the lateral flow assay. There was a strong correlation (r=0.939, p=0.0002 between the results of the latex agglutination test and the lateral flow assay. There was no statistically significant difference (p>0.005 in positivity for cryptococcal antigens between sex, age and sex, though, there was a statistically significant difference (p<0.05 in positivity between management systems i.e. semi-intensive and intensive farming systems. Conclusions: The epidemiological value of this report lies in its demonstration that the risk of cattle and humans infection with cryptococcosis exist in farms in Zaria. The presence of this pathogen among these cattle poses an economic threat to the livestock industry due to the mastitis it causes. It also poses a significant public health threat because of its zoonotic nature and the increasing population of immunocompromised individuals. Large scale studies to determine specific risk factors and the role of the environment and experimental studies to determine what governs the transition from nasal colonisation to infection are recommended. [Vet World 2013; 6(2.000: 64-67

  17. Cryptococcosis in patients with diabetes mellitus II in mainland China: 1993-2015.

    Science.gov (United States)

    Li, Yingfang; Fang, Wenjie; Jiang, Weiwei; Hagen, Ferry; Liu, Jia; Zhang, Lei; Hong, Nan; Zhu, Yu; Xu, Xiaoguang; Lei, Xia; Deng, Danqi; Xu, Jianping; Liao, Wanqing; Boekhout, Teun; Chen, Min; Pan, Weihua

    2017-11-01

    Diabetes mellitus II (DM II) is a newly defined independent factor contributing to the morbidity and mortality of cryptococcosis. This retrospective case analysis aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis in Chinese DM II patients. This study included 30 cases of cryptococcosis with DM II occurring from 1993 to 2015 in mainland China. The hospital-based prevalence of cryptococcosis in DM II was 0.21%. The mean age of the patients was 56.1 years (95% confidence interval: 51.5, 60.6), and 93% of the patients were older than 40 years. Sixty-two per cent of the patients experienced untreated or poorly controlled blood glucose before infection. Multilocus sequence typing analysis categorised all cultured strains as Cryptococcus neoformans and sequence type 5. Sixty-nine per cent of pulmonary cryptococcosis patients experienced misdiagnoses and treatment delays. Sixty per cent of cryptococcal meningitis patients received substandard antifungal therapy. The overall death rate was 33%. Considering the large population size of DM II patients in China, improved attention should be paid to the high prevalence of cryptococcosis as revealed by us. We also emphasised the importance of blood glucose control for infection prevention, especially among the elderly. © 2017 Blackwell Verlag GmbH.

  18. Cryptococcosis in the koala (Phascolarctos cinereus): pathogenesis and treatment in the context of two atypical cases.

    Science.gov (United States)

    Schmertmann, Laura J; Stalder, Kathryn; Hudson, Donald; Martin, Patricia; Makara, Mariano; Meyer, Wieland; Malik, Richard; Krockenberger, Mark B

    2018-02-24

    Disseminated cryptococcosis caused by Cryptococcus gattii (molecular type VGI) was diagnosed in an adult free-ranging female koala (Phascolarctos cinereus). Subclinical cryptococcosis was later diagnosed in this koala's joey. In the adult koala, a pathological fracture of the tibia was associated with the bone lysis of marked focal cryptococcal osteomyelitis. Limb-sparing orthopedic intervention, in the setting of disseminated cryptococcosis, was judged to have a poor prognosis, and the adult koala was euthanized. The joey was removed and hand-reared. Serological testing revealed persistent and increasing cryptococcal capsular antigenemia in the absence of clinical signs of disease and it was subsequently treated with oral fluconazole for approximately 16 months, rehabilitated and released into the wild. It was sighted 3 months post-release in a good state of health and again at 18 months post-release but was not recaptured on either occasion. This is the first published report of cryptococcal appendicular osteomyelitis in a koala. It is also the first report of concurrent disease in a dependent juvenile and the successful treatment of subclinical cryptococcosis to full resolution of the cryptococcal antigenemia in a free-ranging koala. This paper provides a discussion of cryptococcal osteomyelitis in animals, host-pathogen-environment interactions and treatment and monitoring protocols for cryptococcosis in koalas. Published reports describing the treatment of cryptococcosis in koalas are also collated and summarised.

  19. The Role of Cryptococcus in the Immune System of Pulmonary Cryptococcosis Patients.

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    Jinlin Wang

    Full Text Available To investigate the role of Cryptococcus in the immune system of immunocompetent patients with pulmonary cryptococcosis (PC by analysing the dynamic changes of patients' immune status before and after antifungal therapy.The level of the serum interferon-γ (IFN-γ and interleukin (IL-2, -4, -10 and -12 was measured before and after 6-months of treatment. Peripheral blood samples were obtained from 30 immunocompetent PC patients and 30 age- and gender-matched healthy controls. Peripheral blood mononuclear cells (PBMCs were isolated and incubated with recombinant human IL-12 (rhIL-12 for 48 h. Then the concentrations of IFN-γ and IL-4 in the supernatant were analysed.Baseline serum IFN-γ level was significantly lower in the PC patients as compared with the control group (P < 0.001. The serum IL-2 and IFN-γ of PC patients were significantly increased after appropriate treatments (P < 0.05 and P < 0.001 when compared to their baseline levels. The productions of IFN-γ in the culture supernatant of PBMCs showed no significant difference between the control and PC patients both before and after antifungal treatments. RhIL-12 is a potent stimulus for IFN-γ production. Culture PBMCs collected from PC patients before treatments had a smaller increase of IFN-γ production in the present of rhIL-12 than the control (P < 0.01; PBMCs from PC patients completing 6-months of treatment showed a comparable increase of IFN-γ production by rhIL-12 stimulation to the control group.In apparently immunocompetent patients with PC, a normalization of serum IFN-γ was achieved after recovery from infection. This suggests that Cryptococcus infection per se can suppress the immune system and its elimination contributes to the reestablishment of an immune equilibrium.

  20. Pulmonary cryptococcosis in a ruxolitinib-treated patient with primary myelofibrosis

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    Anna Hirano

    2017-01-01

    Full Text Available We present the case of a 79-year-old man who showed multiple pulmonary nodules on chest computed tomography (CT after being treated for 6 months with ruxolitinib, an inhibitor of Janus kinase (JAK 1 and 2, to treat primary myelofibrosis. We examined the lesions by bronchoscopy, and the biopsy specimen revealed fungus bodies of Cryptococcus with granulomatous inflammation. As a result, the patient was diagnosed with pulmonary cryptococcosis. The patient was treated with fluconazole (200 mg daily for 2 weeks with concomitant ruxolitinib administration, but the pulmonary lesions progressed. Subsequently, the patient was treated with voriconazole (300 mg daily for 3 weeks, but the lesions worsened further. The administration of ruxolitinib was therefore discontinued, and the dosage of voriconazole was increased to 400 mg daily. Three months later, the pulmonary lesions diminished in size. The present case of pulmonary cryptococcosis occurred in a patient treated with ruxolitinib. Treatment of pulmonary cryptococcosis with concomitant JAK inhibitor administration may result in poor treatment efficacy. It might be better to stop administration of JAK inhibitors, if possible, in patients being treated for pulmonary cryptococcosis.

  1. [Neuromeningeal cryptococcosis in patients infected with HIV at Agadir regional hospital, (Souss-Massa, Morocco)].

    Science.gov (United States)

    Chadli, S; Aghrouch, M; Taqarort, N; Malmoussi, M; Ouagari, Z; Moustaoui, F; Bourouache, M; Oulkheir, S

    2018-03-01

    Neuromeningeal cryptococcosis (NMC) is a severe and fatal opportunistic infection. Lethality is frequent in the absence of treatment, especially in the presence of HIV co-infection. To determine the prevalence, epidemiological, clinical, biological and therapeutic aspects as well as the evolution of NMC for patients infected with HIV. This is a retrospective study of 40 cases of neuromeningeal cryptococcosis diagnosed in HIV-infected patients. Data are collected for 7 years (from January 2010 to December 2016) in the registers of the parasitology laboratory and the infectious diseases department at the regional hospital center in Agadir. A reduction in the prevalence of neuromeningeal cryptococcosis in HIV-infected patients was noted from 2010 to 2016 (3.66% to 0.83%). The overall prevalence of NMC was 1.53%. The mean age was 37±10 years old, with 90% of patients aged less than 45 years. The main clinical symptomatology was headache (75%). The main cytochemical abnormalities of cerebrospinal fluid analysis were hyperproteinorachy (60%), hypoglycorachy (63%) and lymphocytosis (50%). The mean CD4 cell count was 47/mm 3 . Patients were initially treated with amphotericin B, relayed with fluconazole. The overall lethality was 35%. Neuromeningeal cryptococcosis is a serious opportunistic infection in patients HIV-infected, and the lethality rate remains unacceptable. Fighting NMC in HIV+ patients requires early diagnosis, increased access to antiretrovirals, rapid introduction of appropriate treatment and the prescription of effective systemic antifungals. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  2. Disseminated Cryptococcosis With Brain Involvement in Patients With Chronic Lymphoid Malignancies on Ibrutinib.

    Science.gov (United States)

    Messina, Julia A; Maziarz, Eileen K; Spec, Andrej; Kontoyiannis, Dimitrios P; Perfect, John R

    2017-01-01

    We report 2 cases of disseminated cryptococcosis with central nervous system involvement in patients with chronic lymphoid malignancies occurring within 1 month of starting on ibrutinib. Characteristically, in both cases, no inflammation was seen in the cerebrospinal fluid. Central nervous system mycoses should be considered as a potential complication of ibrutinib.

  3. Disseminated Cryptococcosis With Brain Involvement in Patients With Chronic Lymphoid Malignancies on Ibrutinib

    OpenAIRE

    Messina, Julia A.; Maziarz, Eileen K.; Spec, Andrej; Kontoyiannis, Dimitrios P.; Perfect, John R.

    2017-01-01

    Abstract We report 2 cases of disseminated cryptococcosis with central nervous system involvement in patients with chronic lymphoid malignancies occurring within 1 month of starting on ibrutinib. Characteristically, in both cases, no inflammation was seen in the cerebrospinal fluid. Central nervous system mycoses should be considered as a potential complication of ibrutinib.

  4. Cryptococcosis mimicking cutaneous cellulitis in a patient suffering from rheumatoid arthritis: a case report

    Directory of Open Access Journals (Sweden)

    Probst Corina

    2010-08-01

    Full Text Available Abstract Background Cryptococcus neoformans is an encapsulated yeast and the most frequent cryptococcal species found in humans. Cryptococcosis is considered an opportunistic infection as it affects mainly immunosuppressed individuals. In humans, C. neoformans causes three types of infections: pulmonary cryptococcosis, cryptococcal meningitis and wound or cutaneous cryptococcosis. Case Presentation An 81-year-old woman developed severe necrotizing cellulitis on her left arm without any preceding injury. The patient had been treated with systemic corticosteroids over twenty years for rheumatoid arthritis (RA. Skin biopsies of the wound area were initially interpreted as cutaneous vasculitis of unknown etiology. However, periodic acid Schiff staining and smear analysis later revealed structures consistent with Cryptococcus neoformans, and the infection was subsequently confirmed by culture. After the initiation of therapy with fluconazole 400 mg per day the general condition and the skin ulcers improved rapidly and the patient was discharged to a rehabilitation facility. Subsequently surgical debridement and skin grafting were performed. Conclusions Opportunistic infections such as cryptococcosis can clinically and histologically mimic cutaneous vasculitis and have to be investigated rigorously as a differential diagnosis in immunosuppressed patients.

  5. Cerebellar cryptococcosis characterized by a space-occupying lesion in an immunocompetent non-HIV patient

    Directory of Open Access Journals (Sweden)

    Liu BX

    2014-12-01

    Full Text Available Bi-Xia Liu,1,* Xi-Jian Dai,2,3,* Heng Liu,4,* Hong-Han Gong,3 Yi-Xiang J Wang,2 Lun-Li Zhang1 1Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 2Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; 3Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 4Department of Radiology, Affiliated Hospital of Zunyi Medical University, Guizhou, People’s Republic of China *These authors contributed equally to this work Abstract: Central nervous system (CNS cryptococcosis is an opportunistic fungal infection that typically occurs in patients with reduced immunological function, such as patients with AIDS, patients receiving organ transplants, or patients receiving corticosteroid and immunosuppressive therapy. CNS cryptococcosis rarely occurs in immunocompetent patients. CNS cryptococcosis is characterized by meningitis and encephalitis and occasionally forms isolated granulomas. Isolated cerebellar cryptococcoma is a rare condition, especially in immunocompetent patients, and the misdiagnosis rate is high. A definite diagnosis must be based on pathology. To raise awareness of this disease, the clinical data of a patient with cryptococcomas in the right side of the cerebellum are reported. Keywords: cryptococcosis, cerebellar, central nervous system, magnetic resonance imaging, immunosuppressive

  6. Antiretroviral treatment uptake in patients with HIV- associated TB ...

    African Journals Online (AJOL)

    ART results in a 64 - 95% reduction in mortality risk 5 and is an essential component of care. How soon to start. ART after TB treatment initiation has become clearer from randomised controlled trials. These show that integration of ART and TB treatment in all HIV-associated TB patients regardless of CD4 count significantly.

  7. Management of HIV-associated focal brain lesions in developing ...

    African Journals Online (AJOL)

    Background. HIV-associated focal brain lesions (FBLs) are caused by opportunistic infections, neoplasms, or cerebrovascular diseases. In developed countries toxoplasma encephalitis (TE) is the most frequent cause followed by primary CNS lymphoma (PCNSL). Guidelines based on these causes have been proposed ...

  8. Screening for HIV-associated neurocognitive disorders (HANDs) in ...

    African Journals Online (AJOL)

    The prevalence of HIV-associated neurocognitive disorders necessitates community-based screening. In recent years, progress has been made in developing more localised comparative data for use in such screening on the African continent. These studies used measurements that are considered fair, easily accessible, ...

  9. Prevalence of HIV associated neurocognitive deficit among HIV ...

    African Journals Online (AJOL)

    Background: HIV associated neurocognitive deficit impairs motor activity, neuropsychiatric functioning, daily activity and work activity usually due to the immune suppression effect of the virus. Sub-Saharan region including Ethiopia is the region with the highest burden of HIV. However, a few studies are found on this aspect ...

  10. Advanced oral HIV-associated Kaposi sarcoma with facial ...

    African Journals Online (AJOL)

    Rapidly progressive facial lymphoedoema that develops concurrently with or immediately after rapid enlargement of oral Kaposi sarcoma in human immunodeficiency virus (HIV) -seropositive persons forebodes death. Previously, we reported on three patients with HIV-associated Kaposi sarcoma who had not been ...

  11. Hiv-Associated Pulmonary Hypertension: Case Report | Shavadia ...

    African Journals Online (AJOL)

    With the advent of highly active antiretroviral therapy, there has been a significant change in the epidemiology of pulmonary disease in HIV/AIDS. The relative prevalence of non-infectious manifestations is likely to rise. HIV associated pulmonary hypertension (HIV-PH), albeit low prevalence, is associated with significant ...

  12. Outcomes of cryptococcosis in renal transplant recipients in a less-resourced health care system.

    Science.gov (United States)

    Ponzio, Vinicius; Camargo, Luis F A; Medina-Pestana, José O; Perfect, John R; Colombo, Arnaldo L

    2018-04-20

    Cryptococcosis is the second most common cause of invasive fungal infections in renal transplant recipients in many countries, and data on graft outcome after treatment for this infection is lacking in less-resourced health care settings. Data from 47 renal transplant recipients were retrospectively collected at a single institution during a period of 13 years. Graft dysfunction, graft loss and mortality rates were evaluated. Predictors of mortality and graft loss were estimated. A total of 38 (97.4%) patients treated with amphotericin B deoxycholate (AMBd) showed graft dysfunction after antifungal initiation and 8 (18.2%) had kidney graft loss. Graft loss within 30 days after cryptococcosis onset was significantly associated with disseminated infection, greater baseline creatinine levels and graft dysfunction concomitant to AMBd therapy and an additional nephrotoxic condition. The 30-day mortality rate was 19.2% and it was significantly associated with disseminated and pulmonary infections, somnolence at admission, high CSF opening pressure, positive CSF India ink, creatinine levels greater than 2.0 mg/dL at admission, graft dysfunction in patients treated with AMBd and an additional nephrotoxic condition and graft loss within 30 days. Graft dysfunction was common in renal transplant recipients with cryptococcosis treated with AMBd. The rate of graft loss rate was high, most frequently in patients with concomitant nephrotoxic conditions. Therefore, the clinical focus should be on the use of less nephrotoxic lipid formulations of amphotericin B in this specific population requiring a polyene induction regimen for treatment of severe cryptococcosis in all health care systems caring for transplantation recipients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. Disseminated cryptococcosis and fluconazole resistant oral candidiasis in a patient with acquired immunodeficiency syndrome (AIDS).

    Science.gov (United States)

    Kothavade, Rajendra J; Oberai, Chetan M; Valand, Arvind G; Panthaki, Mehroo H

    2010-10-28

    Disseminated cryptococcosis and recurrent oral candidiasis was presented in a-heterosexual AIDS patient. Candida tropicalis (C.tropicalis) was isolated from the oral pseudomembranous plaques and Cryptococcus neoformans (C. neoformans) was isolated from maculopapular lesions on body parts (face, hands and chest) and body fluids (urine, expectorated sputum, and cerebrospinal fluid). In vitro drug susceptibility testing on the yeast isolates demonstrated resistance to fluconazole acquired by C. tropicalis which was a suggestive possible root cause of recurrent oral candidiasis in this patient.

  14. Primary pulmonary cryptococcosis: evaluation of CT characteristics in 26 immunocompetent Chinese patients

    Energy Technology Data Exchange (ETDEWEB)

    Qu, Yanjuan; Liu, Guobing; Ghimire, Prasanna; Liao, Meiyan; Xu, Liying [Dept. of Radiology, Zhongnan Hospital of Wuhan Univ., Wuhan (China)], E-mail: leometeor123@gmail.com; Shi, Heshui [Dept. of Radiology, Union Hospital affiliated to Tongji Medical College of Huazhong Univ. of Science and Technology, Wuhan (China); Yang, Guifang [Dept. of Pathology, Zhongnan Hospital of Wuhan Univ., Wuhan (China); Wang, Guanliang [Dept. of Radiology, Taizhou Hospital of Zhejiang Province, Taizhou (China)

    2012-07-15

    Background. Discrepancies still exist in the diagnosis of primary pulmonary cryptococcosis in immunocompetent patients. Purpose. To describe and evaluate radiological manifestations of pulmonary cryptococcosis in immunocompetent patients. Material and Methods. Twenty-six histopathologically confirmed cases of pulmonary cryptococcosis were analyzed for clinical, pathological, and CT characteristics. Necessary statistical tests for differences in CT presentations and correlation analysis between clinical and CT characteristics were performed. Results. The patients' ages ranged from 24 to 79 years, with 20 men and six women. Eighteen patients were symptomatic, with cough as the most common symptom (n = 14, 53.8%). Nodules (n = 21, 80.8%) were the most common CT findings. Eight cases presented with solitary and nine with multiple nodules, while 13 cases presented with irregular and 19 with ill-defined nodules. The halo sign was demonstrated, encompassing nodules in 14 of the 21 patients. Lesions were mainly localized in the lower lobes of the lungs (n = 15, 57.7%) with peripheral distribution (n = 18, 69.2%). Ground-glass opacities (GGOs) were more easily detected in older patients (66.7%, P <0.01). No significant differences in CT abnormalities were found between male and female patients. Conclusion. Primary pulmonary cryptococcosis in immunocompetent patients exhibits certain CT characteristics. The typical presentation includes multiple nodules with the halo sign scattered in the peripheral field in the lower lobes of the bilateral lungs. This could contribute to diagnosis of the disease entity. However, vigilance should be exercised when facing GGOs, with or without nodules, in older patients.

  15. Glucosylceramide Administration as a Vaccination Strategy in Mouse Models of Cryptococcosis.

    Directory of Open Access Journals (Sweden)

    Visesato Mor

    Full Text Available Cryptococcus neoformans is an opportunistic fungal pathogen and the causative agent of the disease cryptococcosis. Cryptococcosis is initiated as a pulmonary infection and in conditions of immune deficiency disseminates to the blood stream and central nervous system, resulting in life-threatening meningoencephalitis. A number of studies have focused on the development of a vaccine against Cryptococcus, primarily utilizing protein-conjugated components of the Cryptococcus polysaccharide capsule as antigen. However, there is currently no vaccine against Cryptococcus in the clinic. Previous studies have shown that the glycosphingolipid, glucosylceramide (GlcCer, is a virulence factor in C. neoformans and antibodies against this lipid inhibit fungal growth and cell division. In the present study, we have investigated the possibility of using GlcCer as a therapeutic agent against C. neoformans infections in mouse models of cryptococcosis. GlcCer purified from a non-pathogenic fungus, Candida utilis, was administered intraperitoneally, prior to infecting mice with a lethal dose of C. neoformans. GlcCer administration prevented the dissemination of C. neoformans from the lungs to the brain and led to 60% mouse survival. GlcCer administration did not cause hepatic injury and elicited an anti-GlcCer antibody response, which was observed independent of the route of administration and the strains of mouse. Taken together, our results suggest that fungal GlcCer can protect mice against lethal doses of C. neoformans infection and can provide a viable vaccination strategy against Cryptococcus.

  16. Glucosylceramide Administration as a Vaccination Strategy in Mouse Models of Cryptococcosis.

    Science.gov (United States)

    Mor, Visesato; Farnoud, Amir M; Singh, Ashutosh; Rella, Antonella; Tanno, Hiromasa; Ishii, Keiko; Kawakami, Kazuyoshi; Sato, Toshiya; Del Poeta, Maurizio

    2016-01-01

    Cryptococcus neoformans is an opportunistic fungal pathogen and the causative agent of the disease cryptococcosis. Cryptococcosis is initiated as a pulmonary infection and in conditions of immune deficiency disseminates to the blood stream and central nervous system, resulting in life-threatening meningoencephalitis. A number of studies have focused on the development of a vaccine against Cryptococcus, primarily utilizing protein-conjugated components of the Cryptococcus polysaccharide capsule as antigen. However, there is currently no vaccine against Cryptococcus in the clinic. Previous studies have shown that the glycosphingolipid, glucosylceramide (GlcCer), is a virulence factor in C. neoformans and antibodies against this lipid inhibit fungal growth and cell division. In the present study, we have investigated the possibility of using GlcCer as a therapeutic agent against C. neoformans infections in mouse models of cryptococcosis. GlcCer purified from a non-pathogenic fungus, Candida utilis, was administered intraperitoneally, prior to infecting mice with a lethal dose of C. neoformans. GlcCer administration prevented the dissemination of C. neoformans from the lungs to the brain and led to 60% mouse survival. GlcCer administration did not cause hepatic injury and elicited an anti-GlcCer antibody response, which was observed independent of the route of administration and the strains of mouse. Taken together, our results suggest that fungal GlcCer can protect mice against lethal doses of C. neoformans infection and can provide a viable vaccination strategy against Cryptococcus.

  17. Measuring child awareness for adult symptomatic HIV using a verbal assessment tool: concordance between adult-child dyads on adult HIV-associated symptoms and illnesses.

    Science.gov (United States)

    Becker, Elisabeth; Kuo, Caroline; Operario, Don; Moshabela, Mosa; Cluver, Lucie

    2015-11-01

    This study assessed children's awareness for adult HIV-associated symptoms and illnesses using a verbal assessment tool by analysing inter-rater reliability between adult-child dyads. This study also evaluated sociodemographic and household characteristics associated with child awareness of adult symptomatic HIV. A cross-sectional survey using a representative community sample of adult-child dyads (N=2477 dyads) was conducted in KwaZulu-Natal, South Africa. Analyses focused on a subsample (n=673 adult-child dyads) who completed verbal assessment interviews for symptomatic HIV. We used an existing validated verbal autopsy approach, originally designed to determine AIDS-related deaths by adult proxy reporters. We adapted this approach for use by child proxy reporters for reporting on HIV-associated symptoms and illnesses among living adults. Analyses assessed whether children could reliably report on adult HIV-associated symptoms and illnesses and adult provisional HIV status. Adult-child pairs concurred above the 65th percentile for 9 of the 10 HIV-associated symptoms and illnesses with sensitivities ranging from 10% to 100% and specificities ranging from 20% to 100%. Concordant reporting between adult-child dyads for the adult's provisional HIV status was 72% (sensitivity=68%, specificity=73%). Children were more likely to reliably match adult's reports of provisional HIV status when they lived in households with more household members, and households with more robust socioeconomic indicators including access to potable water, food security and television. Children demonstrate awareness of HIV-associated symptoms and illnesses experienced by adults in their household. Children in households with greater socioeconomic resources and more household members were more likely to reliably report on the adult's provisional HIV status. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Physiotherapy management of patients with HIV-associated Kaposi's sarcoma.

    Science.gov (United States)

    Harris-Love, Michael O; Shrader, Joseph A

    2004-01-01

    Kaposi's sarcoma is the most common form of cancer in patients with human immunodeficiency virus (HIV) infection. Although Kaposi sarcoma lesions may contribute to significant physical impairments, there is a lack of scientific literature detailing the role of physiotherapy in the treatment of HIV-associated Kaposi's sarcoma. The present Case Report includes two males, aged 36 and 39 years, seropositive for HIV with invasive Kaposi's sarcoma. Patient A was evaluated for bilateral foot pain caused by plantar surface Kaposi s sarcoma lesions that rendered him unable to walk. He progressed to walking 400feet after a treatment regimen of gait training with the use of custom plastazote sandals. Patient B was evaluated for right lower extremity lymphoedema secondary to invasive Kaposi's sarcoma. He experienced an 18% reduction in limb volume, a 38% reduction in pain and a 20 degrees increase in terminal knee flexion after therapeutic exercise and the use of compressive bandaging and garments. This Case Report suggests that physiotherapy interventions may be valuable in the conservative management of patients with HIV-associated Kaposi s sarcoma.

  19. Current questions in HIV-associated lung cancer.

    Science.gov (United States)

    Shcherba, Marina; Shuter, Jonathan; Haigentz, Missak

    2013-09-01

    In this review, we explore current questions regarding risk factors contributing to frequent and early onset of lung cancer among populations with HIV infection, treatment, and outcomes of lung cancer in HIV-infected patients as well as challenges in a newly evolving era of lung cancer screening. Lung cancer, seen in three-fold excess in HIV-infected populations, has become the most common non-AIDS defining malignancy in the highly active antiretroviral therapy era. HIV-associated lung cancer appears to be associated with young age at diagnosis, cigarette smoking, advanced stage at presentation, and a more aggressive clinical course. There is no unified explanation for these observations, and aside from traditional risk factors, HIV-related immunosuppression and biological differences might play a role. In addition to smoking cessation interventions, screening and early cancer detection in HIV-infected populations are of high clinical importance, although evidence supporting lung cancer screening in this particularly high-risk subset is currently lacking, as are prospective studies of lung cancer therapy. There is an urgent need for prospective clinical trials in HIV-associated lung cancer to improve understanding of lung cancer pathogenesis and to optimize patient care. Several clinical trials are in progress to address questions in cancer biology, screening, and treatment for this significant cause of mortality in persons with HIV infection.

  20. Ketoconazole in the treatment of cryptococcosis of the central nervous system

    Directory of Open Access Journals (Sweden)

    P. C. Trevisol-Bittencourt

    1991-06-01

    Full Text Available Two patients with cryptococcosis of the CNS were treated with ketoconazole (KTZ, an imidazole derivative with fungistatic properties; they had either failed standard therapy (Amphotericin-B + 5-Flurocytosine or suffred intolerable side-effects to it. Both patients were administered KTZ 800 mg/day as monotherapy for six months without interruption and both responded. One month after KTZ therapy was withdrawn, however, a relapse of the infection was seen in one case. Side-effects were minimal during the trial of treatment. KTZ could be a useful drug in some cases of neurocryptococcosis.

  1. Disseminated cryptococcosis with splenic and meningeal involvement in a patient with AIDS

    International Nuclear Information System (INIS)

    Lizarazo, Jairo; Parra, Edgar; Parada, Oscar

    2010-01-01

    We present the case of a 37-year-old woman with a recent diagnosis of HIV-infection. The patient consulted because of headache, diarrhea, vomit and fever of two weeks' evolution. The patient had a wasting syndrome, and severe splenomegaly. Cerebral spinal fluid study showed meningitis by Cryptococcus neoformans. CT-scan revealed splenomegaly with focal lesions. Percutaneous biopsy with 18-gauge needle from one of the focal lesions confirmed cryptococcosis. The treatment was initiated with amphotericin B, followed by fluconazole. The patient's evolution has been satisfactory. Splenic lesions resolved and the patient is now asymptomatic and on secondary prophylaxis with fluconazole and antiretroviral treatment

  2. National Institute on Drug Abuse symposium report: drugs of abuse, dopamine, and HIV-associated neurocognitive disorders/HIV-associated dementia.

    Science.gov (United States)

    Purohit, Vishnudutt; Rapaka, Rao; Frankenheim, Jerry; Avila, Albert; Sorensen, Roger; Rutter, Joni

    2013-04-01

    The National Institute on Drug Abuse organized a symposium on drugs of abuse, dopamine, and HIV-associated neurocognitive disorders (HAND)/HIV-associated dementia (HAD) in Rockville, Maryland, October 4, 2011. The purpose of this symposium was to evaluate the potential role of dopamine in the potentiation of HAND/HAD by drugs of abuse. A summary of the symposium has been presented in this report.

  3. The Case for Adopting the “Species Complex” Nomenclature for the Etiologic Agents of Cryptococcosis

    Directory of Open Access Journals (Sweden)

    Kyung J. Kwon-Chung

    2017-01-01

    Full Text Available Cryptococcosis is a potentially lethal disease of humans/animals caused by Cryptococcus neoformans and Cryptococcus gattii. Distinction between the two species is based on phenotypic and genotypic characteristics. Recently, it was proposed that C. neoformans be divided into two species and C. gattii into five species based on a phylogenetic analysis of 115 isolates. While this proposal adds to the knowledge about the genetic diversity and population structure of cryptococcosis agents, the published genotypes of 2,606 strains have already revealed more genetic diversity than is encompassed by seven species. Naming every clade as a separate species at this juncture will lead to continuing nomenclatural instability. In the absence of biological differences between clades and no consensus about how DNA sequence alone can delineate a species, we recommend using “Cryptococcus neoformans species complex” and “C. gattii species complex” as a practical intermediate step, rather than creating more species. This strategy recognizes genetic diversity without creating confusion.

  4. Timing of initiation of antiretroviral therapy in human immunodeficiency virus (HIV)--associated tuberculous meningitis

    NARCIS (Netherlands)

    Török, M. Estee; Yen, Nguyen Thi Bich; Chau, Tran Thi Hong; Mai, Nguyen Thi Hoang; Phu, Nguyen Hoan; Mai, Pham Phuong; Dung, Nguyen Thi; Chau, Nguyen Van Vinh; Bang, Nguyen Duc; Tien, Nguyen Anh; Minh, N. H.; Hien, Nguyen Quang; Thai, Phan Vuong Khac; Dong, Doan The; Anh, Do Thi Tuong; Thoa, Nguyen Thi Cam; Hai, Nguyen Ngoc; Lan, Nguyen Ngoc; Lan, Nguyen Thi Ngoc; Quy, Hoang Thi; Dung, Nguyen Huy; Hien, Tran Tinh; Chinh, Nguyen Tran; Simmons, Cameron Paul; de Jong, Menno; Wolbers, Marcel; Farrar, Jeremy James

    2011-01-01

    The optimal time to initiate antiretroviral therapy (ART) in human immunodeficiency virus (HIV)-associated tuberculous meningitis is unknown. We conducted a randomized, double-blind, placebo-controlled trial of immediate versus deferred ART in patients with HIV-associated tuberculous meningitis to

  5. Intestinal Lesion in a Dog Due to Cryptococcus gattii Type VGII and Review of Published Cases of Canine Gastrointestinal Cryptococcosis.

    Science.gov (United States)

    de Abreu, Daniel Paiva Barros; Machado, Carlos Henrique; Makita, Mário Tatsuo; Botelho, Camila Flávia Magalhães; Oliveira, Fernanda Gomes; da Veiga, Cristiano Chaves Pessoa; Martins, Marilena Dos Anjos; Baroni, Francisco de Assis

    2017-06-01

    Cryptococcosis is a mycosis caused by yeasts of genus Cryptococcus, mainly the species C. neoformans and C. gattii that can affect humans and animals. These yeasts are widely distributed in the environment and are typically associated with avian droppings and decaying wood. Most infections are related to the respiratory tract, but the central nervous system and cutaneous lesions are also reported in the literature. The present report is a case of cryptococcosis in an 18-month-old unspayed female English Bulldog with the main complaint of weight loss and diarrhea. The presence of two large masses observed in an ultrasound examination leads us to perform an exploratory laparotomy. Considering the size of the lesion and the impossibility of owner to provide intensive care, the consent for euthanasia was requested. The postmortem diagnosis of cryptococcosis was revealed by cytological evaluation, and the involvement of C. gattii VGII was confirmed by isolation and identification tests as well as by the detection of the URA5 gene restriction fragment length polymorphism PCR analysis. Reports in the literature of the involvement of Cryptococcus in gastrointestinal lesions are rare in both human and veterinary medicine. Data about different forms of cryptococcosis are important to provide more knowledge of uncommon clinical presentations of this yeast and therefore improve the diagnoses and decisions for the best therapy.

  6. {sup 18}F-FDG PET/CT and contrast-enhanced CT findings of pulmonary cryptococcosis

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Si-yun, E-mail: wang_shuxia@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Chen, Gang, E-mail: cgggh@outlook.com [Department of Thoracic Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Luo, Dong-lan, E-mail: 695532870@qq.com [Department of Pathology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Shao, Dan, E-mail: shaodan501@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Liu, En-tao, E-mail: GDGH2015@gmail.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Sun, Taotao, E-mail: sunmoodsdaisy@bjmu.edu.cn [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China); Wang, Shu-Xia, E-mail: wsyggh@outlook.com [Department of PET Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong (China)

    2017-04-15

    Purpose: Pulmonary cryptococcosis is an uncommon cause of pulmonary nodules in non-AIDS patients. This study reports the {sup 18}F-fluorodeoxyglucose-positron emission tomography ({sup 18}F-FDG PET/CT) and contrast-enhanced CT (CE-CT) findings of 42 patients with pulmonary cryptococcosis. Materials and methods: A retrospective review of the {sup 18}F-FDG PET/CT and CE-CT findings of 42 patients with histologically proven pulmonary cryptococcosis was conducted. All patients underwent PET/CT and CE-CT in the same session. The CT diagnosis was based on the location, morphological features, and enhancement of lesions. The PET/CT findings were recorded, and clinical data and surgical and histopathological findings were collected. Results: The results of the PET scans revealed that 37 (88%) of 42 patients showed higher FDG uptake, and 5 (12%) patients demonstrated lower FDG uptake than the mediastinal blood pool. The maximum standardized uptake value (SUV) of pulmonary cryptococcosis ranged from 1.4 to 13.0 (average: 5.7 ± 3.3, median 4.9). A single nodular pattern was the most prevalent pattern observed and was found in 29 (69%) patients. This pattern was followed by scattered nodular (n = 4, 10%), clustered nodular (n = 3, 7%), mass-like (n = 3, 7%), and bronchopneumonic (n = 3, 7%) patterns. The most frequent pattern of immunocompetent patients was the single nodular pattern (29 of 33, 88%). Immunocompromised patients most frequently pattern exhibited mass-like (3 of 9, 33%) and bronchopneumonic (3 of 9, 33%) patterns. Conclusion: Pulmonary cryptococcosis most commonly appears as single nodules in immunocompetent patients. Mass-like and bronchopneumonic patterns were common in immunocompromised patients. In 88% of patients, lung lesions showed high FDG uptake, thus mimicking a possible malignant condition.

  7. Urinary NGAL marks cystic disease in HIV-associated nephropathy.

    Science.gov (United States)

    Paragas, Neal; Nickolas, Thomas L; Wyatt, Christina; Forster, Catherine S; Sise, Meghan; Morgello, Susan; Jagla, Bernd; Buchen, Charles; Stella, Peter; Sanna-Cherchi, Simone; Carnevali, Maria Luisa; Mattei, Silvia; Bovino, Achiropita; Argentiero, Lucia; Magnano, Andrea; Devarajan, Prasad; Schmidt-Ott, Kai M; Allegri, Landino; Klotman, Paul; D'Agati, Vivette; Gharavi, Ali G; Barasch, Jonathan

    2009-08-01

    Nephrosis and a rapid decline in kidney function characterize HIV-associated nephropathy (HIVAN). Histologically, HIVAN is a collapsing focal segmental glomerulosclerosis with prominent tubular damage. We explored the expression of neutrophil gelatinase-associated lipocalin (NGAL), a marker of tubular injury, to determine whether this protein has the potential to aid in the noninvasive diagnosis of HIVAN. We found that expression of urinary NGAL was much higher in patients with biopsy-proven HIVAN than in HIV-positive and HIV-negative patients with other forms of chronic kidney disease. In the HIV-transgenic mouse model of HIVAN, NGAL mRNA was abundant in dilated, microcystic segments of the nephron. In contrast, urinary NGAL did not correlate with proteinuria in human or in mouse models. These data show that marked upregulation of NGAL accompanies HIVAN and support further study of uNGAL levels in large cohorts to aid in the noninvasive diagnosis of HIVAN and screen for HIVAN-related tubular damage.

  8. Acute lethal toxicity following passive immunization for treatment of murine cryptococcosis.

    Science.gov (United States)

    Savoy, A C; Lupan, D M; Manalo, P B; Roberts, J S; Schlageter, A M; Weinhold, L C; Kozel, T R

    1997-01-01

    Passive immunization with monoclonal antibodies (MAbs) specific for the major capsular polysaccharide of Cryptococcus neoformans alters the course of murine cryptococcosis. During studies of passive immunization for treatment of murine cryptococcosis, we noted the occurrence of an acute, lethal toxicity. Toxicity was characterized by scratching, lethargy, respiratory distress, collapse, and death within 20 to 60 min after injection of antibody. The toxic effect was observed only in mice with a cryptococcal infection and was reduced or absent in the early and late stages of disease. The clinical course and histopathology were consistent with those for shock. There was considerable variation between mouse strains in susceptibility to toxicity. Swiss Webster mice from the Charles River colony were most susceptible, followed by C3H/He, BALB/c, and C57BL/6 mice. DBA/2 mice and Swiss Webster mice from the Simonsen colony were resistant. Acute toxicity was mimicked by injection of preformed complexes of MAb and purified polysaccharide. The toxic effect was also produced by injection of MAbs into mice that were preloaded with polysaccharide. The toxic effect was not blocked by treatment of mice with chloropheniramine or anti-tumor necrosis factor alpha antibodies or by depletion of complement components via pretreatment with cobra venom factor. Toxicity was reduced by treatment of mice with high doses of epinephrine, dexamethasone, or chlorpromazine. Finally, the toxic effect was completely blocked by treatment of mice with the platelet-activating factor antagonist WEB 2170 BS or by pretreatment of mice with the liposome-encapsulated drug dichloromethylene diphosphonate, a procedure which depletes macrophages from the spleen and liver. PMID:9125564

  9. Some pharmacokinetic indices of oral fluconazole administration to koalas (Phascolarctos cinereus) infected with cryptococcosis.

    Science.gov (United States)

    Govendir, M; Black, L A; Jobbins, S E; Kimble, B; Malik, R; Krockenberger, M B

    2016-08-01

    Three asymptomatic koalas serologically positive for cryptococcosis and two symptomatic koalas were treated with 10 mg/kg fluconazole orally, twice daily for at least 2 weeks. The median plasma Cmax and AUC0-8 h for asymptomatic animals were 0.9 μg/mL and 4.9 μg/mL·h, respectively; and for symptomatic animals 3.2 μg/mL and 17.3 μg/mL·h, respectively. An additional symptomatic koala was treated with fluconazole (10 mg/kg twice daily) and a subcutaneous amphotericin B infusion twice weekly. After 2 weeks the fluconazole Cmax was 3.7 μg/mL and the AUC0-8 h was 25.8 μg/mL*h. An additional three koalas were treated with fluconazole 15 mg/kg twice daily for at least 2 weeks, with the same subcutaneous amphotericin protocol co-administered to two of these koalas (Cmax : 5.0 μg/mL; mean AUC0-8 h : 18.1 μg/mL*h). For all koalas, the fluconazole plasma Cmax failed to reach the MIC90 (16 μg/mL) to inhibit C. gattii. Fluconazole administered orally at either 10 or 15 mg/kg twice daily in conjunction with amphotericin is unlikely to attain therapeutic plasma concentrations. Suggestions to improve treatment of systemic cryptococcosis include testing pathogen susceptibility to fluconazole, monitoring plasma fluconazole concentrations, and administration of 20-25 mg/kg fluconazole orally, twice daily, with an amphotericin subcutaneous infusion twice weekly. © 2015 The Authors. Journal of Veterinary Pharmacology and Therapeutics Published by John Wiley & Sons Ltd.

  10. Safe interruption of maintenance therapy against previous infection with four common HIV-associated opportunistic pathogens during potent antiretroviral therapy

    DEFF Research Database (Denmark)

    Kirk, Ole; Reiss, Peter; Uberti-Foppa, Caterina

    2002-01-01

    maintenance therapy for cytomegalovirus (CMV) end-organ disease, disseminated Mycobacterium avium complex (MAC) infection, cerebral toxoplasmosis, and extrapulmonary cryptococcosis in patients receiving antiretroviral therapy. DESIGN: Observational study. SETTING: Seven European HIV cohorts. PATIENTS: 358...... identified: 162 for CMV disease, 103 for MAC infection, 75 for toxoplasmosis, and 39 for cryptococcosis. During 781 person-years of follow-up, five patients had relapse. Two relapses (one of CMV disease and one of MAC infection) were diagnosed after maintenance therapy was interrupted when the CD4 lymphocyte....... One relapse (toxoplasmosis) was diagnosed after maintenance therapy interruption at a CD4 lymphocyte count greater than 200 x 10(6) cells/L for 15 months. The overall incidences of recurrent CMV disease, MAC infection, toxoplasmosis, and cryptococcosis were 0.54 per 100 person-years (95% CI, 0.07 to 1...

  11. [Non-neuromeningeal cryptococcosis in patients with AIDS in Bamako, Mali: 2 case reports].

    Science.gov (United States)

    Minta, D K; Traoré, A M; Coulibaly, I; Diallo, K; Soukho-Kaya, A; Dolo, A; Kamaté, B; Ouologuem, D S; Dembélé, M; Traoré, H A; Chabasse, D; Pichard, E

    2014-06-01

    Non-neuromeningeal cryptococcosis forms resulting from disseminated infection are rarely reported in African literature and are non-documented in Malian medical ward. We report two clinical observations. Case 1: a 26-year-old patient, carrying the HIV-1 infection, in which the clinical examination revealed skin lesions simulating molluscum contagiosum and functional impairment of the lower limbs. Radiography of the lumbar spine showed vertebral osteolysis on L4-L5. Cryptococcal research remained negative in the CSF but positive at histological examination of the skin lesions and in pathological products of lumbosacral drainage. The treatment with fluconazole and ARV led to a favorable outcome. Case 2: a 42-year-old patient, admitted for fever cough, known for his non-compliance to ARVs and in which the examination found a syndrome of pleural condensation and a painful swelling of the outer third of the right clavicle (around the acromio-clavicular joint). Paraclinical investigations concluded in osteolysis of the acromial end of the right clavicle and an image of the right lung with abundant effusion. Cryptococcal research was positive in the pleural effusion and in the product of aspiration of acromio-clavicular tumefaction, negative in CSF. It seems important to think of a cryptococcal etiology even in the absence of clinical meningeal signs in front of any cutaneous sign and any fluctuating swelling in HIV+ patient. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  12. Remission of HIV-associated myelopathy after highly active antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Fernandez-Fernandez F

    2004-07-01

    Full Text Available HIV-associated myelopathy is the leading cause of spinal cord disease in HIV-infected patients. Typically, it affects individuals with low CD4 T cell counts, presenting with slowly progressive spastic paraparesis associated with dorsal column sensory loss as well as urinary disturbances. Other aetiologies must be first ruled out before establishing the diagnosis. We report here the case of a 37-year-old woman with advanced HIV disease, who developed HIV-associated myelopathy. The patient showed a gradual improvement after beginning with highly active antiretroviral therapy and, finally, she achieved a complete functional recovery. In addition, neuroimaging and neurophysiological tests normalized.

  13. Criptococose canina: relato de caso Canine ocular cryptococcosis: a case report

    Directory of Open Access Journals (Sweden)

    C.E. Larsson

    2003-10-01

    Full Text Available Descreve-se, pela primeira vez no Brasil, um caso de criptococose canina com acometimento oftalmo e dermatopático, com diagnóstico intra-vitam, em animal da raça Pastor Alemão, fêmea, com 24 meses de vida, criado em São Paulo, em contacto com outros cinco cães assintomáticos, que havia se infectado pelo contato com dejetos de pombos (Columba livia. Evoluia há 90 dias, com quadro tegumentar e ósseo, sintomas e lesões características, sendo, ainda, detectada forma assintomática de coriorretinite, de início unilateral. O diagnóstico foi estabelecido pelos dados da anamnese, dos exames físico, dermatológico e complementares (radiográfico, cultivo micológico, histopatologia de pele tendo-se evidenciado e isolado cepa de Criptococcus neoformans var. neoformans. Após nove meses de terapia com itraconazol (9mg/kg/SID/VO houve involução total do quadro, sem qualquer efeito adverso à droga.A case of cryptococcosis with ocular and cutaneous involvement is reported by the first time in Brazil in a dog. A two-year-old female German Shepherd living in a hold house with other five healthy dogs was infected through the contact with pigeon (Columba livia feces. The illness started 90 days previously with cutaneous and bone involvement resulting in characteristic clinical signs and lesions, in addition to a initially unilateral asymptomatic chorioretinitis. The diagnosis was established based on anamnesis, physical and dermatologic examinations and complementary exams (radiographs, skin biopsy and histopathology and the isolation of a Cryptococcus neoformans var. neoformans strain was accomplished. There was a complete resolution of the disease after nine months of therapy using itraconazole (9mg/kg, q24h, PO and no side effect was observed.

  14. HIV-associated lung cancer: survival in an unselected cohort.

    Science.gov (United States)

    Hoffmann, Christian; Kohrs, Fabienne; Sabranski, Michael; Wolf, Eva; Jaeger, Hans; Wyen, Christoph; Siehl, Jan; Baumgarten, Axel; Hensel, Manfred; Jessen, Arne; Schaaf, Bernhard; Vogel, Martin; Bogner, Johannes; Horst, Heinz-August; Stephan, Christoph

    2013-10-01

    Lung cancer is one of the most common non-AIDS-defining malignancies in HIV-infected patients. However, data on clinical outcome and prognostic factors are scarce. This was a national German multicentre, retrospective cohort analysis of all cases of lung cancer seen in HIV-infected individuals from 2000 through 2010. Survival was analyzed with respect to the use of antiretroviral therapy (ART), specific lung cancer therapies, and other potential prognostic factors. A total of 72 patients (mean age 55.5 y, CD4 T-cells 383/μl) were evaluated in this analysis. At time of lung cancer diagnosis, 86% were on ART. Of these, 79% had undetectable HIV-1 RNA (cancer stage of I-IIIA was associated with better overall survival when compared with the advanced stages IIIb/IV (p = 0.0003). Other factors predictive of improved overall survival were better performance status, CD4 T-cells > 200/μl, and a non-intravenous drug use transmission risk for HIV. Currently, most cases of lung cancer occur in the setting of limited immune deficiency and a long-lasting viral suppression. As in HIV-negative cases, the clinical stage of lung cancer is highly predictive of survival, and long-term overall survival can only be achieved at the limited stages. The still high mortality underscores the importance of smoking cessation strategies in HIV-infected patients.

  15. Insights into the mechanisms of protective immunity against Cryptococcus neoformans infection using a mouse model of pulmonary cryptococcosis.

    Directory of Open Access Journals (Sweden)

    Karen L Wozniak

    2009-09-01

    Full Text Available Cryptococcus neoformans is an opportunistic fungal pathogen that causes life-threatening pneumonia and meningoencephalitis in immune compromised individuals. Previous studies have shown that immunization of BALB/c mice with an IFN-gamma-producing C. neoformans strain, H99gamma, results in complete protection against a second pulmonary challenge with an otherwise lethal cryptococcal strain. The current study evaluated local anamnestic cell-mediated immune responses against pulmonary cryptococcosis in mice immunized with C. neoformans strain H99gamma compared to mice immunized with heat-killed C. neoformans (HKC.n.. Mice immunized with C. neoformans strain H99gamma had significantly reduced pulmonary fungal burden post-secondary challenge compared to mice immunized with HKC.n. Protection against pulmonary cryptococcosis was associated with increased pulmonary granulomatous formation and leukocyte infiltration followed by a rapid resolution of pulmonary inflammation, which protected the lungs from severe allergic bronchopulmonary mycosis (ABPM-pathology that developed in the lungs of mice immunized with HKC.n. Pulmonary challenge of interleukin (IL-4 receptor, IL-12p40, IL-12p35, IFN-gamma, T cell and B cell deficient mice with C. neoformans strain H99gamma demonstrated a requirement for Th1-type T cell-mediated immunity, but not B cell-mediated immunity, for the induction of H99gamma-mediated protective immune responses against pulmonary C. neoformans infection. CD4(+ T cells, CD11c(+ cells, and Gr-1(+ cells were increased in both proportion and absolute number in protected mice. In addition, significantly increased production of Th1-type/pro-inflammatory cytokines and chemokines, and conversely, reduced Th2-type cytokine production was observed in the lungs of protected mice. Interestingly, protection was not associated with increased production of cytokines IFN-gamma or TNF-alpha in lungs of protected mice. In conclusion, immunization with C

  16. Pleural effusion as the initial clinical presentation in disseminated cryptococcosis and fungaemia: an unusual manifestation and a literature review.

    Science.gov (United States)

    Chen, Mayun; Wang, Xiaomi; Yu, Xianjuan; Dai, Caijun; Chen, Dunshun; Yu, Chang; Xu, Xiaomei; Yao, Dan; Yang, Li; Li, Yuping; Wang, Liangxing; Huang, Xiaoying

    2015-09-22

    Cryptococcus neoformans infection usually presents as chronic meningitis and is increasingly being recognized in immunocompromised patients. Presentation with pleural effusion is rare in cryptococcal disease; in fact, only 4 cases of pleural effusion as the initial clinical presentation in cryptococcosis have been reported in English-language literature to date. We report the first case of pleural effusion as the initial clinical presentation in a renal transplant recipient who was initially misdiagnosed with tuberculous pleuritis but who then developed fungaemia and disseminated cryptococcosis. The examination of this rare manifestation and the accompanying literature review will contribute to increased recognition of the disease and a reduction in misdiagnoses. We describe a 63-year-old male renal transplant recipient on an immunosuppressive regimen who was admitted for left pleural effusion and fever. Cytological examinations and pleural fluid culture were nonspecific and negative. Thoracoscopy only found chronic, nonspecific inflammation with fibrosis in the pleura. After empirical anti-tuberculous therapy, the patient developed an elevated temperature, a severe headache and vomiting and fainted in the ward. Cryptococci were specifically found in the cerebrospinal fluid following lumbar puncture. Blood cultures were twice positive for C. neoformans one week later. He was transferred to the respiratory intensive care unit (RICU) immediately and was placed on non-invasive ventilation for respiratory failure for 2 days. He developed meningoencephalitis and fungaemia with C. neoformans during hospitalization. He was given amphotericin B liposome combined with 5-flucytosine and voriconazole for first 11 days, then amphotericin B liposome combined with 5-flucytosine sustained to 8 weeks, after that changed to fluconazole for maintenance. His condition improved after antifungal treatment, non-invasive ventilation and other support. Further pathological consultation

  17. Recommendations for the classification of HIV associated neuromanifestations in the German DRG system.

    Science.gov (United States)

    Evers, Stefan; Fiori, W; Brockmeyer, N; Arendt, G; Husstedt, I-W

    2005-09-12

    HIV associated neuromanifestations are of growing importance in the in-patient treatment of HIV infected patients. In Germany, all in-patients have to be coded according to the ICD-10 classification and the German DRG-system. We present recommendations how to code the different primary and secondary neuromanifestations of HIV infection. These recommendations are based on the commentary of the German DRG procedures and are aimed to establish uniform coding of neuromanifestations.

  18. Clinical Features, Treatment, and Outcome of HIV-Associated Immune Thrombocytopenia in the HAART Era

    Directory of Open Access Journals (Sweden)

    Kimberley L. S. Ambler

    2012-01-01

    Full Text Available The characteristics of HIV-associated ITP were documented prior to the HAART era, and the optimal treatment beyond HAART is unknown. We performed a review of patients with HIV-associated ITP and at least one platelet count <20 × 109/L since January 1996. Of 5290 patients in the BC Centre for Excellence in HIV/AIDS database, 31 (0.6% had an ITP diagnosis and platelet count <20 × 109/L. Initial ITP treatment included IVIG, n=12; steroids, n=10; anti-RhD, n=8; HAART, n=3. Sixteen patients achieved response and nine patients achieved complete response according to the International Working Group criteria. Median time to response was 14 days. Platelet response was not significantly associated with treatment received, but complete response was lower in patients with a history of injection drug use. Complications of ITP treatment occurred in two patients and there were four unrelated deaths. At a median followup of 48 months, 22 patients (71% required secondary ITP treatment. This is to our knowledge the largest series of severe HIV-associated ITP reported in the HAART era. Although most patients achieved a safe platelet count with primary ITP treatment, nearly all required retreatment for ITP recurrence. New approaches to the treatment of severe ITP in this population are needed.

  19. Possible misdiagnosis of HIV associated lymphoma as tuberculosis among patients attending Uganda Cancer Institute.

    Science.gov (United States)

    Buyego, Paul; Nakiyingi, Lydia; Ddungu, Henry; Walimbwa, Stephen; Nalwanga, Damalie; Reynolds, Steven J; Parkes-Ratanshi, Rosalind

    2017-03-14

    Early diagnosis of HIV associated lymphoma is challenging because the definitive diagnostic procedure of biopsy, requires skills and equipment that are not readily available. As a consequence, diagnosis may be delayed increasing the risk of mortality. We set out to determine the frequency and risk factors associated with the misdiagnosis of HIV associated lymphoma as tuberculosis (TB) among patients attending the Uganda Cancer Institute (UCI). A retrospective cohort study design was used among HIV patients with associated lymphoma patients attending the UCI, Kampala, Uganda between February and March 2015. Eligible patient charts were reviewed for information on TB treatment, socio-demographics, laboratory parameters (Hemoglobin, CD4cells count and lactate dehydrogenase) and clinical presentation using a semi structured data extraction form. A total of 183 charts were reviewed; 106/183 were males (57.9%), the median age was 35 (IQR, 28-45). Fifty six (30.6%) patients had a possible misdiagnosis as TB and their median time on TB treatment was 3.5 (1-5.3) months. In multivariate analysis the presence of chest pain had an odd ratio (OR) of 4.4 (95% CI 1.89-10.58, p HIV associated lymphoma attending UCI are misdiagnosed and treated as TB. Chest pain and stage III and IV of lymphoma were associated with an increased risk of a possible misdiagnosis of lymphoma as TB.

  20. [Retrospective study of neuromeningeal cryptococcosis in patients infected with HIV in the infectious diseases unit of university hospital of Casablanca, Morocco].

    Science.gov (United States)

    Dollo, I; Marih, L; El Fane, M; Es-Sebbani, M; Sodqi, M; Oulad Lahsen, A; Chakib, A; El Kadioui, F; Hamdani, A; El Mabrouki, M J; Soussi Abdallaoui, M; Karima, Z; Hassoune, S; Maaroufi, A; Marhoum El Filali, K

    2016-12-01

    To report the cases of neuromeningeal cryptococcosis and to describe the clinical, paraclinical, therapeutic and outcomes of patients. Retrospective study of 43 patients infected with HIV admitted from January first 2010 to June 30th 2015 in the infectious disease unit of UHC Ibn Rochd, for neuromeningeal cryptococcus. The mean frequency of neuromeningeal cryptococcosis in patients infected with HIV was 1.4%. The mean age was 39 years and a sex ratio of 1.38. The mean CD4 count was 70 cells/mm 3 . The diagnosis of HIV was revealed by neuromeningeal cryptococcus in 77% of cases. Fifteen days interval was reported between the first symptom and hospital admission. Headache (77%) was the most represented clinical sign. The cerebrospinal fluid analysis showed hypoglycorachy (67%), hyperproteinorachy (65%) and lymphocytosis (63%). Chinese ink direct examination for Cryptococcus neoformans in CSF was positive in 86% of cases and all cases were positive after culture on Sabouraud's medium. Patients were treated with monotherapy amphotericin B (42%) or fluconazole (28%) and bitherapy amphotéricine B/fluconazole (28%). Fatal evolution was observed in 60% of cases. Neuromeningeal cryptococcosis remains a severe opportunistic infection in HIV patients with a heavy mortality rate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. HIV-associated neurocognitive disorder: rate of referral for neurorehabilitation and psychiatric co-morbidity.

    LENUS (Irish Health Repository)

    Herlihy, D

    2012-04-01

    Despite advances in antiretroviral therapy, HIV-infected patients continue to present with HIV-associated neurocognitive disorder (HAND) which may be associated with significant psychiatric co-morbidity. We audited our patients with HAND referred for psychiatric assessment against the National Service Framework guidelines that they should receive neurorehabilitation. We found that despite these patients posing a risk to themselves and others due to poor insight and medication adherence, high rates of psychiatric co-morbidity and severely challenging behaviour, few were referred for neurorehabilitation. We recommend that clear referral pathways for psychiatric intervention and neurorehabilitation are established in HIV treatment centres.

  2. The role of splenic irradiation in treating HIV-associated immune thrombocytopenia

    International Nuclear Information System (INIS)

    Blauth, Jeanette; Fisher, Scot; Henry, David; Nichini, Franco

    1999-01-01

    Purpose: To evaluate our experience in treating patients with HIV-associated thrombocytopenia using splenic irradiation. Methods and Materials: From 1993 to 1998, 10 patients with HIV-related immune thrombocytopenia (ITP) were treated in our department with low-dose splenic irradiation. All patients had either failed more conventional treatment modalities or possessed some contraindication to them. Results: Nine of 10 patients had at least a small, transient rise in their platelet counts, but only two received a substantial therapeutic benefit. Of these two, one died shortly after completing his course of radiation therapy while the other maintained near normal platelet counts up to approximately 3((1)/(2)) years following treatment. There were no treatment-related morbidities and one patient was treated twice. Conclusion: While most patients with HIV-associated ITP may initially respond favorably to splenic irradiation with small rises in platelet count, few responses are likely to be sustained or provide clinically significant outcomes. Our results support those previously reported by others treating this same condition. What remains to be investigated is whether there are any prognostic indicators to help identify those patients most likely to respond to this treatment, thus enabling us to reserve splenic irradiation for those who might derive a substantial benefit from it

  3. HIV-associated cutaneous Kaposi's sarcoma - palliative local treatment by radiotherapy

    International Nuclear Information System (INIS)

    Saran, F.H.; Adamietz, I.A.; Thilmann, C.; Mose, S.; Boettcher, H.D.

    1997-01-01

    The increasing number of HIV-infected patients makes palliative treatment of HIV-associated Kaposi's sarcoma more common. We retrospectively evaluated a reduced fractionated radiotherapy with 20 Gy in respect to response rates and acute side-effects. From January 1992 to January 1995, 52 patients with HIV-associated Kaposi's sarcoma were treated with 133 single portals. Six weeks after the end of radiotherapy 42 patients with 124 portals were evaluable with respect to response rates and side-effects. Of the treated portals 32% were judged as complete responses (CR), 55% as partial responses (PR) and 12% as no change (NC). Skin reactions RTOG, grade 1 were seen in 74% of the patients. Compared with literature data the reduced overall dose of 20 Gy in 10 fractions led to a reduction of CRs by approximately 50% while the overall response rate remained equal. The success of radiotherapy for the nodular component of Kaposi's sarcoma can be improved, if a dose exceeding 20 Gy in 10 fractions is applied but at the cost of increasing side-effects in case that non-conventional fractionation schemes are used. (orig.)

  4. Household Everyday Functioning in the Internet Age: Online Shopping and Banking Skills Are Affected in HIV-Associated Neurocognitive Disorders.

    Science.gov (United States)

    Woods, Steven Paul; Iudicello, Jennifer E; Morgan, Erin E; Verduzco, Marizela; Smith, Tyler V; Cushman, Clint

    2017-08-01

    The Internet is a fundamental tool for completing many different instrumental activities of daily living (IADL), including shopping and banking. Persons with HIV-associated Neurocognitive Disorders (HAND) are at heightened risk for IADL problems, but the extent to which HAND interferes with the performance of Internet-based household IADLs is not known. Ninety-three individuals with HIV disease, 43 of whom were diagnosed with HAND, and 42 HIV- comparison participants completed Internet-based tests of shopping and banking. Participants used mock credentials to log in to an experimenter-controlled Web site and independently performed a series of typical online shopping (e.g., purchasing household goods) and banking (e.g., transferring funds between accounts) tasks. Individuals with HAND were significantly more likely to fail the online shopping task than neurocognitively normal HIV+ and HIV- participants. HAND was also associated with poorer overall performance versus HIV+ normals on the online banking task. In the HAND group, Internet-based task scores were correlated with episodic memory, executive functions, motor skills, and numeracy. In the HIV+ sample as a whole, lower Internet-based task scores were uniquely associated with poorer performance-based functional capacity and self-reported declines in shopping and financial management in daily life, but not with global manifest functional status. Findings indicate that HAND is associated with difficulties in using the Internet to complete important household everyday functioning tasks. The development and validation of effective Internet training and compensatory strategies may help to improve the household management of persons with HAND. (JINS, 2017, 23, 605-615).

  5. Fluconazole levels in serum and cerebrospinal fluid according to daily dosage in patients with cryptococcosis and other fungal infections

    Directory of Open Access Journals (Sweden)

    Letícia Aparecida Schiave

    2018-01-01

    Full Text Available Fluconazole is extensively used for the treatment of candidiasis and cryptococcosis. Among other factors, successful treatment is related to appropriate fluconazole levels in blood and cerebrospinal fluid. In the present study, fluconazole levels were determined in 15 patients, 14 of whom had AIDS and 13 had neurocryptococcosis. The only selection criterion was treatment with fluconazole, which was performed with a generic or similar form of the drug. Fluconazole level was determined by high performance liquid chromatography and the susceptibility profile of Cryptococcus spp. isolated from the patients was assessed by broth microdilution. Blood and cerebrospinal fluid fluconazole levels were found to be related to the fluconazole daily dose, and exceeded the minimum inhibitory concentration of this antifungal for the Cryptococcus spp. isolates. A good correlation was observed between serum and cerebrospinal fluid drug concentration. In conclusion, treatment with non-original fluconazole under usual medical practice conditions results in appropriate blood and cerebrospinal fluid levels of the drug for inhibiting Cryptococcus spp. susceptible to this antifungal drug. The relatively common failures of neurocryptococcosis treatment appear not to be due to insufficient fluconazole levels in the cerebrospinal fluid, especially with the use of daily doses of 400–800 mg.

  6. Fluconazole levels in serum and cerebrospinal fluid according to daily dosage in patients with cryptococcosis and other fungal infections.

    Science.gov (United States)

    Schiave, Letícia Aparecida; Nascimento, Erika; Vilar, Fernando Crivelenti; de Haes, Tissiana Marques; Takayanagui, Osvaldo Massaiti; Gaitani, Cristiane Masetto de; Martinez, Roberto

    Fluconazole is extensively used for the treatment of candidiasis and cryptococcosis. Among other factors, successful treatment is related to appropriate fluconazole levels in blood and cerebrospinal fluid. In the present study, fluconazole levels were determined in 15 patients, 14 of whom had AIDS and 13 had neurocryptococcosis. The only selection criterion was treatment with fluconazole, which was performed with a generic or similar form of the drug. Fluconazole level was determined by high performance liquid chromatography and the susceptibility profile of Cryptococcus spp. isolated from the patients was assessed by broth microdilution. Blood and cerebrospinal fluid fluconazole levels were found to be related to the fluconazole daily dose, and exceeded the minimum inhibitory concentration of this antifungal for the Cryptococcus spp. isolates. A good correlation was observed between serum and cerebrospinal fluid drug concentration. In conclusion, treatment with non-original fluconazole under usual medical practice conditions results in appropriate blood and cerebrospinal fluid levels of the drug for inhibiting Cryptococcus spp. susceptible to this antifungal drug. The relatively common failures of neurocryptococcosis treatment appear not to be due to insufficient fluconazole levels in the cerebrospinal fluid, especially with the use of daily doses of 400-800mg. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  7. Prognosis of HIV-associated non-Hodgkin lymphoma in patients starting combination antiretroviral therapy

    DEFF Research Database (Denmark)

    Bohlius, Julia; Schmidlin, Kurt; Costagliola, Dominique

    2009-01-01

    OBJECTIVE: We examined survival and prognostic factors of patients who developed HIV-associated non-Hodgkin lymphoma (NHL) in the era of combination antiretroviral therapy (cART). DESIGN AND SETTING: Multicohort collaboration of 33 European cohorts. METHODS: We included all cART-naive patients......-seven patients (72%) from 22 cohorts met inclusion criteria. Survival at 1 year was 66% [95% confidence interval (CI) 63-70%] for systemic NHL (n = 763) and 54% (95% CI: 43-65%) for primary brain lymphoma (n = 84). Risk factors for death included low nadir CD4 cell counts and a history of injection drug use...... with primary brain lymphoma. More advanced immunodeficiency is the dominant prognostic factor for mortality in patients with HIV-related NHL....

  8. Local measures in HIV-associated Kaposi's sarcoma - importance of radiation therapy

    International Nuclear Information System (INIS)

    Plettenberg, A.; Meigel, W.; Janik, I.; Kolb, H.

    1991-01-01

    In 23 patients with HIV-associated Kaposi's sarcoma 53 tumor lesions were treated with fractional radiotherapy. Indication for the radiotherapy were mostly cosmetic reasons in stigmatising tumors, but also in several cases pain, oedema or functional deficits as a result of the tumor lesions. 21 patients received orthovoltage irradiation, the remaining four patients were treated with telecobalt therapy. A complete response was observed in 17%, a partial response in 76% and unchanged lesions in 4%. In two cases (4%), both were treated with telecobalt-therapy by large tumor masses, there occurred a further tumor progression inspite of the radiotherapy. In ten lesions, all with partial remission, we later observed a repeated tumor progression. Important side effects were signs of inflammation as mucositis and edema or hyperpigmentation. The occurrence of acute side effects can be reduced by fractionating of the radiotherapy. (orig.) [de

  9. FDG-PET/CT imaging in the management of HIV-associated multicentric Castleman's disease

    International Nuclear Information System (INIS)

    Barker, Rob; Kazmi, Fahrad; Stebbing, Justin; Chinn, Roger; Ngan, Sarah; Bower, Mark; Nelson, Mark; O'Doherty, Michael

    2009-01-01

    To evaluate the role of FDG-PET/CT scanning in the management of HIV-associated multicentric Castleman's disease (MCD) a rare lymphoproliferative disorder associated with infection by human herpesvirus 8 (HHV8). Nine patients with histologically confirmed MCD underwent fused FDG-PET/CT scans at initial MCD diagnosis (n = 3), at MCD relapse (n = 4), or during remission (n = 2). All seven patients with active MCD had markedly elevated plasma HHV8 viral loads, but the patients in remission had no HHV8 viraemia. The three patients with newly diagnosed MCD were not on antiretroviral therapy at the time of imaging, but the other six were all on fully suppressive antiretroviral regimens. In the seven patients with active MCD (newly diagnosed or relapse) 33/91 lymph node groups (36%) included radiologically enlarged nodes on the CT scan, whilst 57/91 lymph node groups (63%) showed enhanced FDG uptake on the PET scan. In scans from patients in remission, there were no enlarged lymph nodes on the CT scan but 3 lymph nodes (11%) demonstrated enhanced FDG uptake. The median SUV recorded for the seven patients with active MCD was 4.8 (range 2.6-9.3) which was significantly higher than the median value of 2.5 recorded for the patients in remission (Mann-Whitney U test, p = 0.011). Despite the small number of patients, in HIV-positive individuals with active MCD, FDG-PET scans more frequently detected abnormal uptake than CT scans detected enlarged lymph nodes. FDG-PET scanning has a useful role in the management of HIV-associated MCD in selecting appropriate sites for biopsy, and in staging and monitoring these lymphoproliferations. (orig.)

  10. HIV-associated hematologic malignancies: Experience from a Tertiary Cancer Center in India.

    Science.gov (United States)

    Reddy, Rakesh; Gogia, Ajay; Kumar, Lalit; Sharma, Atul; Bakhshi, Sameer; Sharma, Mehar C; Mallick, Saumyaranjan; Sahoo, Ranjit

    2016-01-01

    Data on HIV associated hematologic malignancies is sparse from India. This study attempts to analyze the spectrum and features of this disease at a tertiary cancer center in India. Retrospective study from case records of patients registered with a diagnosis of hematologic malignancy and HIV infection between January 2010 and June 2015. Thirteen cases of HIV associated hematologic malignancies were identified, six of them pediatric. HIV diagnosis was concurrent to diagnosis of cancer in 12 and preceded it in one of them. ECOG PS at presentation was >1 in all of them. All patients, except one, had B symptoms. Six of the patients had bulky disease and six are stage 4. Predominant extranodal disease was seen in 67% of them. NHL accounted for 10 of 13 patients and DLBCL-Germinal center was the most common subtype. Mean CD4+ cell count was 235/μL (range, 32-494). HAART could be given along with chemotherapy to 11 patients. Two-thirds of patients received standard doses of therapy. Chemo-toxicity required hospitalization in 58%. CR was achieved in 45% and 36% had progressive disease with first-line therapy. At the time of last follow up, 3 patients were alive with responsive disease, 2 in CR and 1 in PR. None of the pediatric patients were long time responders. These malignancies were of advanced stage and higher grade. Goal of therapy, in the HAART era, is curative. Pediatric patients had dismal outcome despite good chemotherapy and HAART. There is an urgent need to improve data collection for HIV related cancers in India.

  11. Assessing the impact of defining a global priority research agenda to address HIV-associated tuberculosis.

    Science.gov (United States)

    Odone, Anna; Matteelli, Alberto; Chiesa, Valentina; Cella, Paola; Ferrari, Antonio; Pezzetti, Federica; Signorelli, Carlo; Getahun, Haileyesus

    2016-11-01

    In 2010, the WHO issued 77 priority research questions (PRQs) to address HIV-associated TB. Objective of the this study was to assess the impact of defining the research agenda in stimulating and directing research around priority research questions. We used number and type of scientific publications as a proxy to quantitatively assess the impact of research agenda setting. We conducted 77 single systematic reviews - one for every PRQ - building 77 different search strategies using PRQs' keywords. Multivariate logistic regression models were applied to assess the quantity and quality of research produced over time and accounting for selected covariates. In 2009-2015, PRQs were addressed by 1631 publications (median: 11 studies published per PRQ, range 1-96). The most published area was 'Intensified TB case finding' (median: 23 studies/PRQ, range: 2-74). The majority (62.1%, n = 1013) were published as original studies, and more than half (58%, n = 585) were conducted in the African region. Original studies' publication increased over the study period (P trend = <0.001). They focused more on the 'Intensified TB case finding' (OR = 2.17, 95% CI: 1.56-2.93) and 'Drug-resistant TB and HIV infection' (OR = 2.12, 95% CI: 1.47-3.06) areas than non-original studies. Original studies were published in journals of lower impact factor and received a smaller number of citations than non-original studies (OR = 0.54, 95% CI: 0.42-0.69). The generation of evidence to address PRQs has increased over time particularly in selected fields. Setting a priority research agenda for HIV-associated TB might have positively influenced the direction and the conduct of research and contributed to the global response to such a major threat to health. © 2016 John Wiley & Sons Ltd.

  12. Detecting altered connectivity patterns in HIV associated neurocognitive impairment using mutual connectivity analysis

    Science.gov (United States)

    Abidin, Anas Zainul; D'Souza, Adora M.; Nagarajan, Mahesh B.; Wismüller, Axel

    2016-03-01

    The use of functional Magnetic Resonance Imaging (fMRI) has provided interesting insights into our understanding of the brain. In clinical setups these scans have been used to detect and study changes in the brain network properties in various neurological disorders. A large percentage of subjects infected with HIV present cognitive deficits, which are known as HIV associated neurocognitive disorder (HAND). In this study we propose to use our novel technique named Mutual Connectivity Analysis (MCA) to detect differences in brain networks in subjects with and without HIV infection. Resting state functional MRI scans acquired from 10 subjects (5 HIV+ and 5 HIV-) were subject to standard preprocessing routines. Subsequently, the average time-series for each brain region of the Automated Anatomic Labeling (AAL) atlas are extracted and used with the MCA framework to obtain a graph characterizing the interactions between them. The network graphs obtained for different subjects are then compared using Network-Based Statistics (NBS), which is an approach to detect differences between graphs edges while controlling for the family-wise error rate when mass univariate testing is performed. Applying this approach on the graphs obtained yields a single network encompassing 42 nodes and 65 edges, which is significantly different between the two subject groups. Specifically connections to the regions in and around the basal ganglia are significantly decreased. Also some nodes corresponding to the posterior cingulate cortex are affected. These results are inline with our current understanding of pathophysiological mechanisms of HIV associated neurocognitive disease (HAND) and other HIV based fMRI connectivity studies. Hence, we illustrate the applicability of our novel approach with network-based statistics in a clinical case-control study to detect differences connectivity patterns.

  13. Value of conventionally fractionated radiotherapy for the local treatment of HIV associated Kaposi's sarcoma

    International Nuclear Information System (INIS)

    Saran, F.; Adamietz, I.A.; Mose, S.; Thilmann, C.; Boettcher, H.D.

    1995-01-01

    From June 1991 to June 1993, 43 patients with 111 HIV-associated Kaposi's sarcoma of the skin or oral cavity were treated. Lesions were irradiated with 5 to 12 MeV electrons or 60Co gamma-rays. The fractionation scheme was 5 times 2 Gy/week for skin and enoral lesions with a total reference dosage of up to 20 Gy. Side effects were assessed during therapy and the therapeutic result 6 weeks after end of treatment. Thirty-eight out of 111 lesions were judged as complete response (CR) (34%), 61/111 as partial response (PR) (55%) and 12/111 were judged as no change (NC) (11%). Overall response (CR + PR) was 89%. Two patients with lesions of oral cavity suffered from RTOG grade-IV mucositis after 10 and 14 Gy. In 71/106 skin lesions (67%), radiation induced RTOG grade-I reactions were observed. Conclusion: In patients with HIV associated Kaposi's sarcoma effective palliation can be achieved by means of radiotherapy with an overall dose of 20 Gy in conventional fractionation. Yet, the fraction of patients with complete responses is with 34 to 47% lower compared with doses above 20 Gy (66 to 100%). With reference to the reported data our results point to a dose-response relationship for Kaposi's sarcoma. Therefore higher total reference doses, e.g. 30 Gy with weekly 5 times 2 Gy or 24 Gy with 5 times 1.6 Gy for mucous lesions, respectively, are suggested as by this mean the complete response rate can be coubled. (orig./MG) [de

  14. Assessment, diagnosis, and treatment of HIV-associated neurocognitive disorder: a consensus report of the mind exchange program

    NARCIS (Netherlands)

    Antinori, Andrea; Arendt, Gabriele; Grant, Igor; Letendre, Scott; Chair, N. N.; Munoz-Moreno, Jose A.; Eggers, Christian; Brew, Bruce; Brouillette, Marie-Josee; Bernal-Cano, Francisco; Carvalhal, Adriana; Christo, Paulo Pereira; Cinque, Paola; Cysique, Lucette; Ellis, Ronald; Everall, Ian; Gasnault, Jacques; Husstedt, Ingo; Korten, Volkan; Machala, Ladislav; Obermann, Mark; Ouakinin, Silvia; Podzamczer, Daniel; Portegies, Peter; Rackstraw, Simon; Rourke, Sean; Sherr, Lorraine; Streinu-Cercel, Adrian; Winston, Alan; Wojna, Valerie; Yazdanpannah, Yazdan; Arbess, Gordon; Baril, Jean-Guy; Begovac, Josip; Bergin, Colm; Bonfanti, Paolo; Bonora, Stefano; Brinkman, Kees; Canestri, Ana; Cholewinska-Szymanska, Grazyna; Chowers, Michal; Cooney, John; Corti, Marcelo; Doherty, Colin; Elbirt, Daniel; Esser, Stefan; Florence, Eric; Force, Gilles; Gill, John; Goffard, Jean-Christophe

    2013-01-01

    Many practical clinical questions regarding the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) remain unanswered. We sought to identify and develop practical answers to key clinical questions in HAND management. Sixty-six specialists from 30 countries

  15. Cryptococcus gattii urease as a virulence factor and the relevance of enzymatic activity in cryptococcosis pathogenesis.

    Science.gov (United States)

    Feder, Vanessa; Kmetzsch, Lívia; Staats, Charley Christian; Vidal-Figueiredo, Natalia; Ligabue-Braun, Rodrigo; Carlini, Célia Regina; Vainstein, Marilene Henning

    2015-04-01

    Ureases (EC 3.5.1.5) are Ni(2+) -dependent metalloenzymes produced by plants, fungi and bacteria that hydrolyze urea to produce ammonia and CO2 . The insertion of nickel atoms into the apo-urease is better characterized in bacteria, and requires at least three accessory proteins: UreD, UreF, and UreG. Our group has demonstrated that ureases possess ureolytic activity-independent biological properties that could contribute to the pathogenicity of urease-producing microorganisms. The presence of urease in pathogenic bacteria strongly correlates with pathogenesis in some human diseases. Some medically important fungi also produce urease, including Cryptococcus neoformans and Cryptococcus gattii. C. gattii is an etiological agent of cryptococcosis, most often affecting immunocompetent individuals. The cryptococcal urease might play an important role in pathogenesis. It has been proposed that ammonia produced via urease action might damage the host endothelium, which would enable yeast transmigration towards the central nervous system. To analyze the role of urease as a virulence factor in C. gattii, we constructed knockout mutants for the structural urease-coding gene URE1 and for genes that code the accessory proteins Ure4 and Ure6. All knockout mutants showed reduced multiplication within macrophages. In intranasally infected mice, the ure1Δ (lacking urease protein) and ure4Δ (enzymatically inactive apo-urease) mutants caused reduced blood burdens and a delayed time of death, whereas the ure6Δ (enzymatically inactive apo-urease) mutant showed time and dose dependency with regard to fungal burden. Our results suggest that C. gattii urease plays an important role in virulence, in part possibly through enzyme activity-independent mechanism(s). © 2015 FEBS.

  16. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis

    Science.gov (United States)

    Rajasingham, Radha; Smith, Rachel M; Park, Benjamin J; Jarvis, Joseph N; Govender, Nelesh P; Chiller, Tom M; Denning, David W; Loyse, Angela; Boulware, David R

    2018-01-01

    Summary Background Cryptococcus is the most common cause of meningitis in adults living with HIV in sub-Saharan Africa. Global burden estimates are crucial to guide prevention strategies and to determine treatment needs, and we aimed to provide an updated estimate of global incidence of HIV-associated cryptococcal disease. Methods We used 2014 Joint UN Programme on HIV and AIDS estimates of adults (aged >15 years) with HIV and antiretroviral therapy (ART) coverage. Estimates of CD4 less than 100 cells per µL, virological failure incidence, and loss to follow-up were from published multinational cohorts in low-income and middle-income countries. We calculated those at risk for cryptococcal infection, specifically those with CD4 less than 100 cells/µL not on ART, and those with CD4 less than 100 cells per µL on ART but lost to follow-up or with virological failure. Cryptococcal antigenaemia prevalence by country was derived from 46 studies globally. Based on cryptococcal antigenaemia prevalence in each country and region, we estimated the annual numbers of people who are developing and dying from cryptococcal meningitis. Findings We estimated an average global cryptococcal antigenaemia prevalence of 6·0% (95% CI 5·8–6·2) among people with a CD4 cell count of less than 100 cells per µL, with 278 000 (95% CI 195 500–340 600) people positive for cryptococcal antigen globally and 223 100 (95% CI 150 600–282 400) incident cases of cryptococcal meningitis globally in 2014. Sub-Saharan Africa accounted for 73% of the estimated cryptococcal meningitis cases in 2014 (162 500 cases [95% CI 113 600–193 900]). Annual global deaths from cryptococcal meningitis were estimated at 181 100 (95% CI 119 400–234 300), with 135 900 (75%; [95% CI 93 900–163 900]) deaths in sub-Saharan Africa. Globally, cryptococcal meningitis was responsible for 15% of AIDS-related deaths (95% CI 10–19). Interpretation Our analysis highlights the substantial ongoing burden of HIV-associated

  17. Impact of previous ART and of ART initiation on outcome of HIV-associated tuberculosis.

    Science.gov (United States)

    Girardi, Enrico; Palmieri, Fabrizio; Angeletti, Claudio; Vanacore, Paola; Matteelli, Alberto; Gori, Andrea; Carbonara, Sergio; Ippolito, Giuseppe

    2012-01-01

    Combination antiretroviral therapy (cART) has progressively decreased mortality of HIV-associated tuberculosis .To date, however, limited data on tuberculosis treatment outcomes among coinfected patients who are not ART-naive at the time of tuberculosis diagnosis are available. A multicenter, observational study enrolled 246 HIV-infected patients diagnosed with tuberculosis, in 96 Italian infectious diseases hospital units, who started tuberculosis treatment. A polytomous logistic regression model was used to identify baseline factors associated with the outcome. A Poisson regression model was used to explain the effect of ART during tuberculosis treatment on mortality, as a time-varying covariate, adjusting for baseline characteristics. Outcomes of tuberculosis treatment were as follows: 130 (52.8%) were successfully treated, 36 (14.6%) patients died in a median time of 2 months (range: 0-16), and 80 (32.6%) had an unsuccessful outcome. Being foreign born or injecting drug users was associated with unsuccessful outcomes. In multivariable Poisson regression, cART during tuberculosis treatment decreased the risk of death, while this risk increased for those who were not ART-naive at tuberculosis diagnosis. ART during tuberculosis treatment is associated with a substantial reduction of death rate among HIV-infected patients. However, patients who are not ART-naive when they develop tuberculosis remain at elevated risk of death.

  18. Lymphocyte proliferation to mycobacterial antigens is detectable across a spectrum of HIV-associated tuberculosis

    Directory of Open Access Journals (Sweden)

    Bakari Muhammad

    2009-02-01

    Full Text Available Abstract Background Identifying novel TB diagnostics is a major public health priority. We explored the diagnostic characteristics of antimycobacterial lymphocyte proliferation assays (LPA in HIV-infected subjects with latent or active TB. Methods HIV-infected subjects with bacille Calmette Guérin (BCG scars and CD4 counts ≥ 200 cells/mm3 entering a TB booster vaccine trial in Tanzania had baseline in vivo and in vitro immune tests performed: tuberculin skin tests (TST, LPA and five day assays of interferon gamma (IFN-γ release. Assay antigens were early secreted antigenic target 6 (ESAT-6, antigen 85 (Ag85, and Mycobacterium tuberculosis whole cell lysate (WCL. Subjects were screened for active TB at enrollment by history, exam, sputum smear and culture. We compared antimycobacterial immune responses between subjects with and without latent or active TB at enrollment. Results Among 1885 subjects screened, 635 had latent TB and 13 had active TB. Subjects with latent TB were more likely than subjects without TB to have LPA responses to ESAT-6 (13.2% vs. 5.5%, P Conclusion Lymphoproliferative responses to mycobacteria are detectable during HIV-associated active TB, and are less sensitive but more specific than TST. Trial registration ClinicalTrials.gov Identifier NCT00052195.

  19. The cross-talk of HIV-1 Tat and methamphetamine in HIV-associated neurocognitive disorders

    Directory of Open Access Journals (Sweden)

    Susana T Valente

    2015-10-01

    Full Text Available Antiretroviral therapy (ART has dramatically improved the lives of HIV-1 infected individuals. Nonetheless, HIV associated neurocognitive disorders (HAND, which range from undetectable neurocognitive impairments to severe dementia, still affect approximately 50% of the infected population, hampering their quality of life.The persistence of HAND is promoted by several factors, including longer life expectancies, the residual levels of virus in the central nervous system and the continued presence of HIV-1 regulatory proteins such as the transactivator of transcription (Tat in the brain. Tat is a secreted viral protein that crosses the blood brain barrier into the central nervous system, where it has the ability to directly act on neurons and non-neuronal cells alike. These actions result in the release of soluble factors involved in inflammation, oxidative stress and excitotoxicity, ultimately resulting in neuronal damage. The percentage of methamphetamine abusers is high among the HIV-1-positive population compared to the general population. On the other hand, methamphetamine abuse is correlated with increased viral replication, enhanced Tat-mediated neurotoxicity and neurocognitive impairments. Although several strategies have been investigated to reduce HAND and methamphetamine use, no clinically approved treatment is currently available. Here, we review the latest findings of the effects of Tat and methamphetamine in HAND and discuss a few promising potential therapeutic developments.

  20. Safety and efficacy of pegylated liposomal doxorubicin in HIV-associated Kaposi’s sarcoma

    Directory of Open Access Journals (Sweden)

    Francesca Cainelli

    2009-08-01

    Full Text Available Francesca Cainelli1, Alfredo Vallone21Department of Internal Medicine, School of Medicine, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana; 2Infectious Diseases Unit, Annunziata Hospital, Cosenza, ItalyAbstract: Kaposi’s sarcoma is a vascular tumor linked to the presence of Kaposi’s sarcoma-associated herpesvirus (human herpesvirus-8 and the incidence of which has increased considerably the world over after the onset of the human immunodeficiency virus (HIV pandemic. Antiretroviral therapy combined with cytotoxic agents has been established as the treatment of choice in the past 10 years. Among chemotherapeutic agents, pegylated liposomal doxorubicin has become the preferred one for patients with HIV-associated Kaposi’s sarcoma in Western countries. The drug in this formulation localizes better to the tumor and has higher efficacy. Skin toxicity, mucositis, and leukopenia/neutropenia are the main side effects. Hepatotoxicity and mild cardiotoxicity are observed less frequently. Pegylated liposomal doxorubicin impacts favorably on quality of life. Although cost effective in Western countries, the drug is less so in developing countries.Keywords: pegylated liposomal doxorubicin, Kaposi’s sarcoma, HIV infection

  1. Bile duct-duodenal fistula caused by AIDS/HIV-associated tuberculosis

    Directory of Open Access Journals (Sweden)

    Patino Carlos

    2003-01-01

    Full Text Available Allthough infrequent, digestive fistulae in HIV/AIDS patients have been reported throughout the digestive tract from the esophagus to the anus, with predominance of esophageal fistulae. AIDS/HIV-associated opportunistic infections may invade the digestive system and lead to fistula formation. Tuberculosis is the most common infection associated with these esophageal fistulae. We report here one case of bile duct-duodenal fistula in a female AIDS patient with associated abdominal Mycobacterium tuberculosis infection compromising lymphnodes of the hepatic pedicle where the fistula was found. According to the reviewed literature, this is the third case of bile duct-duodenal fistula associated with abdominal tuberculosis in AIDS patient, and the first where both the fistula and the tuberculosis infection were diagnosed at laparotomy for acute abdomen. Whether the AIDS patient with abdominal pain needs or not a laparotomy to treat an infectious disease is often a difficult matter for the surgeon to decide, as most of the times appropriate medical treatment will bring more benefit.

  2. An SIV/macaque model targeted to study HIV-associated neurocognitive disorders.

    Science.gov (United States)

    Beck, Sarah E; Queen, Suzanne E; Metcalf Pate, Kelly A; Mangus, Lisa M; Abreu, Celina M; Gama, Lucio; Witwer, Kenneth W; Adams, Robert J; Zink, M Christine; Clements, Janice E; Mankowski, Joseph L

    2018-04-01

    Simian immunodeficiency virus (SIV) infection of pigtailed macaques is a highly representative and well-characterized animal model for HIV neuropathogenesis studies that provides an excellent opportunity to study and develop prognostic markers of HIV-associated neurocognitive disorders (HAND) for HIV-infected individuals. SIV studies can be performed in a controlled setting that enhances reproducibility and offers high-translational value. Similar to observations in HIV-infected patients receiving antiretroviral therapy (ART), ongoing neurodegeneration and inflammation are present in SIV-infected pigtailed macaques treated with suppressive ART. By developing quantitative viral outgrowth assays that measure both CD4+ T cells and macrophages harboring replication competent SIV as well as a highly sensitive mouse-based viral outgrowth assay, we have positioned the SIV/pigtailed macaque model to advance our understanding of latent cellular reservoirs, including potential CNS reservoirs, to promote HIV cure. In addition to contributing to our understanding of the pathogenesis of HAND, the SIV/pigtailed macaque model also provides an excellent opportunity to test innovative approaches to eliminate the latent HIV reservoir in the brain.

  3. Interactive Effects of Morphine on HIV Infection: Role in HIV-Associated Neurocognitive Disorder

    Directory of Open Access Journals (Sweden)

    Pichili Vijaya Bhaskar Reddy

    2012-01-01

    Full Text Available HIV epidemic continues to be a severe public health problem and concern within USA and across the globe with about 33 million people infected with HIV. The frequency of drug abuse among HIV infected patients is rapidly increasing and is another major issue since injection drug users are at a greater risk of developing HIV associated neurocognitive dysfunctions compared to non-drug users infected with HIV. Brain is a major target for many of the recreational drugs and HIV. Evidences suggest that opiate drug abuse is a risk factor in HIV infection, neural dysfunction and progression to AIDS. The information available on the role of morphine as a cofactor in the neuropathogenesis of HIV is scanty. This review summarizes the results that help in understanding the role of morphine use in HIV infection and neural dysfunction. Studies show that morphine enhances HIV-1 infection by suppressing IL-8, downregulating chemokines with reciprocal upregulation of HIV coreceptors. Morphine also activates MAPK signaling and downregulates cAMP response element-binding protein (CREB. Better understanding on the role of morphine in HIV infection and mechanisms through which morphine mediates its effects may help in devising novel therapeutic strategies against HIV-1 infection in opiate using HIV-infected population.

  4. Modeling the Mechanisms by Which HIV-Associated Immunosuppression Influences HPV Persistence at the Oral Mucosa.

    Science.gov (United States)

    Verma, Meghna; Erwin, Samantha; Abedi, Vida; Hontecillas, Raquel; Hoops, Stefan; Leber, Andrew; Bassaganya-Riera, Josep; Ciupe, Stanca M

    2017-01-01

    Human immunodeficiency virus (HIV)-infected patients are at an increased risk of co-infection with human papilloma virus (HPV), and subsequent malignancies such as oral cancer. To determine the role of HIV-associated immune suppression on HPV persistence and pathogenesis, and to investigate the mechanisms underlying the modulation of HPV infection and oral cancer by HIV, we developed a mathematical model of HIV/HPV co-infection. Our model captures known immunological and molecular features such as impaired HPV-specific effector T helper 1 (Th1) cell responses, and enhanced HPV infection due to HIV. We used the model to determine HPV prognosis in the presence of HIV infection, and identified conditions under which HIV infection alters HPV persistence in the oral mucosa system. The model predicts that conditions leading to HPV persistence during HIV/HPV co-infection are the permissive immune environment created by HIV and molecular interactions between the two viruses. The model also determines when HPV infection continues to persist in the short run in a co-infected patient undergoing antiretroviral therapy. Lastly, the model predicts that, under efficacious antiretroviral treatment, HPV infections will decrease in the long run due to the restoration of CD4+ T cell numbers and protective immune responses.

  5. Modeling the Mechanisms by Which HIV-Associated Immunosuppression Influences HPV Persistence at the Oral Mucosa.

    Directory of Open Access Journals (Sweden)

    Meghna Verma

    Full Text Available Human immunodeficiency virus (HIV-infected patients are at an increased risk of co-infection with human papilloma virus (HPV, and subsequent malignancies such as oral cancer. To determine the role of HIV-associated immune suppression on HPV persistence and pathogenesis, and to investigate the mechanisms underlying the modulation of HPV infection and oral cancer by HIV, we developed a mathematical model of HIV/HPV co-infection. Our model captures known immunological and molecular features such as impaired HPV-specific effector T helper 1 (Th1 cell responses, and enhanced HPV infection due to HIV. We used the model to determine HPV prognosis in the presence of HIV infection, and identified conditions under which HIV infection alters HPV persistence in the oral mucosa system. The model predicts that conditions leading to HPV persistence during HIV/HPV co-infection are the permissive immune environment created by HIV and molecular interactions between the two viruses. The model also determines when HPV infection continues to persist in the short run in a co-infected patient undergoing antiretroviral therapy. Lastly, the model predicts that, under efficacious antiretroviral treatment, HPV infections will decrease in the long run due to the restoration of CD4+ T cell numbers and protective immune responses.

  6. Factors related to HIV-associated neurocognitive impairment differ with age.

    Science.gov (United States)

    Fogel, Gary B; Lamers, Susanna L; Levine, Andrew J; Valdes-Sueiras, Miguel; McGrath, Michael S; Shapshak, Paul; Singer, Elyse J

    2015-02-01

    Over 50% of HIV-infected (HIV+) persons are expected to be over age 50 by 2015. The pathogenic effects of HIV, particularly in cases of long-term infection, may intersect with those of age-related illnesses and prolonged exposure to combined antiretroviral therapy (cART). One potential outcome is an increased prevalence of neurocognitive impairment in older HIV+ individuals, as well as an altered presentation of HIV-associated neurocognitive disorders (HANDs). In this study, we employed stepwise regression to examine 24 features sometimes associated with HAND in 40 older (55-73 years of age) and 30 younger (32-50 years of age) HIV+, cART-treated participants without significant central nervous system confounds. The features most effective in generating a true assessment of the likelihood of HAND diagnosis differed between older and younger cohorts, with the younger cohort containing features associated with drug abuse that were correlated to HAND and the older cohort containing features that were associated with lipid disorders mildly associated with HAND. As the HIV-infected population grows and the demographics of the epidemic change, it is increasingly important to re-evaluate features associated with neurocognitive impairment. Here, we have identified features, routinely collected in primary care settings, that provide more accurate diagnostic value than a neurocognitive screening measure among younger and older HIV individuals.

  7. PET brain imaging in HIV-associated neurocognitive disorders (HAND) in the era of combination antiretroviral therapy

    Energy Technology Data Exchange (ETDEWEB)

    Vera, Jaime H. [Brighton and Sussex Medical School, Department of Infection and Global Health, Brighton (United Kingdom); Brighton and Sussex University Hospitals NHS Trust, HIV Department, Brighton (United Kingdom); Ridha, Basil [Brighton and Sussex University Hospitals NHS Trust, Neurology Department, Brighton (United Kingdom); Gilleece, Yvonne; Amlani, Aliza [Brighton and Sussex University Hospitals NHS Trust, HIV Department, Brighton (United Kingdom); Thorburn, Patrick; Dizdarevic, Sabina [Brighton and Sussex University Hospitals NHS Trust, Imaging and Nuclear Medicine Department, Brighton (United Kingdom); Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton (United Kingdom)

    2017-05-15

    Effective combination antiretroviral therapy (cART) has lead to a significant reduction in the prevalence and incidence of central nervous system (CNS) HIV-associated brain disease, particularly CNS opportunistic infections and HIV encephalitis. Despite this, cognitive deficits in people living with HIV, also known as HIV-associated neurocognitive disorders (HAND) have become more prevalent in recent years. The pathogenesis of HAND is likely to be multifactorial, however recent evidence suggests that brain microglial activation is the most likely pathogenic mechanism. Recent developments in positron emission tomography (PET) brain neuroimaging using novel brain radioligands targeting a variety of physiological changes in the brains of HIV-positive individuals have improved our understanding of the mechanisms associated with the development of HAND. This review will highlight recent PET brain neuroimaging studies in the cART era, focusing on physiological and neurochemical changes associated with HAND in people living with HIV. (orig.)

  8. PET brain imaging in HIV-associated neurocognitive disorders (HAND) in the era of combination antiretroviral therapy

    International Nuclear Information System (INIS)

    Vera, Jaime H.; Ridha, Basil; Gilleece, Yvonne; Amlani, Aliza; Thorburn, Patrick; Dizdarevic, Sabina

    2017-01-01

    Effective combination antiretroviral therapy (cART) has lead to a significant reduction in the prevalence and incidence of central nervous system (CNS) HIV-associated brain disease, particularly CNS opportunistic infections and HIV encephalitis. Despite this, cognitive deficits in people living with HIV, also known as HIV-associated neurocognitive disorders (HAND) have become more prevalent in recent years. The pathogenesis of HAND is likely to be multifactorial, however recent evidence suggests that brain microglial activation is the most likely pathogenic mechanism. Recent developments in positron emission tomography (PET) brain neuroimaging using novel brain radioligands targeting a variety of physiological changes in the brains of HIV-positive individuals have improved our understanding of the mechanisms associated with the development of HAND. This review will highlight recent PET brain neuroimaging studies in the cART era, focusing on physiological and neurochemical changes associated with HAND in people living with HIV. (orig.)

  9. Epidemiology, Diagnosis, and Treatment of HIV-Associated Non-Hodgkin Lymphoma in Resource-Limited Settings

    Directory of Open Access Journals (Sweden)

    Matthew Ulrickson

    2012-01-01

    Full Text Available Lymphoma was a common complication of HIV infection in the pre-antiretroviral era, and the incidence of HIV-associated lymphoma has dropped dramatically since the introduction of combination antiretroviral therapy (cART in resource-rich regions. Conversely, lymphoma is an increasingly common complication of HIV infection in resource-limited settings where the prevalence of HIV infection is high. Relatively little is known, however, about the true incidence and optimal treatment regimens for HIV-associated lymphoma in resource-poor regions. We review the epidemiology, diagnosis, and treatment of HIV-associated non-Hodgkin lymphoma in developing nations and highlight areas for further research that may benefit care in both settings. Examples include risk modification and dose modification of chemotherapy based on HIV risk factors, improving our understanding of the current burden of disease through national cancer registries, and developing cost-effective hematopathological diagnostic strategies to optimize care delivery and maximize use of available chemotherapy.

  10. Perceived HIV-associated stigma among HIV-seropositive men: psychometric study of HIV stigma scale

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    Adrian eValle

    2015-07-01

    Full Text Available Objectives: To assess the internal consistency and factor structure of the abridged Spanish version of the Berger HIV Stigma Scale (HSS-21, provide evidence for its convergent and discriminant validity, and describe perceived stigma in an urban population from northeast Mexico. Methods: Seventy five HIV-positive men who have sex with men (MSM were recruited. Participants answered the Spanish versions of three Likert-type scales: HSS-21, Robsenberg’s self-esteem scale, and the abbreviated version of the Zung’s Depression Scale.Results: HSS-21 showed high reliability and validity; its factor structure included four components: concern with public attitudes; negative self-image; disclosure concerns; and enacted stigma. The level of stigma was high in 27 out of 75 (36% participants; nevertheless, the score found in the component related to disclosure concerns indicated high level of stigma in 68% of participants. The score of HSS-21 was positively correlated with the score of depression and negatively correlated with the score of self-esteem. Conclusion: Results demonstrated high reliability for the HSS-21; correlations with other scales supported its validity. This scale demonstrated to be a practical tool for assessing stigma among Mexican HIV-positive MSM. High level of stigma was found only in the factor related to disclosure concerns. Policy Implications: Identifying HIV-associated stigma through a short, reliable and validated instrument will allow the development of interventions that cope and manage stigma in HIV-positive MSM. HSS-21 distinguishes between different dimensions of stigma and will contribute to a better understanding of this phenomenon.

  11. Phase II Study of Bevacizumab in Patients With HIV-Associated Kaposi's Sarcoma Receiving Antiretroviral Therapy

    Science.gov (United States)

    Uldrick, Thomas S.; Wyvill, Kathleen M.; Kumar, Pallavi; O'Mahony, Deirdre; Bernstein, Wendy; Aleman, Karen; Polizzotto, Mark N.; Steinberg, Seth M.; Pittaluga, Stefania; Marshall, Vickie; Whitby, Denise; Little, Richard F.; Yarchoan, Robert

    2012-01-01

    Purpose Alternatives to cytotoxic agents are desirable for patients with HIV-associated Kaposi's sarcoma (KS). Vascular endothelial growth factor-A (VEGF-A) contributes to KS pathogenesis. We evaluated the humanized anti–VEGF-A monoclonal antibody, bevacizumab, in patients with HIV-KS. Patients and Methods Patients with HIV-KS who either experienced progression while receiving highly active antiretroviral therapy (HAART) for at least 1 month or did not regress despite HAART for at least 4 months were administered bevacizumab 15 mg/kg intravenously on days 1 and 8 and then every 3 weeks. The primary objective was assessment of antitumor activity using modified AIDS Clinical Trial Group (ACTG) criteria for HIV-KS. HIV-uninfected patients were also eligible and observed separately. Results Seventeen HIV-infected patients were enrolled. Fourteen patients had been receiving effective HAART for at least 6 months (median, 1 year). Thirteen patients had advanced disease (ACTG T1), 13 patients had received prior chemotherapy for KS, and seven patients had CD4 count less than 200 cells/μL. Median number of cycles was 10 (range, 1 to 37 cycles); median follow-up was 8.3 months (range, 3 to 36 months). Of 16 assessable patients, best tumor responses observed were complete response (CR) in three patients (19%), partial response (PR) in two patients (12%), stable disease in nine patients (56%), and progressive disease in two patients (12%). Overall response rate (CR + PR) was 31% (95% CI, 11% to 58.7%). Four of five responders had received prior chemotherapy for KS. Over 202 cycles, grade 3 to 4 adverse events at least possibly attributed to therapy included hypertension (n = 7), neutropenia (n = 5), cellulitis (n = 3), and headache (n = 2). Conclusion Bevacizumab is tolerated in patients with HIV-KS and has activity in a subset of patients. PMID:22430271

  12. Current trends and intricacies in the management of HIV-associated pulmonary tuberculosis.

    Science.gov (United States)

    Gopalan, Narendran; Chandrasekaran, Padmapriyadarsini; Swaminathan, Soumya; Tripathy, Srikanth

    2016-01-01

    Human immunodeficiency virus (HIV) epidemic has undoubtedly increased the incidence of tuberculosis (TB) globally, posing a formidable global health challenge affecting 1.2 million cases. Pulmonary TB assumes utmost significance in the programmatic perspective as it is readily transmissible as well as easily diagnosable. HIV complicates every aspect of pulmonary tuberculosis from diagnosis to treatment, demanding a different approach to effectively tackle both the diseases. In order to control these converging epidemics, it is important to diagnose early, initiate appropriate therapy for both infections, prevent transmission and administer preventive therapy. Liquid culture methods and nucleic acid amplification tests for TB confirmation have replaced conventional solid media, enabling quicker and simultaneous detection of mycobacterium and its drug sensitivity profile Unique problems posed by the syndemic include Acquired rifampicin resistance, drug-drug interactions, malabsorption of drugs and immune reconstitution inflammatory syndrome or paradoxical reaction that complicate dual and concomitant therapy. While the antiretroviral therapy armamentarium is constantly reinforced by discovery of newer and safer drugs every year, only a few drugs for anti tuberculosis treatment have successfully emerged. These include bedaquiline, delamanid and pretomanid which have entered phase III B trials and are also available through conditional access national programmes. The current guidelines by WHO to start Antiretroviral therapy irrespective of CD4+ cell count based on benefits cited by recent trials could go a long way in preventing various complications caused by the deadly duo. This review provides a consolidated gist of the advancements, concepts and updates that have emerged in the management of HIV-associated pulmonary TB for maximizing efficacy, offering latest solutions for tackling drug-drug interactions and remedial measures for immune reconstitution inflammatory

  13. Dual-mixed HIV-1 coreceptor tropism and HIV-associated neurocognitive deficits.

    Science.gov (United States)

    Morris, Sheldon R; Woods, Steven Paul; Deutsch, Reena; Little, Susan J; Wagner, Gabriel; Morgan, Erin E; Heaton, Robert K; Letendre, Scott L; Grant, Igor; Smith, Davey M

    2013-10-01

    HIV coreceptor usage of CXCR4 (X4) is associated with decreased CD4+ T-cell counts and accelerated disease progression, but the role of X4 tropism in HIV-associated neurocognitive disorders (HAND) has not previously been described. This longitudinal study evaluated data on 197 visits from 72 recently HIV-infected persons who had undergone up to four sequential neurocognitive assessments over a median of 160 days (IQR, 138–192). Phenotypic tropism testing (Trofile ES, Monogram, Biosciences) was performed on stored blood samples. Multivariable mixed model repeated measures regression was used to determine the association between HAND and dual-mixed (DM) viral tropism, estimated duration of infection (EDI), HIV RNA, CD4 count, and problematic methamphetamine use. Six subjects (8.3 %) had DM at their first neurocognitive assessment and four converted to DM in subsequent sampling (for total of 10 DM) at a median EDI of 10.1 months (IQR, 7.2–12.2). There were 44 (61.1 %) subjects who demonstrated HAND on at least one study visit. HAND was associated with DM tropism (odds ratio, 4.4; 95 % CI, 0.9–20.5) and shorter EDI (odds ratio 1.1 per month earlier; 95 % CI, 1.0–1.2). This study found that recency of HIV-1 infection and the development of DM tropism may be associated with HAND in the relatively early stage of infection. Together, these data suggest that viral interaction with cellular receptors may play an important role in the early manifestation of HAND.

  14. Primary Cutaneous Cryptococcosis Treated with Debridement and Fluconazole Monotherapy in an Immunosuppressed Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Jennifer Wang

    2015-01-01

    Full Text Available Cryptococcus neoformans is an opportunistic yeast present in the environment. Practitioners are familiar with the presentation and management of the most common manifestation of cryptococcal infection, meningoencephalitis, in patients with AIDS or other conditions of immunocompromise. There is less awareness, however, of uncommon presentations where experience rather than evidence guides therapy. We report a case of primary cutaneous cryptococcosis (PCC in a patient who had been immunosuppressed by chronic high-dose corticosteroid for the treatment of severe asthma. This case highlights the importance of early recognition of aggressive cellulitis that fails standard empiric antibiotic treatment in an immunocompromised patient. It also demonstrates successful treatment of PCC with a multispecialty approach including local debridement and fluconazole monotherapy.

  15. [Palpebral cryptococcosis: case report].

    Science.gov (United States)

    Souza, Murilo Barreto; Melo, Carlos Sergio Nascimento; Silva, Cristiana Silveira; Santo, Ruth Miyuki; Matayoshi, Suzana

    2006-01-01

    This paper is about a patient with acquired immunodeficiency syndrome empirically treated for miliary tuberculosis. During the clinical evolution the patient presented lesions compromising the right eyelid and tarsal conjunctiva. The initial diagnostic hypothesis was ocular tuberculosis with conjunctival and eyelid involvement. The biopsy of the conjunctival lesion identified an encapsulated yeast-like fungus: Criptococcus neoformans. After starting treatment with B anfotericin, the cutaneus lesions cleared.

  16. Palpebral cryptococcosis: case report

    OpenAIRE

    Souza, Murilo Barreto; Melo, Carlos Sergio Nascimento; Silva, Cristiana Silveira; Santo, Ruth Miyuki; Matayoshi, Suzana

    2006-01-01

    Relata-se o caso de uma paciente portadora de síndrome da imunodeficiência adquirida empiricamente tratada com esquema tríplice para tuberculose miliar. Durante a evolução clínica a paciente cursou com lesões comprometendo a pálpebra e conjuntiva tarsal à direita. A hipótese diagnóstica inicial foi de tuberculose ocular com comprometimento conjuntival e palpebral. A biópsia da lesão conjuntival mostrou presença do Criptococcus neoformans. Após o início do tratamento específico com anfotericin...

  17. Cryptococcosis (C. neoformans)

    Science.gov (United States)

    ... Foodborne, Waterborne, and Environmental Diseases Mycotic Diseases Branch C. neoformans Infection Recommend on Facebook Tweet Share Compartir ... throughout the world. People can become infected with C. neoformans after breathing in the microscopic fungus, although ...

  18. Transdermal rivastigmine for HIV-associated cognitive impairment: A randomized pilot study.

    Directory of Open Access Journals (Sweden)

    Jose A Muñoz-Moreno

    Full Text Available To assess the efficacy and safety of transdermal rivastigmine for the treatment of HIV-associated cognitive impairment.We recruited HIV-infected patients with cognitive impairment on stable antiretroviral therapy in a randomized controlled pilot trial with a 48-week follow-up. An additional assessment was held at 12 weeks. Participants received transdermal rivastigmine (9.5 mg daily, lithium (400 mg twice daily, titrated progressively, or remained in a control group (no new medication. The primary efficacy endpoint was change in a global cognitive score (NPZ-7. Secondary endpoints included change in specific cognitive measures, domains, and functional parameters. Safety covered the frequency of adverse events and changes in laboratory results.Seventy-six subjects were screened, and 29 were finally enrolled. Better cognitive outcomes were observed in all groups, although there were no significant differences between the arms (mean NPZ-7 change [SD]: rivastigmine, 0.35 (0.14; lithium, 0.25 (0.40; control, 0.20 (0.44 (p = 0.78. The rivastigmine group showed the highest positive trend (mean NPZ-7 [SD], baseline vs week 48: rivastigmine, -0.47 (0.22 vs -0.11 (0.29, p = 0.06; lithium, -0.50 (0.40 vs -0.26 (0.21, p = 0.22; control, -0.52 (0.34 vs -0.32 (0.52, p = 0.44. The cognitive domains with the highest positive trends were information processing speed at week 12 and executive function at week 48 (rivastigmine vs control: information processing speed, 0.35 (0.64 vs -0.13 (0.25, p = 0.17, d = 0.96; and executive functioning, 0.73 (0.33 vs 0.03 (0.74, p = 0.09, d = 1.18. No relevant changes were observed regarding functional outcomes. A total of 12 (41% individuals dropped out of the study: 2 (20% were due to medication-related effects in the rivastigmine group and 4 (36% in the lithium group. No severe adverse events were reported.The results from this small randomized trial indicate that transdermal rivastigmine did not provide significant

  19. Interrupción exitosa de la profilaxis secundaria antifúngica en la criptococosis asociada al sida Successful discontinuation of antifungal secondary prophylaxis in AIDS-related cryptococcosis

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    R. Negroni

    2004-09-01

    Full Text Available Se presentan los datos clínicos de 22 pacientes con criptococosis asociada al VIH que interrumpieron la profilaxis antifúngica secundaria, después de haber recibido la terapéutica antirretroviral de gran actividad (TARGA. Fueron 14 varones y 8 mujeres con edades comprendidas entre los 15 y los 50 años (X: 34 años. Todos presentaron un síndrome infeccioso general grave y 19 tuvieron meningoencefalitis. En el momento del diagnóstico 59% de los enfermos tenía recuentos de células CD4+ The clinical and laboratory data of 22 patients with AIDS related cryptococcosis who were able to interrupt antifungal secondary prophylaxis afterHAART administration, are presented. They were 14 males and 8 females, between 15 and 50years old (X: 34 years old. All patients presented fever andsevere deterioration of their general health status, and 19 exhibited a meningeal syndrome. At the start of antifungal treatment, 59% of the cases presented < 50 CD4+ cells/µl, the median viral burden was 134,804 RNA copies/ml and the median titer ofserum cryptococcal antigen was 1/3,000. Amphotericin B by intravenous route, (0.7 mg/kg/day or fluconazole (600 to 800 mg/day were given as a treatment of the initial episode, up to CSF cultures negativization. Oral fluconazole (200 mg/day or intravenous amphotericin B, 50 mg twice a week, were given as a secondary prophylaxis. The secondary prophylaxis was interrupted when the patients had received HAART for an average lapse of 19 months (6 to 36 months and the medianCD4+ cells counts was 249/µl. The follow up after secondary prophylaxis discontinuation lasted for a median lapse of 22 months. These data seem to show that secondary prophylaxisis not necessary when the patient are clinically asymptomatic and the CD4+ cells counts are above 150/µl.

  20. Management of HIV-associated tuberculosis in resource-limited settings: a state-of-the-art review.

    Science.gov (United States)

    Lawn, Stephen D; Meintjes, Graeme; McIlleron, Helen; Harries, Anthony D; Wood, Robin

    2013-12-02

    The HIV-associated tuberculosis (TB) epidemic remains a huge challenge to public health in resource-limited settings. Reducing the nearly 0.5 million deaths that result each year has been identified as a key priority. Major progress has been made over the past 10 years in defining appropriate strategies and policy guidelines for early diagnosis and effective case management. Ascertainment of cases has been improved through a twofold strategy of provider-initiated HIV testing and counseling in TB patients and intensified TB case finding among those living with HIV. Outcomes of rifampicin-based TB treatment are greatly enhanced by concurrent co-trimoxazole prophylaxis and antiretroviral therapy (ART). ART reduces mortality across a spectrum of CD4 counts and randomized controlled trials have defined the optimum time to start ART. Good outcomes can be achieved when combining TB treatment with first-line ART, but use with second-line ART remains challenging due to pharmacokinetic drug interactions and cotoxicity. We review the frequency and spectrum of adverse drug reactions and immune reconstitution inflammatory syndrome (IRIS) resulting from combined treatment, and highlight the challenges of managing HIV-associated drug-resistant TB.

  1. Identification and functional characterization of HIV-associated neurocognitive disorders with large-scale Granger causality analysis on resting-state functional MRI

    Science.gov (United States)

    Chockanathan, Udaysankar; DSouza, Adora M.; Abidin, Anas Z.; Schifitto, Giovanni; Wismüller, Axel

    2018-02-01

    Resting-state functional MRI (rs-fMRI), coupled with advanced multivariate time-series analysis methods such as Granger causality, is a promising tool for the development of novel functional connectivity biomarkers of neurologic and psychiatric disease. Recently large-scale Granger causality (lsGC) has been proposed as an alternative to conventional Granger causality (cGC) that extends the scope of robust Granger causal analyses to high-dimensional systems such as the human brain. In this study, lsGC and cGC were comparatively evaluated on their ability to capture neurologic damage associated with HIV-associated neurocognitive disorders (HAND). Functional brain network models were constructed from rs-fMRI data collected from a cohort of HIV+ and HIV- subjects. Graph theoretic properties of the resulting networks were then used to train a support vector machine (SVM) model to predict clinically relevant parameters, such as HIV status and neuropsychometric (NP) scores. For the HIV+/- classification task, lsGC, which yielded a peak area under the receiver operating characteristic curve (AUC) of 0.83, significantly outperformed cGC, which yielded a peak AUC of 0.61, at all parameter settings tested. For the NP score regression task, lsGC, with a minimum mean squared error (MSE) of 0.75, significantly outperformed cGC, with a minimum MSE of 0.84 (p < 0.001, one-tailed paired t-test). These results show that, at optimal parameter settings, lsGC is better able to capture functional brain connectivity correlates of HAND than cGC. However, given the substantial variation in the performance of the two methods at different parameter settings, particularly for the regression task, improved parameter selection criteria are necessary and constitute an area for future research.

  2. Randomized, Double-Blind, Crossover Trial of Amitriptyline for Analgesia in Painful HIV-Associated Sensory Neuropathy.

    Directory of Open Access Journals (Sweden)

    Natalya Dinat

    Full Text Available We conducted a randomized, double-blind, placebo-controlled, crossover study at a single center in South Africa, to ascertain whether amitriptyline is an effective analgesic for painful HIV-associated sensory neuropathy of moderate to severe intensity in: i antiretroviral drug naive individuals, and ii antiretroviral drug users. 124 HIV-infected participants (antiretroviral drug naive = 62, antiretroviral drug users = 62 who met the study criteria for painful HIV-associated sensory neuropathy were randomized to once-daily oral amitriptyline (titrated to a median: interquartile range of 50: 25-50 mg or placebo for six weeks, followed by a three-week washout period and subsequent treatment crossover. The primary outcome measure was change from baseline in worst pain intensity of the feet (measured by participant self-report using an 11-point numerical pain rating scale after six weeks of treatment. 122 of 124 participants completed all study visits and were included in the analysis of the primary outcome. In the antiretroviral drug-naive group (n = 61 there was no significant difference in the mean change in pain score from baseline after six weeks of treatment with placebo or amitriptyline [amitriptyline: 2.8 (SD 3.3 vs. placebo: 2.8 (3.4]. Similarly, there was no significant difference in the change in pain score after six weeks of treatment with placebo or amitriptyline in the antiretroviral drug-user group (n = 61 [amitriptyline: 2.7 (3.3 vs. placebo: 2.1 (2.8]. Controlling for period effects and treatment order effects did not alter the outcome of the analyses. Nor did analyzing the intention-to-treat cohort (missing data interpolated using baseline observation carried forward alter the outcome of the analyses. In summary, amitriptyline, at the doses used here, was no more effective than an inactive placebo at reducing pain intensity in individuals with painful HIV-associated sensory neuropathy of moderate to severe intensity, irrespective of

  3. Disseminated cutaneous cryptococcosis in a patient with AIDS Criptococose cutânea disseminada em paciente com SIDA. Relato de caso

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    Sandra Lopes Mattos e Dinato

    2006-12-01

    Full Text Available The authors study a patient carrying Aids, with exuberant dermatological manifestations of cryptococcosis. They stress the therapeutic effectiveness of short-term amphotericin B. The authors reviewed cases of cutaneous infection with Cryptococcus reported in the national and international literature, verifying that the frequency has increased with the AIDS epidemic. Also, they discuss about the differential diagnosis with some cases of dermatosis, particularly with the disseminated giant molluscum contagiosum. In relation to the therapy, they affirm that the choice of drug depends on the organ involved, as well as the immune state of the patient.Os autores estudam um paciente portador de SIDA, com manifestações dermatológicas exuberantes de criptococose. Destacam a eficácia terapêutica da anfotericina B, a curto prazo. Revisam os casos de criptococose cutânea relatados na literatura nacional e internacional, ressaltando o aumento de sua freqüência com a epidemia da SIDA. Também discutem o diagnóstico diferencial com várias dermatoses, particularmente com o molusco contagioso gigante disseminado. Em relação à terapêutica, afirmam que a escolha da droga depende do órgão comprometido, assim como do estado imunológico do paciente.

  4. Improving detection of HIV-associated cognitive impairment: Comparison of the International HIV Dementia Scale and a Brief Screening Battery

    Science.gov (United States)

    de Almeida, Sergio Monteiro; Kamat, Rujvi; Cherner, Mariana; Umlauf, Anya; Ribeiro, Clea Elisa; de Pereira, Ana Paula; Franklin, Donald; Heaton, Robert K.; Ellis, Ronald J.

    2016-01-01

    Objectives The International HIV Dementia Scale (IHDS) was developed to screen for HIV-associated dementia (HAD), but it has been used more generally for HIV-associated neurocognitive disorder (HAND). This study sought to examine the accuracy of the IHDS in a cohort of Brazilian HIV-infected individuals and compare its performance to an alternative screening battery for detecting HAND. Methods 108 participants (including 60 HIV-infected persons), completed the IHDS and a gold standard neuropsychological (NP) battery of 17 tests. As alternative screening method, all possible three-test combinations from the NP battery were examined and a superiority index (a marker of specificity and sensitivity) was calculated. Results Sensitivity and specificity to HAND using the standard IHDS cutpoint of 10 were 36% and 75% respectively. The best balance between sensitivity and specificity was accomplished with a modified cutpoint of 11.5, which yielded sensitivity of 72% and specificity of 58%. The top two most sensitive test combinations, compared to the gold standard NP battery, were Trail Making Test A, WAIS-III Digit Symbol (DS) and HVLT-R Total Recall (sensitivity 91%, specificity 96%), and DS, BVMT-R Total Recall and Grooved Pegboard Test-Dominant Hand (sensitivity 94%, specificity 91%). Conclusions Both test combinations can be administered in under 10 minutes and were more accurate than the IHDS in classifying HIV+ participants as NP impaired or unimpaired. These data suggest that demographically corrected T-scores from commonly used NP measures with modest time and material demands can improve identification of patients with HAND who may benefit from a more extensive NP examination. PMID:27828876

  5. HIV-associated disruption of tight and adherens junctions of oral epithelial cells facilitates HSV-1 infection and spread.

    Directory of Open Access Journals (Sweden)

    Irna Sufiawati

    Full Text Available Herpes simplex virus (HSV types 1 and 2 are the most common opportunistic infections in HIV/AIDS. In these immunocompromised individuals, HSV-1 reactivates and replicates in oral epithelium, leading to oral disorders such as ulcers, gingivitis, and necrotic lesions. Although the increased risk of HSV infection may be mediated in part by HIV-induced immune dysfunction, direct or indirect interactions of HIV and HSV at the molecular level may also play a role. In this report we show that prolonged interaction of the HIV proteins tat and gp120 and cell-free HIV virions with polarized oral epithelial cells leads to disruption of tight and adherens junctions of epithelial cells through the mitogen-activated protein kinase signaling pathway. HIV-induced disruption of oral epithelial junctions facilitates HSV-1 paracellular spread between the epithelial cells. Furthermore, HIV-associated disruption of adherens junctions exposes sequestered nectin-1, an adhesion protein and critical receptor for HSV envelope glycoprotein D (gD. Exposure of nectin-1 facilitates binding of HSV-1 gD, which substantially increases HSV-1 infection of epithelial cells with disrupted junctions over that of cells with intact junctions. Exposed nectin-1 from disrupted adherens junctions also increases the cell-to-cell spread of HSV-1 from infected to uninfected oral epithelial cells. Antibodies to nectin-1 and HSV-1 gD substantially reduce HSV-1 infection and cell-to-cell spread, indicating that HIV-promoted HSV infection and spread are mediated by the interaction of HSV gD with HIV-exposed nectin-1. Our data suggest that HIV-associated disruption of oral epithelial junctions may potentiate HSV-1 infection and its paracellular and cell-to-cell spread within the oral mucosal epithelium. This could be one of the possible mechanisms of rapid development of HSV-associated oral lesions in HIV-infected individuals.

  6. FDG-PET/CT imaging in the management of HIV-associated multicentric Castleman's disease

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    Barker, Rob; Kazmi, Fahrad; Stebbing, Justin; Chinn, Roger [Imperial College School of Medicine, The Chelsea and Westminster Hospital, Department of Radiology, London (United Kingdom); Ngan, Sarah; Bower, Mark [Imperial College School of Medicine, The Chelsea and Westminster Hospital, Department of Oncology, London (United Kingdom); Nelson, Mark [Imperial College School of Medicine, The Chelsea and Westminster Hospital, Department of HIV Medicine, London (United Kingdom); O' Doherty, Michael [St. Thomas' Hospital, Clinical PET Centre, Guys and St. Thomas Hospital Trust, London (United Kingdom)

    2009-04-15

    To evaluate the role of FDG-PET/CT scanning in the management of HIV-associated multicentric Castleman's disease (MCD) a rare lymphoproliferative disorder associated with infection by human herpesvirus 8 (HHV8). Nine patients with histologically confirmed MCD underwent fused FDG-PET/CT scans at initial MCD diagnosis (n = 3), at MCD relapse (n = 4), or during remission (n = 2). All seven patients with active MCD had markedly elevated plasma HHV8 viral loads, but the patients in remission had no HHV8 viraemia. The three patients with newly diagnosed MCD were not on antiretroviral therapy at the time of imaging, but the other six were all on fully suppressive antiretroviral regimens. In the seven patients with active MCD (newly diagnosed or relapse) 33/91 lymph node groups (36%) included radiologically enlarged nodes on the CT scan, whilst 57/91 lymph node groups (63%) showed enhanced FDG uptake on the PET scan. In scans from patients in remission, there were no enlarged lymph nodes on the CT scan but 3 lymph nodes (11%) demonstrated enhanced FDG uptake. The median SUV recorded for the seven patients with active MCD was 4.8 (range 2.6-9.3) which was significantly higher than the median value of 2.5 recorded for the patients in remission (Mann-Whitney U test, p = 0.011). Despite the small number of patients, in HIV-positive individuals with active MCD, FDG-PET scans more frequently detected abnormal uptake than CT scans detected enlarged lymph nodes. FDG-PET scanning has a useful role in the management of HIV-associated MCD in selecting appropriate sites for biopsy, and in staging and monitoring these lymphoproliferations. (orig.)

  7. Prognostic value of a quantitative analysis of lipoarabinomannan in urine from patients with HIV-associated tuberculosis.

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    Andrew D Kerkhoff

    Full Text Available Detection of the mycobacterial cell wall antigen lipoarabinomannan (LAM in urine can be used to diagnose HIV-associated tuberculosis (TB using a qualitative (positive/negative read-out. However, it is not known whether the quantity of LAM present in urine provides additional prognostic information.Consecutively recruited adult outpatients initiating antiretroviral therapy (ART in South Africa were investigated for TB regardless of clinical symptoms using sputum smear microscopy and liquid culture (reference standard. Urine samples were tested using the Clearview TB-ELISA for LAM and the Xpert MTB/RIF assay. The ELISA optical densities (OD were used as a quantitative assessment of urine LAM. Among 514 patients with complete sputum and urine LAM OD results, culture-confirmed TB was diagnosed in 84 patients. Twenty-three (27.3% were LAM-positive with a median LAM OD of 0.68 (IQR 0.16-2.43; range, 0.10-3.29 and 61 (72.6% were LAM negative (LAM OD <0.1 above background. Higher LAM ODs were associated with a range of prognostic indices, including lower CD4 cell counts, lower haemoglobin levels, higher blood neutrophil counts and higher mycobacterial load as assessed using both sputum and urine samples. The median LAM OD among patients who died was more than 6.8-fold higher than that of patients who remained alive at 3 months (P<0.001. The small number of deaths, however, precluded adequate assessment of mortality risk stratified according to urine LAM OD.In patients with HIV-associated TB, concentrations of LAM in urine were strongly associated with a range of poor prognostic characteristics known to be associated with mortality risk. Urine LAM assays with a semi-quantitative (negative vs. low-positive vs. high-positive read-out may have improved clinical utility over assays with a simple binary result.

  8. Generalized systemic cryptococcosis in a dog after immunosuppressive corticotherapy Criptococose sistêmica generalizada em cão após corticoterapia imunossupressora

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    C.S. Honsho

    2003-04-01

    Full Text Available A male Boxer dog aged 2 years and 11 months was referred to the veterinary hospital with a history of a gastrointestinal disorder of two months duration, with apathy, hyporexia, progressive weight loss and visual deficit. Ataxia and vocalization were observed during hospitalization. The animal had been treated previously with antibiotics and immunosuppressive doses of corticoids to control chronic inflammatory bowel disease. The dog died five days later. Gross and microscopic observations indicated systemic cryptococcosis. The alimentary tract, eyes, brain, kidneys, pancreas and lymph nodes were involved.Um cão da raça Boxer, macho, com 2 anos e 11 meses de idade foi encaminhado ao hospital veterinário com histórico de distúrbio gastroentérico de dois meses de duração, apatia, hiporexia, emagrecimento progressivo e deficiência visual. Ataxia e vocalização foram observadas posteriormente. O animal estava sendo tratado em outra clínica veterinária com antibióticos e doses imunossupressoras de corticóides, direcionados ao controle de provável enterite alimentar. A morte ocorreu após cinco dias. As observações macro e microscópica revelaram tratar-se de criptococose sistêmica, atingindo trato digestório, olhos, SNC, rins, pâncreas e linfonodos. O presente relato enfatiza a infecção fúngica criptocócica quanto aos seus aspectos grastrointestinais iniciais a serem considerados no diagnóstico clínico, ressaltando a imunossupressão induzida pela corticoterapia.

  9. Vaccination with Recombinant Cryptococcus Proteins in Glucan Particles Protects Mice against Cryptococcosis in a Manner Dependent upon Mouse Strain and Cryptococcal Species

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    Charles A. Specht

    2017-11-01

    Full Text Available Development of a vaccine to protect against cryptococcosis is a priority given the enormous global burden of disease in at-risk individuals. Using glucan particles (GPs as a delivery system, we previously demonstrated that mice vaccinated with crude Cryptococcus-derived alkaline extracts were protected against lethal challenge with Cryptococcus neoformans and Cryptococcus gattii. The goal of the present study was to identify protective protein antigens that could be used in a subunit vaccine. Using biased and unbiased approaches, six candidate antigens (Cda1, Cda2, Cda3, Fpd1, MP88, and Sod1 were selected, recombinantly expressed in Escherichia coli, purified, and loaded into GPs. Three mouse strains (C57BL/6, BALB/c, and DR4 were then vaccinated with the antigen-laden GPs, following which they received a pulmonary challenge with virulent C. neoformans and C. gattii strains. Four candidate vaccines (GP-Cda1, GP-Cda2, GP-Cda3, and GP-Sod1 afforded a significant survival advantage in at least one mouse model; some vaccine combinations provided added protection over that seen with either antigen alone. Vaccine-mediated protection against C. neoformans did not necessarily predict protection against C. gattii. Vaccinated mice developed pulmonary inflammatory responses that effectively contained the infection; many surviving mice developed sterilizing immunity. Predicted T helper cell epitopes differed between mouse strains and in the degree to which they matched epitopes predicted in humans. Thus, we have discovered cryptococcal proteins that make promising candidate vaccine antigens. Protection varied depending on the mouse strain and cryptococcal species, suggesting that a successful human subunit vaccine will need to contain multiple antigens, including ones that are species specific.

  10. Cross-cultural assessment of HIV-associated cognitive impairment using the Kaufman assessment battery for children: a systematic review.

    Science.gov (United States)

    van Wyhe, Kaylee S; van de Water, Tanya; Boivin, Michael J; Cotton, Mark F; Thomas, Kevin Gf

    2017-06-14

    Despite improved efficacy of, and access to, combination antiretroviral therapy (cART), HIV-associated cognitive impairments remain prevalent in both children and adults. Neuropsychological tests that detect such impairment can help clinicians formulate effective treatment plans. The Kaufman Assessment Battery for Children (KABC), although developed and standardized in the United States, is used frequently in many different countries and cultural contexts to assess paediatric performance across various cognitive domains. This systematic review investigated the cross-cultural utility of the original KABC, and its 2nd edition (KABC-II), in detecting HIV-associated cognitive impairment in children and adolescents. We entered relevant keywords and MeSH terms into the PubMed, PsycInfo, EBSCOHost, ProQuest, and Scopus databases, with search limits set from 1983-2017. Two independent reviewers evaluated the retrieved abstracts and manuscripts. Studies eligible for inclusion in the review were those that (a) used the KABC/KABC-II to assess cognitive function in children/adolescents aged 2-18 years, (b) featured a definition of cognitive impairment (e.g. >2 SD below the mean) or compared the performance of HIV-infected and uninfected control groups, and (c) used a sample excluded from population on which the instruments were normed. We identified nine studies (eight conducted in African countries, and one in the United Kingdom) to comprise the review's sample. All studies detected cognitive impairment in HIV-infected children, including those who were cART-naïve or who were cART treated and clinically stable. KABC/KABC-II subtests assessing simultaneous processing appeared most sensitive. Evaluation of the methodological quality of the selected studies by two independent reviews suggested that shortcomings included reporting and selection biases. This systematic review provides evidence for the cross-cultural utility of the KABC/KABC-II, particularly the simultaneous

  11. Cerebrospinal fluid cytokine profiles predict risk of early mortality and immune reconstitution inflammatory syndrome in HIV-associated cryptococcal meningitis.

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    Joseph N Jarvis

    2015-04-01

    Full Text Available Understanding the host immune response during cryptococcal meningitis (CM is of critical importance for the development of immunomodulatory therapies. We profiled the cerebrospinal fluid (CSF immune-response in ninety patients with HIV-associated CM, and examined associations between immune phenotype and clinical outcome. CSF cytokine, chemokine, and macrophage activation marker concentrations were assayed at disease presentation, and associations between these parameters and microbiological and clinical outcomes were examined using principal component analysis (PCA. PCA demonstrated a co-correlated CSF cytokine and chemokine response consisting primarily of Th1, Th2, and Th17-type cytokines. The presence of this CSF cytokine response was associated with evidence of increased macrophage activation, more rapid clearance of Cryptococci from CSF, and survival at 2 weeks. The key components of this protective immune-response were interleukin (IL-6 and interferon-γ, IL-4, IL-10 and IL-17 levels also made a modest positive contribution to the PC1 score. A second component of co-correlated chemokines was identified by PCA, consisting primarily of monocyte chemotactic protein-1 (MCP-1 and macrophage inflammatory protein-1α (MIP-1α. High CSF chemokine concentrations were associated with low peripheral CD4 cell counts and CSF lymphocyte counts and were predictive of immune reconstitution inflammatory syndrome (IRIS. In conclusion CSF cytokine and chemokine profiles predict risk of early mortality and IRIS in HIV-associated CM. We speculate that the presence of even minimal Cryptococcus-specific Th1-type CD4+ T-cell responses lead to increased recruitment of circulating lymphocytes and monocytes into the central nervous system (CNS, more effective activation of CNS macrophages and microglial cells, and faster organism clearance; while high CNS chemokine levels may predispose to over recruitment or inappropriate recruitment of immune cells to the CNS and

  12. Focal glomerulosclerosis in proviral and c-fms transgenic mice links Vpr expression to HIV-associated nephropathy

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    Dickie, Peter; Roberts, Amanda; Uwiera, Richard; Witmer, Jennifer; Sharma, Kirti; Kopp, Jeffrey B.

    2004-01-01

    Clinical and morphologic features of human immunodeficiency virus (HIV)-associated nephropathy (HIVAN), such as proteinuria, sclerosing glomerulopathy, tubular degeneration, and interstitial disease, have been modeled in mice bearing an HIV proviral transgene rendered noninfectious through a deletion in gag/pol. Exploring the genetic basis of HIVAN, HIV transgenic mice bearing mutations in either or both of the accessory genes nef and vpr were created. Proteinuria and focal glomerulosclerosis (FGS) only developed in mice with an intact vpr gene. Transgenic mice bearing a simplified proviral DNA (encoding only Tat and Vpr) developed renal disease characterized by FGS in which Vpr protein was localized to glomerular and tubular epithelia by immunohistochemistry. The dual transgenic progeny of HIV[Tat/Vpr] mice bred to HIV[ΔVpr] proviral transgenic mice displayed a more severe nephropathy with no apparent increase in Vpr expression, implying that multiple viral genes contribute to HIVAN. However, the unique contribution of macrophage-specific Vpr expression in the development of glomerular disease was underscored by the induction of FGS in multiple murine lines bearing a c-fms/vpr transgene

  13. Neuroimaging of HIV-associated cryptococcal meningitis: comparison of magnetic resonance imaging findings in patients with and without immune reconstitution.

    Science.gov (United States)

    Katchanov, Juri; Branding, Gordian; Jefferys, Laura; Arastéh, Keikawus; Stocker, Hartmut; Siebert, Eberhard

    2016-02-01

    To determine the frequency, imaging characteristics, neuroanatomical distribution and dynamics of magnetic resonance imaging findings in HIV-associated cryptococcal meningitis in immunocompromised patients we compared patients without antiretroviral therapy with patients undergoing immune reconstitution. Neuroimaging and clinical data of 21 consecutive patients presenting to a German HIV centre in a 10-year period between 2005 and 2014 were reviewed. We identified eight patients with magnetic resonance imaging findings related to cryptococcal disease: five patients without antiretroviral therapy and three patients receiving effective antiretroviral therapy resulting in immune reconstitution. The pattern of magnetic resonance imaging manifestations was different in the two groups. In patients not on antiretroviral therapy, pseudocysts (n = 3) and lacunar ischaemic lesions (n = 2) were detected. Contrast-enhancing focal leptomeningeal and/or parenchymal lesions were found in all patients under immune reconstitution (n = 3). Magnetic resonance imaging lesions suggestive of leptomeningitis or meningoencephalitis were detected in all patients with a recurrence of cryptococcal meningitis under immune reconstitution, which differs from the classical magnetic resonance imaging findings in patients without antiretroviral therapy. In antiretroviral therapy-treated patients with past medical history of cryptococcal meningitis, detection of contrast-enhancing focal meningeal and/or parenchymal lesions should prompt further investigations for a recurrence of cryptococcal meningitis under immune reconstitution. © The Author(s) 2015.

  14. HIV-1 Tat reduces nephrin in human podocytes: a potential mechanism for enhanced glomerular permeability in HIV-associated nephropathy.

    Science.gov (United States)

    Doublier, Sophie; Zennaro, Cristina; Spatola, Tiziana; Lupia, Enrico; Bottelli, Antonella; Deregibus, Maria Chiara; Carraro, Michele; Conaldi, Pier Giulio; Camussi, Giovanni

    2007-02-19

    To determine whether HIV-1 Tat may directly alter glomerular permeability in HIV-associated nephropathy (HIVAN). Heavy proteinuria is a hallmark of HIVAN. The slit diaphragm is the ultimate glomerular filtration barrier critical for maintaining the efficiency of the ultrafiltration unit of the kidney. In this study, we evaluated the direct effect of Tat protein on the permeability of isolated glomeruli and on the expression of nephrin, the main slit diaphragm component, by human cultured podocytes. Permeability was studied by measuring the permeability to albumin in isolated rat glomeruli. We also evaluated the expression of nephrin in human cultured podocytes by using immunofluorescence and Western blot. We found that Tat increased albumin permeability in isolated glomeruli, and rapidly induced the redistribution and loss of nephrin in cultured podocytes. Pretreatment of glomeruli and podocytes with blocking antibodies showed that Tat reduced nephrin expression by engaging vascular endothelial growth factor receptors types 2 and 3 and the integrin alphavbeta3. Pre-incubation of podocytes with two platelet-activating factor (PAF) receptor antagonists prevented the loss and redistribution of nephrin induced by Tat, suggesting that PAF is an intracellular mediator of Tat action. Tat induced a rapid PAF synthesis by podocytes. When podocytes transfected to overexpress PAF-acetylhydrolase, the main catabolic enzyme of PAF, were stimulated with Tat, the redistribution and loss of nephrin was abrogated. The present results define a mechanism by which Tat may reduce nephrin expression in podocytes, thus increasing glomerular permeability. This provides new insights in the understanding of HIVAN pathogenesis.

  15. Treatment factors affecting outcomes in HIV-associated non-Hodgkin lymphomas: a pooled analysis of 1546 patients

    Science.gov (United States)

    Xue, Xiaonan; Wang, Dan; Tamari, Roni; Lee, Jeannette Y.; Mounier, Nicolas; Kaplan, Lawrence D.; Ribera, Josep-Maria; Spina, Michele; Tirelli, Umberto; Weiss, Rudolf; Galicier, Lionel; Boue, Francois; Wilson, Wyndham H.; Wyen, Christoph; Oriol, Albert; Navarro, José-Tomás; Dunleavy, Kieron; Little, Richard F.; Ratner, Lee; Garcia, Olga; Morgades, Mireia; Remick, Scot C.; Noy, Ariela; Sparano, Joseph A.

    2013-01-01

    Limited comparative data exist for the treatment of HIV-associated non-Hodgkin lymphoma. We analyzed pooled individual patient data for 1546 patients from 19 prospective clinical trials to assess treatment-specific factors (type of chemotherapy, rituximab, and concurrent combination antiretroviral [cART] use) and their influence on the outcomes complete response (CR), progression free survival (PFS), and overall survival (OS). In our analysis, rituximab was associated with a higher CR rate (odds ratio [OR] 2.89; P < .001), improved PFS (hazard ratio [HR] 0.50; P < .001), and OS (HR 0.51; P < .0001). Compared with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), initial therapy with more dose-intense regimens resulted in better CR rates (ACVBP [doxorubicin, cyclophosphamide, vindesine, bleomycin and prednisolone]: OR 1.70; P < .04), PFS (ACVBP: HR 0.72; P = .049; “intensive regimens”: HR 0.35; P < .001) and OS (“intensive regimens”: HR 0.54; P < .001). Infusional etoposide, prednisone, infusional vincristine, infusional doxorubicin, and cyclophosphamide (EPOCH) was associated with significantly better OS in diffuse large B-cell lymphoma (HR 0.33; P = .03). Concurrent use of cART was associated with improved CR rates (OR 1.89; P = .005) and trended toward improved OS (HR 0.78; P = .07). These findings provide supporting evidence for current patterns of care where definitive evidence is unavailable. PMID:24014242

  16. Altered brain functions in HIV positive patients free of HIV- associated neurocognitive disorders: A MRI study during unilateral hand movements

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    Jing Zhao

    2015-03-01

    Full Text Available This paper aimed to investigate the brain activity of human immunodeficiency virus (HIV positive patients with normal cognition during unilateral hand movement and whether highly active antiretroviral therapy (HAART could affect the brain function. Functional magnetic resonance imaging (fMRI was performed for 60 HIV positive (HIV+ subjects and −42 healthy age-matched right-handed control subjects. Each subject was evaluated by the neuropsychological test and examined with fMRI during left and right hand movement tasks. HIV+ subjects showed greater activation in anterior cingulum, precuneus, occipital lobes, ipsilateral postcentral gyrus and contralateral cerebellum compared with control group during right hand movement task. However, during left hand movement no statistically significant difference was detected between these two groups. HAART medication for HIV+ subjects lowered the increased activity to normal level. Meanwhile patients receiving the regimen of zidovudine, lamivudine and efavirenz showed lower activity at bilateral caudate and ipsilateral inferior frontal gyrus in comparison with subjects receiving other HAART regimens. Therefore, HIV+ subjects demonstrated brain asymmetry in motor cortex, with increased activity present during right hand movement but absent during left hand movement. HAART proves effective in HIV+ subjects even with normal cognition and the specific regimen of HAART could prevent cerebral abnormal functions. Meanwhile, this study validates that during motor tasks, fMRI can detect the brain signal changes prior to the occurrences of other HIV- associated dysfunctions.

  17. Theranostic quantum dots for crossing blood–brain barrier in vitro and providing therapy of HIV-associated encephalopathy

    Science.gov (United States)

    Xu, Gaixia; Mahajan, Supriya; Roy, Indrajit; Yong, Ken-Tye

    2013-01-01

    The blood–brain barrier (BBB) is a complex physiological checkpoint that restricts the free diffusion of circulating molecules from the blood into the central nervous system. Delivering of drugs and other active agents across the BBB is one of the major technical challenges faced by scientists and medical practitioners. Therefore, development of novel methodologies to address this challenge holds the key for both the diagnosis and treatment of brain diseases, such as HIV-associated encephalopathy. Bioconjugated quantum dots (QDs) are excellent fluorescent probes and nano-vectors, being designed to transverse across the BBB and visualize drug delivery inside the brain. This paper discusses the use of functionalized QDs for crossing the blood–brain barrier and treating brain disease. We highlight the guidelines for using in vitro BBB models for brain disease studies. The theranostic QDs offers a strategy to significantly improve the effective dosages of drugs to transverse across the BBB and orientate to the targets inside the brain. PMID:24298256

  18. HIV-associated neurocognitive disorders: recent advances in pathogenesis, biomarkers, and treatment [version 1; referees: 4 approved

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    Antonia Carroll

    2017-03-01

    Full Text Available HIV-associated neurocognitive disorders (HAND remain prevalent despite plasma viral suppression by antiretroviral agents. In fact, the prevalence of milder subtypes of cognitive impairment is increasing. Neuropsychologic testing remains the “gold standard” of diagnosis; however, this is time consuming and costly in a resource-poor environment. Recently developed screening tools, such as CogState and the revised HIV dementia scale, have very good sensitivity and specificity in the more severe stages of HAND. However, questions remain regarding the utility of, optimal population for, and insensitivity of tests in mild HAND. Recognition of ongoing viral persistence and the inflammatory milieu in the central nervous system (CNS has advanced our understanding of the pathogenesis of HAND and facilitated the development of biomarkers of CNS disease. The importance of the monocyte-macrophage lineage cell and the astrocyte as viral reservoirs, HIV viral proteins, self-perpetuating CNS inflammation, and CCR5 chemokine receptor neurotropism has been identified. Whilst biomarkers demonstrate monocyte activation, inflammation, and neuronal injury, they remain limited in their clinical utility. The improved understanding of pathogenic mechanisms has led to novel approaches to the treatment of HAND; however, despite these advances, the optimal management is still undefined.

  19. Genetically Modified Peripheral Blood Stem Cell Transplant in Treating Patients With HIV-Associated Non-Hodgkin or Hodgkin Lymphoma

    Science.gov (United States)

    2015-05-06

    Adult Nasal Type Extranodal NK/T-cell Lymphoma; AIDS-related Diffuse Large Cell Lymphoma; AIDS-related Diffuse Mixed Cell Lymphoma; AIDS-related Diffuse Small Cleaved Cell Lymphoma; AIDS-related Immunoblastic Large Cell Lymphoma; AIDS-related Lymphoblastic Lymphoma; AIDS-related Peripheral/Systemic Lymphoma; AIDS-related Small Noncleaved Cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; HIV-associated Hodgkin Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage I AIDS-related Lymphoma; Stage II AIDS-related Lymphoma; Stage III AIDS-related Lymphoma; Stage IV AIDS-related Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

  20. Methamphetamine and inflammatory cytokines increase neuronal Na+/K+-ATPase isoform 3: relevance for HIV associated neurocognitive disorders.

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    Gurudutt Pendyala

    Full Text Available Methamphetamine (METH abuse in conjunction with human immunodeficiency virus (HIV exacerbates neuropathogenesis and accelerates neurocognitive impairments in the central nervous system (CNS, collectively termed HIV Associated Neurocognitive Disorders (HAND. Since both HIV and METH have been implicated in altering the synaptic architecture, this study focused on investigating alterations in synaptic proteins. Employing a quantitative proteomics approach on synaptosomes isolated from the caudate nucleus from two groups of rhesus monkeys chronically infected with simian immunodeficiency virus (SIV differing by one regimen, METH treatment, we identified the neuron specific Na(+/K(+-ATPase alpha 1 isoform 3 (ATP1A3 to be up regulated after METH treatment, and validated its up regulation by METH in vitro. Further studies on signaling mechanisms revealed that the activation of ATP1A3 involves the extracellular regulated kinase (ERK pathway. Given its function in maintaining ionic gradients and emerging role as a signaling molecule, changes in ATP1A3 yields insights into the mechanisms associated with HAND and interactions with drugs of abuse.

  1. Investigating changes in brain network properties in HIV-associated neurocognitive disease (HAND) using mutual connectivity analysis (MCA)

    Science.gov (United States)

    Abidin, Anas Zainul; D'Souza, Adora M.; Nagarajan, Mahesh B.; Wismüller, Axel

    2016-03-01

    About 50% of subjects infected with HIV present deficits in cognitive domains, which are known collectively as HIV associated neurocognitive disorder (HAND). The underlying synaptodendritic damage can be captured using resting state functional MRI, as has been demonstrated by a few earlier studies. Such damage may induce topological changes of brain connectivity networks. We test this hypothesis by capturing the functional interdependence of 90 brain network nodes using a Mutual Connectivity Analysis (MCA) framework with non-linear time series modeling based on Generalized Radial Basis function (GRBF) neural networks. The network nodes are selected based on the regions defined in the Automated Anatomic Labeling (AAL) atlas. Each node is represented by the average time series of the voxels of that region. The resulting networks are then characterized using graph-theoretic measures that quantify various network topology properties at a global as well as at a local level. We tested for differences in these properties in network graphs obtained for 10 subjects (6 male and 4 female, 5 HIV+ and 5 HIV-). Global network properties captured some differences between these subject cohorts, though significant differences were seen only with the clustering coefficient measure. Local network properties, such as local efficiency and the degree of connections, captured significant differences in regions of the frontal lobe, precentral and cingulate cortex amongst a few others. These results suggest that our method can be used to effectively capture differences occurring in brain network connectivity properties revealed by resting-state functional MRI in neurological disease states, such as HAND.

  2. Modeling HIV-associated neurocognitive disorders in mice: new approaches in the changing face of HIV neuropathogenesis.

    Science.gov (United States)

    Jaeger, Laura B; Nath, Avindra

    2012-05-01

    It is well established that infection with the human immunodeficiency virus (HIV) leads to immune suppression. Less well known is the fact that long-term, progressive HIV disease is associated with the development of cognitive deficits. Since the introduction of combined antiretroviral therapy (cART), the clinical presentation of HIV infection has evolved into a chronic illness with very low levels of viral replication and chronic immune activation, with compliant affected individuals surviving for decades with a high quality of life. Despite these advances, many HIV-infected individuals develop some degree of neurodegeneration and cognitive impairment. The underlying pathophysiological mechanisms are not well understood, and there are no effective treatments. Thus, there is an unmet need for animal models that enable the study of HIV-associated neurocognitive disorders (HAND) and the testing of new therapeutic approaches to combat them. Here, we review the pros and cons of existing mouse models of HIV infection for addressing these aims and propose a detailed strategy for developing a new mouse model of HIV infection.

  3. Modeling HIV-associated neurocognitive disorders in mice: new approaches in the changing face of HIV neuropathogenesis

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    Laura B. Jaeger

    2012-05-01

    Full Text Available It is well established that infection with the human immunodeficiency virus (HIV leads to immune suppression. Less well known is the fact that long-term, progressive HIV disease is associated with the development of cognitive deficits. Since the introduction of combined antiretroviral therapy (cART, the clinical presentation of HIV infection has evolved into a chronic illness with very low levels of viral replication and chronic immune activation, with compliant affected individuals surviving for decades with a high quality of life. Despite these advances, many HIV-infected individuals develop some degree of neurodegeneration and cognitive impairment. The underlying pathophysiological mechanisms are not well understood, and there are no effective treatments. Thus, there is an unmet need for animal models that enable the study of HIV-associated neurocognitive disorders (HAND and the testing of new therapeutic approaches to combat them. Here, we review the pros and cons of existing mouse models of HIV infection for addressing these aims and propose a detailed strategy for developing a new mouse model of HIV infection.

  4. HIV-Associated Burkitt Lymphoma: Good Efficacy and Tolerance of Intensive Chemotherapy Including CODOX-M/IVAC with or without Rituximab in the HAART Era

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    J. A. Rodrigo

    2012-01-01

    Full Text Available Background. The outcome of HIV-associated non-Hodgkin lymphoma (NHL has improved substantially in the highly active antiretroviral therapy (HAART era. However, HIV-Burkitt lymphoma (BL, which accounts for up to 20% of HIV-NHL, has poor outcome with standard chemotherapy. Patients and Methods. We retrospectively reviewed HIV-BL treated in the HAART era with the Magrath regimen (CODOX-M/IVAC±R at four Canadian centres. Results. Fourteen patients with HIV-BL received at least one CODOX-M/IVAC±R treatment. Median age at BL diagnosis was 45.5 years, CD4 count 375 cells/mL and HIV viral load (VL 250 cells/mL and undetectable, respectively, in 4. Conclusion. Intensive chemotherapy with CODOX-M/IVAC±R yielded acceptable toxicity and good survival rates in patients with HIV-associated Burkitt lymphoma receiving HAART.

  5. HIV-Associated Burkitt Lymphoma: Good Efficacy and Tolerance of Intensive Chemotherapy Including CODOX-M/IVAC with or without Rituximab in the HAART Era

    Science.gov (United States)

    Rodrigo, J. A.; Hicks, L. K.; Cheung, M. C.; Song, K. W.; Ezzat, H.; Leger, C. S.; Boro, J.; Montaner, J. S. G.; Harris, M.; Leitch, H. A.

    2012-01-01

    Background. The outcome of HIV-associated non-Hodgkin lymphoma (NHL) has improved substantially in the highly active antiretroviral therapy (HAART) era. However, HIV-Burkitt lymphoma (BL), which accounts for up to 20% of HIV-NHL, has poor outcome with standard chemotherapy. Patients and Methods. We retrospectively reviewed HIV-BL treated in the HAART era with the Magrath regimen (CODOX-M/IVAC±R) at four Canadian centres. Results. Fourteen patients with HIV-BL received at least one CODOX-M/IVAC±R treatment. Median age at BL diagnosis was 45.5 years, CD4 count 375 cells/mL and HIV viral load (VL) 250 cells/mL and undetectable, respectively, in 4. Conclusion. Intensive chemotherapy with CODOX-M/IVAC±R yielded acceptable toxicity and good survival rates in patients with HIV-associated Burkitt lymphoma receiving HAART. PMID:22190945

  6. 5-fluorocitosina e anfotericina-B no tratamento da criptococose do sistema nervoso central Amphotericin-B and 5-fluorocytosine in the treatment of cryptococcosis of the central nervous system: report of two cases

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    J. P. S. Nobrega

    1975-09-01

    Full Text Available Registro de dois casos de criptococose do sistema nervoso central, em um deles associada a candidíase. Em ambos foram utilizados no tratamento anfotericina-B e 5-fluorocitosina. Em função dos resultados obtidos são feitas considerações quanto à utilidade de cada uma das drogas no tratamento da criptococose, bem como quanto ao uso associado de ambas.Two cases of cryptococcosis of the central nervous system are reported. The treatment was based on the association of amphotericin-B with 5-fluorocytosine. Details on the therapeutic proprieties of these drugs are discussed considering the results obtained. Amphotericin-B was administered intravenously and intrathecally in the two cases. The total amount of amphotericin administered intravenously in the first case was 5.375 mgm, and the oral doses of 5-fluorocytosine were not superior to 100 mgm/kg/of body weight. This patient died 130 days after the first symptoms of the disease. The second patient had been submitted previously to kidney transplantation after bilateral nephrectomy, and inmunossupressive drugs were administered to him since then. Candidiasis and cryptococcosis of the central nervous system developped two years later. 5-fluorocytosine was administered orally (200 mgm/kg of body weight and amphotericin-B. The total amount of this drug administered intravenously was 2.00 mgm. There was complete clinical and laboratory remission of the mycoses in this case.

  7. Medicalising normality? Using a simulated dataset to assess the performance of different diagnostic criteria of HIV-associated cognitive impairment

    Science.gov (United States)

    De Francesco, Davide; Leech, Robert; Sabin, Caroline A.; Winston, Alan

    2018-01-01

    Objective The reported prevalence of cognitive impairment remains similar to that reported in the pre-antiretroviral therapy era. This may be partially artefactual due to the methods used to diagnose impairment. In this study, we evaluated the diagnostic performance of the HIV-associated neurocognitive disorder (Frascati criteria) and global deficit score (GDS) methods in comparison to a new, multivariate method of diagnosis. Methods Using a simulated ‘normative’ dataset informed by real-world cognitive data from the observational Pharmacokinetic and Clinical Observations in PeoPle Over fiftY (POPPY) cohort study, we evaluated the apparent prevalence of cognitive impairment using the Frascati and GDS definitions, as well as a novel multivariate method based on the Mahalanobis distance. We then quantified the diagnostic properties (including positive and negative predictive values and accuracy) of each method, using bootstrapping with 10,000 replicates, with a separate ‘test’ dataset to which a pre-defined proportion of ‘impaired’ individuals had been added. Results The simulated normative dataset demonstrated that up to ~26% of a normative control population would be diagnosed with cognitive impairment with the Frascati criteria and ~20% with the GDS. In contrast, the multivariate Mahalanobis distance method identified impairment in ~5%. Using the test dataset, diagnostic accuracy [95% confidence intervals] and positive predictive value (PPV) was best for the multivariate method vs. Frascati and GDS (accuracy: 92.8% [90.3–95.2%] vs. 76.1% [72.1–80.0%] and 80.6% [76.6–84.5%] respectively; PPV: 61.2% [48.3–72.2%] vs. 29.4% [22.2–36.8%] and 33.9% [25.6–42.3%] respectively). Increasing the a priori false positive rate for the multivariate Mahalanobis distance method from 5% to 15% resulted in an increase in sensitivity from 77.4% (64.5–89.4%) to 92.2% (83.3–100%) at a cost of specificity from 94.5% (92.8–95.2%) to 85.0% (81.2–88

  8. Interactive Effects of Cocaine on HIV Infection: Implication in HIV-Associated Neurocognitive Disorder and NeuroAIDS

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    Santosh eDahal

    2015-09-01

    Full Text Available Substantial epidemiological studies suggest that not only, being one of the reasons for the transmission of the human immunodeficiency virus (HIV, but drug abuse also serves its role in determining the disease progression and severity among the HIV infected population. This article focuses on the drug cocaine, and its role in facilitating entry of HIV into the CNS and mechanisms of development of neurologic complications in infected individuals. Cocaine is a powerfully addictive central nervous system stimulating drug, which increases the level of neurotransmitter dopamine in the brain, by blocking the dopamine transporters (DAT which is critical for dopamine homeostasis and neurocognitive function. Tat protein of HIV acts as an allosteric modulator of DAT, where as cocaine acts as reuptake inhibitor. When macrophages in the CNS are exposed to dopamine, their number increases. These macrophages release inflammatory mediators and neurotoxins, causing chronic neuroinflammation. Cocaine abuse during HIV infection enhances the production of platelet monocyte complexes (PMCs, which may cross transendothelial barrier, and result in HIV-associated neurocognitive disorder (HAND. HAND is characterized by neuroinflammation, including astrogliosis, multinucleated giant cells, and neuronal apoptosis that is linked to progressive virus infection and immune deterioration. Cocaine and viral proteins are capable of eliciting signaling transduction pathways in neurons, involving in mitochondrial membrane potential loss, oxidative stress, activation of JNK, p38, and ERK/MAPK pathways, and results in downstream activation of NF-κB that leads to HAND. Tat-induced inflammation provokes permeability of the Blood Brain Barrier (BBB in the platelet dependent manner, which can potentially be the reason for progression to HAND during HIV infection. A better understanding on the role of cocaine in HIV infection can give a clue in developing novel therapeutic strategies

  9. Incidence of HIV-associated tuberculosis among individuals taking combination antiretroviral therapy: a systematic review and meta-analysis.

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    Tendesayi Kufa

    Full Text Available Knowledge of tuberculosis incidence and associated factors is required for the development and evaluation of strategies to reduce the burden of HIV-associated tuberculosis.Systematic literature review and meta-analysis of tuberculosis incidence rates among HIV-infected individuals taking combination antiretroviral therapy.From PubMed, EMBASE and Global Index Medicus databases, 42 papers describing 43 cohorts (32 from high/intermediate and 11 from low tuberculosis burden settings were included in the qualitative review and 33 in the quantitative review. Cohorts from high/intermediate burden settings were smaller in size, had lower median CD4 cell counts at study entry and fewer person-years of follow up. Tuberculosis incidence rates were higher in studies from Sub-Saharan Africa and from World Bank low/middle income countries. Tuberculosis incidence rates decreased with increasing CD4 count at study entry and duration on combination antiretroviral therapy. Summary estimates of tuberculosis incidence among individuals on combination antiretroviral therapy were higher for cohorts from high/intermediate burden settings compared to those from the low tuberculosis burden settings (4.17 per 100 person-years [95% Confidence Interval (CI 3.39-5.14 per 100 person-years] vs. 0.4 per 100 person-years [95% CI 0.23-0.69 per 100 person-years] with significant heterogeneity observed between the studies.Tuberculosis incidence rates were high among individuals on combination antiretroviral therapy in high/intermediate burden settings. Interventions to prevent tuberculosis in this population should address geographical, socioeconomic and individual factors such as low CD4 counts and prior history of tuberculosis.

  10. Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya.

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    Anne Korir

    Full Text Available Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a "strength-of-evidence" approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis.The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1 documentation of positive HIV serology; 2 antiretroviral drug prescription; 3 CD4+ lymphocyte count; and 4 WHO HIV clinical stage or immune suppression syndrome (ISS, which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3% met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association - Kaposi's sarcoma, cervical cancer, non-Hodgkin's and Hodgkin's lymphoma, and conjunctiva carcinoma and 31% (53 were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27% cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria.This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease

  11. Developing clinical strength-of-evidence approach to define HIV-associated malignancies for cancer registration in Kenya.

    Science.gov (United States)

    Korir, Anne; Mauti, Nathan; Moats, Pamela; Gurka, Matthew J; Mutuma, Geoffrey; Metheny, Christine; Mwamba, Peter M; Oyiro, Peter O; Fisher, Melanie; Ayers, Leona W; Rochford, Rosemary; Mwanda, Walter O; Remick, Scot C

    2014-01-01

    Sub-Saharan Africa cancer registries are beset by an increasing cancer burden further exacerbated by the AIDS epidemic where there are limited capabilities for cancer-AIDS match co-registration. We undertook a pilot study based on a "strength-of-evidence" approach using clinical data that is abstracted at the time of cancer registration for purposes of linking cancer diagnosis to AIDS diagnosis. The standard Nairobi Cancer Registry form was modified for registrars to abstract the following clinical data from medical records regarding HIV infection/AIDS in a hierarchal approach at time of cancer registration from highest-to-lowest strength-of-evidence: 1) documentation of positive HIV serology; 2) antiretroviral drug prescription; 3) CD4+ lymphocyte count; and 4) WHO HIV clinical stage or immune suppression syndrome (ISS), which is Kenyan terminology for AIDS. Between August 1 and October 31, 2011 a total of 1,200 cancer cases were registered. Of these, 171 cases (14.3%) met clinical strength-of-evidence criteria for association with HIV infection/AIDS; 69% (118 cases were tumor types with known HIV association - Kaposi's sarcoma, cervical cancer, non-Hodgkin's and Hodgkin's lymphoma, and conjunctiva carcinoma) and 31% (53) were consistent with non-AIDS defining cancers. Verifiable positive HIV serology was identified in 47 (27%) cases for an absolute seroprevalence rate of 4% among the cancer registered cases with an upper boundary of 14% among those meeting at least one of strength-of-evidence criteria. This pilot demonstration of a hierarchal, clinical strength-of-evidence approach for cancer-AIDS registration in Kenya establishes feasibility, is readily adaptable, pragmatic, and does not require additional resources for critically under staffed cancer registries. Cancer is an emerging public health challenge, and African nations need to develop well designed population-based studies in order to better define the impact and spectrum of malignant disease in the

  12. Identifying HIV associated neurocognitive disorder using large-scale Granger causality analysis on resting-state functional MRI

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    DSouza, Adora M.; Abidin, Anas Z.; Leistritz, Lutz; Wismüller, Axel

    2017-02-01

    We investigate the applicability of large-scale Granger Causality (lsGC) for extracting a measure of multivariate information flow between pairs of regional brain activities from resting-state functional MRI (fMRI) and test the effectiveness of these measures for predicting a disease state. Such pairwise multivariate measures of interaction provide high-dimensional representations of connectivity profiles for each subject and are used in a machine learning task to distinguish between healthy controls and individuals presenting with symptoms of HIV Associated Neurocognitive Disorder (HAND). Cognitive impairment in several domains can occur as a result of HIV infection of the central nervous system. The current paradigm for assessing such impairment is through neuropsychological testing. With fMRI data analysis, we aim at non-invasively capturing differences in brain connectivity patterns between healthy subjects and subjects presenting with symptoms of HAND. To classify the extracted interaction patterns among brain regions, we use a prototype-based learning algorithm called Generalized Matrix Learning Vector Quantization (GMLVQ). Our approach to characterize connectivity using lsGC followed by GMLVQ for subsequent classification yields good prediction results with an accuracy of 87% and an area under the ROC curve (AUC) of up to 0.90. We obtain a statistically significant improvement (p<0.01) over a conventional Granger causality approach (accuracy = 0.76, AUC = 0.74). High accuracy and AUC values using our multivariate method to connectivity analysis suggests that our approach is able to better capture changes in interaction patterns between different brain regions when compared to conventional Granger causality analysis known from the literature.

  13. Routine monitoring and assessment of adults living with HIV: results of the British HIV Association (BHIVA) national audit 2015.

    Science.gov (United States)

    Molloy, A; Curtis, H; Burns, F; Freedman, A

    2017-09-13

    The clinical care of people living with HIV changed fundamentally as a result of the development of effective antiretroviral therapy (ART). HIV infection is now a long-term treatable condition. We report a national audit to assess adherence to British HIV Association guidelines for the routine investigation and monitoring of adult HIV-1-infected individuals. All UK sites known as providers of adult HIV outpatient services were invited to complete a case-note review and a brief survey of local clinic practices. Participating sites were asked to randomly select 50-100 adults, who attended for specialist HIV care during 2014 and/or 2015. Each site collected data electronically using a self-audit spreadsheet tool. This included demographic details (gender, ethnicity, HIV exposure, and age) and whether 22 standardised and pre-defined clinical audited outcomes had been recorded. Data were collected on 8258 adults from 123 sites, representing approximately 10% of people living with HIV reported in public health surveillance as attending UK HIV services. Sexual health screening was provided within 96.4% of HIV services, cervical cytology and influenza vaccination within 71.4% of HIV services. There was wide variation in resistance testing across sites. Only 44.9% of patients on ART had a documented 10-year CVD risk within the past three years and fracture risk had been assessed within the past three years for only 16.7% patients aged over 50 years. There was high participation in the national audit and good practice was identified in some areas. However improvements can be made in monitoring of cardiovascular risk, bone and sexual health.

  14. HIV Associated Sensory Neuropathy.

    Science.gov (United States)

    G, Amruth; S, Praveen-Kumar; B, Nataraju; Bs, Nagaraja

    2014-07-01

    In the era of highly active antiretroviral therapy, sensory neuropathies have increased in prevalence. We have documented the frequency and profile of the two most common forms of sensory neuropathies associated with Human Immunodeficiency Virus (HIV) infection and looked into clinicoelectrophysiological correlates to differentiate the two entities. The study population comprised of all consecutive patients detected to be HIV positive and attending the Neurology outpatient department (from March 2011 to March 2012) who were aged ≥ 18 years and were able to give informed consent. The data were collected from the patient records (including CD4 counts and treatment details) and questionnaire based interview with each patient. All patients underwent detailed clinical examination and nerve conduction studies (NCSs). Among the total study population of 50 patients, there were 31 men and 19 women. Thirty two patients were in age range of 21 - 40 years and rest were above 40 years. 25 were on antiretroviral therapy (18 on regimen containing zidovudine; seven on regimen containing stavudine). The mean duration of antiretroviral therapy was 16.6±8.4 months. Low CD4 counts ( 40 years. Subclinical neuropathy was common in those on antiretroviral therapy. Axonal neuropathy was the commonest pattern noted in patients who were receiving antiretroviral therapy and demyelinating neuropathy in patients not on antiretroviral therapy. Surprisingly no significant correlation was found between low CD4 counts and symptomatic neuropathy.

  15. HIV-associated vasculopathy

    African Journals Online (AJOL)

    Third World countries. HIV has brought an array of new clinical presentations and has also generated new syndromes.4. HIV vasculopathy was first described as an entity in 19875 and may ..... The EGF pathway is also implicated in cancer, which suggests that anticancer drugs that interfere with this pathway might increase.

  16. The mitochondrial DNA T16189C polymorphism and HIV-associated cardiomyopathy: a genotype-phenotype association study

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    Poulton Joanna

    2009-04-01

    Full Text Available Abstract Background The mitochondrial DNA (mtDNA T16189C polymorphism, with a homopolymeric C-tract of 10–12 cytosines, is a putative genetic risk factor for idiopathic dilated cardiomyopathy in the African and British populations. We hypothesized that this variant may predispose to dilated cardiomyopathy in people who are infected with the human immunodeficiency virus (HIV. Methods A case-control study of 30 HIV-positive cases with dilated cardiomyopathy and 37 HIV-positive controls without dilated cardiomyopathy was conducted. The study was confined to persons of black African ancestry to minimize confounding of results by population admixture. HIV-positive patients with an echocardiographically confirmed diagnosis of dilated cardiomyopathy and HIV-positive controls with echocardiographically normal hearts were studied. Patients with secondary causes of cardiomyopathy (such as hypertension, diabetes, pregnancy, alcoholism, valvular heart disease, and opportunistic infection were excluded from the study. DNA samples were sequenced for the mtDNA T16189C polymorphism with a homopolymeric C-tract in the forward and reverse directions on an ABI3100 sequencer. Results The cases and controls were well matched for age (median 35 years versus 34 years, P = 0.93, gender (males 60% vs 53%, P = 0.54, and stage of HIV disease (mean CD4 T cell count 260.7/μL vs. 176/μL, P = 0.21. The mtDNA T16189C variant with a homopolymeric C-tract was detected at a frequency of 26.7% (8/30 in the HIV-associated cardiomyopathy cases and 13.5% (5/37 in the HIV-positive controls. There was no significant difference between cases and controls (Odds Ratio 2.33, 95% Confidence Interval 0.67–8.06, p = 0.11. Conclusion The mtDNA T16189C variant with a homopolymeric C-tract is not associated with dilated cardiomyopathy in black African people infected with HIV.

  17. Pharmacological treatment of painful HIV-associated sensory neuropathy: a systematic review and meta-analysis of randomised controlled trials.

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    Tudor J C Phillips

    Full Text Available BACKGROUND: Significant pain from HIV-associated sensory neuropathy (HIV-SN affects ∼40% of HIV infected individuals treated with antiretroviral therapy (ART. The prevalence of HIV-SN has increased despite the more widespread use of ART. With the global HIV prevalence estimated at 33 million, and with infected individuals gaining increased access to ART, painful HIV-SN represents a large and expanding world health problem. There is an urgent need to develop effective pain management strategies for this condition. METHOD AND FINDINGS: OBJECTIVE: To evaluate the clinical effectiveness of analgesics in treating painful HIV-SN. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Cochrane central register of controlled trials, www.clinicaltrials.gov, www.controlled-trials.com and the reference lists of retrieved articles. SELECTION CRITERIA: Prospective, double-blinded, randomised controlled trials (RCTs investigating the pharmacological treatment of painful HIV-SN with sufficient quality assessed using a modified Jadad scoring method. REVIEW METHODS: Four authors assessed the eligibility of articles for inclusion. Agreement of inclusion was reached by consensus and arbitration. Two authors conducted data extraction and analysis. Dichotomous outcome measures (≥ 30% and ≥ 50% pain reduction were sought from RCTs reporting interventions with statistically significant efficacies greater than placebo. These data were used to calculate RR and NNT values. RESULTS: Of 44 studies identified, 19 were RCTs. Of these, 14 fulfilled the inclusion criteria. Interventions demonstrating greater efficacy than placebo were smoked cannabis NNT 3.38 95%CI(1.38 to 4.10, topical capsaicin 8%, and recombinant human nerve growth factor (rhNGF. No superiority over placebo was reported in RCTs that examined amitriptyline (100mg/day, gabapentin (2.4 g/day, pregabalin (1200 mg/day, prosaptide (16 mg/day, peptide-T (6 mg/day, acetyl-L-carnitine (1g

  18. Pharmacological Treatment of Painful HIV-Associated Sensory Neuropathy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

    Science.gov (United States)

    Phillips, Tudor J. C.; Cherry, Catherine L.; Cox, Sarah; Marshall, Sarah J.; Rice, Andrew S. C.

    2010-01-01

    Background Significant pain from HIV-associated sensory neuropathy (HIV-SN) affects ∼40% of HIV infected individuals treated with antiretroviral therapy (ART). The prevalence of HIV-SN has increased despite the more widespread use of ART. With the global HIV prevalence estimated at 33 million, and with infected individuals gaining increased access to ART, painful HIV-SN represents a large and expanding world health problem. There is an urgent need to develop effective pain management strategies for this condition. Method and Findings Objective: To evaluate the clinical effectiveness of analgesics in treating painful HIV-SN. Design: Systematic review and meta-analysis. Data sources: Medline, Cochrane central register of controlled trials, www.clinicaltrials.gov, www.controlled-trials.com and the reference lists of retrieved articles. Selection criteria: Prospective, double-blinded, randomised controlled trials (RCTs) investigating the pharmacological treatment of painful HIV-SN with sufficient quality assessed using a modified Jadad scoring method. Review methods: Four authors assessed the eligibility of articles for inclusion. Agreement of inclusion was reached by consensus and arbitration. Two authors conducted data extraction and analysis. Dichotomous outcome measures (≥30% and ≥50% pain reduction) were sought from RCTs reporting interventions with statistically significant efficacies greater than placebo. These data were used to calculate RR and NNT values. Results Of 44 studies identified, 19 were RCTs. Of these, 14 fulfilled the inclusion criteria. Interventions demonstrating greater efficacy than placebo were smoked cannabis NNT 3.38 95%CI(1.38 to 4.10), topical capsaicin 8%, and recombinant human nerve growth factor (rhNGF). No superiority over placebo was reported in RCTs that examined amitriptyline (100mg/day), gabapentin (2.4g/day), pregabalin (1200mg/day), prosaptide (16mg/day), peptide-T (6mg/day), acetyl-L-carnitine (1g/day), mexilitine (600mg

  19. Interferon gamma increases survival in urine experimental cryptococcosis El Interferon gamma incrementa la sobrevida de un modelo experimental murino de criptococosis

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    Amadeo J. Bava

    1995-10-01

    Full Text Available Systemic disease by Cryptococcus neoformans (C. neoformans is a common opportunistic infection in immunodeficient patients. Cellular immunity seems to be the most important determinant of resistance. The aim of this study was to assess the effect of recombinant rat interferon gamma (IFN-gamma in murine cryptococcosis (Balb/c mice infected by IP route with the Rivas strain of C. neoformans, evaluating survival time, macroscopic and microscopic examination of the organs, and massive seeding of brain homogenate. IFN-gamma treatment, at a daily dose of 10,000 IU, did not modify significantly these variables when mice were challenged with a high inoculum (10(7 yeasts and treatment was delayed to 5 days after infection (median survival 21 days in control mice vs. 23 days in IFN-treated. Another set of experiments suggested that IFN-gamma treatment, at a dose of 10,000 IU/day, begun at the moment of infection could be useful (it prolonged survival from 20 to 28 days, although the difference did not achieve statistical signification. When used simultaneously with infection by 3.5 x 10(5 yeasts, IFN-gamma at 10,000 IU/day for 15 days significantly prolonged survival of mice (p = 0.004. These results suggest that, depending on the experimental conditions, IFN-gamma can improve survival of mice infected with a lethal dose of C. neoformans.Se evaluó la efectividad del interferon-gamma (IFN-gamma recombinante de rata en un modelo experimental de criptococosis desarollado en ratones Balb/C inoculados por vía intraperitoneal con la cepa Rivas de Cryptococcus neoformans (C. neoformans. Se tuvieron en cuenta el tiempo de sobrevida de los animales, el aspecto macroscópico de los órganos en la autopsia, la presencia de levaduras capsuladas en los tejidos y la siembra masiva de un homogenato de cerebro. El tratamiento con IFN-gamma, en dosis diarias de 10.000 UI, no modificó estos parámetros cuando la dosis infectante fue de 10(7 levaduras y el tratamiento se

  20. Measuring mortality due to HIV-associated tuberculosis among adults in South Africa: Comparing verbal autopsy, minimally-invasive autopsy, and research data

    Science.gov (United States)

    Tlali, Mpho; Fielding, Katherine L.; Charalambous, Salome; Chihota, Violet N.; Churchyard, Gavin J.; Hanifa, Yasmeen; Johnson, Suzanne; McCarthy, Kerrigan; Martinson, Neil A.; Omar, Tanvier; Kahn, Kathleen; Chandramohan, Daniel; Grant, Alison D.

    2017-01-01

    Background The World Health Organization (WHO) aims to reduce tuberculosis (TB) deaths by 95% by 2035; tracking progress requires accurate measurement of TB mortality. International Classification of Diseases (ICD) codes do not differentiate between HIV-associated TB and HIV more generally. Verbal autopsy (VA) is used to estimate cause of death (CoD) patterns but has mostly been validated against a suboptimal gold standard for HIV and TB. This study, conducted among HIV-positive adults, aimed to estimate the accuracy of VA in ascertaining TB and HIV CoD when compared to a reference standard derived from a variety of clinical sources including, in some, minimally-invasive autopsy (MIA). Methods and findings Decedents were enrolled into a trial of empirical TB treatment or a cohort exploring diagnostic algorithms for TB in South Africa. The WHO 2012 instrument was used; VA CoD were assigned using physician-certified VA (PCVA), InterVA-4, and SmartVA-Analyze. Reference CoD were assigned using MIA, research, and health facility data, as available. 259 VAs were completed: 147 (57%) decedents were female; median age was 39 (interquartile range [IQR] 33–47) years and CD4 count 51 (IQR 22–102) cells/μL. Compared to reference CoD that included MIA (n = 34), VA underestimated mortality due to HIV/AIDS (94% reference, 74% PCVA, 47% InterVA-4, and 41% SmartVA-Analyze; chance-corrected concordance [CCC] 0.71, 0.42, and 0.31, respectively) and HIV-associated TB (41% reference, 32% PCVA; CCC 0.23). For individual decedents, all VA methods agreed poorly with reference CoD that did not include MIA (n = 259; overall CCC 0.14, 0.06, and 0.15 for PCVA, InterVA-4, and SmartVA-Analyze); agreement was better at population level (cause-specific mortality fraction accuracy 0.78, 0.61, and 0.57, for the three methods, respectively). Conclusions Current VA methods underestimate mortality due to HIV-associated TB. ICD and VA methods need modifications that allow for more specific

  1. Validation of the International HIV Dementia Scale as a Screening Tool for HIV-Associated Neurocognitive Disorders in a German-Speaking HIV Outpatient Clinic.

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    Victor Marin-Webb

    Full Text Available HIV-associated neurocognitive disorders (HAND are widely present among people living with HIV. Especially its milder forms, asymptomatic neurocognitive impairment (ANI and mild neurocognitive disorder (MND, remain highly prevalent worldwide. Diagnosing these conditions is subject to a time and resource consuming neuropsychological assessment. Selecting patients at a higher risk of cognitive impairment by using a simple but effective screening tool helps to organise access to further neuropsychological diagnosis. The International HIV Dementia Scale (IHDS has until now been a well-established screening tool in African and American countries, however these populations' demographics defer significantly from ours, so using the same parameters could be ineffective.To calculate the prevalence of this condition among people attending an HIV outpatient clinic in Berlin and to validate the use of the IHDS as a screening tool for HAND in a German-speaking population.We screened 480 HIV-infected patients using the IHDS, 89% of them were on a stable antiretroviral treatment. Ninety of them completed a standardised neuropsychological battery of tests and a specific cognitive complaints questionnaire. The same procedure was applied to a control group of 30 HIV-negative participants. HAND diagnosis was established according to the Frascati criteria.The overall prevalence of HAND in our cohort was 43% (20% ANI, 17% MND and 6% HIV-associated dementia. The optimal cut-off on the IHDS for detecting HAND cases was set at 11 and achieved both a sensitivity and a specificity of 80%. When specifically screening for the more severe form of HAND, HIV-associated dementia, a cut-off value of 10 offered an increase in both sensitivity (94% and specificity (86%. The Youden Index for diagnostic accuracy was 0.6 and 0.8, respectively.The prevalence of HAND was comparable to the reported by recent studies performed in countries with a similar economic development. The study

  2. Validation of the International HIV Dementia Scale as a Screening Tool for HIV-Associated Neurocognitive Disorders in a German-Speaking HIV Outpatient Clinic.

    Science.gov (United States)

    Marin-Webb, Victor; Jessen, Heiko; Kopp, Ute; Jessen, Arne B; Hahn, Katrin

    2016-01-01

    HIV-associated neurocognitive disorders (HAND) are widely present among people living with HIV. Especially its milder forms, asymptomatic neurocognitive impairment (ANI) and mild neurocognitive disorder (MND), remain highly prevalent worldwide. Diagnosing these conditions is subject to a time and resource consuming neuropsychological assessment. Selecting patients at a higher risk of cognitive impairment by using a simple but effective screening tool helps to organise access to further neuropsychological diagnosis. The International HIV Dementia Scale (IHDS) has until now been a well-established screening tool in African and American countries, however these populations' demographics defer significantly from ours, so using the same parameters could be ineffective. To calculate the prevalence of this condition among people attending an HIV outpatient clinic in Berlin and to validate the use of the IHDS as a screening tool for HAND in a German-speaking population. We screened 480 HIV-infected patients using the IHDS, 89% of them were on a stable antiretroviral treatment. Ninety of them completed a standardised neuropsychological battery of tests and a specific cognitive complaints questionnaire. The same procedure was applied to a control group of 30 HIV-negative participants. HAND diagnosis was established according to the Frascati criteria. The overall prevalence of HAND in our cohort was 43% (20% ANI, 17% MND and 6% HIV-associated dementia). The optimal cut-off on the IHDS for detecting HAND cases was set at 11 and achieved both a sensitivity and a specificity of 80%. When specifically screening for the more severe form of HAND, HIV-associated dementia, a cut-off value of 10 offered an increase in both sensitivity (94%) and specificity (86%). The Youden Index for diagnostic accuracy was 0.6 and 0.8, respectively. The prevalence of HAND was comparable to the reported by recent studies performed in countries with a similar economic development. The study confirms

  3. [Cryptococcus neoformans chemotyping. Review of the literature. New epidemiologic data on cryptococcosis. Our experience with the use of C.G.B. media in the study of this yeast].

    Science.gov (United States)

    de Melo, N T; Lacaz, C da S; Charbel, C E; Pereira, A D; Heins-Vaccari, E M; França-Netto, A S; Machado, L dos R; Livramento, J A

    1993-01-01

    The purpose of this work was to collect the main information from the literature about the biotyping of Cryptococcus neoformans. The more up-to date research concerning the epidemiology of cryptococcosis comprising quite a few articles, mainly after the advent of AIDS, was also reviewed. The Cryptococcus neoformans varieties neoformans and gattii are well defined biochemically nowadays chiefly through the C.G.B. medium, according to Kwon-Chung et al. (1982). The isolation of C. neoformans var. gattii from flowers and leaves of Eucalyptus camaldulensis and Eucalyptus tereticornis, specially in Australia, through the works of Ellis & Pfeiffer (1990) and Pfeiffer & Ellis (1992) permitted very interesting epidemiological investigations on C. neoformans, a capsulated yeast by which Sanfelice, in Italy (1894; 1895) attracted attention of medical class. Busse, in 1894, described the first human case of cryptococcosis under the presentation of a bone lesion simulating sarcoma. In this paper, the Brazilian researchers focused on this subject were pointed out, followed by the Author's experience with the C.G.B. medium (L-canavanine, glycine and bromothymol blue) proposed by Kwon-Chung et al. (1982) with very good results. It was possible with such medium the study of 50 C.N.S. liquor samples, being 39 from AIDS patients (78%) and 11 from non-AIDS ones (22%). Thirty-seven out of the 39 HIV-positive patients (74%) were identified as C. neoformans var. gattii. From the negative HIV, 8 (16%) were classified as C. neoformans var. neoformans and 3 (6%) as C. neoformans var. gattii. We could not perform the serotyping of the above referred samples. It is evident anyway that in Brazil there exist both varieties gattii and neoformans, agents of neurocryptococcosis, including AIDS patients. The importance of neurocryptococcosis, mainly among AIDS patients, is stressed here, showing once more the value of C.G.B. medium in the typing of C. neoformans in its two varieties. Also, it is of

  4. The albumin-bilirubin grade uncovers the prognostic relationship between hepatic reserve and immune dysfunction in HIV-associated hepatocellular carcinoma.

    Science.gov (United States)

    Pinato, D J; Sharma, R; Citti, C; Platt, H; Ventura-Cots, M; Allara, E; Chen, T-Y; Dalla Pria, A; Jain, M; Mínguez, B; Kikuchi, L; Kaufman West, E; Merli, M; Kaplan, D E; Hasson, H; Marks, K; Nelson, M; Núñez, M; Aytaman, A; Bower, M; Bräu, N

    2018-01-01

    Hepatocellular carcinoma (HCC) is a leading cause of liver-related mortality in people living with HIV, where co-infection with hepatotropic viruses accelerates the course of chronic liver disease. To evaluate whether the albumin-bilirubin (ALBI) grade, a more accurate marker of liver dysfunction in HCC, might identify patients with progressive liver dysfunction in the context of HIV/hepatitis co-infection. Using uni- and multi-variable analyses, we studied the albumin-bilirubin grade as a predictor of overall survival (OS) in a large, multi-center cohort of patients with HIV-associated HCC recruited from 44 centres in 9 countries within the Liver Cancer in HIV study group. Patients who underwent liver transplantation were excluded. A total of 387 patients, predominantly HCV co-infected (78%) with balanced representation of all Barcelona Clinic Liver Cancer (BCLC) stages (A = 33%, B = 18%, C = 37%, D = 12%) were recruited. At HCC diagnosis, 84% had been on anti-retrovirals for a median duration of 8.8 years. The albumin-bilirubin grade identified significant differences in median survival of 97 months for grade 1 (95% CI 13-180 months), 17 months for grade 2 (95% CI 11-22 months) and 6 months for grade 3 (95% CI 4-9 months, P bilirubin grade correlated with lower CD4 counts (464/373/288 cells/mm 3 for grades 1/2/3) and higher HIV viraemia (3.337/8.701/61.845 copies/mL for grades 1/2/3, P bilirubin grade highlights the interplay between liver reserve and immune dysfunction as prognostic determinants in HIV-associated HCC. © 2017 John Wiley & Sons Ltd.

  5. HIV associated neurocognitive disorders (HAND in Malawian adults and effect on adherence to combination anti-retroviral therapy: a cross sectional study.

    Directory of Open Access Journals (Sweden)

    Christine M Kelly

    Full Text Available Little is known about the prevalence and burden of HIV associated neurocognitive disorder (HAND among patients on combination antiretroviral therapy (cART in sub-Saharan Africa. We estimated the prevalence of HAND in adult Malawians on cART and investigated the relationship between HAND and adherence to cART.HIV positive adults in Blantyre, Malawi underwent a full medical history, neurocognitive test battery, depression score, Karnofsky Performance Score and adherence assessment. The Frascati criteria were used to diagnose HAND and the Global Deficit Score (GDS was also assessed. Blood was drawn for CD4 count and plasma nevirapine and efavirenz concentrations. HIV negative adults were recruited from the HIV testing clinic to provide normative scores for the neurocognitive battery.One hundred and six HIV positive patients, with median (range age 39 (18-71 years, 73% female and median (range CD4 count 323.5 (68-1039 cells/µl were studied. Symptomatic neurocognitive impairment was present in 15% (12% mild neurocognitive disorder [MND], 3% HIV associated dementia [HAD]. A further 55% fulfilled Frascati criteria for asymptomatic neurocognitive impairment (ANI; however factors other than neurocognitive impairment could have confounded this estimate. Neither the symptomatic (MND and HAD nor asymptomatic (ANI forms of HAND were associated with subtherapeutic nevirapine/efavirenz concentrations, adjusted odds ratio 1.44 (CI. 0.234, 8.798; p = 0.696 and aOR 0.577 (CI. 0.09, 3.605; p = 0.556 respectively. All patients with subtherapeutic nevirapine/efavirenz levels had a GDS of less than 0.6, consistent with normal neurocognition.Fifteen percent of adult Malawians on cART had a diagnosis of MND or HAD. Subtherapeutic drug concentrations were found exclusively in patients with normal neurocognitive function suggesting HAND did not affect cART adherence. Further study of HAND requires more robust locally derived normative neurocognitive values and

  6. N-(Pivaloyloxy)alkoxy-carbonyl Prodrugs of the Glutamine Antagonist 6-Diazo-5-oxo-l-norleucine (DON) as a Potential Treatment for HIV Associated Neurocognitive Disorders.

    Science.gov (United States)

    Nedelcovych, Michael T; Tenora, Lukáš; Kim, Boe-Hyun; Kelschenbach, Jennifer; Chao, Wei; Hadas, Eran; Jančařík, Andrej; Prchalová, Eva; Zimmermann, Sarah C; Dash, Ranjeet P; Gadiano, Alexandra J; Garrett, Caroline; Furtmüller, Georg; Oh, Byoungchol; Brandacher, Gerald; Alt, Jesse; Majer, Pavel; Volsky, David J; Rais, Rana; Slusher, Barbara S

    2017-08-24

    Aberrant excitatory neurotransmission associated with overproduction of glutamate has been implicated in the development of HIV-associated neurocognitive disorders (HAND). The glutamine antagonist 6-diazo-5-oxo-l-norleucine (DON, 14) attenuates glutamate synthesis in HIV-infected microglia/macrophages, offering therapeutic potential for HAND. We show that 14 prevents manifestation of spatial memory deficits in chimeric EcoHIV-infected mice, a model of HAND. 14 is not clinically available, however, because its development was hampered by peripheral toxicities. We describe the synthesis of several substituted N-(pivaloyloxy)alkoxy-carbonyl prodrugs of 14 designed to circulate inert in plasma and be taken up and biotransformed to 14 in the brain. The lead prodrug, isopropyl 6-diazo-5-oxo-2-(((phenyl(pivaloyloxy)methoxy)carbonyl)amino)hexanoate (13d), was stable in swine and human plasma but liberated 14 in swine brain homogenate. When dosed systemically in swine, 13d provided a 15-fold enhanced CSF-to-plasma ratio and a 9-fold enhanced brain-to-plasma ratio relative to 14, opening a possible clinical path for the treatment of HAND.

  7. Lessons learned developing a diagnostic tool for HIV-associated dementia feasible to implement in resource-limited settings: pilot testing in Kenya.

    Directory of Open Access Journals (Sweden)

    Judith Kwasa

    Full Text Available To conduct a preliminary evaluation of the utility and reliability of a diagnostic tool for HIV-associated dementia (HAD for use by primary health care workers (HCW which would be feasible to implement in resource-limited settings.In resource-limited settings, HAD is an indication for anti-retroviral therapy regardless of CD4 T-cell count. Anti-retroviral therapy, the treatment for HAD, is now increasingly available in resource-limited settings. Nonetheless, HAD remains under-diagnosed likely because of limited clinical expertise and availability of diagnostic tests. Thus, a simple diagnostic tool which is practical to implement in resource-limited settings is an urgent need.A convenience sample of 30 HIV-infected outpatients was enrolled in Western Kenya. We assessed the sensitivity and specificity of a diagnostic tool for HAD as administered by a primary HCW. This was compared to an expert clinical assessment which included examination by a physician, neuropsychological testing, and in selected cases, brain imaging. Agreement between HCW and an expert examiner on certain tool components was measured using Kappa statistic.The sample was 57% male, mean age was 38.6 years, mean CD4 T-cell count was 323 cells/µL, and 54% had less than a secondary school education. Six (20% of the subjects were diagnosed with HAD by expert clinical assessment. The diagnostic tool was 63% sensitive and 67% specific for HAD. Agreement between HCW and expert examiners was poor for many individual items of the diagnostic tool (K = .03-.65. This diagnostic tool had moderate sensitivity and specificity for HAD. However, reliability was poor, suggesting that substantial training and formal evaluations of training adequacy will be critical to enable HCW to reliably administer a brief diagnostic tool for HAD.

  8. Motor function declines over time in human immunodeficiency virus and is associated with cerebrovascular disease, while HIV-associated neurocognitive disorder remains stable.

    Science.gov (United States)

    M Elicer, Isabel; Byrd, Desiree; Clark, Uraina S; Morgello, Susan; Robinson-Papp, Jessica

    2018-04-25

    HIV-associated neurocognitive disorders (HAND) remain prevalent in the combined antiretroviral therapy (CART) era, especially the milder forms. Despite these milder phenotypes, we have shown that motor abnormalities persist and have quantified them with the HIV Dementia Motor Scale (HDMS). Our objectives were to replicate, in an independent sample, our prior findings that the HDMS is associated with cognitive impairment in HIV, while adding consideration of age-associated comorbidities such as cerebrovascular disease, and to examine the longitudinal trajectories of cognitive and motor dysfunction. We included all participants enrolled in the Manhattan HIV Brain Bank (MHBB) from January 2007 to May 2017 who had complete baseline data (N = 164). MHBB participants undergo standardized longitudinal assessments including documentation of comorbidities and medications, blood work, the HDMS, and neurocognitive testing. We found that motor dysfunction, cognitive impairment, and cerebrovascular disease were significantly associated with each other at baseline. Cerebrovascular disease independently predicted cognitive impairment in a multivariable model. Longitudinal analysis in a subset of 78 participants with ≥ 4 years of follow-up showed a stable cognition but declining motor function. We conclude that the HDMS is a valid measurement of motor dysfunction in HIV-infected patients and is associated with cognitive impairment and the presence of cerebrovascular disease. Cognitive impairment is mild and stable in CART-treated HIV; however, motor function declines over time, which may be related to the accrual of comorbidities such as cerebrovascular disease. Further research should examine the mechanisms underlying motor dysfunction in HIV and its clinical impact.

  9. Effect of Recombinant Human Growth Hormone and Rosiglitazone for HIV-Associated Abdominal Fat Accumulation on Adiponectin and other Markers of Inflammation

    Science.gov (United States)

    Leung, Vivien; Chiu, Ya-Lin; Kotler, Donald P.; Albu, Jeanine; Zhu, Yuan-Shan; Ham, Kirsis; Engelson, Ellen S.; Hammad, Hoda; Christos, Paul; Donovan, Daniel S.; Ginsberg, Henry N.; Glesby, Marshall J.

    2016-01-01

    Background/Objective In a previous report of HIV-infected patients with fat redistribution, we found that recombinant human growth hormone (rhGH) therapy reduced visceral adipose tissue (VAT) but increased insulin resistance, and that the addition of rosiglitazone reversed the negative effects of rhGH on insulin sensitivity. In this study, we sought to determine the effects of recombinant human growth hormone (rhGH) and rosiglitazone therapy on an array of inflammatory and fibrinolytic markers. Methods 72 patients with HIV-associated abdominal obesity and insulin resistance were randomized to treatment with rhGH, rosiglitazone, the combination of rhGH and rosiglitazone, or placebo for 12 weeks. Subjects with plasma and serum samples available at weeks 0 (n = 63) and 12 (n = 46-48) were assessed for adiponectin, C-reactive protein (CRP), homocysteine, interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), fibrinogen, plasminogen activator inhibitor-1 (PAI-1) antigen, and tissue plasminogen activator (tPA) antigen. Results Treatment with both rosiglitazone alone and the combination of rosiglitazone and rhGH for 12 weeks resulted in significant increases in adiponectin levels from baseline. Adiponectin levels did not change significantly in the rhGH alone arm. There were no significant changes in the other biomarkers amongst the different treatment groups. Discussion In this study of HIV-infected patients with altered fat distribution, treatment with rosiglitazone had beneficial effects on adiponectin concentrations, an effect that was also seen with combination rosiglitazone and rhGH. RhGH administration alone, however, did not demonstrate any significant impact on adiponectin levels despite reductions in VAT. PMID:27077672

  10. [An exploratory study on the diagnostic cutoff value of International HIV-associated Dementia Scale in minority ethnic groups with different educational levels, in Guangxi].

    Science.gov (United States)

    Zhao, Ting-ting; Feng, Qi-ming; Liang, Hao; Tang, Xian-yan; Wei, Bo

    2011-11-01

    Using Intelligence Scale of Mini Mental State Estimated (MMSE) as the gold standard to determine the relevance of International HIV-associated Dementia Scale (IHDS) in minority ethnic areas in Guangxi populations with different cultural values. Corresponding boundary value related to the authenticity and reliability on IHDS were also evaluated. 200 patients with HIV infection were randomly selected from the minority ethnic groups in Guangxi. For each infected person, MMSE and IHDS blind scale were tested at the same period. Using the results from MMSE scale test as the gold standard, ROC curve and IHDS scale in Guangxi minority populations with different education levels which related to the diagnosis of dementia-HIV values were determined. The value of a specific sector under the IHDS sensitivity, specificity, and internal consistency coefficients was also evaluated. When considering the infected person did not differ on their educational level, the IHDS scale diagnostic cutoff appeared as 8.25, while IHDS sensitivity as 0.925, specificity as 0.731 and Kappa as 0.477 (P education groups showed different IHDS diagnostic cutoff values. People with high school, secondary school or higher education levels, the IHDS diagnosis appeared to be 8.25, when sensitivity was 0.917, specificity was 0.895 and Kappa was 0.722 (P education level, the IHDS appeared to be 7.25. When sensitivity was 0.875, specificity was 0.661 and Kappa was 0.372 (P value (IHDS ≤ 10 points). When using IHDS to perform the HIV related dementia screening program, in the minority areas of Guangxi, culture context, the degree and difference of HIV infection should be considered, especially in using IHDS diagnostic cutoff values.

  11. Identification of an abbreviated test battery for detection of HIV-associated neurocognitive impairment in an early-managed HIV-infected cohort.

    Directory of Open Access Journals (Sweden)

    David J Moore

    Full Text Available HIV-associated neurocognitive disorders (HAND remain prevalent despite improved antiretroviral treatment (ART, and it is essential to have a sensitive and specific HAND screening tool.Participants were 200 HIV-infected US military beneficiaries, managed early in the course of HIV infection, had few comorbidities, and had open access to ART. Participants completed a comprehensive, seven-domain (16-test, neuropsychological battery (∼120 min; neurocognitive impairment (NCI was determined using a standardized score derived from demographically adjusted T-scores (global deficit score ≥0.5. Restricting the estimated administration time of the screening battery to < = 20 minutes, we examined the sensitivity and specificity of detecting NCI for all possible combinations of 2-, 3-, and 4- tests from the comprehensive battery.Participants were relatively healthy (median CD4 count: 546 cells/mm(3 with 64% receiving ART. Prevalence of NCI was low (19%. The best 2-test screener included the Stroop Color Test and the Hopkins Verbal Learning Test-Revised (11 min; sensitivity = 73%; specificity = 83%; the best 3-test screener included the above measures plus the Paced Auditory Serial Addition Test (PASAT; 16 min; sensitivity = 86%; specificity = 75%. The addition of Action Fluency to the above three tests improved specificity (18 min; sensitivity = 86%; specificity = 87%.Combinations of widely accepted neuropsychological tests with brief implementation time demonstrated good sensitivity and specificity compared to a time intensive neuropsychological test battery. Tests of verbal learning, attention/working memory, and processing speed are particularly useful in detecting NCI. Utilizing validated, easy to administer, traditional neuropsychological tests with established normative data may represent an excellent approach to screening for NCI in HIV.

  12. Absolute leukocyte telomere length in HIV-infected and uninfected individuals: evidence of accelerated cell senescence in HIV-associated chronic obstructive pulmonary disease.

    Directory of Open Access Journals (Sweden)

    Joseph C Y Liu

    Full Text Available Combination antiretroviral therapy (cART has extended the longevity of human immunodeficiency virus (HIV-infected individuals. However, this has resulted in greater awareness of age-associated diseases such as chronic obstructive pulmonary disease (COPD. Accelerated cellular senescence may be responsible, but its magnitude as measured by leukocyte telomere length is unknown and its relationship to HIV-associated COPD has not yet been established. We measured absolute telomere length (aTL in peripheral leukocytes from 231 HIV-infected adults. Comparisons were made to 691 HIV-uninfected individuals from a population-based sample. Subject quartiles of aTL were assessed for relationships with measures of HIV disease severity, airflow obstruction, and emphysema severity on computed tomographic (CT imaging. Multivariable regression models identified factors associated with shortened aTL. Compared to HIV-uninfected subjects, the mean aTL in HIV-infected patients was markedly shorter by 27 kbp/genome (p<0.001; however, the slopes of aTL vs. age were not different (p=0.469. Patients with longer known durations of HIV infection (p=0.019 and lower nadir CD4 cell counts (p=0.023 had shorter aTL. Shorter aTL were also associated with older age (p=0.026, smoking (p=0.005, reduced forced expiratory volume in one second (p=0.030, and worse CT emphysema severity score (p=0.049. HIV-infected subjects demonstrate advanced cellular aging, yet in a cART-treated cohort, the relationship between aTL and age appears no different from that of HIV-uninfected subjects.

  13. Using Culturally Sensitive Media Messages to Reduce HIV-associated Sexual Behavior in High-risk African-American Adolescents: Results from a Randomized Trial

    Science.gov (United States)

    Sznitman, Sharon; Vanable, Peter A.; Carey, Michael P.; Hennessy, Michael; Brown, Larry K.; Valois, Robert F.; Stanton, Bonita F.; Salazar, Laura F.; DiClemente, Ralph; Farber, Naomi; Romer, Daniel

    2010-01-01

    Purpose To test the long-term effects of a mass media intervention that used culturally and developmentally appropriate messages to enhance HIV-preventive beliefs and behavior of high-risk African-American adolescents. Methods Television and radio messages were delivered over three years in two cities (Syracuse, NY and Macon, GA) that were randomly selected within each of two regionally matched city pairs with the other cities (Providence, RI and Columbia, SC) serving as controls. African American adolescents ages 14 to 17 (N = 1710), recruited in the four cities over a 16-month period, completed audio computer-assisted self-interviews at recruitment and again at 3, 6, 12 and 18-months post-recruitment to assess the long-term effects of the media program. To identify the unique effects of the media intervention, youth who completed at least one follow-up and who did not test positive for any of three sexually transmitted infections at recruitment or at 6 and 12-month follow-up were retained for analysis (N=1346). Results The media intervention reached virtually all of the adolescents in the trial and produced a range of effects including improved normative condom-use negotiation expectancies and increased sex refusal self-efficacy. Most importantly, older adolescents (ages 16-17) exposed to the media program exhibited a less risky age trajectory of unprotected sex than those in the non-media cities. Conclusions Culturally tailored mass media messages delivered consistently over time have the potential to reach a large audience of high-risk adolescents, to support changes in HIV-preventive beliefs, and to reduce HIV-associated risk behaviors among older youth. PMID:21856515

  14. Vorinostat positively regulates synaptic plasticity genes expression and spine density in HIV infected neurons: role of nicotine in progression of HIV-associated neurocognitive disorder

    Science.gov (United States)

    2014-01-01

    Background HIV-associated neurocognitive disorder (HAND) is characterized by development of cognitive, behavioral and motor abnormalities, and occurs in approximately 50% of HIV infected individuals. In the United States, the prevalence of cigarette smoking ranges from 35-70% in HIV-infected individuals compared to 20% in general population. Cognitive impairment in heavy cigarette smokers has been well reported. However, the synergistic effects of nicotine and HIV infection and the underlying mechanisms in the development of HAND are unknown. Results In this study, we explored the role of nicotine in the progression of HAND using SK-N-MC, a neuronal cell line. SK-N-MC cells were infected with HIV-1 in the presence or absence of nicotine for 7 days. We observed significant increase in HIV infectivity in SK-N-MC treated with nicotine compared to untreated HIV-infected neuronal cells. HIV and nicotine synergize to significantly dysregulate the expression of synaptic plasticity genes and spine density; with a concomitant increase of HDAC2 levels in SK-N-MC cells. In addition, inhibition of HDAC2 up-regulation with the use of vorinostat resulted in HIV latency breakdown and recovery of synaptic plasticity genes expression and spine density in nicotine/HIV alone and in co-treated SK-N-MC cells. Furthermore, increased eIF2 alpha phosphorylation, which negatively regulates eukaryotic translational process, was observed in HIV alone and in co-treatment with nicotine compared to untreated control and nicotine alone treated SK-N-MC cells. Conclusions These results suggest that nicotine and HIV synergize to negatively regulate the synaptic plasticity gene expression and spine density and this may contribute to the increased risk of HAND in HIV infected smokers. Apart from disrupting latency, vorinostat may be a useful therapeutic to inhibit the negative regulatory effects on synaptic plasticity in HIV infected nicotine abusers. PMID:24886748

  15. Neonatal HIV-associated nephropathy

    African Journals Online (AJOL)

    HIV-related kidney disease in Africa, 19 children (37.3%) were younger than 5 years; the ... Serological tests were conducted for toxoplasmosis, Epstein-. Barr virus, hepatitis B and C, syphilis (rapid plasma reaction) and. CMV (including a ...

  16. HIV-Associated Gastrointestinal Cancer.

    Science.gov (United States)

    Jensen, Björn E-O; Oette, Mark; Haes, Johannes; Häussinger, Dieter

    2017-01-01

    People living nowadays with HIV and AIDS may be treated effectively regarding virus replication and immunology. However, non-AIDS-defining cancer is of growing relevance due to high incidence and unfavorable outcome. The aim of this review is to summarize current knowledge on gastrointestinal (GI) carcinoma. Although literature on GI cancer is rare, an increased incidence of esophageal, gastric, pancreatic, hepatocellular, and colorectal carcinoma has been demonstrated. However, there are only few reports on therapy strategies and outcome, so that, despite increased occurrence of many GI carcinomas, only little is known about individualized treatment options and outcome in HIV-positive patients. More efforts have to be undertaken to close this gap. © 2017 S. Karger GmbH, Freiburg.

  17. HIV-Associated Lung Cancer.

    Science.gov (United States)

    Kiderlen, Til R; Siehl, Jan; Hentrich, Marcus

    2017-01-01

    Lung cancer (LC) is one of the most common non-AIDS (acquired immune deficiency syndrome)-defining malignancies. It occurs more frequently in persons living with human immunodeficiency virus (PLWHIV) than in the HIV-negative population. Compared to their HIV-negative counterparts, patients are usually younger and diagnosed at more advanced stages. The pathogenesis of LC in PLWHIV is not fully understood, but immunosuppression in combination with chronic infection and the oncogenic effects of smoking and HIV itself all seem to play a role. Currently, no established preventive screening is available, making smoking cessation the most promising preventive measure. Treatment protocols and standards are the same as for the general population. Notably, immuno-oncology will also become standard of care in a significant subset of HIV-infected patients with LC. As drug interactions and hematological toxicity must be taken into account, a multidisciplinary approach should include a physician experienced in the treatment of HIV. Only limited data is available on novel targeted therapies and checkpoint inhibitors in the setting of HIV. © 2017 S. Karger GmbH, Freiburg.

  18. Platelet-derived growth factor (PDGF-BB-mediated induction of monocyte chemoattractant protein 1 in human astrocytes: implications for HIV-associated neuroinflammation

    Directory of Open Access Journals (Sweden)

    Bethel-Brown Crystal

    2012-12-01

    Full Text Available Abstract Chemokine (C-C motif ligand 2, also known as monocyte chemoattractant protein 1 (MCP-1 is an important factor for the pathogenesis of HIV-associated neurocognitive disorders (HAND. The mechanisms of MCP-1-mediated neuropathogenesis, in part, revolve around its neuroinflammatory role and the recruitment of monocytes into the central nervous system (CNS via the disrupted blood-brain barrier (BBB. We have previously demonstrated that HIV-1/HIV-1 Tat upregulate platelet-derived growth factor (PDGF-BB, a known cerebrovascular permeant; subsequently, the present study was aimed at exploring the regulation of MCP-1 by PDGF-BB in astrocytes with implications in HAND. Specifically, the data herein demonstrate that exposure of human astrocytes to HIV-1 LAI elevated PDGF-B and MCP-1 levels. Furthermore, treating astrocytes with the human recombinant PDGF-BB protein significantly increased the production and release of MCP-1 at both the RNA and protein levels. MCP-1 induction was regulated by activation of extracellular-signal-regulated kinase (ERK1/2, c-Jun N-terminal kinase (JNK and p38 mitogen-activated protein (MAP kinases and phosphatidylinositol 3-kinase (PI3K/Akt pathways and the downstream transcription factor, nuclear factor κB (NFκB. Chromatin immunoprecipitation (ChIP assays demonstrated increased binding of NFκB to the human MCP-1 promoter following PDGF-BB exposure. Conditioned media from PDGF-BB-treated astrocytes increased monocyte transmigration through human brain microvascular endothelial cells (HBMECs, an effect that was blocked by STI-571, a tyrosine kinase inhibitor (PDGF receptor (PDGF-R blocker. PDGF-BB-mediated release of MCP-1 was critical for increased permeability in an in vitro BBB model as evidenced by blocking antibody assays. Since MCP-1 is linked to disease severity, understanding its modulation by PDGF-BB could aid in understanding the proinflammatory responses in HAND. These results suggest that astrocyte

  19. Respiratory health status is impaired in UK HIV-positive adults with virologically suppressed HIV infection.

    Science.gov (United States)

    Brown, J; McGowan, J A; Chouial, H; Capocci, S; Smith, C; Ivens, D; Johnson, M; Sathia, L; Shah, R; Lampe, F C; Rodger, A; Lipman, M

    2017-09-01

    We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals. We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation. PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P respiratory health appears more common in HIV-positive adults, and has a significant impact on health-related quality of life. © 2017 The Authors HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

  20. Regional differences in astrocyte activation in HIV-associated dementia Diferencias regionales en la activación astrocitaria en demencia asociada a HIV

    Directory of Open Access Journals (Sweden)

    María C. Vanzani

    2006-04-01

    Full Text Available Since astrogliosis is a histological marker usually observed in HIV-associated dementia (HIV-D, we decided to investigate the potential relationship between the expression of glial fibrillary acidic protein (GFAP and the regional distribution of cells positive (+ for this specific marker of astrocyte activation. Histological sections of brain tissues obtained at necropsy from 5 HIV-D patients and 5 age-matched controls without history of neuropsychiatric illness were immunostained with peroxidase. Mean numbers of GFAP(+ astrocytes were significantly increased in entorhinal cortex, hippocampus and subcortical white matter of patients, but values in frontal cortex and basal ganglia were similar to those of controls. In contrast, surface density of immunoreactive GFAP was significantly increased in all tested brain areas from all patients, including unusually affected regions such as entorhinal cortex and hippocampus. Therefore, such consistent finding of hypertrophic astrocytes, ranging from highest cell percentajes in subcortical white matter to lowest in basal ganglia indicates that quantification of surface density in GFAP (+ cells appears to be a more reliable approach to score gliosis than the counting of their cell nuclei. Because astrocyte activation involves both protective and detrimental effects on adjacent neuronal subsets, the evidence of regional differences in this reactive potential highlights the importance of accurately defining their contribution to the neuropathogenesis not only of HIV-D, but of a wide range of neurodegenerative disorders.Siendo la astrogliosis un signo histológico habitualmente presente en demencia asociada a HIV, se investigó la eventual relación entre expresión de proteína gliofibrilar ácida (GFAP y localización regional de células positivas para ese marcador específico de la activación astrocitaria. Por inmunoperoxidasa, se procesaron cortes histológicos de tejidos cerebrales obtenidos por

  1. Status epilepticus

    NARCIS (Netherlands)

    Hensiek, AE; Absalom, Anthony

    2006-01-01

    Status epilepticus is defined as epileptic activity that continues for more than 30 minutes as a single seizure or as recurrent seizures without inter-ictal return of consciousness. The seizure activity is usually classified as partial or generalized. Although status epilepticus is an uncommon

  2. [Virchowian Hansen's disease, Lucio's phenomenon, cryptococcosis].

    Science.gov (United States)

    1988-12-01

    A 75 years old white male, for 3 years on treatment for virchowian hanseniasis, was admitted with active HD lesions, infiltration on the base of right lung, leg ulcer and malaise. After two days he developed purpura and hemorrhagic blisters in the limbs. The biopsy of these lesions revealed Lucio phenomenon. The patient worsened with mental confusion, psychomotor agitation and anisocoric pupils. In the 18th day of internation the patient died. Necropsy revealed virchowian infiltration plenty of bacilli in the skin and viscera as well as tuberculoid granuloma with acid-fast bacilli in the liver, spleen and bone marrow. These findings lead us to review the patient's classification from virchowian to borderline. In the lungs, leptomeninge, renal papile, prostate and thyroid it was found loose tuberculoid granuloma with a great amount of fungi surrounded by a gelly halo resembling Criptococcus neoformans. These findings and the onset of Lucio phenomenon are discussed in a patient that has been treated for 3 years and still having several virchowian lesions and a great amount of acid-fast bacilli.

  3. Massive pulmonary cryptococcosis in an immunocompetent patient.

    Science.gov (United States)

    Silachamroon, U; Shuangshoti, S

    1998-03-01

    A 64-year-old man presented with progressive dyspnea. The symptom of severe hypoxia requiring mechanical ventilator, and bilateral pulmonary infiltrates on the chest film led to the clinical diagnosis of adult respiratory distress syndrome. Autopsy demonstrated widespread cryptococci and mucinous material in alveoli with mild inflammatory response.

  4. Stock Status

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data inform the public of the most recent stock status for all stocks (FSSI and non-FSSI) in the fishery management unit contained in a fishery managment plan....

  5. Current status and prospects of HIV treatment.

    Science.gov (United States)

    Cihlar, Tomas; Fordyce, Marshall

    2016-06-01

    Current antiviral treatments can reduce HIV-associated morbidity, prolong survival, and prevent HIV transmission. Combination antiretroviral therapy (cART) containing preferably three active drugs from two or more classes is required for durable virologic suppression. Regimen selection is based on virologic efficacy, potential for adverse effects, pill burden and dosing frequency, drug-drug interaction potential, resistance test results, comorbid conditions, social status, and cost. With prolonged virologic suppression, improved clinical outcomes, and longer survival, patients will be exposed to antiretroviral agents for decades. Therefore, maximizing the safety and tolerability of cART is a high priority. Emergence of resistance and/or lack of tolerability in individual patients require availability of a range of treatment options. Development of new drugs is focused on improving safety (e.g. tenofovir alafenamide) and/or resistance profile (e.g. doravirine) within the existing drug classes, combination therapies with improved adherence (e.g. single-tablet regimens), novel mechanisms of action (e.g. attachment inhibitors, maturation inhibitors, broadly neutralizing antibodies), and treatment simplification with infrequent dosing (e.g. long-acting injectables). In parallel with cART innovations, research and development efforts focused on agents that target persistent HIV reservoirs may lead to prolonged drug-free remission and HIV cure. Copyright © 2016 Gilead Sciences, Inc. Published by Elsevier B.V. All rights reserved.

  6. Compliance status

    International Nuclear Information System (INIS)

    Black, D.G.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford's compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute

  7. Compliance status

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford`s compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute.

  8. STATUS REPORT

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. STATUS REPORT. Raman scattering observed – 90, 135, 180 degrees and back scattering. Traditionally specific angle dependence to learn about polarization response. Learn molecular information from the surface or materials just below the surface (upto 12 mm depth) ...

  9. Decreased chronic morbidity but elevated HIV associated cytokine levels in HIV-infected older adults receiving HIV treatment: benefit of enhanced access to care?

    Directory of Open Access Journals (Sweden)

    Portia C Mutevedzi

    Full Text Available The association of HIV with chronic morbidity and inflammatory markers (cytokines in older adults (50+years is potentially relevant for clinical care, but data from African populations is scarce.To examine levels of chronic morbidity by HIV and ART status in older adults (50+years and subsequent associations with selected pro-inflammatory cytokines and body mass index.Ordinary, ordered and generalized ordered logistic regression techniques were employed to compare chronic morbidity (heart disease (angina, arthritis, stroke, hypertension, asthma and diabetes and cytokines (Interleukins-1 and -6, C-Reactive Protein and Tumor Necrosis Factor-alpha by HIV and ART status on a cross-sectional random sample of 422 older adults nested within a defined rural South African population based demographic surveillance.Using a composite measure of all morbidities, controlling for age, gender, BMI, smoking and wealth quintile, HIV-infected individuals on ART had 51% decreased odds (95% CI:0.26-0.92 of current morbidity compared to HIV-uninfected. In adjusted regression, compared to HIV-uninfected, the proportional odds (aPOR of having elevated inflammation markers of IL6 (>1.56 pg/mL was nearly doubled in HIV-infected individuals on (aPOR 1.84; 95%CI: 1.05-3.21 and not on (aPOR 1.94; 95%CI: 1.11-3.41 ART. Compared to HIV-uninfected, HIV-infected individuals on ART had >twice partial proportional odds (apPOR=2.30;p=0.004 of having non-clinically significant raised hsCRP levels(>1 ug/mL; ART-naïve HIV-infected individuals had >double apPOR of having hsCRP levels indicative of increased heart disease risk(>3.9 ug/mL;p=0.008.Although HIV status was associated with increased inflammatory markers, our results highlight reduced morbidity in those receiving ART and underscore the need of pro-actively extending these services to HIV-uninfected older adults, beyond mere provision at fixed clinics. Providing health services through regular community chronic disease

  10. Status Epilepticus

    Science.gov (United States)

    Seinfeld, Syndi; Goodkin, Howard P.; Shinnar, Shlomo

    2016-01-01

    Although the majority of seizures are brief and cause no long-term consequences, a subset is sufficiently prolonged that long-term consequences can result. These very prolonged seizures are termed “status epilepticus” (SE) and are considered a neurological emergency. The clinical presentation of SE can be diverse. SE can occur at any age but most commonly occurs in the very young and the very old. There are numerous studies on SE in animals in which the pathophysiology, medication responses, and pathology can be rigorously studied in a controlled fashion. Human data are consistent with the animal data. In particular, febrile status epilepticus (FSE), a form of SE common in young children, is associated with injury to the hippocampus and subsequent temporal lobe epilepsy (TLE) in both animals and humans. PMID:26931807

  11. CMS Status

    International Nuclear Information System (INIS)

    Dobrzynski, L.

    2007-01-01

    The status of the construction and installation of CMS detector is reviewed. The 4T magnet is cold since end of February 2006. Its commissioning up to the nominal field started in July 2006 allowing a Cosmic Challenge in which elements of the final detector are involved. All big mechanical pieces equipped with muons chambers have been assembled in the surface hall SX5. Since mid July the detector is closed with commissioned HCAL, two ECAL supermodules and representative elements of the silicon tracker. The trigger system as well as the DAQ are tested. After the achievement of the physics TDR, CMS is now ready for the promising signal hunting. (author)

  12. Nef exosomes isolated from the plasma of individuals with HIV-associated dementia (HAD) can induce Aβ(1-42) secretion in SH-SY5Y neural cells.

    Science.gov (United States)

    Khan, Mahfuz B; Lang, Michelle J; Huang, Ming-Bo; Raymond, Andrea; Bond, Vincent C; Shiramizu, Bruce; Powell, Michael D

    2016-04-01

    In the era of combined antiretroviral therapy (CART), many of the complications due to HIV-1 infection have diminished. One exception is HIV-associated neurocognitive disorder (HAND). HAND is a spectrum of disorders in cognitive function that ranges from asymptomatic disease to severe dementia (HAD). The milder form of HAND has actually remained the same or slightly increased in prevalence in the CART era. Even in individuals who have maintained undetectable HIV RNA loads, viral proteins such as Nef and Tat can continue to be expressed. In this report, we show that Nef protein and nef messenger RNA (mRNA) are packaged into exosomes that remain in circulation in patients with HAD. Plasma-derived Nef exosomes from patients with HAD have the ability to interact with the neuroblastoma cell line SH-SY5Y and deliver nef mRNA. The mRNA can induce expression of Nef in target cells and subsequently increase expression and secretion of beta-amyloid (Aβ) and Aβ peptides. Increase secretion of amyloid peptide could contribute to cognitive impairment seen in HAND.

  13. Biomarkers of HIV-associated Cancer

    OpenAIRE

    Flepisi, Brian Thabile; Bouic, Patrick; Sissolak, Gerhard; Rosenkranz, Bernd

    2014-01-01

    Cancer biomarkers have provided great opportunities for improving the management of cancer patients by enhancing the efficiency of early detection, diagnosis, and efficacy of treatment. Every cell type has a unique molecular signature, referred to as biomarkers, which are identifiable characteristics such as levels or activities of a myriad of genes, proteins, or other molecular features. Biomarkers can facilitate the molecular definition of cancer, provide information about the course of can...

  14. HIV-Associated TB: Facts 2013

    Science.gov (United States)

    ... 2012 . Around 75% of these people live in sub-Saharan Africa.  TB is the leading cause of death among ... adopted by policy makers and implemented by all health facilities offering HIV care services.  The number of ...

  15. Neoplasms HIV associated Kaposi sarcoma not

    International Nuclear Information System (INIS)

    Lombardo, K.; Sosa, A.; Krygier, G.; Muse, I.

    2004-01-01

    Abstract - The incidence of malignancies in virus carriers acquired immunodeficiency (HIV) has increased in conjunction with the disease during the past decade. 40% of all AIDS patients develop cancer during the course of HIV infection. Kaposi's sarcoma (KS), Non-Hodgkin lymphoma (NHL) and cervical cancer have an impact extremely high in HIV infected patients, and they are considered as disease AIDS-defining stage. Many reports suggest that other neoplasms they can have a high impact on the population of HIV carrier, including head and neck carcinoma, rectal cancer - anal, plasma cytomas, and melanoma lung cancer. Methods - We examined the spectrum of cancer in HIV-infected patients, specifically neoplasms except Kaposi sarcoma diagnosed between 1/1998 - 6/2004. Information on age, sex, factors was gathered risk for AIDS, neoplasms and mortality rate. Results: The total number of patients in our study was 21 patients, what 15 were male (71%) and 6 females (29%); the median age was 36 (29-70). Tumors were reported: 11 Non-Hodgkin lymphomas (52%), 2 Hodgkin's lymphoma (6.6%), 1 medullary thyroid cancer (6.6%), 1 melanoma (6.6%), 1 rectal cancer (5%) and three head and neck cancers (14%), 1 cancer 1 lung and breast cancer. Five of the patients were intravenous drug abusers (24%); 4 patients were homosexual, bisexual March 8 straight, on 6 patients know the data. Conclusions - The spectrum of malignancies associated with infection HIV in our study was similar to that described in other populations. ratio between the immune system and the epidemiology of the virus-induced tumors is to importance to identify new therapeutic approaches in the treatment and / or prevention of these neoplasms

  16. Controversies in HIV-associated neurocognitive disorders

    Science.gov (United States)

    Nightingale, Sam; Winsto, Alan; Letendre, Scott; Michael, Benedict D; McArthur, Justin C; Khoo, Saye; Solomon, Tom

    2015-01-01

    Cross-sectional studies show that around half of individuals infected with HIV-1 have some degree of cognitive impairment despite the use of antiretroviral drugs. However, prevalence estimates vary depending on the population and methods used to assess cognitive impairment. Whether asymptomatic patients would benefit from routine screening for cognitive difficulties is unclear and the appropriate screening method and subsequent management is the subject of debate. In some patients, HIV-1 RNA can be found at higher concentrations in CSF than in blood, which potentially results from the poor distribution of antiretroviral drugs into the CNS. However, the clinical relevance of so-called CSF viral escape is not well understood. The extent to which antiretroviral drug distribution and toxicity in the CNS affect clinical decision making is also debated. PMID:25316020

  17. Innovations, status, and networks

    NARCIS (Netherlands)

    P. Wang (Pengfei)

    2016-01-01

    markdownabstractTo obtain and maintain competitive advantage, firms need to implement appropriate innovation strategies (i.e. exploration or exploitation) and acquire status in external networks. In this dissertation, I investigate how innovation strategy, status, and network structure jointly

  18. USCIS My Case Status

    Data.gov (United States)

    Department of Homeland Security — USCIS provide a way for the public who applied for U.S. citizenship to check the status of their application online. To view the status of a case, the application...

  19. Quimiotipagem do Cryptococcus neoformans. Revisão da literatura. Novos dados epidemiológicos sobre a criptococose. Nossa experiência com o emprego do meio de C.G.B. no estudo daquela levedura Biotyping of Cryptococcus neoformans. Review of the literature. New epidemiologic informations about cryptococcosis. Our experience with the utilization of C.G.B medium in this yeast

    Directory of Open Access Journals (Sweden)

    Natalina Takahashi de Melo

    1993-10-01

    about the biotyping of Cryptococcus neoformans. The more up-to date research concerning the epidemiology of cryptococcosis comprising quite a few articles, mainly after the advent of AIDS, was also reviewed. The Cryptococcus neoformans varieties neoformans and gattii are well defined biochemically nowadays chiefly through the C.G.B. medium, according to KWON-CHUNG et al. (198224. The isolation of C. neoformans var. gattii from flowers and leaves of Eucalyptus camaldulensis and Eucalyptus tereticornis, specially in Australia, through the works of ELLIS & PFEIFFER (1990 16 and PFEIFFER & ELLIS (1992 41 permitted very interesting epidemiological investigations on C. neoformans, a capsulaled yeast by which SANFELICE 50, 51, in Italy (1894; 1895 attracted attention of medical class. BUSSE 8, in 1894, described the first human case of cryptococcosis under the presentation of a bone lesion simulating sarcoma. In this paper, the Brazilian researchers focused on this subject were pointed out, followed by the Author's experience with the C.G.B medium (L - canavanine, glycin and bromothymol blue proposed by KWON-CHUNG et al. (1982 24 with very good results. It was possible with such medium the study of 50 C.N.S. liquor samples, being 39 from AIDS patients (78% and 11 from non-AIDS ones (22%. Thirty-seven out of the 39 HIV- positive patients (74% were identified as C. neoformans var. neoformans and 2 (4% as C. neoformans var. gattii. From the negative HIV, 8 (16% were classified as C. neoformans var. neoformans and 3 (6% as C. neoformans var. gattii. We could not perform the serotyping of the above referred samples. It is evident anyway that in Brazil there exist both varieties gattii and neoformans, agents of neurocryptococcosis, including AIDS patients. The importance of neurocryptococcosis, mainly among AIDS patients, is stressed here, showing once more the value of C.G.B. medium in the typing of C. neoformans in its two varieties. Also, it is of relevant importance the

  20. Service Level Status

    CERN Multimedia

    Lopienski, S

    2007-01-01

    Nowadays, IT departments provide, and people use, computing services of an increasingly heterogeneous nature. There is thus a growing need for a status display that groups these different services and reports status and availability in a uniform way. The Service Level Status (SLS) system addresses these needs by providing a web-based display that dynamically shows availability, basic information and statistics about various IT services, as well as the dependencies between them.

  1. SIS - Status Determination

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Status Determination dataset within the Species Information System (SIS) contains information related to overfishing, overfished, and approaching overfished...

  2. Pediatric Status Epilepticus Management

    Science.gov (United States)

    Abend, Nicholas S; Loddenkemper, Tobias

    2014-01-01

    Purpose of Review This review discusses management of status epilepticus in children including both anticonvulsant medications and overall management approaches. Recent Findings Rapid management of status epilepticus is associated with a greater likelihood of seizure termination and better outcomes, yet data indicate there are often management delays. This review discusses an overall management approach aiming to simultaneously identify and manage underlying precipitant etiologies, administer anticonvulsants in rapid succession until seizures have terminated, and identify and manage systemic complications. An example management pathway is provided. Summary Status epilepticus is a common neurologic emergency in children and requires rapid intervention. Having a predetermined status epilepticus management pathway can expedite management. PMID:25304961

  3. Criptococose palpebral: relato de caso Palpebral cryptococcosis: case report

    Directory of Open Access Journals (Sweden)

    Murilo Barreto Souza

    2006-04-01

    Full Text Available Relata-se o caso de uma paciente portadora de síndrome da imunodeficiência adquirida empiricamente tratada com esquema tríplice para tuberculose miliar. Durante a evolução clínica a paciente cursou com lesões comprometendo a pálpebra e conjuntiva tarsal à direita. A hipótese diagnóstica inicial foi de tuberculose ocular com comprometimento conjuntival e palpebral. A biópsia da lesão conjuntival mostrou presença do Criptococcus neoformans. Após o início do tratamento específico com anfotericina B, a paciente apresentou melhora das lesões cutâneas.This paper is about a patient with acquired immunodeficiency syndrome empirically treated for miliary tuberculosis. During the clinical evolution the patient presented lesions compromising the right eyelid and tarsal conjunctiva. The initial diagnostic hypothesis was ocular tuberculosis with conjunctival and eyelid involvement. The biopsy of the conjuctival lesion identified an encapsulated yeast-like fungus: Criptococcus neoformans. After starting treatment with B anfotericin, the cutaneus lesions cleared.

  4. Fatal disseminated cryptococcosis and concurrent ehrlichiosis in a dog.

    Science.gov (United States)

    Collett, M G; Doyle, A S; Reyers, F; Kruse, T; Fabian, B

    1987-12-01

    Laboratory findings in an adult bull terrier presented with a history of anorexia and weight loss included the following: severe anaemia, leukocytosis, neutrophilia, lymphopaenia, thrombocytopaenia, Ehrlichia canis morulae in monocytes, hypergammaglo-bulinaemia, a bleeding tendency, icterus and proteinuria. In addition, a high Haemobartonella canis parasitaemia, non-encapsulated yeasts on urinalysis and a localised Demodex canis infestation were present. Treatment for ehrlichiosis was initiated but the dog died. Lesions found were a severe cryptococcal granulomatous pneumonia and cryptococcal colonies in the lungs, bronchial lymph nodes, kidneys, liver, spleen, heart, meninges, eyes and thoracic cavity. In addition, hyphal forms resembling Filobasidiella neoformans, the teleomorph of Cryptococcus neoformans, were seen in lung fine needle aspiration smears, impression smears and lung sections. C. neoformans was cultured from urine, lung and liver. Lung and kidney also yielded Salmonella typhimureum. Cortical atrophy with T-cell depletion of lymph nodes as well as splenic lymphoid follicular atrophy, typical of chronic ehrlichiosis-induced cell mediated immunosuppression, could have predisposed to the fatal disseminated cryptococcis.

  5. A case of cutaneous Rhodotorula infection mimicking cryptococcosis.

    Science.gov (United States)

    George, S M C; Quante, M; Cubbon, M D; MacDiarmaid-Gordon, A R; Topham, E J

    2016-12-01

    Rhodotorula is a ubiquitous environmental and commensal yeast, and an emerging opportunistic pathogen, particularly in immunocompromised individuals. Clinical infections with Rhodotorula have been increasingly recognized over the past 30 years; however, infections in solid-organ transplant recipients are uncommon, and cutaneous manifestations have rarely been reported. We describe a 59-year-old male renal transplant recipient, who developed cutaneous infection with Rhodotorula upon failure of his graft and commencement of haemodialysis. © 2016 British Association of Dermatologists.

  6. Fighting status inequalities

    DEFF Research Database (Denmark)

    Nielsen, Morten Ebbe Juul; Landes, Xavier

    2016-01-01

    Status inequalities seem to play a fairly big role in creating inequalities in health. This article assumes that there can be good reasons to fight status inequalities in order to reduce inequalities in health. It examines whether the neorepublican ideal of non-dominance does a better job as a th...

  7. Morocco: Country Status Report.

    Science.gov (United States)

    McFerren, Margaret

    A survey of the status of language usage in Morocco begins with an overview of the distribution and usage of Arabic, the official language, the Berber dialects, and French, an unofficial second language. The continuing high status and widespread use of French despite arabization efforts is discussed. A matrix follows that rates these languages and…

  8. Adolescent Weight Status

    DEFF Research Database (Denmark)

    Hjort Kjelldgaard, Heidi; Holstein, Bjørn Evald; Due, Pernille

    2017-01-01

    day) communication with friends through cellphones, SMS messages, or Internet (1.66, 1.03-2.67). In the full population, overweight/obese weight status was associated with not perceiving best friend as a confidant (1.59, 1.11-2.28). No associations were found between weight status and number of close...

  9. Status Epilepticus and Refractory Status Epilepticus Management

    Science.gov (United States)

    Abend, Nicholas S.; Bearden, David; Helbig, Ingo; McGuire, Jennifer; Narula, Sona; Panzer, Jessica A.; Topjian, Alexis; Dlugos, Dennis J.

    2014-01-01

    Status epilepticus (SE) describes persistent or recurring seizures without a return to baseline mental status, and is a common neurologic emergency. SE can occur in the context of epilepsy or may be symptomatic of a wide range of underlying etiologies. The clinician’s aim is to rapidly institute care that simultaneously stabilizes the patient medically, identifies and manages any precipitant conditions, and terminates seizures. Seizure management involves “emergent” treatment with benzodiazepines followed by “urgent” therapy with other anti-seizure medications. If seizures persist then refractory SE is diagnosed and management options include additional anti-seizure medications or infusions of midazolam or pentobarbital. This paper reviews the management of pediatric SE and RSE. PMID:25727508

  10. Management of status epilepticus.

    Science.gov (United States)

    Pichler, M; Hocker, S

    2017-01-01

    Status epilepticus is a neurologic and medical emergency manifested by prolonged seizure activity or multiple seizures without return to baseline. It is associated with substantial medical cost, morbidity, and mortality. There is a spectrum of severity dependent on the type of seizure, underlying pathology, comorbidities, and appropriate and timely medical management. This chapter discusses the evolving definitions of status epilepticus and multiple patient and clinical factors which influence outcome. The pathophysiology of status epilepticus is reviewed to provide a better understanding of the mechanisms which contribute to status epilepticus, as well as the potential long-term effects. The clinical presentations of different types of status epilepticus in adults are discussed, with emphasis on the hospital course and management of the most dangerous type, generalized convulsive status epilepticus. Strategies for the evaluation and management of status epilepticus are provided based on available evidence from clinical trials and recommendations from the Neurocritical Care Society and the European Federation of Neurological Societies. © 2017 Elsevier B.V. All rights reserved.

  11. STATUS GIZI DAN STATUS KESEHATAN SUKU BADUY

    Directory of Open Access Journals (Sweden)

    Faisal Anwar

    2012-03-01

    Full Text Available 800x600 Normal 0 false false false IN X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";} The objectives of the study were: (1 To analyze the socio-economic and demographic characteristics of Baduy people; (2 To analyze the health status and nutritional status of Baduy people and its influential factors. This research is an explorative and descriptive study on the socio-cultural aspects of food system. The data were collected through a direct interview and discussion with respondents as well as a direct observation at the location of respondents. A sample size of 338 households was drawn from the population. To obtain the data on the cultural aspects, history and  socio aspect of food, in-depth interviews was conducted with 19 key persons. The study was last for 12 months. In Outer Baduy, the factors significantly related to nutritional status are age, number of household size, income, nutritional knowledge, and wife’s ability to read. In Moslem Baduy, only age and income are related to the nutritional status of children. In Moslem Baduy and the Outer Baduy, the correlation between age and W/A or W/H is similar: namely, the higher the age, the lower would the Z-score for the W/A or W/H. The income is significantly correlated to the child nutritional status according to Z-score for W/A with a high correlation coefficient, that is, 0.61. This means that the higher the income, the higher would be the Z-score value for the W/A.  The distribution of adults according to BMI classification in Outer Baduy it shows that 12.7% husbands and 17.6% wives are thin (wasted, while the

  12. Deadline Compliance Status Reports

    Data.gov (United States)

    Department of Housing and Urban Development — These monthly Deadline Compliance Status Reports assist Participating Jurisdictions and HUD Field Offices in monitoring compliance with the 2-year commitment and...

  13. Topical report review status

    International Nuclear Information System (INIS)

    1982-08-01

    A Topical Report Review Status is scheduled to be published semi-annually. The primary purpose of this document is to provide periodic progress reports of on-going topical report reviews, to identify those topical reports for which the Nuclear Regulatory Commission (NRC) staff review has been completed and, to the extent practicable, to provide NRC management with sufficient information regarding the conduct of the topical report program to permit taking whatever actions deemed necessary or appropriate. This document is also intended to be a source of information to NRC Licensing Project Managers and other NRC personnel regarding the status of topical reports which may be referenced in applications for which they have responsibility. This status report is published primarily for internal NRC use in managing the topical report program, but is also used by NRC to advise the industry of report review status

  14. Topical report review status

    International Nuclear Information System (INIS)

    1983-01-01

    A Topical Report Review Status is scheduled to be published semi-annually. The primary purpose of this document is to provide periodic progress reports of on-going topical report reviews, to identify those topical reports for which the Nuclear Regulatory Commission (NRC) staff review has been completed and, to the extent practicable, to provide NRC management with sufficient information regarding the conduct of the topical report program to permit taking whatever actions deemed necessary or appropriate. This document is also intended to be a source of information to NRC Licensing Project Managers and other NRC personnel regarding the status of topical reports which may be referenced in applications for which they have responsibility. This status report is published primarily for internal NRC use in managing the topical report program, but is also used by NRC to advise the industry of report review status

  15. PRESENT STATUS IN INDIA

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. PRESENT STATUS IN INDIA. FIXED LINES – 36 MILLION. MOBILE CONNECTIONS – 14 MILLION. TELEDENSITY APPROXIMATELY 5. INTERNET CONNECTIONS – 5 MILLION. INTERNET USERS NEARLY – 25 MILLION.

  16. NAIP Status Maps Gallery

    Data.gov (United States)

    Farm Service Agency, Department of Agriculture — NAIP Status Maps Gallery. These maps illustrate what aerial imagery collection is planned, whats been collected, when it is available and how it is available. These...

  17. Safety system status monitoring

    International Nuclear Information System (INIS)

    Lewis, J.R.; Morgenstern, M.H.; Rideout, T.H.; Cowley, P.J.

    1984-03-01

    The Pacific Northwest Laboratory has studied the safety aspects of monitoring the preoperational status of safety systems in nuclear power plants. The goals of the study were to assess for the NRC the effectiveness of current monitoring systems and procedures, to develop near-term guidelines for reducing human errors associated with monitoring safety system status, and to recommend a regulatory position on this issue. A review of safety system status monitoring practices indicated that current systems and procedures do not adequately aid control room operators in monitoring safety system status. This is true even of some systems and procedures installed to meet existing regulatory guidelines (Regulatory Guide 1.47). In consequence, this report suggests acceptance criteria for meeting the functional requirements of an adequate system for monitoring safety system status. Also suggested are near-term guidelines that could reduce the likelihood of human errors in specific, high-priority status monitoring tasks. It is recommended that (1) Regulatory Guide 1.47 be revised to address these acceptance criteria, and (2) the revised Regulatory Guide 1.47 be applied to all plants, including those built since the issuance of the original Regulatory Guide

  18. Safety system status monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, J.R.; Morgenstern, M.H.; Rideout, T.H.; Cowley, P.J.

    1984-03-01

    The Pacific Northwest Laboratory has studied the safety aspects of monitoring the preoperational status of safety systems in nuclear power plants. The goals of the study were to assess for the NRC the effectiveness of current monitoring systems and procedures, to develop near-term guidelines for reducing human errors associated with monitoring safety system status, and to recommend a regulatory position on this issue. A review of safety system status monitoring practices indicated that current systems and procedures do not adequately aid control room operators in monitoring safety system status. This is true even of some systems and procedures installed to meet existing regulatory guidelines (Regulatory Guide 1.47). In consequence, this report suggests acceptance criteria for meeting the functional requirements of an adequate system for monitoring safety system status. Also suggested are near-term guidelines that could reduce the likelihood of human errors in specific, high-priority status monitoring tasks. It is recommended that (1) Regulatory Guide 1.47 be revised to address these acceptance criteria, and (2) the revised Regulatory Guide 1.47 be applied to all plants, including those built since the issuance of the original Regulatory Guide.

  19. Rethinking status dystonicus.

    Science.gov (United States)

    Ruiz-Lopez, Marta; Fasano, Alfonso

    2017-12-01

    Status dystonicus is a movement disorder emergency that has been a source of controversy in terms of terminology, phenomenology, and management since it was first described in 1982. Here we argue that the current use of the term status dystonicus falls well short of the precision needed for either clinical or academic use. We performed a critical review on this topic, describing possible pathophysiological mechanisms and areas of uncertainties. This review also addresses the problems derived by the extreme clinical heterogeneity of this condition, as the lack of an objective criterion useful for the definition, or the fact that status dystonicus may present not only in the context of a known dystonic syndrome. We propose a new possible definition that includes not only dystonia but also other hyperkinetic movements in the wide range of movement disorders that can be seen during an episode. The new definition keeps the term status dystonicus and highlights the fact that this is a medical emergency based on the impairment of bulbar and/or respiratory function requiring hospital admission as the principal feature. Furthermore, the new definition should not consider as necessary unspecific features as patient's condition at baseline, the distribution of dystonia, occurrence of systemic symptoms such as fever or laboratory findings. We hope that this proposal will stimulate the debate on this subject among our peers, further developing a clinical and pathophysiological understanding of status dystonicus. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  20. Refractory status epilepticus

    Directory of Open Access Journals (Sweden)

    Sanjay P Singh

    2014-01-01

    Full Text Available Refractory status epilepticus is a potentially life-threatening medical emergency. It requires early diagnosis and treatment. There is a lack of consensus upon its semantic definition of whether it is status epilepticus that continues despite treatment with benzodiazepine and one antiepileptic medication (AED, i.e., Lorazepam + phenytoin. Others regard refractory status epilepticus as failure of benzodiazepine and 2 antiepileptic medications, i.e., Lorazepam + phenytoin + phenobarb. Up to 30% patients in SE fail to respond to two antiepileptic drugs (AEDs and 15% continue to have seizure activity despite use of three drugs. Mechanisms that have made the treatment even more challenging are GABA-R that is internalized during status epilepticus and upregulation of multidrug transporter proteins. All patients of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of RSE. These include pentobarbital or thiopental, midazolam and propofol. RSE was shown to result in mortality in 35% cases, 39.13% of patients were left with severe neurological deficits, while another 13% had mild neurological deficits.

  1. Refractory status epilepticus

    Science.gov (United States)

    Singh, Sanjay P; Agarwal, Shubhi; Faulkner, M

    2014-01-01

    Refractory status epilepticus is a potentially life-threatening medical emergency. It requires early diagnosis and treatment. There is a lack of consensus upon its semantic definition of whether it is status epilepticus that continues despite treatment with benzodiazepine and one antiepileptic medication (AED), i.e., Lorazepam + phenytoin. Others regard refractory status epilepticus as failure of benzodiazepine and 2 antiepileptic medications, i.e., Lorazepam + phenytoin + phenobarb. Up to 30% patients in SE fail to respond to two antiepileptic drugs (AEDs) and 15% continue to have seizure activity despite use of three drugs. Mechanisms that have made the treatment even more challenging are GABA-R that is internalized during status epilepticus and upregulation of multidrug transporter proteins. All patients of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of RSE. These include pentobarbital or thiopental, midazolam and propofol. RSE was shown to result in mortality in 35% cases, 39.13% of patients were left with severe neurological deficits, while another 13% had mild neurological deficits. PMID:24791086

  2. Status of voluntary restraint

    Energy Technology Data Exchange (ETDEWEB)

    Aarts, W. [SWOKA Institute for Strategic Consumer Behaviour, Leiden (Netherlands)

    2000-05-01

    Do people enjoying a higher status, especially those with a higher education, constrain their consumption more than others? In general, higher status and high levels of consumption go hand in hand. But the greater availability of luxury goods has led to a decline in their exclusivity. Since environmental awareness has increased, a countercurrent may be possible. It is possible that certain high status groups, the environmentally aware trendsetters, can now be distinguished by their voluntary restraint rather than by their conspicuous consumption. This hypothesis formed the basis for a sociological doctoral project at the University of Amsterdam. The research was conducted under the umbrella of the National Research Programme on Global Air Pollution and Climate Change.

  3. Fukushima Daiichi Status Report

    International Nuclear Information System (INIS)

    2012-01-01

    The IAEA issues regular status reports to the public on the current status of the Fukushima Daiichi Nuclear Power Plant, including information on environmental radiation monitoring, the status of workers, and current conditions on-site at the plant. The information cited in this report is compiled from official Japanese sources, including the Ministry of Economy, Trade and Industry (METI), the Nuclear and Industrial Safety Agency (NISA), the Ministry of Education, Culture, Sports, Science and Technology (MEXT), the Ministry of Land, Infrastructure, Transport and Tourism (MLIT), the Ministry of Health, Labour and Welfare (MHLW) and the Ministry of Foreign Affairs (MOFA) through the Japanese Permanent Mission in Vienna and the Cabinet's Office of the Prime Minister. Information is also provided by the Tokyo Electric Power Company (TEPCO), the operator of the Fukushima Daiichi Nuclear Power Plant.

  4. Status Report Jilin University

    Energy Technology Data Exchange (ETDEWEB)

    Dong, Yang; Huo Junde, E-mail: huojd@jlu.edu.cn

    2013-08-15

    Status of mass chain evaluation: Jilin University (JLU) group is responsible for nuclear structure and decay data evaluation of mass chains: A=52, 53, 54, 55, 56, and 63. (1) Status of publication in Nuclear Data Sheets (NDS): 52 - NDS, 106, 773 (2007); 53 - NDS, 110, 2689 (2009); 54 - NDS, 107, 1393 (2006); 55 - NDS, 109, 787 (2008); 56 - NDS, 112, 1513 (2011); 63 - NDS, 92, 147 (2001); ENSDF (2009) (2) Evaluation since last meeting (2011). A=54 in review (since 26-Dec-2012) A=52 evaluating A=63 evaluating. Other activities are briefly presented.

  5. New Service Status Board

    CERN Multimedia

    2013-01-01

    On Monday 14 October, the Service Status Board for GS and IT will change. The new Status Board will be integrated with the CERN Service Portal and with the CERN Service Catalogue.   As of today, the SSB will display “Service Incidents”, “Planned Interventions” and “Service Changes”. References valid from 14 October: CERN SSB at https://cern.ch/ssb Computing SSB (previously IT SSB) at https://cern.ch/itssb   Nicole Cremel, IT and GS Service Management Support

  6. NICMOS status and plans

    Science.gov (United States)

    Thompson, Rodger I.

    1997-01-01

    Near Infrared Camera and Multi-Object Spectrometer (NICMOS) has been in orbit for about 8 months. This is a report on its current status and future plans. Also included are some comments on particular aspects of data analysis concerning dark subtraction, shading, and removal of cosmic rays. At present NICMOS provides excellent images of high scientific content. Most of the observations utilize cameras 1 and 2 which are in excellent focus. Camera 3 is not yet within the range of the focus adjustment mechanism, but its current images are still quite excellent. In this paper we will present the status of various aspects of the NICMOS instrument.

  7. FRIB Cryogenic Plant Status

    Energy Technology Data Exchange (ETDEWEB)

    Dixon, Kelly D. [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Ganni, Venkatarao [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Knudsen, Peter N. [Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Casagranda, Fabio [Michigan State Univ., East Lansing, MI (United States)

    2015-12-01

    After practical changes were approved to the initial conceptual design of the cryogenic system for MSU FRIB and an agreement was made with JLab in 2012 to lead the design effort of the cryogenic plant, many activities are in place leading toward a cool-down of the linacs prior to 2018. This is mostly due to using similar equipment used at CHLII for the 12 GeV upgrade at JLab and an aggressive schedule maintained by the MSU Conventional Facilities department. Reported here is an updated status of the cryogenic plant, including the equipment procurement status, plant layout, facility equipment and project schedule.

  8. Clinical and laboratory peculiarities of cryptococcal meningoencephalitis in patients with hiv-negative status

    Directory of Open Access Journals (Sweden)

    Елена Леонидовна Панасюк

    2015-09-01

    microscopically detected microorganisms (yeast cells that are morphologically similar to cryptococcous including actively budding forms. In CSF of 3 patients (in one case at the negative microscopy antigens Cryptococcus neoformans was detected by the method of latex-agglutination (CALAS®system.Conclusions: The risk group on development of cryptococcal meningoencephalitis on the background of HIV-negative status is patients with oncopathology (especially of ENT-organs and brain, chronic somatic pathology at the stage of decompensation, tuberculosis. The negative results of microscopic and culture study of CSF for Cryptococcus neoformans are not the reason for excluding the diagnosis cryptococcal ME at primary examination and in the course of treatment it not always indicate recovery (the end of pathologic process. The combined intensive care with intrathecal methods allow carry out monitoring of intracranial pressure (ICP, CSF, to rise an efficiency of intensive care and the survival rate of patients in first 3-4 months. The lethality at cryptococcosis of CNS is as before the one of the highest and reaches 42,9 %

  9. HESYRL control system status

    International Nuclear Information System (INIS)

    Yao Chihyuan

    1992-01-01

    HESYRL synchrotron radiation storage ring was completed in 1989 and has been in commissioning since then. Now it has met its design specification and is ready for synchrotron light experiments. Control system of the project was completed in 1989 and some modifications were made during commissioning. This paper describes its present configuration, status and upgrading plan. (author)

  10. Experimental status QCD

    International Nuclear Information System (INIS)

    Radyushkin, A.V.; Slepchenko, L.A.

    1983-01-01

    Analysis of experimental status of quantum chromodynamics (QCD) has been carried out. A short introduction into QCD is given. QCD sum rules are considered. Jets in e + e - annihilation and inclusive processes of lepton-hadron and hadron-hadron scattering are considered. Effect of QCD corrections to perturbation theory on quark count is analyzed

  11. Somalia: Country Status Report.

    Science.gov (United States)

    McFerren, Margaret

    A survey of the status of language usage in Somalia begins with an overview of the usage patterns of Somali, the official language, and three languages previously used officially: English, Italian, and Arabic. The cultural context that for many years has supported the usage of a single native language for communication and administration is also…

  12. Behavior, Expectations and Status

    Science.gov (United States)

    Webster, Jr, Murray; Rashotte, Lisa Slattery

    2010-01-01

    We predict effects of behavior patterns and status on performance expectations and group inequality using an integrated theory developed by Fisek, Berger and Norman (1991). We next test those predictions using new experimental techniques we developed to control behavior patterns as independent variables. In a 10-condition experiment, predictions…

  13. VERITAS: status c.2005

    International Nuclear Information System (INIS)

    Weekes, T. C.; Atkins, R. W.; Badran, H. M.; Blaylock, G.; Bond, I. H.; Boyle, P. J.; Bradbury, S. M.; Buckley, J. H.; Bryum, K. L.; Carter-Lewis, D. A.; Celik, O.; Chow, Y. C. K.; Cogan, P.; Cui, W.; Daniel, M. K.; Calle Perez, I. de la; Dowdall, C.; Dowkontt, P.; Duke, C.; Ergin, T.

    2006-01-01

    VERITAS (Very Energetic Radiation Imaging Telescope Array System), is one of a new generation of TeV gamma-ray observatories. The current status of its construction is described here. The first two telescopes and cameras have been completed and meet the design specifications; the full array of four telescopes could be operational by the end of 2006

  14. Status of TRISTAN operation

    International Nuclear Information System (INIS)

    Satoh, Kotaro

    1990-01-01

    The present status of the TRISTAN operation is summarized mainly after the installation of superconducting cavities in the 1988 summer shutdown. The paper describes the initial experience of the superconducting cavity operation, the colliding operation at 30.4 GeV and the beam injection. Future improvement is also reported. (author)

  15. Nuclear power status 1999

    International Nuclear Information System (INIS)

    2000-01-01

    The document gives statistical information on nuclear power plants status in the world in 1999, including the number of reactors in operation or under construction, the electricity supplied by nuclear power reactors and the respective percentage of electricity produced by nuclear energy in 1999, and the total operating experience to 31 December 1999, by country

  16. Algeria: Country Status Report.

    Science.gov (United States)

    McFerren, Margaret

    A survey of the status of language usage in Algeria begins with an overview of the usage patterns of Arabic, the Berber languages, and French. The country's return to Arabic as its official language after independence from France in 1962 is discussed along with the resultant language planning, issues of language of instruction at the elementary,…

  17. Glueballs: a status report

    International Nuclear Information System (INIS)

    Scharre, D.L.

    1982-01-01

    It is expected from quantum chromodynamics (QCD) that glueballs, bound states which contain gluons but no valence quarks, should exist. To date, no conclusive evidence for glueballs has been presented. After a brief review of the expected properties and experimental signatures of glueballs the status of some glueball candidate states are discussed

  18. Status, Numbers and Influence

    Science.gov (United States)

    Melamed, David; Savage, Scott V.

    2013-01-01

    We develop a theoretical model of social influence in n-person groups. We argue that disagreement between group members introduces uncertainty into the social situation, and this uncertainty motivates people to use status characteristics to evaluate the merits of a particular opinion. Our model takes the numerical distribution of opinions and the…

  19. Super Refractory Status Epilepticus

    African Journals Online (AJOL)

    user

    et al did retrospective cohort study from 1 January st. 1994 to 31 March 1998 at Presbyterian Medical. Centre in Columbia, to determine the frequency, risk factors and impact on the outcome of RSE. They found out that 69% of seizures recurred after. Key Words: Super refractory status epilepticus, Zambia. Medical Journal of ...

  20. Status of Tristan

    International Nuclear Information System (INIS)

    Horikoshi, G.; Kimura, Y.

    1987-01-01

    After the five years construction period, the TRISTAN electron-positron beam collider was commissioned successfully in November 1986. With three detectors installed at three out of four beam collision areas in the ring, colliding beam experiments have begun in December 1986. The current status of the TRISTAN accelerator operation is presented along with a brief description on the accelerator sub-systems

  1. COMPASS Status Report 2010

    CERN Document Server

    COMPASS Collaboration

    2010-01-01

    This report gives an overview of the setup and the performance of the COMPASS experiment during the 2009 hadron beam run and describes the preparation and startup of the 2010 muon beam run with the polarised target. The status of analysis is presented both for the hadron and muon data with emphasis on the 2008/2009 hadron data.

  2. Fusion safety status report

    International Nuclear Information System (INIS)

    1986-10-01

    This report includes information on a) tritium handling and safety; b) activation product generation and release; c) lithium safety; d) superconducting magnet safety; e) operational safety and shielding; f) environmental impact; g) recycling, decommissioning and waste management; and h) accident analysis. Recommendations for high priority research and development are presented, as well as the current status in each area

  3. Angola: Country Status Report.

    Science.gov (United States)

    Bruhn, Thea C.

    A survey of the status of language usage in Angola begins with an overview of the usage and distribution of Portuguese as the official language, and the four most significant native languages and dialects spoken there: Umbundu, Kimbundu, Kikongo, and Lunda-Chokwe. The introduction of Spanish through Cuban trainers, teachers, and military advisors…

  4. NASA Armstrong Status

    Science.gov (United States)

    Jacobson, Steven R.

    2014-01-01

    Armstrong (formerly Dryden) Flight Research Center continues it's legacy of exciting work in the area of dynamics and control of advanced vehicle concepts. This status presentation highlights the research and technology development that Armstrong's Control and Dynamics branch is performing in the areas of Control of Flexible Structures and Automated Cooperative Trajectories.

  5. Assessment of Mental Status.

    Science.gov (United States)

    Finney, Glen R; Minagar, Alireza; Heilman, Kenneth M

    2016-02-01

    Assessing the mental status of patients with a neurobehavioral disorder is a critical element in the diagnosis and treatment of these patients. This assessment should always be performed after the patient's history it taken and a general physical as well as a neurologic examination is completed. The mental status examination commences with observing the patient's appearance and level of consciousness. The examiner should also pay attention to patient's social behavior, emotional state and mood. There are 3 major means of assessing a patient's mental status. One type attempts to determine if the patient is demented and the severity of the dementia as it pertains to their ability to perform activities of daily living as well as instrumental activities. A second type of assessment utilizes what may be termed as "screening tests" or "omnibus tests". These brief tests are performed independent of the patient's history and examination. The two most frequently used screening tests are the Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The third means of assessing a patient's mental status is by using specific neuropsychological tests that focus on specific domains of cognition, such as frontal executive functions, attention, episodic verbal and visuospatial memory, declarative knowledge such as language (speech, reading and writing) and arithmetical, as well as visuospatial and perceptual abilities. These neurobehavioral, neuropsychiatric and neuropsychological assessments of patients with a cognitive decline and behavioral abnormalities should often be accompanied by laboratory tests, and neuroimaging that can help determine the underlying pathologic process so that effective therapeutic and management approaches can be provided. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Status of memory loss.

    LENUS (Irish Health Repository)

    Iyer, Parameswaran Mahadeva

    2012-01-01

    A 72-year-old woman presented with first onset of seizure with no prior history of cognitive dysfunction. EEG revealed focal non-convulsive status epilepticus. MRI brain showed a left temporal non-enhancing lesion. Temporal pole biopsy showed acute neuronal necrosis and astrocyte hyperplasia together with extensive amyloid plaques and neurofibrillary tangles. Perivascular oligodendroglial hyperplasia was present. Postmortem examination revealed extensive plaque and tangle disease. Perivascular oligodendroglial hyperplasia was limited to the left temporal area. The presence of focal perivascular oligodendroglial hyperplasia in the left temporal cortex, combined with extensive plaque and tangle disease may have contributed to the focal status epilepticus in this patient. Although the presence of focal perivascular oligodendroglial hyperplasia has been reported in cases of temporal lobe epilepsy, it has not been reported as a cause of seizure in patients with Alzheimer\\'s disease previously. Further studies for clinical-pathologic correlation would be required to confirm this hypothesis.

  7. Status of fusion maintenance

    International Nuclear Information System (INIS)

    Fuller, G.M.

    1984-01-01

    Effective maintenance will be an essential ingredient in determining fusion system productivity. This level of productivity will result only after close attention is paid to the entire system as an entity and appropriate integration of the elements is made. The status of fusion maintenance is reviewed in the context of the entire system. While there are many challenging developmental tasks ahead in fusion maintenance, the required technologies are available in several high-technology industries, including nuclear fission

  8. ISIS status report

    International Nuclear Information System (INIS)

    Finney, J.L.; Gray, D.A.

    1989-01-01

    The authors review the progress on ISIS, the pulsed neutron source at the Rutherford-Appleton Laboratory, since the last ICANS meeting. The machine is now running regularly at 100 μA at 750 MeV, and delivering neutrons for an increasing UK and international neutron scattering program. The current status of the operating and development instruments is summarized, and some examples given of recent science. 3 refs., 11 figs., 3 tabs

  9. Status of MARS Code

    Energy Technology Data Exchange (ETDEWEB)

    N.V. Mokhov

    2003-04-09

    Status and recent developments of the MARS 14 Monte Carlo code system for simulation of hadronic and electromagnetic cascades in shielding, accelerator and detector components in the energy range from a fraction of an electronvolt up to 100 TeV are described. these include physics models both in strong and electromagnetic interaction sectors, variance reduction techniques, residual dose, geometry, tracking, histograming. MAD-MARS Beam Line Build and Graphical-User Interface.

  10. Battery waste management status

    International Nuclear Information System (INIS)

    Barnett, B.M.; Sabatini, J.C.; Wolsky, S.

    1993-01-01

    The paper consists of a series of slides used in the conference presentation. The topics outlined in the slides are: an overview of battery waste management; waste management of lead acid batteries; lead acid recycling; typical legislation for battery waste; regulatory status in European countries; mercury use in cells; recent trends in Hg and Cd use; impact of batteries to air quality at MSW incinerators; impact of electric vehicles; new battery technologies; and unresolved issues

  11. FASTBUS software status

    International Nuclear Information System (INIS)

    Gustavson, D.B.

    1980-10-01

    Computer software will be needed in addition to the mechanical, electrical, protocol and timing specifications of the FASTBUS, in order to facilitate the use of this flexible new multiprocessor and multisegment data acquisition and processing system. Software considerations have been important in the FASTBUS design, but standard subroutines and recommended algorithms will be needed as the FASTBUS comes into use. This paper summarizes current FASTBUS software projects, goals and status

  12. ATLAS construction status

    International Nuclear Information System (INIS)

    Jenni, P.

    2006-01-01

    The ATLAS detector is being constructed at the LHC, in view of a data-taking startup in 2007. This report concentrates on the progress and the technical challenges of the detector construction, and summarizes the status of the work as of August 2004. The project is on track to allow the highly motivated ATLAS Collaboration to enter into a new exploratory domain of high-energy physics in 2007. (author)

  13. Status of gluonium searches

    International Nuclear Information System (INIS)

    Heusch, C.A.; California Univ., Santa Cruz, CA

    1991-01-01

    Quantum chromodynamics predicts the existence of quarkless mesons. The search for these hadrons has been ingenious and persevering. A review is presented of the current status of research that considers all model-dependent theoretical prejudice when searching for specific states. Early hints for candidate states have been investigated in the light of recent data, mostly from the Mark III Collaboration, in radiative charmonium decay. No 'smoking-gun' candidate stands out. (R.P.) 25 refs., 20 figs., 2 tabs

  14. Automated Status Notification System

    Science.gov (United States)

    2005-01-01

    NASA Lewis Research Center's Automated Status Notification System (ASNS) was born out of need. To prevent "hacker attacks," Lewis' telephone system needed to monitor communications activities 24 hr a day, 7 days a week. With decreasing staff resources, this continuous monitoring had to be automated. By utilizing existing communications hardware, a UNIX workstation, and NAWK (a pattern scanning and processing language), we implemented a continuous monitoring system.

  15. The status of GALLEX

    International Nuclear Information System (INIS)

    Cribier, M.

    1990-01-01

    The present status of the Gallium Solar Neutrino Experiment performed by the GALLEX Collaboration in the Gran Sasso Underground Laboratory is described. The implementation phase of this experiment is now completed, the whole gallium is at hand and data taking starts now. After a short introduction and an outline of the basic experimental procedure, details will be given on different parts of the experiment and on some background. 14 refs., 2 figs

  16. Women Status and their Discrimination

    OpenAIRE

    PEŠKOVÁ, Pavlína

    2008-01-01

    My work deal with women status and their discrimination. Chapter one contains women status in different historical periods and development of their status to bigger equal with men. There is also written about present feminist trends. Chapter two is about women discrimination. There is about women´ job discrimination, job segregation according to gender and inequality in payment. There is also written about women status at home and unequal duties at home among family mates. Chapter three is ab...

  17. Sibling Status Effects: Adult Expectations.

    Science.gov (United States)

    Baskett, Linda Musun

    1985-01-01

    This study attempted to determine what expectations or beliefs adults might hold about a child based on his or her sibling status alone. Ratings on 50 adjective pairs for each of three sibling status types, only, oldest, and youngest child, were assessed in relation to adult expectations, birth order, and parental status of rater. (Author/DST)

  18. Status of safeguards instrumentation

    International Nuclear Information System (INIS)

    Higinbotham, W.A.

    The International Atomic Energy Agency is performing safeguards at some nuclear power reactors, 50 bulk processing facilities, and 170 research facilities. Its verification activities require the use of instruments to measure nuclear materials and of surveillance instruments to maintain continuity of knowledge of the locations of nuclear materials. Instruments that are in use and under development to measure weight, volume, concentration, and isotopic composition of nuclear materials, and the major surveillance instruments, are described in connection with their uses at representative nuclear facilities. The current status of safeguards instrumentation and the needs for future development are discussed

  19. Model Validation Status Review

    International Nuclear Information System (INIS)

    E.L. Hardin

    2001-01-01

    The primary objective for the Model Validation Status Review was to perform a one-time evaluation of model validation associated with the analysis/model reports (AMRs) containing model input to total-system performance assessment (TSPA) for the Yucca Mountain site recommendation (SR). This review was performed in response to Corrective Action Request BSC-01-C-01 (Clark 2001, Krisha 2001) pursuant to Quality Assurance review findings of an adverse trend in model validation deficiency. The review findings in this report provide the following information which defines the extent of model validation deficiency and the corrective action needed: (1) AMRs that contain or support models are identified, and conversely, for each model the supporting documentation is identified. (2) The use for each model is determined based on whether the output is used directly for TSPA-SR, or for screening (exclusion) of features, events, and processes (FEPs), and the nature of the model output. (3) Two approaches are used to evaluate the extent to which the validation for each model is compliant with AP-3.10Q (Analyses and Models). The approaches differ in regard to whether model validation is achieved within individual AMRs as originally intended, or whether model validation could be readily achieved by incorporating information from other sources. (4) Recommendations are presented for changes to the AMRs, and additional model development activities or data collection, that will remedy model validation review findings, in support of licensing activities. The Model Validation Status Review emphasized those AMRs that support TSPA-SR (CRWMS M and O 2000bl and 2000bm). A series of workshops and teleconferences was held to discuss and integrate the review findings. The review encompassed 125 AMRs (Table 1) plus certain other supporting documents and data needed to assess model validity. The AMRs were grouped in 21 model areas representing the modeling of processes affecting the natural and

  20. The status of GALLEX

    Energy Technology Data Exchange (ETDEWEB)

    Kirsten, T.; Anselmann, P.; Breitenbach, M.; Hampel, W.; Heusser, G.; Kiko, J.; Kirsten, T.; Lenzing, A.; Pernicka, E.; Plaga, R.; Povh, B.; Schlosser, C.; Voelk, H.; Wink, R.; Wojcik, M. (Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany, F.R.)); Bellotti, E. (Laboratori Nazionali del Gran Sasso (Italy)); Ammon, R. v.; Balata, M.; Ebert, K.; Fritsch, T.; Hellriegel, K.; Henrich, E.; Stieglitz, L.; Weyrich, F. (Kernforschungszentrum Karlsruhe GmbH (Germany, F.R.)); Cremonesi, O.; Fiorini, E.; Ragazzi, S.; Zanotti, L. (Milan Univ. (Italy). Dipt. di Fisica); Feilitzsch, F. v.; Moessbauer, R.; Schanda, U. (Technische Univ. Muenchen, Garching (Germany, F.R.). Fakultaet fuer Physik); Berthomieu, G.; Schatzmann, E. (Nice Univ., 06 (France). Observatoire); Carmi, I.; Dostrovsky, I. (Weizmann Inst. of Science, Rehovoth (Israel)); D' Angelo, S.; Bacci, C.; Belli, P.; Bernabei, R.; Paoluzi, L. (Rome-2 Univ. (Italy)); Cribier, M.; Dupont, G.; Gosset, L.; Pichard, B.; Rich, J.; Spiro; GALLEX Collaboration

    1991-04-01

    A radiochemical Gallium-Solar-Neutrino Detector has been set up at the Gran Sasso Underground Laboratory. All major installations are implemented and the target, 53,5 m{sup 3} of galliumchloride solution containing 30.3 tons of gallium, has been brought underground after removing cosmogenic Ge-isotopes through nitrogen purge. This final implementation status and the achieved parameters characterizing the experiment are described in this report. Full scale performance tests and optimalization of the operating conditions of the extraction system are presently under way. (orig.).

  1. Status of APE projects

    CERN Document Server

    Alfieri, R; Onofri, E; Bartoloni, A; Battista, C; Cabibbo, Nicola; Cosimi, M; Lonardo, A; Michelotti, A; Proietti, B; Rapuano, F; Rossetti, D; Sacco, G; Tassa, S; Torelli, M; Vicini, P; Pène, O; Errico, W; Magazzù, G; Sartori, L; Schiiano, F; Tripiccione, R; De Riso, P; Petronzio, Roberto; Destri, C; Frezzotti, R; Marchesini, G; Gensch, Ulrich; Jansen, K; Kretzschmann, A; Leich, H; Paschedag, N; Pleiter, D; Schwendicke, U; Simma, H; Sommer, Rainer; Sulanke, K; Wegner, P; Fucci, A; Martin, B; Pech, J; Panizzi, E; Petricola, A

    2001-01-01

    This talk is divided in two parts. In the first part, we will summarize the status of the APEmille project that will be completed by the end of the year. We will then devote the rest of the talk to the description of a new project for a multi-TeraFlop machine, ape NEXT. The interested reader will find a much more detailed discussion of all the items touched upon here in the full proposal of the project that will shortly appear on hep-lat. (9 refs).

  2. Teleradiology - current status

    International Nuclear Information System (INIS)

    Baltadjiev, D.; Charakchiev

    2000-01-01

    Tele-radiology is a term becoming increasingly popular in the medical literature. Nevertheless, terminological definitions in this particular field are still rather vague. The scope of applications extend from simple image presenting via analogue telephone lines to transmission of 3-D medical images through a satellite. It is a matter of standards highly differing in terms of data transmission rates, safety, technical demands on the systems and the like. In this article new information technologies, technical aspects, as well as some major applications of tele-radiology are discussed. The current status of tele-medicine/tele-radiology in this country is likewise briefly outlined

  3. Status epilepticus in scleromyxedema

    Institute of Scientific and Technical Information of China (English)

    Soifa Markoula; Soifa Zouroudi; Soitrios Giannopoulos; Kimon Tsoukanelis; Ananstasia Zikou; Athanassios P Kyritsis

    2016-01-01

    Scleromyxedema is a rare dermatologic disorder, characterized by erythematous or yelowish lichenoid waxy papules. Neurological manifestations are rare but wel-recognized. A 51-year-old woman, diagnosed with scleromyxedema, was admitted to the hospital with status epilepticus, caused by brain lesions, as disclosed in a brain magnetic resonance imaging (MRI). The patient was treated with anticonvulsants and corticosteroids and gradualy recovered fuly. A complete remission of the lesions was shown in a folow-up brain MRI. In cases with scleromyxedema and the presence of neurological manifestations, we need to pay attention to central nervous system involvement, especialy when combined with brain MRI lesions, and treat the patient appropriately.

  4. 1998 status report

    International Nuclear Information System (INIS)

    1998-01-01

    Since its creation in 1945, the activities of Cea have been centered on the study and development of the pacific use of nuclear energy and on assuring the credibility of nuclear deterrent. This status report presents the research programs led by Cea in 1998. The main topics are: the designing of reactor cores, fuel cycle, nuclear safety, radiation protection, the activities for defense, high technologies for industry, biology and fundamental sciences. The quality of research work is assured by an independent and regular assessment of the scientific activities. (A.C.)

  5. Model Validation Status Review

    Energy Technology Data Exchange (ETDEWEB)

    E.L. Hardin

    2001-11-28

    The primary objective for the Model Validation Status Review was to perform a one-time evaluation of model validation associated with the analysis/model reports (AMRs) containing model input to total-system performance assessment (TSPA) for the Yucca Mountain site recommendation (SR). This review was performed in response to Corrective Action Request BSC-01-C-01 (Clark 2001, Krisha 2001) pursuant to Quality Assurance review findings of an adverse trend in model validation deficiency. The review findings in this report provide the following information which defines the extent of model validation deficiency and the corrective action needed: (1) AMRs that contain or support models are identified, and conversely, for each model the supporting documentation is identified. (2) The use for each model is determined based on whether the output is used directly for TSPA-SR, or for screening (exclusion) of features, events, and processes (FEPs), and the nature of the model output. (3) Two approaches are used to evaluate the extent to which the validation for each model is compliant with AP-3.10Q (Analyses and Models). The approaches differ in regard to whether model validation is achieved within individual AMRs as originally intended, or whether model validation could be readily achieved by incorporating information from other sources. (4) Recommendations are presented for changes to the AMRs, and additional model development activities or data collection, that will remedy model validation review findings, in support of licensing activities. The Model Validation Status Review emphasized those AMRs that support TSPA-SR (CRWMS M&O 2000bl and 2000bm). A series of workshops and teleconferences was held to discuss and integrate the review findings. The review encompassed 125 AMRs (Table 1) plus certain other supporting documents and data needed to assess model validity. The AMRs were grouped in 21 model areas representing the modeling of processes affecting the natural and

  6. Integrated process status overview

    International Nuclear Information System (INIS)

    Gertman, D.I.; Gaudio, P. Jr.

    1986-01-01

    This report summarizes findings to date with the IPSO, a large plant status overview currently under development at the OECD Halden Reactor Project. As part of a joint Halden and Combustion Engineering project, the overview is being tested in part to determine whether the large screen overview concept being entertained for use in the nuclear power plant (NPP) industry will facilitate operator performance. To this end an interactive simulation technique was used to establish a proof-of-principle test for the IPSO. Process control, operations, and human factors experts at Halden participated in the test and evaluation

  7. NESTOR: A status report

    CERN Document Server

    Anassontzis, E G; Barone, M; Foudas, C; Grammatikakis, G; Katsanevas, S; Kourkoumelis, C; Manousakis-Katsikakis, A; Resvanis, L K; Siotis, I; Sotiriou, S A; Voulgaris, G; Minkowski, P; Grieder, P K F; Ball, A E; Bottai, S; Cartacci, A M; Monteleoni, B; Naumov, Vadim A; Trasatti, L; Fahrun, E; Keusen, U; Koske, P; Rathlev, J; Schmidt, N P; Voight, G; Bezrukov, Leonid B; Butkevich, A V; Dedenko, L G; Karaevsky, S K; Mironovich, A A; Zakharov, L M; Zheleznykh, I M; Zhukov, V A; Demidova, T A; Deineko, A O; Eremeev, A P; Paka, V T; Permyakov, A A; Platonov, M N; Rukol, V Kh; Sheremet, N A; Surin, N M; Albul, V I; Ledenev, V V

    2000-01-01

    NESTOR is an underwater neutrino astrophysics laboratory to be located in the international waters of the southwest of Greece. The first phase of this experiment is the construction and deployment of one hexagonal tower consisting of 168 optical modules, with effective are of 20000m2 for E ⩾ TeV neutrinos. Over the past few years detailed studies of the site have been carried out while many tests have been performed. The current status of the preparation of the experiment and the future plans will be presented.

  8. Reactor gamma spectrometry: status

    International Nuclear Information System (INIS)

    Gold, R.; Kaiser, B.J.

    1979-01-01

    Current work is described for Compton Recoil Gamma-Ray Spectrometry including developments in experimental technique as well as recent reactor spectrometry measurements. The current status of the method is described concerning gamma spectromoetry probe design and response characteristics. Emphasis is given to gamma spectrometry work in US LWR and BR programs. Gamma spectrometry in BR environments are outlined by focussing on start-up plans for the Fast Test Reactor (FTR). Gamma spectrometry results are presented for a LWR pressure vessel mockup in the Poolside Critical Assembly (PCA) at Oak Ridge National Laboratory

  9. Status of Standardization Projects

    Science.gov (United States)

    1991-06-30

    MCA GL G4 913 914 914 A GL SA 50 SS N D 8915 TOTAL- 6. DELINQUENT- 0. STATUS CODES: A- 5, G- 1. Y- 0, Z- 0 8920 0539 MIL R 35084A RICE INSTANT ENRICHED...44171GL CARROTS GLA POW GL H5 904 914 914 A N D 8940 A693 MIL N 44178GL NOODLES PARMESAN AND ROMA GL H5 904 914 914 A N D 8940 A694 MIL P 44181GL PIE...20184 COFFEE INSTANT GL B4 A 893 903 913 A GL SA 50 SS U B 8955 0062 MIL T 3527D I NOT 1 TEA INSTANT GL H5 912 921 921 A GL SA 50 SS N 8955 TOTAL- 2

  10. Belle status and prospects

    International Nuclear Information System (INIS)

    Hara, Takanori

    2003-01-01

    We review the current status and the future perspectives of the Belle experiment and KEKB asymmetric e + e - collider. Thanks to many efforts of Belle collaborators and KEKB accelerator staffs, we could accumulate a 41.8 fb -1 data by the end of 2001 (more than 80 fb -1 data by the end of summer, 2002), also the KEKB recorded the highest peak luminosity (7.35 x 10 33 cm -2 s -1 ) in the world. Furthermore, the Super KEKB project is being proposed not only to extract the CP violation parameters and moduluses of the CKM matrix with high accuracy, but also to search for B rare decays and explore beyond the Standard Model

  11. Status of French reactors

    Energy Technology Data Exchange (ETDEWEB)

    Ballagny, A. [Commissariat a l`Energie Atomique, Saclay (France)

    1997-08-01

    The status of French reactors is reviewed. The ORPHEE and RHF reactors can not be operated with a LEU fuel which would be limited to 4.8 g U/cm{sup 3}. The OSIRIS reactor has already been converted to LEU. It will use U{sub 3}Si{sub 2} as soon as its present stock of UO{sub 2} fuel is used up, at the end of 1994. The decision to close down the SILOE reactor in the near future is not propitious for the start of a conversion process. The REX 2000 reactor, which is expected to be commissioned in 2005, will use LEU (except if the fast neutrons core option is selected). Concerning the end of the HEU fuel cycle, the best option is reprocessing followed by conversion of the reprocessed uranium to LEU.

  12. Mars Drilling Status

    Science.gov (United States)

    Mandell, Humboldt, C., Jr.

    2002-01-01

    This slide presentation reviews the current status of work to explore Mars beneath the surface of planet. One of the objective of this work is to enable further exploration of Mars by humans. One of the requirements for this is to find water on Mars. The presences of water is critical for Human Exploration and a permanent presence on Mars. If water is present beneath the surface it is the best chance of finding life on Mars. The presentation includes a timeline showing the robotic missions, those that have already been on Mars, and planned missions, an explanation of why do we want to drill on Mars, and some of the challenges, Also include are reviews of a missions that would drill 200 and 4,000 to 6,000 meters into the Martian bedrock, and a overview description of the drill. There is a view of some places where we have hopes of finding water.

  13. Status of legislation

    International Nuclear Information System (INIS)

    Warner, C.

    1982-01-01

    The status of the House legislation, the major differences between the House and Senate legislation and a preview of what is likely to take place during the lame duck session in December are presented. The House legislation provides: long-term program leading toward permanent disposal of nuclear waste; an interim program for storage and for expansion of storage space for spent fuel; provides an R and D component through what is called a test and evaluation facility; an alternative long-term storage program based on a proposal to be completed by the Department of Energy on what's called Monitored Retrievable Storage; full upfront financing of the program through user fees based on contracts between the government and the users of the nuclear waste disposal services

  14. The status of molecules

    International Nuclear Information System (INIS)

    Barnes, T.; Oak Ridge National Lab., TN; Tennessee Univ., Knoxville, TN

    1994-06-01

    This report summarizes the experimental and theoretical status of hadronic molecules, which are weakly-bound states of two or more hadrons. We begin with a brief history of the subject and discuss a few good candidates, and then abstract some signatures for molecules which may be of interest in the classification of possible molecule states. Next we argue that a more general understanding of 2 → 2 hadron-hadron scattering amplitudes will be crucial for molecule searches, and discuss some of our recent work in this area. We conclude with a discussion of a few more recent molecule candidates (notably the f o (1710)) which are not well established as molecules but satisfy some of the expected signatures. (Author)

  15. LIGO: Status and plans

    International Nuclear Information System (INIS)

    Barish, B.C.

    2001-01-01

    One of the most important consequences of the Theory of General Relativity is the concept of gravitational waves. As we enter the new millennium, a new generation of detectors sensitive enough to directly detect such waves will become operational. Detectable events could originate from a variety of catastrophic events in the distant universe, such as the gravitational collapse of stars or the coalescence of compact binary systems. In this talk, I review the detection technique of suspended mass interferometry, including the status and plans for the Laser Interferometry Gravitational-wave Observatory (LIGO). I also discuss the astrophysical sources of gravitational waves and the preparations for data analysis to search for signals of gravitational waves. (author)

  16. ARAC status report: 1985

    International Nuclear Information System (INIS)

    Dickerson, M.H.; Gudiksen, P.H.; Sullivan, T.J.; Greenly, G.D.

    1985-05-01

    The Atmospheric Release Advisory Capability is a real-time emergency-response service available to federal and state agencies for providing estimates of the environmental consequences of accidental releases of radioactivity into the atmosphere. This includes the estimation of radiation doses to nearby population centers and the levels and extent of surface contamination. The service is currently being expanded to support the emergency response plans at approximately 50 Department of Defense and Department of Energy facilities. This expansion consists of the installation of enhanced computational and data communications and processing systems, development of terrain and geographic data bases, improvements in modeling capabilities, as well as increased staff housing facilities. This report summarizes the current status of ARAC and the requirements to receive the service

  17. Status of the SLC

    International Nuclear Information System (INIS)

    Moffeit, K.C.

    1987-01-01

    The status and research possibilities of the Stanford Linear Collider (SLC) are reviewed. The physics program concentrates on production of Z 0 's and their decay. The SLC systems include a new injector and booster, two damping rings to provide the small beam emittance, a new positron source, the existing LINAC structure upgraded for higher energy and better beam control, beam transport arcs, a final focus section, and experimental halls are detectors. Energy spectrometers with an accuracy of ± 50 MeV/c 2 for pulse-to-pulse center of mass energy measurement are to be installed. Longitudinal polarized electrons are expected, and will allow more precise tests of the standard model

  18. Quasat - European status report

    International Nuclear Information System (INIS)

    Schilizzi, R.T.

    1987-01-01

    The scientific goals, design, and current development status of Quasat are reviewed. Quasat is a proposed 15-m orbiting radio telescope intended to serve as the space leg of an astronomical VLBI network comprising the existing large arrays in Europe, the U.S., the USSR, and Australia. The planned 63-deg-inclination 5700 x 12,500-km elliptical orbit is optimized for high-resolution imaging of quasar and radio-galaxy nuclei at cm wavelengths with the U.S. and European ground arrays. A drawing of the ESA inflatable-antenna concept, a diagram of the space/ground system, and tables listing additional observing targets and the predicted angular and spatial resolutions of a Quasat-based array at different wavelengths are included

  19. Status of CSNS project

    International Nuclear Information System (INIS)

    Zhang, J.; Fu, S.N.; Chen, H.S.

    2015-01-01

    The China Spallation Neutron Source (CSNS) accelerator is designed to accelerate proton beam pulses to 1.6 GeV at 25 Hz repetition rate, striking a solid metal target to produce spallation neutrons. The accelerator provides a beam power of 100 kW on the target in the first phase and then 500 kW in the second phase by increasing the average beam intensity 5 times while raising the linac output energy. The project construction has been formally launched in 2011 and it is planned to complete the project in March 2018. It is one of the high intensity proton accelerator projects in the world and it imposes a great challenge to Chinese accelerator community. This presentation will cover the status and challenges of the CSNS project. (author)

  20. COHERENT Experiment: current status

    International Nuclear Information System (INIS)

    Akimov, D; Belov, V; Bolozdynya, A; Burenkov, A; Albert, J B; Del Valle Coello, M; D’Onofrio, M; Awe, C; Barbeau, P S; Cervantes, M; Becker, B; Cabrera-Palmer, B; Collar, J I; Cooper, R J; Cooper, R L; Cuesta, C; Detwiler, J; Eberhardt, A; Dean, D; Dolgolenko, A G

    2017-01-01

    The COHERENT Collaboration is realizing a long term neutrino physics research program. The main goals of the program are to detect and study elastic neutrino-nucleus scattering (CEνNS). This process is predicted by Standard Model but it has never been observed experimentally because of the very low energy of the recoil nucleus. COHERENT is using different detector technologies: CsI[Na] and NaI scintillator crystals, a single-phase liquid Ar and a Ge detectors. The placement of all the detector setups is in the basement of the Spallation Neutron Source (SNS) at Oak Ridge National Laboratory (ORNL). The current status of the COHERENT experimental program is presented. (paper)

  1. Status of French reactors

    International Nuclear Information System (INIS)

    Ballagny, A.

    1997-01-01

    The status of French reactors is reviewed. The ORPHEE and RHF reactors can not be operated with a LEU fuel which would be limited to 4.8 g U/cm 3 . The OSIRIS reactor has already been converted to LEU. It will use U 3 Si 2 as soon as its present stock of UO 2 fuel is used up, at the end of 1994. The decision to close down the SILOE reactor in the near future is not propitious for the start of a conversion process. The REX 2000 reactor, which is expected to be commissioned in 2005, will use LEU (except if the fast neutrons core option is selected). Concerning the end of the HEU fuel cycle, the best option is reprocessing followed by conversion of the reprocessed uranium to LEU

  2. Contribution of intestinal barrier damage, microbial translocation and HIV-1 infection status to an inflammaging signature.

    Directory of Open Access Journals (Sweden)

    Amanda K Steele

    Full Text Available Systemic inflammation is a characteristic of both HIV-1 infection and aging ("inflammaging". Intestinal epithelial barrier damage (IEBD and microbial translocation (MT contribute to HIV-associated inflammation, but their impact on inflammaging remains unclear.Plasma biomarkers for IEBD (iFABP, MT (LPS, sCD14, T-cell activation (sCD27, and inflammation (hsCRP, IL-6 were measured in 88 HIV-1 uninfected (HIV(neg and 83 treated, HIV-1-infected (HIV(pos adults from 20-100 years old.Age positively correlated with iFABP (r = 0.284, p = 0.008, sCD14 (r = 0.646, p = <0.0001 and LPS (r = 0.421, p = 0.0002 levels in HIV(neg but not HIV(pos subjects. Age also correlated with sCD27, hsCRP, and IL-6 levels regardless of HIV status. Middle-aged HIV(pos subjects had elevated plasma biomarker levels similar to or greater than those of elderly HIV(neg subjects with the exception of sCD14. Clustering analysis described an inflammaging phenotype (IP based on iFABP, sCD14, sCD27, and hsCRP levels in HIV(neg subjects over 60 years of age. The IP in HIV(neg subjects was used to develop a classification model that was applied to HIV(pos subjects to determine whether HIV(pos subjects under 60 years of age were IP+. HIV(pos IP+ subjects were similar in age to IP- subjects but had a greater risk of cardiovascular disease (CVD based on Framingham risk score (p =  0.01.We describe a novel IP that incorporates biomarkers of IEBD, MT, immune activation as well as inflammation. Application of this novel IP in HIV-infected subjects identified a group at higher risk of CVD.

  3. Updates in Refractory Status Epilepticus

    Science.gov (United States)

    Mahulikar, Advait; Suchdev, Kushak; Shah, Aashit

    2018-01-01

    Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause. New-onset refractory status epilepticus (NORSE) is a recently coined term for refractory status epilepticus where no apparent cause is found after initial testing. A large proportion of NORSE cases are eventually found to have an autoimmune etiology needing immunomodulatory treatment. Management of refractory status epilepticus involves treatment of an underlying etiology in addition to intravenous anesthetics and antiepileptic drugs. Alternative treatment options including diet therapies, electroconvulsive therapy, and surgical resection in case of a focal lesion should be considered. Short-term and long-term outcomes tend to be poor with significant morbidity and mortality with only one-third of patients reaching baseline neurological status. PMID:29854452

  4. Mechanisms Underlying HIV-Associated Noninfectious Lung Disease.

    Science.gov (United States)

    Presti, Rachel M; Flores, Sonia C; Palmer, Brent E; Atkinson, Jeffrey J; Lesko, Catherine R; Lau, Bryan; Fontenot, Andrew P; Roman, Jesse; McDyer, John F; Twigg, Homer L

    2017-11-01

    Pulmonary disease remains a primary source of morbidity and mortality in persons living with HIV (PLWH), although the advent of potent combination antiretroviral therapy has resulted in a shift from predominantly infectious to noninfectious pulmonary complications. PLWH are at high risk for COPD, pulmonary hypertension, and lung cancer even in the era of combination antiretroviral therapy. The underlying mechanisms of this are incompletely understood, but recent research in both human and animal models suggests that oxidative stress, expression of matrix metalloproteinases, and genetic instability may result in lung damage, which predisposes PLWH to these conditions. Some of the factors that drive these processes include tobacco and other substance use, direct HIV infection and expression of specific HIV proteins, inflammation, and shifts in the microbiome toward pathogenic and opportunistic organisms. Further studies are needed to understand the relative importance of these factors to the development of lung disease in PLWH. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  5. Antiretroviral therapy and HIV-associated cancers: Anti- angiogenic ...

    African Journals Online (AJOL)

    Tropical Journal of Pharmaceutical Research November 2017; 16 (11): 2741- ... Keywords: Efavirenz, HIV, Cancers, Angiogenesis, Chick chorioallantoic membrane ... Index Medicus, JournalSeek, Journal Citation Reports/Science Edition, Directory of Open Access Journals ... [18] and Tumor necrosis factor alpha (TNF-a).

  6. Prevalence of Internalized Homophobia and HIV Associated Risks ...

    African Journals Online (AJOL)

    This study assessed the level of internalized homophobia and associated factors among men who have sex with men (MSM) in Nigeria. Using respondent driven sampling, MSM were recruited in Lagos and Ibadan between July and September, 2006. Internalized homophobia was assessed as a negative composite score ...

  7. HIV-associated Lipodystrophy Syndrome: A Review of Clinical Aspects

    Directory of Open Access Journals (Sweden)

    Jean-Guy Baril

    2005-01-01

    Full Text Available Approximately two years after the introduction of highly active antiretroviral therapy for the treatment of HIV infection, body shape changes and metabolic abnormalities were increasingly observed. Initially, these were ascribed to protease inhibitors, but it is now clear that nucleoside reverse transcriptase inhibitors also contribute to lipodystrophy syndrome. The syndrome groups together clinical conditions describing changes in body fat distribution that include lipoatrophy, lipoaccumulation or both. However, there does not appear to be a direct link between lipoatrophy and lipoaccumulation that would support a single mechanism for the redistribution of body fat. Currently, there is no clear definition of lipodystrophy, which explains the difficulty in determining its prevalence and etiology. There are no current guidelines for the treatment of fat distribution abnormalities that occur in the absence of other metabolic complications. The present article reviews the current state of knowledge of the definition, symptoms, risk factors, pathogenesis, diagnosis and treatment of the morphological changes associated with lipodystrophy syndrome.

  8. What's in a Name? AIDS Dementia Complex, HIV-associated ...

    African Journals Online (AJOL)

    The updated terminology is preferred because it requires assessing cognition objectively with neuropsychological tests. It is recommended that the International HIV Dementia Scale be used to screen patients and to thereafter confirm diagnosis with further neuropsychological tests e.g. the trail making and digit span tests.

  9. Symptomatic relapse of HIV-associated cryptococcal meningitis in ...

    African Journals Online (AJOL)

    Objectives. Cryptococcal meningitis is the most common cause of adult meningitis in southern Africa. Much of this disease burden is thought to be due to symptomatic relapse of previously treated infection. We studied the contribution of inadequate secondary fluconazole prophylaxis to symptomatic relapses of cryptococcal ...

  10. HIV-associated multicentric Castleman’s disease

    Directory of Open Access Journals (Sweden)

    Fauzia de Fátima Naime

    2012-09-01

    Full Text Available Multicentric Castleman’s disease (MCD is a rare lymphoproliferative disorder. It is found with higher frequency in patients with HIV infection, with systemic symptoms and poor prognosis. We present the case of a 32-year old man with HIV disease, Kaposi’s sarcoma, lymphadenopathy, fever and hemolytic anemia. A diagnosis of Castleman’s disease is confirmed through biopsy and treatment is often based only on published case reports. Systemic treatments for MCD have included chemotherapy, anti-herpes virus, highly active antiretroviral therapy and, more recently, monoclonal antibodies against both IL6 and CD20.

  11. Screening for HIV-associated neurocognitive disorders (HANDs) in ...

    African Journals Online (AJOL)

    2013-03-01

    Mar 1, 2013 ... presented of variance in both cross-national and local demographic screening and neuropsychological test scores, with the ... C van Wijk, MA (Clinical Psychology) .... not reflect true cross-national or cross-cultural differences.

  12. Management of HIV associated Kaposi's Sarcoma in Malawi ...

    African Journals Online (AJOL)

    Kaposi's sarcoma is a common malignancy in Malawi and is often managed with single agent vincristine. This article outlines feasible combination chemotherapy for Kaposi's sarcoma in Malawi which should be made more widely available. Malawi Medical Journal Vol. 20 (4) 2008: pp. 129-132.

  13. Diagnosing HIV-associated tuberculosis | Wilson | Southern African ...

    African Journals Online (AJOL)

    The world has made defeating AIDS a top priority. This is a blessing. But TB remains ignored. Today we are calling on the world to recognise that we can't fight AIDS unless we do much more to fight TB as well.' Nelson Mandela: Media briefing on 'Confronting the Joint HIV-TB Epidemics', co-convened by the Bill & Melinda ...

  14. HIV-associated lipodystrophy syndrome: A review of clinical aspects

    Science.gov (United States)

    Baril, Jean-Guy; Junod, Patrice; LeBlanc, Roger; Dion, Harold; Therrien, Rachel; Laplante, François; Falutz, Julian; Côté, Pierre; Hébert, Marie-Nicole; Lalonde, Richard; Lapointe, Normand; Lévesque, Dominic; Pinault, Lyse; Rouleau, Danielle; Tremblay, Cécile; Trottier, Benoît; Trottier, Sylvie; Tsoukas, Chris; Weiss, Karl

    2005-01-01

    Approximately two years after the introduction of highly active antiretroviral therapy for the treatment of HIV infection, body shape changes and metabolic abnormalities were increasingly observed. Initially, these were ascribed to protease inhibitors, but it is now clear that nucleoside reverse transcriptase inhibitors also contribute to lipodystrophy syndrome. The syndrome groups together clinical conditions describing changes in body fat distribution that include lipoatrophy, lipoaccumulation or both. However, there does not appear to be a direct link between lipoatrophy and lipoaccumulation that would support a single mechanism for the redistribution of body fat. Currently, there is no clear definition of lipodystrophy, which explains the difficulty in determining its prevalence and etiology. There are no current guidelines for the treatment of fat distribution abnormalities that occur in the absence of other metabolic complications. The present article reviews the current state of knowledge of the definition, symptoms, risk factors, pathogenesis, diagnosis and treatment of the morphological changes associated with lipodystrophy syndrome. PMID:18159551

  15. HIV-associated neurocognitive disorders | Vally | South African ...

    African Journals Online (AJOL)

    Relevant literature is also reviewed regarding the differential impact upon component cognitive domains known to be affected in HAND, which in turn should ideally be targeted during clinical and neuropsychological assessments: psychomotor and information processing speed, learning and memory, attention and working ...

  16. HIV-associated TB syndemic: A growing clinical challenge worldwide

    Directory of Open Access Journals (Sweden)

    Maria Theresa Montales

    2015-12-01

    Full Text Available The association of tuberculosis (TB with human immunodeficiency virus (HIV infection and acquired immune deficiency syndrome (AIDS over the past several years has become an emerging syndemic. Approximately 10% of people living with HIV (PLHIV with latent TB infection will develop active TB disease each year. In this review, we highlight that this phenomenon is not limited to high endemic regions like Afro-Asian nations, but globalization/migration is causing increased case detection even in developed nations such as the United States (US. Active screening should be performed for tuberculosis in PLHIV. A high degree of clinical suspicion for tuberculosis is warranted in PLHIV presenting with fever, cough and unintentional weight loss. HIV-Mycobacterium tuberculosis (MTB coinfection is often paucibacillary, precluding diagnosis by conventional diagnostics and/or smear-microscopy/culture. Improved detection of pulmonary and extrapulmonary tuberculosis is now possible by incorporation of the GeneXPERT MTB/RIF assay (Cepheid Inc, Sunnyvale, USA. The World Health Organization (WHO recommends instituting immediate therapy for Mycobacterium tuberculosis, in conjunction with ongoing or newly introduced antiretroviral therapy (ART. Vigilance is required to detect drug-induced organ injuries, and early-treatment induced immune reconstitution inflammatory syndrome (IRIS. Collaborating MTB and HIV activities in concentrated HIV epidemic settings should become a high public health priority.

  17. Prevalence of HIV associated neurocognitive deficit among HIV ...

    African Journals Online (AJOL)

    International HIV dementia scale, activity of daily living scale and Hospital Anxiety and Depression scale were used to assess neuro cognitive deficit, activity of daily living, anxiety and depression respectively. The data was analyzed by using SPSS window 20. Result: About 88% of the subjects were receiving highly active ...

  18. Challenges to diagnosis of HIV-associated wasting.

    Science.gov (United States)

    Kotler, Donald

    2004-12-01

    There is a wide variability in the clinical presentation of the protein energy malnutrition often characterized as wasting in patients infected with HIV. Moreover, the clinical presentation has evolved over time. Initially, protein energy malnutrition was characterized by profound weight loss and depletion of body cell mass (BCM). Recently, unrelated concurrent metabolic abnormalities, such as lipodystrophy, may complicate the diagnosis of HIV wasting. Although measures of BCM are relatively accurate for the diagnosis of HIV wasting, the optimal tools for assessing BCM are not necessarily available to the clinician. From the practical standpoint, HIV wasting may be a self-evident diagnosis in advanced stages, but effective interpretation of the early signs of HIV wasting requires familiarity with other complications included in the differential diagnosis.

  19. Biosimilar drugs: Current status.

    Science.gov (United States)

    Kumar, Rajiv; Singh, Jagjit

    2014-07-01

    Biologic products are being developed over the past three decades. The expiry of patent protection for many biological medicines has led to the development of biosimilars in UK or follow on biologics in USA. This article reviews the literature on biosimilar drugs that covers the therapeutic status and regulatory guidelines. Appraisal of published articles from peer reviewed journals for English language publications, search from PubMed, and guidelines from European Medicines Agency, US Food Drug Administration (FDA) and India were used to identify data for review. Literature suggest that biosimilars are similar biological products, i.e., comparable but not identical to the reference product, are not generic version of innovator product and do not ensure therapeutic equivalence. Biosimilars present more challenges than conventional generics and marketing approval is also more complicated. To improve access, US Congress passed the Biologics Price Competition and Innovation act 2009 and US FDA allowed "abbreviated pathway" for their approval. U.S law has defined new standards and terms and EMA scientific guidelines have also set detailed approval standards. India being one of the most preferred manufacturing destinations of biosimilars, there is a need for stringent safety and regulatory guidelines. The New India Guidelines "Draft Guidelines on Similar Biologics were announced in June 2012, by Department of Biotechnology at Boston bio and available online.

  20. Status of fusion technology

    International Nuclear Information System (INIS)

    Mohan, Ashok

    1978-01-01

    The current status of fusion technology is surveyed. Limited reserves of fossil fuel and dangers of proliferation from nuclear reactors have brought into focus the need to develop an optional energy source. Fusion is being looked upon as an optional energy source which is free from environmental hazards unlike fossil fuels and nuclear reactors. Investments in R and D of fusion energy have increased rapidly in USA, Japan, USSR and European countries. Out of the various fusion fuels known, a mixture of D and T is widely chosen. The main problem in fusion technology is the confinement of plasma for a time sufficient to start the fusion reaction. This can be done magnetically or inertially. The three approaches to magnetic confinement are : (1) tokamak, (2) mirror and (3) pinch. Inertial confinement makes use of lasers or electron beams or ion beams. Both the methods of confinement i.e. magnetic and inertial have problems which are identified and their nature is discussed. (M.G.B.)

  1. Nanometals - Status and perspective

    International Nuclear Information System (INIS)

    Faester, S.; Hansen, N.; Huang, X.; Juul Jensen, D.; Ralph, B.

    2012-01-01

    Nanometals and nanotechnology have over the years been covered in papers, books and conferences - also in many Risoe International Symposia, where the 30th in 2009 dealt solely with nanostructured metals. Since then, rapid progress has been made in synthesis, characterization and modeling, and it is timely to discuss status and perspective also with a view on applications in an international forum such as the Risoe Symposium. Both keynote and contributed papers address important current problems illustrating global research and development in this field. Examples are the development of new synthesis techniques followed by characterization and modeling of microstructures both in 2D and 3D now starting to bridge the micrometer scales. The vital area of mechanical behavior is addressed by the development of new testing techniques and a broad effort to characterize and model mechanical properties of metals strengthened by dislocations and twins. This research has now led to new understanding of both strengthening mechanisms and strengh structure relationships based on experiments in combination with analytical and numerical modeling. The holistic approach to research on nanometals demonstrated by these proceedings can guide both scientists and technologists in their future work also with the aim of introducing into society this new group of advanced materials. Such an effort is important, as science and technology today is significantly affected by politics of governments and international institutions, and therefore a new initiative in the pressent is to include a discussion of research and development in the area of nanometals i USA, China and Japan. (Author)

  2. Nanometals - Status and perspective

    Energy Technology Data Exchange (ETDEWEB)

    Faester, S.; Hansen, N.; Huang, X.; Juul Jensen, D.; Ralph, B. (eds.)

    2012-11-01

    Nanometals and nanotechnology have over the years been covered in papers, books and conferences - also in many Risoe International Symposia, where the 30th in 2009 dealt solely with nanostructured metals. Since then, rapid progress has been made in synthesis, characterization and modeling, and it is timely to discuss status and perspective also with a view on applications in an international forum such as the Risoe Symposium. Both keynote and contributed papers address important current problems illustrating global research and development in this field. Examples are the development of new synthesis techniques followed by characterization and modeling of microstructures both in 2D and 3D now starting to bridge the micrometer scales. The vital area of mechanical behavior is addressed by the development of new testing techniques and a broad effort to characterize and model mechanical properties of metals strengthened by dislocations and twins. This research has now led to new understanding of both strengthening mechanisms and strengh structure relationships based on experiments in combination with analytical and numerical modeling. The holistic approach to research on nanometals demonstrated by these proceedings can guide both scientists and technologists in their future work also with the aim of introducing into society this new group of advanced materials. Such an effort is important, as science and technology today is significantly affected by politics of governments and international institutions, and therefore a new initiative in the pressent is to include a discussion of research and development in the area of nanometals i USA, China and Japan. (Author)

  3. Status of load management

    Energy Technology Data Exchange (ETDEWEB)

    Juchymenko, A

    1983-08-01

    A summary is presented of the status of load management, defined as any activity by an electric utility to affect the size and characteristics of its load. Load management is currently viewed by electric utilities as an important tool for marketing electricity in a competitive fuel situation. A major aim of the National Energy Program is to reduce Canada's dependence on oil by 1990 to 10% of the energy used by all markets. As a result, electricity may play a greater role in the supply of primary energy. Research in load management has been directed mostly towards the residential market, especially direct control of domestic hot water heaters and air conditioners. Studies conducted in Canada and the U.S. to determine user's receptiveness to direct control of loads and thermal energy storage systems indicate that these load management techniques are in most cases not acceptable to customers, who prefer voluntary reduction in demand. The potential exists in the industrial market to use load management to assist in electrifying many of the fossil fuel-fired processes at competitive energy prices. Some of the more important applications include an industrial heat pump to heat liquids to 120{degree}C, induction heating for melting and heat treating of metals, and mechanical vapor recompression equipment to produce proces steam. 21 refs., 2 figs., 2 tabs.

  4. TESLA Test Facility. Status

    International Nuclear Information System (INIS)

    Aune, B.

    1996-01-01

    The TESLA Test Facility (TTF), under construction at DESY by an international collaboration, is an R and D test bed for the superconducting option for future linear e+/e-colliders. It consists of an infrastructure to process and test the cavities and of a 500 MeV linac. The infrastructure has been installed and is fully operational. It includes a complex of clean rooms, an ultra-clean water plant, a chemical etching installation and an ultra-high vacuum furnace. The linac will consist of four cryo-modules, each containing eight 1 meter long nine-cell cavities operated at 1.3 GHz. The base accelerating field is 15 MV/m. A first injector will deliver a low charge per bunch beam, with the full average current (8 mA in pulses of 800 μs). A more powerful injector based on RF gun technology will ultimately deliver a beam with high charge and low emittance to allow measurements necessary to qualify the TESLA option and to demonstrate the possibility of operating a free electron laser based on the Self-Amplified-Spontaneous-Emission principle. Overview and status of the facility will be given. Plans for the future use of the linac are presented. (R.P.)

  5. Differentiation of HIV-associated lymphoma from HIV-associated reactive adenopathy using quantitative FDG PET and symmetry

    Energy Technology Data Exchange (ETDEWEB)

    Mhlanga, Joyce C.; Durand, Daniel; Leal, Jeffrey P. [Johns Hopkins University School of Medicine, Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Tsai, Hua-Ling; Wang, Hao [Johns Hopkins University School of Medicine, Department of Oncology Biostatistics Division, Baltimore, MD (United States); Durand, Christine M.; Moore, Richard [Johns Hopkins University School of Medicine, Maryland Infectious Diseases Department, Baltimore, MD (United States); Wahl, Richard L. [Johns Hopkins University School of Medicine, Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Sciences, Baltimore, MD (United States); Johns Hopkins University School of Medicine, Department of Oncology, Baltimore, MD (United States)

    2014-04-15

    To determine the diagnostic accuracy of a semiautomated {sup 18}F-FDG PET/CT measurement of total lesion glycolysis (TLG), maximum and peak standardized uptake value at lean body mass (SUL-Max and SUL-Peak), qualitative estimates of left/right nodal symmetry and FDG uptake for differentiating lymphoma from reactive adenopathy in HIV-infected patients. We retrospectively analyzed 41 whole-body {sup 18}F-FDG PET/CT studies performed in HIV-infected patients for clinical reasons. The study received institutional review board approval. Of the 41 patients, 19 had biopsy-proven untreated lymphoma, and 22 with reactive adenopathy without malignancy on follow-up were used as controls. Nodal and extranodal visual qualitative metabolic scores, SUL-Max, SUL-Peak, CT nodal size, and PERCIST 1.0 threshold-based TLG and metabolic tumor volume (MTV) were determined. The qualitative intensity of nodal involvement and symmetry of uptake were compared using receiver operator curve (ROC) analysis. HIV plasma viral RNA measurements were also obtained. All of the quantitative PET metrics performed well in differentiating lymphoma from reactive adenopathy and performed better than qualitative visual intensity scores. The areas under the ROC curves (AUC) were significantly higher for TLG = 0.96, single SUL-Peak = 0.96, single SUL-Max = 0.97, and MTV = 0.96, compared to 0.67 for CT nodal size (p < 0.001). These PET metrics performed best in separating the two populations in aviremic patients, with AUCs of 1 (AUC 0.91 for CT nodal size). TLG, MTV, SUL-Peak and SUL-Max were more reliable markers among viremic individuals, with AUCs between 0.84 and 0.93, compared to other metrics. PET metrics were significantly correlated with plasma viral load in HIV-reactive adenopathy controls. Asymmetrical FDG uptake had an accuracy of 90.4 % for differentiating lymphoma from reactive adenopathy in HIV-infected patients. Quantitative PET metabolic metrics as well as the qualitative assessment of symmetry of nodal uptake appear to be valuable tools for differentiating lymphoma from reactive adenopathy in HIV-infected patients using FDG PET. These parameters appear more robust in aviremic patients. (orig.)

  6. Status of ITER

    International Nuclear Information System (INIS)

    Aymar, R.

    2002-01-01

    At the end of engineering design activities (EDA) in July 2001, all the essential elements became available to make a decision on construction of ITER. A sufficiently detailed and integrated engineering design now exists for a generic site, has been assessed for feasibility, and costed, and essential physics and technology R and D has been carried out to underpin the design choices. Formal negotiations have now begun between the current participants--Canada, Euratom, Japan, and the Russian Federation--on a Joint Implementation Agreement for ITER which also establishes the legal entity to run ITER. These negotiations are supported on technical aspects by Coordinated Technical Activities (CTA), which maintain the integrity of the project, for the good of all participants, and concentrate on preparing for procurement by industry of the longest lead items, and for formal application for a construction license with the host country. This paper highlights the main features of the ITER design. With cryogenically-cooled magnets close to neutron-generating plasma, the design of shielding with adequate access via port plugs for auxiliaries such as heating and diagnostics, and of remote replacement and refurbishing systems for in-vessel components, are particularly interesting nuclear technology challenges. Making a safety case for ITER to satisfy potential regulators and to demonstrate, as far as possible at this stage, the environmental attractiveness of fusion as an energy source, is also important. The paper gives illustrative details on this work, and an update on the progress of technical preparations for construction, as well as the status of the above negotiations

  7. Status of thorium technology

    International Nuclear Information System (INIS)

    Garg, R.K.; Raghavan, R.V.; Karve, V.M.; Narayandas, G.R.

    1977-01-01

    Although a number of studies have been conducted in various countries to evolve reactor systems based on thorium fuel cycle, its use, so far, is limited to only a few reactors. However, for countries having large reserves of thorium, its utilization is of great significance for their nuclear power programmes. Reasonably assured world resources of thorium in the lower price range have been estimated at more than 500,000 tons of ThO 2 . While most of these resources are in placer deposits in various parts of the world, some vein deposits and uranium ores are other important sources of thorium. Monazite, the most important mineral of thorium, is found in the beach sand deposits along with other heavy minerals like ilmenite, rutile, zircon, and sillimanite etc. Mining of these deposits is usually carried out by suction dredging and separation of monazite from other minerals is effected by a combination of magnetic, electrostatic and gravity separation techniques. Chemical processing of monazite is carried out either by sulphuric acid or caustic treatment, followed by separation of the rare earths and thorium by partial precipitation or leaching. The thorium concentrate is further processed to obtain mantle grade thorium nitrate by chemical purification steps whereas solvent extraction using TBP is adopted for making nuclear-grade material. The purified thorium nitrate is converted to the oxide usually by precipitation as oxalate followed by calcination. The oxide is reduced directly with calcium or converted to the chloride or fluoride and then reduced by calcium or magnesium to obtain thorium metal. Various fuel designs based on the metal or its alloys, mixed oxides or carbides, and dispersed type fuel elements have been developed and accordingly, different fabrication techniques have been employed. Work on irradiation of thorium containing fuel elements and separation of U 233 is being carried out. This paper reviews the status of thorium technology in the world with

  8. Status of funded actions

    International Nuclear Information System (INIS)

    2003-01-01

    The GEDEPEON status workshop is organised to review the GEDEPEON research actions, which have been funded in 2003. Presentations are made by research teams actively involved in GEDEPEON research areas. Speakers were invited to show how the presented research data are related to the general goals of transmutation, for which 2006 is an important milestone, and innovative systems. This document gathers 18 presentations (slides) among the 32 given at this workshop and dealing with: 1 - nuclear data: measurement of cross-sections of neutron induced reactions at the nTof time of flight facilities of CERN and of Gelina at Geel (F. Gunsing), study of (n,xn) reactions thanks to prompt gamma spectroscopy (M. Kerveno), iodine 129 cross-sections (G. Noguere); 2 - reactor physics/cycles: CEA-CNRS scenarios (F. Varaine, D. Heuer), analysis of uncertainties and sensitivity factors of nuclear data on innovative systems (molten-salt reactors) (A. Bidaud); 3 - materials: contribution to the study of T91 steel fatigue by lead-bismuth (D. Gorse), kinetics and mechanisms of fatigue by liquid metals (V. Laporte), studies of molten salts corrosion in future reactors (S. Sanchez), stress-induced fatigue by liquid metal (A. Verleene), thermodynamic study of the Bi-Fe-Hg-O-Pb quinary system (A. Maitre), synchrotron imaging study of fatigue by liquid metals (D. Bellet); 4 - future systems: molten salts reprocessing strategy - impact on the molten salt reactors neutronics (L. Mathieu), microscopy technique for the characterization of the thermal properties of inert materials for gas-cooled reactors (L. David), modeling and application of sub-atomic phenomena (J. Maillard), forecasting of the chemical compatibility between fissile compounds and inert materials in future high temperature reactors using a thermodynamical approach (A. Maitre), hydrogen production by thermochemical cycles (S. Colette), development of Ni-W refractory alloys for high temperature and molten salts reactors (J

  9. Between Status and Contract?

    Directory of Open Access Journals (Sweden)

    Thorsten Keiser

    2013-01-01

    Full Text Available This contribution deals with unfree labour in Germany from the early modern age until the beginning of the 20th century. It presents the main conclusions of a book published in 2013 on this subject in German. Unfree labour is not identified in the first place with slavery or any other labour relationship based on status. Instead, this study aims at an analysis of freedom and coercion in contractual labour relationships. It will be argued that in Germany contractual labour relationships before 1800 were embedded in a legal system that strongly restricted contractual autonomy and aimed at the suppression of free labour markets. The scope of this legislation was to guarantee efficient labour performance, which was not only perceived as being in the personal interest of an employer, but as a fundamental element of the common good. After 1800 the system changed to more incentive-based legislation that established freedom of contract for labour relations. Nevertheless, coercion in order to perform the contractual duties of a work contract remained important for many groups of workers, especially farmhands and industrial workers. The last criminal sanctions for breaches of labour contracts were only abolished in the revolution of 1919. This development shows the difficulties German law had in extending the principles of private law to workers. When a system of free labour was fully established, the issue of unemployment and economic problems, especially in the Weimar Republic, required a new system of protective rules. The history of free market based labour contracts in Germany was therefore very short, with state intervention shi ing from control and coercion to social assistance.

  10. Treatment of Established Status Epilepticus.

    Science.gov (United States)

    Falco-Walter, Jessica J; Bleck, Thomas

    2016-04-25

    Status epilepticus is the most severe form of epilepsy, with a high mortality rate and high health care costs. Status epilepticus is divided into four stages: early, established, refractory, and super-refractory. While initial treatment with benzodiazepines has become standard of care for early status epilepticus, treatment after benzodiazepine failure (established status epilepticus (ESE)) is incompletely studied. Effective treatment of ESE is critical as morbidity and mortality increases dramatically the longer convulsive status epilepticus persists. Phenytoin/fosphenytoin, valproic acid, levetiracetam, phenobarbital, and lacosamide are the most frequently prescribed antiseizure medications for treatment of ESE. To date there are no class 1 data to support pharmacologic recommendations of one agent over another. We review each of these medications, their pharmacology, the scientific evidence in support and against each in the available literature, adverse effects and safety profiles, dosing recommendations, and limitations of the available evidence. We also discuss future directions including the established status epilepticus treatment trial (ESETT). Substantial further research is urgently needed to identify these patients (particularly those with non-convulsive status epilepticus), elucidate the most efficacious antiseizure treatment with head-to-head randomized prospective trials, and determine whether this differs for convulsive vs. non-convulsive ESE.

  11. Treatment of Established Status Epilepticus

    Science.gov (United States)

    Falco-Walter, Jessica J.; Bleck, Thomas

    2016-01-01

    Status epilepticus is the most severe form of epilepsy, with a high mortality rate and high health care costs. Status epilepticus is divided into four stages: early, established, refractory, and super-refractory. While initial treatment with benzodiazepines has become standard of care for early status epilepticus, treatment after benzodiazepine failure (established status epilepticus (ESE)) is incompletely studied. Effective treatment of ESE is critical as morbidity and mortality increases dramatically the longer convulsive status epilepticus persists. Phenytoin/fosphenytoin, valproic acid, levetiracetam, phenobarbital, and lacosamide are the most frequently prescribed antiseizure medications for treatment of ESE. To date there are no class 1 data to support pharmacologic recommendations of one agent over another. We review each of these medications, their pharmacology, the scientific evidence in support and against each in the available literature, adverse effects and safety profiles, dosing recommendations, and limitations of the available evidence. We also discuss future directions including the established status epilepticus treatment trial (ESETT). Substantial further research is urgently needed to identify these patients (particularly those with non-convulsive status epilepticus), elucidate the most efficacious antiseizure treatment with head-to-head randomized prospective trials, and determine whether this differs for convulsive vs. non-convulsive ESE. PMID:27120626

  12. Large block test status report

    International Nuclear Information System (INIS)

    Wilder, D.G.; Lin, W.; Blair, S.C.

    1997-01-01

    This report is intended to serve as a status report, which essentially transmits the data that have been collected to date on the Large Block Test (LBT). The analyses of data will be performed during FY98, and then a complete report will be prepared. This status report includes introductory material that is not needed merely to transmit data but is available at this time and therefore included. As such, this status report will serve as the template for the future report, and the information is thus preserved

  13. Status of solar neutrino experiments

    International Nuclear Information System (INIS)

    Beier, E.W.; Davis, R. Jr.; Kim, S.B.; Jelley, N.

    1990-01-01

    A summary of the status of four solar neutrino experiments is presented. The Homestake 37 Cl data are presented and the possible time dependence of the data is addressed. Data from 1040 days of operation of the Kamiokande II detector are presented next. The status of the 71 Ga experiment in the Baksan Neutrino Observatory, which has operated for a short time, is discussed. The summary concludes with a discussion of the status of the Sudbury Neutrino Observatory, which has been under construction since the beginning of 1990. 7 refs., 6 figs

  14. Status of women microbiologists.

    Science.gov (United States)

    Kashket, E R; Robbins, M L; Leive, L; Huang, A S

    1974-02-08

    beginning student. For older women, there must be increased placement in positions of responsibility and visibility. Protective practices that discourage women from entering arenas of competition can only be viewed as discrimination on the basis of sex, since women professionals are rarely given the choice between being protected and being independent. Unexpectedly, this study illustrates the lower status of another group of individuals who are considered deviants from the expected roles of the established society-single men with doctorates, who were found in the positions predominately filled by women. In conclusion, this study of a select group of scientists probably has general applicability to all women professionals in their roles vis-à-vis men. Examination and documentation of discriminatory practices based on sex points to the areas in which women must direct their demands for equality.

  15. Immune-Mediated Damage Completes the Parabola: Cryptococcus neoformans Pathogenesis Can Reflect the Outcome of a Weak or Strong Immune Response

    Directory of Open Access Journals (Sweden)

    Liise-anne Pirofski

    2017-12-01

    Full Text Available Cryptococcosis occurs most frequently in immunocompromised individuals. This has led to the prevailing view that this disease is the result of weak immune responses that cannot control the fungus. However, increasingly, clinical and experimental studies have revealed that the host immune response can contribute to cryptococcal pathogenesis, including the recent study of L. M. Neal et al. (mBio 8:e01415-17, 2017, https://doi.org/10.1128/mBio.01415-17 that reports that CD4+ T cells mediate tissue damage in experimental murine cryptococcosis. This finding has fundamental implications for our understanding of the pathogenesis of cryptococcal disease; it helps explain why immunotherapy has been largely unsuccessful in treatment and provides insight into the paradoxical observation that HIV-associated cryptococcosis may have a better prognosis than cryptococcosis in those with no known immune impairment. The demonstration that host-mediated damage can drive cryptococcal disease provides proof of concept that the parabola put forth in the damage-response framework has the flexibility to depict complex and changing outcomes of host-microbe interaction.

  16. Experimental status of quantum electrodynamics

    International Nuclear Information System (INIS)

    Drell, S.D.

    1978-10-01

    This review of the experimental status of quantum electrodynamics covers the fine structure constant, the muon g-2 value, the Lamb shift in hydrogen, the finite proton radius, progress in muonium, and positronium. 37 references

  17. Status of Fermilab E-710

    International Nuclear Information System (INIS)

    Rubinstein, R.

    1993-08-01

    This report give the current status of E-710, an experiment at the Fermilab bar pp Tevatron Collider to measure elastic scattering, total cross sections and diffraction dissociation up to √s = 1.8 TeV

  18. Status of time reversal invariance

    International Nuclear Information System (INIS)

    Henley, E.M.

    1989-01-01

    Time Reversal Invariance is introduced, and theories for its violation are reviewed. The present experimental and theoretical status of Time Reversal Invariance and tests thereof will be presented. Possible future tests will be discussed. 30 refs., 2 figs., 1 tab

  19. Fusion technology status and requirements

    International Nuclear Information System (INIS)

    Thomassen, K.I.

    1982-01-01

    This paper summarizes the status of fusion technology and discusses the requirements to be met in order to build a demonstration fusion plant. Strategies and programmatic considerations in pursuing engineering feasibility are also outlined

  20. Refugee status determination: three challenges

    Directory of Open Access Journals (Sweden)

    Martin Jones

    2009-04-01

    Full Text Available Refugee status determination (RSD, which is vital to the protection of so many asylum seekers worldwide, is at best an imperfect, haphazard and challenging process. It merits greater attention and appropriate reform.

  1. Status report on pavement management.

    Science.gov (United States)

    1984-01-01

    This report traces the developments in pavement management in the Virginia Department of Highways and Transportation from the initial efforts in the mid-1970s through early 1984. Included are status reports on pavement management for the interstate, ...

  2. Fukushima Daiichi Status Report. 28 June 2012

    International Nuclear Information System (INIS)

    2012-01-01

    The IAEA issues regular status reports to the public on the current status of the Fukushima Daiichi Nuclear Power Plant, including information on environmental radiation monitoring, the status of workers, and current conditions on-site at the plant.

  3. Coagulation Status in Hidradenitis Suppurativa

    DEFF Research Database (Denmark)

    Miller, Iben Marie; Johansen, Maria Egede; Mogensen, Ulla B

    2015-01-01

    BACKGROUND: Chronic inflammatory diseases other than hidradenitis suppurativa (HS) have been associated with prothrombotic/hypercoagulable status. OBJECTIVE: To investigate a possible association between the chronic inflammatory skin disease HS and prothrombotic/hypercoagulable state. METHODS: We.......3432). CONCLUSION: We did not find an association between HS and prothrombotic/hypercoagulable status. Thus, thrombocytes may not be activated in HS. Furthermore, INR may not be affected in HS, suggesting that intrinsic and vitamin K-dependent coagulation factors appear unaffected....

  4. The status of BAT detector

    Science.gov (United States)

    Lien, Amy; Markwardt, Craig B.; Krimm, Hans Albert; Barthelmy, Scott D.; Cenko, Bradley

    2018-01-01

    We will present the current status of the Swift/BAT detector. In particular, we will report the updated detector gain calibration, the number of enable detectors, and the global bad time intervals with potential calibration issues. We will also summarize the results of the yearly BAT calibration using the Crab nebula. Finally, we will discuss the effects on the BAT survey, such as the sensitivity, localization, and spectral analysis, due to the changes in detector status.

  5. Present status of CP violation

    International Nuclear Information System (INIS)

    Ng, J.N.

    1989-06-01

    A review of the status of CP violation in kaons is given. Status of our knowledge of quark mixing angles in the standard six quark model is presented. The role Β d o - Βd o transition plays in this study is examined. A comparison of the estimates of CP violation effects from models beyond the standard one is given. Other experiments that have the capability of testing different CP violation models are also discussed. (Author) 35 refs., 6 figs., tab

  6. Status report, canister fabrication

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Claes-Goeran; Eriksson, Peter; Westman, Marika [Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden); Emilsson, Goeran [CSM Materialteknik AB, Linkoeping (Sweden)

    2004-06-01

    The report gives an account of the development of material and fabrication technology for copper canisters with cast inserts during the period from 2000 until the start of 2004. The engineering design of the canister and the choice of materials in the constituent components described in previous status reports have not been significantly changed. In the reference canister, the thickness of the copper shell is 50 mm. Fabrication of individual components with a thinner copper thickness is done for the purpose of gaining experience and evaluating fabrication and inspection methods for such canisters. As a part of the development of cast inserts, computer simulations of the casting processes and techniques used at the foundries have been performed for the purpose of optimizing the material properties. These properties have been evaluated by extensive tensile testing and metallographic inspection of test material taken from discs cut at different points along the length of the inserts. The testing results exhibit a relatively large spread. Low elongation values in certain tensile test specimens are due to the presence of poorly formed graphite, porosities, slag or other casting defects. It is concluded in the report that it will not be possible to avoid some presence of observed defects in castings of this size. In the deep repository, the inserts will be exposed to compressive loading and the observed defects are not critical for strength. An analysis of the strength of the inserts and formulation of relevant material requirements must be based on a statistical approach with probabilistic calculations. This work has been initiated and will be concluded during 2004. An initial verifying compression test of a canister in an isostatic press has indicated considerable overstrength in the structure. Seamless copper tubes are fabricated by means of three methods: extrusion, pierce and draw processing, and forging. It can be concluded that extrusion tests have revealed a

  7. Status report, canister fabrication

    International Nuclear Information System (INIS)

    Andersson, Claes-Goeran; Eriksson, Peter; Westman, Marika; Emilsson, Goeran

    2004-06-01

    The report gives an account of the development of material and fabrication technology for copper canisters with cast inserts during the period from 2000 until the start of 2004. The engineering design of the canister and the choice of materials in the constituent components described in previous status reports have not been significantly changed. In the reference canister, the thickness of the copper shell is 50 mm. Fabrication of individual components with a thinner copper thickness is done for the purpose of gaining experience and evaluating fabrication and inspection methods for such canisters. As a part of the development of cast inserts, computer simulations of the casting processes and techniques used at the foundries have been performed for the purpose of optimizing the material properties. These properties have been evaluated by extensive tensile testing and metallographic inspection of test material taken from discs cut at different points along the length of the inserts. The testing results exhibit a relatively large spread. Low elongation values in certain tensile test specimens are due to the presence of poorly formed graphite, porosities, slag or other casting defects. It is concluded in the report that it will not be possible to avoid some presence of observed defects in castings of this size. In the deep repository, the inserts will be exposed to compressive loading and the observed defects are not critical for strength. An analysis of the strength of the inserts and formulation of relevant material requirements must be based on a statistical approach with probabilistic calculations. This work has been initiated and will be concluded during 2004. An initial verifying compression test of a canister in an isostatic press has indicated considerable overstrength in the structure. Seamless copper tubes are fabricated by means of three methods: extrusion, pierce and draw processing, and forging. It can be concluded that extrusion tests have revealed a

  8. Conceptions of nuclear threshold status

    International Nuclear Information System (INIS)

    Quester, G.H.

    1991-01-01

    This paper reviews some alternative definitions of nuclear threshold status. Each of them is important, and major analytical confusions would result if one sense of the term is mistaken for another. The motives for nations entering into such threshold status are a blend of civilian and military gains, and of national interests versus parochial or bureaucratic interests. A portion of the rationale for threshold status emerges inevitably from the pursuit of economic goals, and another portion is made more attraction by the derives of the domestic political process. Yet the impact on international security cannot be dismissed, especially where conflicts among the states remain real. Among the military or national security motives are basic deterrence, psychological warfare, war-fighting and, more generally, national prestige. In the end, as the threshold phenomenon is assayed for lessons concerning the role of nuclear weapons more generally in international relations and security, one might conclude that threshold status and outright proliferation coverage to a degree in the motives for all of the states involved and in the advantages attained. As this paper has illustrated, nuclear threshold status is more subtle and more ambiguous than outright proliferation, and it takes considerable time to sort out the complexities. Yet the world has now had a substantial amount of time to deal with this ambiguous status, and this may tempt more states to exploit it

  9. Is Subjective Status Influenced by Psychosocial Factors?

    OpenAIRE

    Lundberg, Johanna; Kristenson, Margareta

    2008-01-01

    Objective Associations between subjective status and health are still relatively unexplored. This study aimed at testing whether subjective status is uniquely confounded by psychosocial factors compared to objective status, and what factors that may predict subjective status. Design A cross-sectional analysis of a population-based, random sample of 795 middle-aged men and women from the southeast of Sweden. Questionnaires included subjective status, objective measures of socioeconomic status,...

  10. LARGE BLOCK TEST STATUS REPORT

    International Nuclear Information System (INIS)

    D.G. WILDER, W. LIN, S.C. BLAIR, T. BUSCHECK, R.C. CARLSON, K. LEE, A. MEIKE, A.L. RAMIREZ, J.L. WAGONER, AND J. WANG

    1997-01-01

    This report is intended to serve as a status report, which essentially transmits the data that have been collected to date on the Large Block Test (LBT). The analyses of data will be performed during FY98, and then a complete report will be prepared. This status report includes introductory material that is not needed merely to transmit data but is available at this time and therefore included. As such, this status report will serve as the template for the future report, and the information is thus preserved. The United States Department of Energy (DOE) is investigatinq the suitability of Yucca Mountain (YM) as a potential site for the nation's first high-level nuclear waste repository. As shown in Fig. 1-1, the site is located about 120 km northwest of Las Vegas, Nevada, in an area of uninhabited desert

  11. Predicting outcome of status epilepticus.

    Science.gov (United States)

    Leitinger, M; Kalss, G; Rohracher, A; Pilz, G; Novak, H; Höfler, J; Deak, I; Kuchukhidze, G; Dobesberger, J; Wakonig, A; Trinka, E

    2015-08-01

    Status epilepticus (SE) is a frequent neurological emergency complicated by high mortality and often poor functional outcome in survivors. The aim of this study was to review available clinical scores to predict outcome. Literature review. PubMed Search terms were "score", "outcome", and "status epilepticus" (April 9th 2015). Publications with abstracts available in English, no other language restrictions, or any restrictions concerning investigated patients were included. Two scores were identified: "Status Epilepticus Severity Score--STESS" and "Epidemiology based Mortality score in SE--EMSE". A comprehensive comparison of test parameters concerning performance, options, and limitations was performed. Epidemiology based Mortality score in SE allows detailed individualization of risk factors and is significantly superior to STESS in a retrospective explorative study. In particular, EMSE is very good at detection of good and bad outcome, whereas STESS detecting bad outcome is limited by a ceiling effect and uncertainty of correct cutoff value. Epidemiology based Mortality score in SE can be adapted to different regions in the world and to advances in medicine, as new data emerge. In addition, we designed a reporting standard for status epilepticus to enhance acquisition and communication of outcome relevant data. A data acquisition sheet used from patient admission in emergency room, from the EEG lab to intensive care unit, is provided for optimized data collection. Status Epilepticus Severity Score is easy to perform and predicts bad outcome, but has a low predictive value for good outcomes. Epidemiology based Mortality score in SE is superior to STESS in predicting good or bad outcome but needs marginally more time to perform. Epidemiology based Mortality score in SE may prove very useful for risk stratification in interventional studies and is recommended for individual outcome prediction. Prospective validation in different cohorts is needed for EMSE, whereas

  12. [Nutritional status and the relationship regarding functional status after stroke].

    Science.gov (United States)

    López Espuela, Fidel; Portilla Cuenca, Juan Carlos; Holguín Mohedas, Marta; Párraga Sánchez, José Manuel; Cordovilla-Guardia, Sergio; Casado Naranjo, Ignacio

    2017-09-14

    To assess the nutritional status (NS) of patients at three months of suffering a stroke, and to establish the relationship between functional recovery and complications in this period. A cross-sectional observational study evaluating the NS of patients older than 65 years at three months of having a stroke. The NS was assessed using the Mini Nutritional Assessment (MNA). Sociodemographic and anthropometric data, cardiovascular risk factors, as well as functional status (through the Barthel index and the modified Rankin scale) and the presented complications were collected. One hundred and three patients were included, with a medium age of 75.81 (± 6.73). The MNA score was 23.13 points (± 4.47); 8.2% had malnutrition and 38.1% had risk of malnutrition. There were no differences in the NS between women and men (p = 0.076) neither relation of the NS with age. NS deficiency was associated with poorer function (r = 0.608; p nutritional status had a better quality of life (r = 0.506; p < 0.001). It was also associated with poorer socioeconomic status (p = 0.020) and institutionalization (p = 0.004). The risk of malnutrition is common in stroke survivors at the short-term. This NS is associated with a worse functional situation and self-perceived quality of life and with a higher rate of complications. Early detection of the risk of malnutrition is essential in patients who have suffered a stroke.

  13. Status of spallation neutron source

    Energy Technology Data Exchange (ETDEWEB)

    Oyama, Yukio [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1997-03-01

    Existing and planned facilities using proton accelerator driven spallation neutron source are reviewed. These include new project of neutron science proposed from Japan Atomic Energy Research Institute. The present status of facility requirement and accelerator technology leads us to new era of neutron science such as neutron scattering research and nuclear transmutation study using very intense neutron source. (author)

  14. Status of Japanese university reactors

    International Nuclear Information System (INIS)

    Fujita, Yoshiaki

    1999-01-01

    Status of Japanese university reactors, their role and value in research and education, and the spent fuel problem are presented. Some of the reactors are now faced by severe difficulties in continuing their operation services. The point of measures to solve the difficulties is suggested. (author)

  15. The Epistemic Status of Intelligence

    DEFF Research Database (Denmark)

    Rønn, Kira Vrist; Høffding, Simon

    2012-01-01

    We argue that the majority of intelligence definitions fail to recognize that the normative epistemic status of intelligence is knowledge and not an inferior alternative. We refute the counter-arguments that intelligence ought not to be seen as knowledge because of 1) its action-oriented scope...... and robustness of claims to intelligence-knowledge can be assessed....

  16. RD39 Status Report 2009

    CERN Document Server

    Anbinderis, P; Bates, R; Bol, H; Buttar, C; Chen, W; Cindro, V; de Boer, W; Eremin, V; Gaubas, E; Grigoriev, E; Härkönen, J; Heijne, E; Heising, S; Ilyashenko, I; Kalesinskas, V; Krause, M; Li, Z; Luukka, P; Mäenpää, T; Mandi, I; Mikuz, M; Mueller, S; Niinikoski, T; O'Shea, V; Parkes, C; Pusa, P; Räisänen, J; Reinhardt, S; Spiegel, L; Tuominen, E; Tuovinen, E; Vaitkus, J; Väyrynen, S; Verbitskaya, E; Zavrtanik, M; CERN. Geneva. The LHC experiments Committee; LHCC

    2010-01-01

    RD39 Status Report 2009. CERN RD39 Collaboration is developing super-radiation hard cryogenic silicon detectors for applications of LHC experiments and their future upgrades. The activities of RD39 Collaboration were focused in 2009 on concept of charge injected detector (CID).

  17. ANTIOXIDANT STATUS IN DIABETIC NEUROPATHY

    Directory of Open Access Journals (Sweden)

    Giriraja Vrushabaiah Kanakapura

    2017-09-01

    Full Text Available BACKGROUND Diabetic neuropathy, retinopathy and nephropathy are the chronic complications of diabetes mellitus. Neuropathy, retinopathy and nephropathy are microvascular complication of diabetes mellitus. Antioxidant status is reduced in DM-induced retinopathy and nephropathy. Present study is undertaken to evaluate the degree of oxidative stress in diabetic neuropathy patients. The aim of the study is to study on oxidative stress as measured by lipid peroxidation marker, malondialdehyde and antienzyme status in type II DM patients with neuropathy and compared them with a controlled nondiabetic group. MATERIALS AND METHODS The study included 100 subjects from Sapthagiri Medical College, Bangalore, from January 1, 2015, to December 31, 2015, of age group 50 to 70 yrs. out of which 50 patients were non-insulin-dependent DM with neuropathy and rest 50 age and sex matched apparently healthy individuals (control group. Antioxidant status was assessed by measuring superoxide dismutase (SOD, glutathione peroxidase (GPx, glutathione reductase (GR, Catalase and Reduced Glutathione (GSH. RESULTS It showed a significant increase p<0.001 in FBS, PPBS, TC, TG, LDL, VLDL, CAT, MDA, while HDL, GSH, GPX, GR and SOD were found to be decreased significantly (p 0.001. CONCLUSION MDA was significantly elevated in diabetic group, whereas antioxidant enzymes superoxide dismutase, glutathione peroxidase, glutathione reductase and reduced glutathione were significantly decreased, which might be helpful in risk assessment of various complications of DM. The data suggests that alteration in antioxidant status and MDA may help to predict the risk of diabetic neuropathy.

  18. DYMAC system: status and experience

    International Nuclear Information System (INIS)

    Malanify, J.J.

    1980-01-01

    The Dynamic Materials Accountability (DYMAC) system has been in operation at the Plutonium Processing Facility at the Los Alamos Scientific Laboratory since January 1978. The current status of this development and demonstration program, as well as the achieved operational experience, is reported

  19. The Medicina Station Status Report

    Science.gov (United States)

    Orfei, Alessandro; Orlati, Andrea; Maccaferri, Giuseppe

    2013-01-01

    General information about the Medicina Radio Astronomy Station, the 32-m antenna status, and the staff in charge of the VLBI observations is provided. In 2012, the data from geodetic VLBI observations were acquired using the Mark 5A recording system with good results. Updates of the hardware were performed and are briefly described.

  20. Present status of processing method

    Energy Technology Data Exchange (ETDEWEB)

    Kosako, Kazuaki [Sumitomo Atomic Energy Industries Ltd., Tokyo (Japan)

    1998-11-01

    Present status of processing method for a high-energy nuclear data file was examined. The NJOY94 code is the only one available to the processing. In Japan, present processing used NJOY94 is orienting toward the production of traditional cross section library, because a high-energy transport code using a high-energy cross section library is indistinct. (author)

  1. Berber Dialects. Materials Status Report.

    Science.gov (United States)

    Center for Applied Linguistics, Washington, DC. Language/Area Reference Center.

    The materials status report for the Berber languages, minority languages spoken in northern Africa, is one of a series intended to provide the nonspecialist with a picture of the availability and quality of texts for teaching various languages to English speakers. The report consists of: (1) a brief narrative description of the Berber language,…

  2. Experimental Status of B Physics

    International Nuclear Information System (INIS)

    Stone, Sheldon

    2006-01-01

    A short summary is given of the current status of B physics. Reasons for physics beyond the Standard Model are discussed. Constraints on New Physics are given using measurements of B mixing, BS mixing, and CP violation, along with |Vub|. Future goals, and upcoming new experiments are also mentioned

  3. Socioeconomic status and fertility decline

    DEFF Research Database (Denmark)

    Dribe, Martin; Breschi, Marco; Gagnon, Alain

    2017-01-01

    America to analyse the relationship between socio-economic status and fertility during the fertility transition. Using comparable analytical models and class schemes for each population, we examined the changing socio-economic differences in marital fertility and related these to common theories...

  4. The status of cold fusion

    Science.gov (United States)

    Storms, E.

    This report attempts to update the status of the phenomenon of cold fusion. The new field is continuing to grow as a variety of nuclear reactions are discovered to occur in a variety of chemical environments at modest temperatures. However, it must be cautioned that most scientists consider cold fusion as something akin to UFO's, ESP, and numerology.

  5. Standards development status. Summary report

    International Nuclear Information System (INIS)

    1981-12-01

    The Standards Development Status Summary Report is designed for scheduling, monitoring, and controlling the process by which Regulatory Standards, Guides, Reports, Petitions, and Environmental Statements are written. It is a summary of the current schedule plans for development of the above products

  6. Experimental status of B decays

    International Nuclear Information System (INIS)

    Horwitz, N.

    1987-01-01

    This paper reviews the status of a number of current B-meson decay topics. Topics reviewed are: B reconstruction, penguins and rare decay modes, is there a charm deficit?, V ub /V bc , new limit on FCNC. Results are presented

  7. The status of 'standard' SUSY

    CERN Document Server

    Zwirner, F

    1992-01-01

    We summarize the present status of low-energy supersymmetry, exemplified by the Minimal Supersymmetric extension of the Standard Model (MSSM). We review the searches for Supersymmetric particles and supersymmetric Higgs bosons. We conclude with some comments on the open theoretical problems related to spontaneous supersymmetry breaking in the underlying fundamental theory.

  8. Status of the OPERA Experiment

    CERN Document Server

    Zimmermann, R.

    2006-01-01

    In this article the physics motivation and the detector design of the OPERA experiment will be reviewed. The construction status of the detector, which will be situated in the CNGS beam from CERN to the Gran Sasso laboratory, will be reported. A survey on the physics performance will be given and the physics plan in 2006 will be presented.

  9. Population and status of women.

    Science.gov (United States)

    Selvaratnam, S

    1988-06-01

    It is difficult to determine the social status or rank of women, since no uniform indicators of status have been approved. Currently, in most Asian and Pacific countries, women make up the majority of illiterates (75% in South Asia; 70% in China), even in areas that have expanded their educational facilities. East and Southeast Asia have succeeded so far in their attempts to increase the enrollment ratios for women (90% female enrollment ratio as opposed to less than 50% in South Asia). Male-female roles seem to be entrenched in the society of all the countries. Women have benefited from an improvement in health care in East and Southeast Asia. In South Asia, female mortality is still very high. In most of the Asian and Pacific countries, female participation in the labor force is relatively low. However, this may be a misnomer, since the estimates do not include domestic workers that produce familial income. Women in the labor force seem to group into 4 major areas: professional and technical, clerical, service, and production work--all of which are usually low paying, low status jobs. Population growth in developing countries seems to have slowed the advancement of women toward greater gender equality by increasing the dependency burden and limiting social and material resources. High fertility rates among women correlate with an increase in illiteracy and a decrease in status improvement through education. Child bearing and home-making place heavy burdens on those women who marry young because of social pressures. Males are normally educated first in these larger families. The correlation of mortality conditions and female status is not currently clear. Rural-to-urban migration of the husband causes a weakening of the wife's status. Migration of some women to urban areas relieves social pressures and allows them to seek employment, but isolates others from a life with which they are familiar. Higher education of women seems to postpone marriage and child

  10. [Health status of elderly persons in Korea].

    Science.gov (United States)

    Choi, Y H; Kim, M S; Byon, Y S; Won, J S

    1990-12-01

    This Study was done to design and test an instrument to measure the health status of the elderly including physical, psychological and social dimensions. Data collection was done from July 18 to August 17, 1990. Subjects were 412 older persons in Korea. A convenience sample was used but the place of residence was stratified into large, medium and small city and rural areas. Participants located in Sudaemun-Gu, Mapo-Gu, and Kangnam-Gu, Seoul were interviewed by brained nursing students, and those in Chungju, Jonju, Chuncheon, and Jinju by professors of nursing colleges. Rural residents were interviewed by community health practitioners working in Kungsang-Buk-Do, Kyngsang-Nam-Do, Jonla Buk-Do, and Kyung Ki-Do. The tool developed for this study was a structured questionnaire based on previous literature and then tested for reliability and validity. This tool contained 20 physical health status items, 17 mental-emotional health status items and 38 social health status items. Physical health status items clustered in to six factors such as personal hygiene, activity, home management, digestive, sexual, sensory, and climatization functions. Mental-emotional health status items clustered into two factors, mental health and emotional health. Social health status items clustered into seven factors, grandparent, parent, spouse, friend, kinships, group member and religious role functions. Data analysis included percentage, average, S.D., t-test and ANOVA. The results of the analysis were as follows: 1. The tool measuring the health status of the elderly and developed for this research had a relatively high reliability indicated by a Cronbach = 0.97793. 2. Average score of the subjects physical health status was 4,054 in a 5 point likert scale, mental-emotional health status was 3.803, social health status was 2.939 and the total average was 3.521. The social status of the subjects was the lowest and the next was mental-emotional health status; physical health status was the

  11. Management of Autoimmune Status Epilepticus

    Directory of Open Access Journals (Sweden)

    Batool F. Kirmani

    2018-05-01

    Full Text Available Status epilepticus is a neurological emergency with increased morbidity and mortality. Urgent diagnosis and treatment are crucial to prevent irreversible brain damage. In this mini review, we will discuss the recent advances in the diagnosis and treatment of autoimmune status epilepticus (ASE, a rare form of the disorder encountered in the intensive care unit. ASE can be refractory to anticonvulsant therapy and the symptoms include subacute onset of short-term memory loss with rapidly progressive encephalopathy, psychiatric symptoms with unexplained new-onset seizures, imaging findings, CSF pleocytosis, and availability of antibody testing makes an earlier diagnosis of ASE possible. Neuroimmunomodulatory therapies are the mainstay in the treatment of ASE. The goal is to maximize the effectiveness of anticonvulsant agents and find an optimal combination of therapies while undergoing immunomodulatory therapy to reduce morbidity and mortality.

  12. HOMEOPATHY TODAY - EDUCATION AND STATUS

    Directory of Open Access Journals (Sweden)

    Snezana M Cupara

    2007-01-01

    Full Text Available Due to its encouaring results, classic homeopathy soon became very popular that a great number of homeopathic hospitals and educational institutions in Europe and America were founded at the end of the 19th century. However, historic events at the beinning of the 20th century diminished its use for the longer period of time. Since 1970, homoeopathy has been reviving in many countries of the world in different domains – educational institutions have appeared, it has been incorporated in many national health systems and there has been research development. Nowadays, homeopathy is recognised in all continents either as an independent or alternative (complementary medical system. Since status of homeopathy and possibilities for education have not been uniformed and standardized in the world, the aim of this article is to offer an abbreviated review on possibilities of education, status and history of homeopathy. The refer belong to developed countries, different continents and neighboring countries.

  13. Distributed systems status and control

    Science.gov (United States)

    Kreidler, David; Vickers, David

    1990-01-01

    Concepts are investigated for an automated status and control system for a distributed processing environment. System characteristics, data requirements for health assessment, data acquisition methods, system diagnosis methods and control methods were investigated in an attempt to determine the high-level requirements for a system which can be used to assess the health of a distributed processing system and implement control procedures to maintain an accepted level of health for the system. A potential concept for automated status and control includes the use of expert system techniques to assess the health of the system, detect and diagnose faults, and initiate or recommend actions to correct the faults. Therefore, this research included the investigation of methods by which expert systems were developed for real-time environments and distributed systems. The focus is on the features required by real-time expert systems and the tools available to develop real-time expert systems.

  14. 2016 Bioenergy Industry Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Moriarty, Kristen L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Milbrandt, Anelia R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Warner, Ethan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lewis, John E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Schwab, Amy A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2018-03-03

    This report provides a snapshot of the bioenergy industry status at the end of 2016. The report compliments other annual market reports from the U.S. Department of Energy’s (DOE’s) Office of Energy Efficiency and Renewable Energy offices and is supported by DOE’s Bioenergy Technologies Office (BETO). The 2016 Bioenergy Industry Status Report focuses on past year data covering multiple dimensions of the bioenergy industry and does not attempt to make future market projections. The report provides a balanced and unbiased assessment of the industry and associated markets. It is openly available to the public and is intended to compliment International Energy Agency and industry reports with a focus on DOE stakeholder needs.

  15. Narcissism and the Pursuit of Status.

    Science.gov (United States)

    Zeigler-Hill, Virgil; Vrabel, Jennifer K; McCabe, Gillian A; Cosby, Cheryl A; Traeder, Caitlin K; Hobbs, Kelsey A; Southard, Ashton C

    2018-04-10

    The purpose of the present studies was to examine the connections that narcissistic admiration and narcissistic rivalry had with various aspects of status. Study 1 examined the associations that narcissism had with the motivation to seek status in a sample of 1,219 community members. Study 2 examined whether narcissism interacted with the status seeking motive to predict how individuals pursued status in a sample of 760 community members and college students. Study 3 used a daily diary approach to examine whether narcissism moderated the associations that daily perceptions of status and affiliation had with state self-esteem in 356 college students. Our results revealed that narcissistic admiration and narcissistic rivalry were somewhat similar in their desire for status but had divergent associations with other aspects of status (e.g., strategies employed to attain status, perceptions of status, reactions to perceived status). The results of the present studies suggest that narcissistic admiration is associated with an agentic orientation to the pursuit of status, whereas narcissistic rivalry is associated with an antagonistic orientation to the pursuit of status. Discussion focuses on the implications of these results for our understanding of the connections between narcissism and status. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  16. Status report on ILDG activities

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, K. [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC

    2006-09-15

    A status report about the International Lattice Data Grid (ILDG) is given. Different countries participating in the ILDG have created regional lattice data grid solutions that are implemented, working and used. The remaining task and the focus of present activities is the development of the interoperability of these regional grids. A first, successful step in this direction is a metadata catalogue service which is already working interoperable. (orig.)

  17. Status report on ILDG activities

    International Nuclear Information System (INIS)

    Jansen, K.

    2006-09-01

    A status report about the International Lattice Data Grid (ILDG) is given. Different countries participating in the ILDG have created regional lattice data grid solutions that are implemented, working and used. The remaining task and the focus of present activities is the development of the interoperability of these regional grids. A first, successful step in this direction is a metadata catalogue service which is already working interoperable. (orig.)

  18. Subcutaneous emphysema during status astmaticus

    International Nuclear Information System (INIS)

    Schwarz, E.

    1985-01-01

    Spontaneous subcutaneous accumulations of air in the soft parts of the thorax during an asthmatic crisis (status asthmaticus) are rarely seen. The pathomechanism of the phenomenon, which may lead to the formation of an emphysema of the soft parts via the pneumomediastinum, is discussed, and the possible complications which must be taken into account are pointed out. The value of radiological examination of the thorax in children suffering from asthma bronchiale, is explained briefly. (orig.) [de

  19. The status of perturbative QCD

    International Nuclear Information System (INIS)

    Ellis, R.K.

    1988-10-01

    The advances in perturbative QCD are reviewed. The status of determinations of the coupling constant α/sub S/ and the parton distribution functions is presented. New theoretical results on the spin dependent structure functions of the proton are also reviewed. The theoretical description of the production of vector bosons, jets and heavy quarks is outlined with special emphasis on new results. Expected rates for top quark production at hadronic colliders are presented. 111 refs., 8 figs

  20. Status of the MAGIC telescopes

    Energy Technology Data Exchange (ETDEWEB)

    Colin, Pierre; Carmona, Emiliano; Schweizer, Thomas; Sitarek, Julian [Max-Planck-Institut fuer Physik, Werner-Heisenberg Institut, Muenchen (Germany)

    2010-07-01

    MAGIC is a system of two 17-m Cherenkov telescopes located on La Palma (Canary islands),sensitive to gamma-rays above 30 GeV. It has been recently upgraded by a second telescope which strongly improves the sensitivity, particularly at low energy. Here we present the status of the MAGIC telescopes and an overview of the recent results obtained in single or stereoscopic mode. We also discuss the real performance of the new stereoscopic system based on Crab Nebula observations.

  1. Photoprotection and vitamin D status.

    Science.gov (United States)

    Springbett, Peter; Buglass, Surhi; Young, Antony R

    2010-11-03

    The adverse effects of solar ultraviolet radiation on the skin are well documented, especially in fair-skinned people. These can be ameliorated by photoprotection strategies advocated by many public health bodies and typically include sun avoidance, sunscreen use and clothing. The UVB waveband which is the main cause of all adverse effects investigated in the laboratory to date is also the waveband for vitamin D photosynthesis which is the only established benefit of solar exposure. This is especially important because solar UVB is the main source of vitamin D for most people. There is increasing evidence that vitamin D plays a much greater role in human health than was previously thought. This has given rise to concerns that photoprotection, especially sunscreen use, could adversely affect vitamin D status and human health. Furthermore, it is stated that people with heavily pigmented skins often have poor vitamin D status because of photoprotection by melanin. In this paper we review the effect of photoprotection strategies and pigmentation on vitamin D status. Clothing can clearly be very effective at inhibiting vitamin D synthesis. Sunscreens are effective in theory and some limited human studies support this. However, most studies show little or no effect and the most likely reason for this is that sunscreens have not been applied in the manner that was used to determine their labelled index of protection against sunburn. This could change in the future if public health campaigns and the sunscreen industry are successful in encouraging the public to apply sunscreens more liberally and/or use much higher levels of labelled protection. The role of melanin on vitamin D status is not clear and requires further investigation. Copyright © 2010. Published by Elsevier B.V.

  2. Happiness and Sexual Minority Status.

    Science.gov (United States)

    Thomeer, Mieke Beth; Reczek, Corinne

    2016-10-01

    We used logistic regression on nationally representative data (General Social Survey, N = 10,668 and N = 6680) to examine how sexual minority status related to happiness. We considered two central dimensions of sexual minority status-sexual behavior and sexual identity. We distinguished between same-sex, both-sex, and different-sex-oriented participants. Because individuals transition between sexual behavior categories over the life course (e.g., from both-sex partners to only same-sex partners) and changes in sexual minority status have theoretical associations with well-being, we also tested the associations of transitions with happiness. Results showed that identifying as bisexual, gay, or lesbian, having both male and female partners since age 18, or transitioning to only different-sex partners was negatively related to happiness. Those with only same-sex partners since age 18 or in the past 5 years had similar levels of happiness as those with only different-sex partners since age 18. Additional tests showed that the majority of these happiness differences became non-significant when economic and social resources were included, indicating that the lower happiness was a product of structural and societal forces. Our findings clearly and robustly underscored the importance of taking a multi-faceted approach to understanding sexuality and well-being, demonstrating that not all sexual minority groups experience disadvantaged happiness. Our study calls for more attention to positive aspects of well-being such as happiness in examinations of sexual minorities and suggests that positive psychology and other happiness subfields should consider the role of sexual minority status in shaping happiness.

  3. The WIMP Paradigm: Current Status

    International Nuclear Information System (INIS)

    Feng, Jonathan

    2011-01-01

    The WIMP paradigm is the glue that joins together much of the high energy and cosmic frontiers. It postulates that most of the matter in the Universe is made of weakly-interacting massive particles, with implications for a broad range of experiments and observations. I will review the WIMP paradigm's underlying motivations, its current status in view of rapid experimental progress on several fronts, and recent theoretical variations on the WIMP paradigm theme.

  4. Marital status, health and mortality.

    Science.gov (United States)

    Robards, James; Evandrou, Maria; Falkingham, Jane; Vlachantoni, Athina

    2012-12-01

    Marital status and living arrangements, along with changes in these in mid-life and older ages, have implications for an individual's health and mortality. Literature on health and mortality by marital status has consistently identified that unmarried individuals generally report poorer health and have a higher mortality risk than their married counterparts, with men being particularly affected in this respect. With evidence of increasing changes in partnership and living arrangements in older ages, with rising divorce amongst younger cohorts offsetting the lower risk of widowhood, it is important to consider the implications of such changes for health in later life. Within research which has examined changes in marital status and living arrangements in later life a key distinction has been between work using cross-sectional data and that which has used longitudinal data. In this context, two key debates have been the focus of research; firstly, research pointing to a possible selection of less healthy individuals into singlehood, separation or divorce, while the second debate relates to the extent to which an individual's transitions earlier in the life course in terms of marital status and living arrangements have a differential impact on their health and mortality compared with transitions over shorter time periods. After reviewing the relevant literature, this paper argues that in order to fully account for changes in living arrangements as a determinant of health and mortality transitions, future research will increasingly need to consider a longer perspective and take into account transitions in living arrangements throughout an individual's life course rather than simply focussing at one stage of the life course. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Drug-induced status epilepticus.

    Science.gov (United States)

    Cock, Hannah R

    2015-08-01

    Drug-induced status epilepticus (SE) is a relatively uncommon phenomenon, probably accounting for less than 5% of all SE cases, although limitations in case ascertainment and establishing causation substantially weaken epidemiological estimates. Some antiepileptic drugs, particularly those with sodium channel or GABA(γ-aminobutyric acid)-ergic properties, frequently exacerbate seizures and may lead to SE if used inadvertently in generalized epilepsies or less frequently in other epilepsies. Tiagabine seems to have a particular propensity for triggering nonconvulsive SE sometimes in patients with no prior history of seizures. In therapeutic practice, SE is most commonly seen in association with antibiotics (cephalosporins, quinolones, and some others) and immunotherapies/chemotherapies, the latter often in the context of a reversible encephalopathy syndrome. Status epilepticus following accidental or intentional overdoses, particularly of antidepressants or other psychotropic medications, has also featured prominently in the literature: whilst there are sometimes fatal consequences, this is more commonly because of cardiorespiratory or metabolic complications than as a result of seizure activity. A high index of suspicion is required in identifying those at risk and in recognizing potential clues from the presentation, but even with a careful analysis of patient and drug factors, establishing causation can be difficult. In addition to eliminating the potential trigger, management should be as for SE in any other circumstances, with the exception that phenobarbitone is recommended as a second-line treatment for suspected toxicity-related SE where the risk of cardiovascular complications is higher anyways and may be exacerbated by phenytoin. There are also specific recommendations/antidotes in some situations. The outcome of drug-induced status epilepticus is mostly good when promptly identified and treated, though less so in the context of overdoses. This article is

  6. Status of 239Pu evaluations

    International Nuclear Information System (INIS)

    Kawano, Toshihiko; Talou, Patrick; Chadwick, Mark B.

    2014-01-01

    This paper summarises the current status of nuclear data evaluations for n+ 239 Pu. The nuclear data we address include fission, capture, scattering cross-sections, as well as the prompt fission neutron energy spectrum, which has large sensitivities to the criticality benchmark testing. The evaluated nuclear data files currently available for 239 Pu are compared, and the source of differences in the cross-sections are discussed. Some open questions on the statistical model calculations for deformed systems are also given. (authors)

  7. Renewables 2013. Global Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Sawin, J. L. [and others

    2013-07-01

    Renewable energy markets, industries, and policy frameworks have evolved rapidly in recent years. The Renewables Global Status Report provides a comprehensive and timely overview of renewable energy market, industry, investment, and policy developments worldwide. It relies on the most recent data available, provided by many contributors and researchers from around the world, all of which is brought together by a multi-disciplinary authoring team. The report covers recent developments, current status, and key trends; by design, it does not provide analysis or forecasts. This latest Renewables Global Status Report saw: a shift in investment patterns that led to a global decrease in clean energy investment; continuing growth in installed capacity due to significant technology cost reductions and increased investment in developing countries; renewables progressively supplementing established electricity systems, demonstrating that the implementation of suitable policies can enable the successful integration of higher shares of variable renewables; and the emergence of integrated policy approaches that link energy efficiency measures with the implementation of renewable energy technologies.

  8. Nonconvulsive status epilepticus disguising as hepatic encephalopathy.

    Science.gov (United States)

    Jo, Yong Min; Lee, Sung Wook; Han, Sang Young; Baek, Yang Hyun; Ahn, Ji Hye; Choi, Won Jong; Lee, Ji Young; Kim, Sang Ho; Yoon, Byeol A

    2015-04-28

    Nonconvulsive status epilepticus has become an important issue in modern neurology and epileptology. This is based on difficulty in definitively elucidating the condition and its various clinical phenomena and on our inadequate insight into the intrinsic pathophysiological processes. Despite nonconvulsive status epilepticus being a situation that requires immediate treatment, this disorder may not be appreciated as the cause of mental status impairment. Although the pathophysiology of nonconvulsive status epilepticus remains unknown, this disorder is thought to lead to neuronal damage, so its identification and treatment are important. Nonconvulsive status epilepticus should be considered in the differential diagnosis of patients with liver cirrhosis presenting an altered mental status. We report a case of a 52-year-old male with liver cirrhosis presenting an altered mental status. He was initially diagnosed with hepatic encephalopathy but ultimately diagnosed with nonconvulsive status epilepticus by electroencephalogram.

  9. Nonconvulsive status epilepticus after electroconvulsive therapy

    DEFF Research Database (Denmark)

    Povlsen, Uffe Juul; Wildschiødtz, Gordon; Høgenhaven, Hans

    2003-01-01

    SUMMARY: We describe three cases of nonconvulsive status epilepticus induced by electroconvulsive therapy (ECT). Nonconvulsive status epilepticus is an important differential diagnosis in patients who develop prolonged confusion after ECT. The present cases exemplify the difficulty in defining...

  10. The Retinal Readout System: a status report A Status Report

    CERN Document Server

    Litke, A M

    1999-01-01

    The 'Retinal Readout System' is being developed to study the language the eye uses to send information about the visual world to the brain. Its architecture is based on that of silicon microstrip detectors. An array of 512 microscopic electrodes picks up the signals generated by the output neurons of live retinal tissue in response to a dynamic image focused on the input neurons. These signals are amplified, filtered and multiplexed by a set of eight custom-designed VLSI readout chips, and digitized and recorded by a data acquisition system. This report describes the goals, design, and status of the system. (author)

  11. Status and the evaluation of workplace deviance.

    Science.gov (United States)

    Bowles, Hannah Riley; Gelfand, Michele

    2010-01-01

    Bias in the evaluation of workplace misbehavior is hotly debated in courts and corporations, but it has received little empirical attention. Classic sociological literature suggests that deviance by lower-status actors will be evaluated more harshly than deviance by higher-status actors. However, more recent psychological literature suggests that discrimination in the evaluation of misbehavior may be moderated by the relative status of the evaluator because status influences both rule observance and attitudes toward social hierarchy. In Study 1, the psychological experience of higher status decreased rule observance and increased preferences for social hierarchy, as we theorized. In three subsequent experiments, we tested the hypothesis that higher-status evaluators would be more discriminating in their evaluations of workplace misbehavior, evaluating fellow higher-status deviants more leniently than lower-status deviants. Results supported the hypothesized interactive effect of evaluator status and target status on the evaluation of workplace deviance, when both achieved status characteristics (Studies 2a and 2b) and ascribed status characteristics (i.e., race and gender in Study 3) were manipulated.

  12. Does Status Inconsistency Matter for Marital Quality?

    Science.gov (United States)

    Gong, Min

    2007-01-01

    This study tests status inconsistency theory by examining the associations between wives' and husbands' relative statuses--that is, earnings, work-time, occupational, and educational inconsistencies--and marital quality and global happiness. The author asks three questions: (a) Is status inconsistency associated with marital quality and overall…

  13. Status Configurations, Military Service and Higher Education

    Science.gov (United States)

    Wang, Lin; Elder, Glen H., Jr.; Spence, Naomi J.

    2012-01-01

    The U.S. Armed Forces offer educational and training benefits as incentives for service. This study investigates the influence of status configurations on military enlistment and their link to greater educational opportunity. Three statuses (socioeconomic status of origin, cognitive ability and academic performance) have particular relevance for…

  14. 27 CFR 28.30 - Export status.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Export status. 28.30... Export status. (a) Distilled spirits and wines manufactured, produced, bottled in bottles packed in... such purposes are considered to be exported. Export status is not acquired until application on Form...

  15. Management of Status Epilepticus in Children

    Science.gov (United States)

    Smith, Douglas M.; McGinnis, Emily L.; Walleigh, Diana J.; Abend, Nicholas S.

    2016-01-01

    Status epilepticus is a common pediatric neurological emergency. Management includes prompt administration of appropriately selected anti-seizure medications, identification and treatment of seizure precipitant(s), as well as identification and management of associated systemic complications. This review discusses the definitions, classification, epidemiology and management of status epilepticus and refractory status epilepticus in children. PMID:27089373

  16. Management of Status Epilepticus in Children

    Directory of Open Access Journals (Sweden)

    Douglas M. Smith

    2016-04-01

    Full Text Available Status epilepticus is a common pediatric neurological emergency. Management includes prompt administration of appropriately selected anti-seizure medications, identification and treatment of seizure precipitant(s, as well as identification and management of associated systemic complications. This review discusses the definitions, classification, epidemiology and management of status epilepticus and refractory status epilepticus in children.

  17. Preference for High Status Predicts Implicit Outgroup Bias among Children from Low-Status Groups

    Science.gov (United States)

    Newheiser, Anna-Kaisa; Dunham, Yarrow; Merrill, Anna; Hoosain, Leah; Olson, Kristina R.

    2014-01-01

    Whereas members of high-status racial groups show ingroup preference when attitudes are measured implicitly, members of low-status racial groups--both adults and children--typically show no bias, potentially reflecting awareness of the ingroup's low status. We hypothesized that when status differences are especially pronounced, children from…

  18. Estimated status 2006-2015

    International Nuclear Information System (INIS)

    2003-01-01

    According to article 6 of the French law from February 10, 2000 relative to the modernization and development of the electric public utility, the manager of the public power transportation grid (RTE) has to produce, at least every two years and under the control of the French government, a pluri-annual estimated status. Then, the energy ministry uses this status to prepare the pluri-annual planning of power production investments. The estimated status aims at establishing a medium- and long-term diagnosis of the balance between power supply and demand and at evaluating the new production capacity needs to ensure a durable security of power supplies. The hypotheses relative to the power consumption and to the evolution of the power production means and trades are presented in chapters 2 to 4. Chapter 5 details the methodology and modeling principles retained for the supply-demand balance simulations. Chapter 6 presents the probabilistic simulation results at the 2006, 2010 and 2015 prospects and indicates the volumes of reinforcement of the production parks which would warrant an acceptable level of security. Chapter 7 develops the critical problem of winter demand peaks and evokes the possibilities linked with demand reduction, market resources and use of the existing park. Finally, chapter 8 makes a synthesis of the technical conclusions and recalls the determining hypotheses that have been retained. The particular situations of western France, of the Mediterranean and Paris region, and of Corsica and overseas territories are examined in chapter 9. The simulation results for all consumption-production scenarios and the wind-power production data are presented in appendixes. (J.S.)

  19. Happiness and Sexual Minority Status

    Science.gov (United States)

    Thomeer, Mieke Beth; Reczek, Corinne

    2017-01-01

    We used logistic regression on nationally representative data (General Social Survey, N = 10,668 and N = 6,680) to examine how sexual minority status related to happiness. We considered two central dimensions of sexual minority status—sexual behavior and sexual identity. We distinguished between same-sex, both-sex, and different-sex oriented participants. Because individuals transition between sexual behavior categories over the life course (e.g., from both-sex partners to only same-sex partners) and changes in sexual minority status have theoretical associations with well-being, we also tested the effects of transitions on happiness. Results showed that identifying as bisexual, gay, or lesbian, having both male and female partners since age 18, or transitioning to only different-sex partners was negatively related to happiness. Those with only same-sex partners since age 18 or in the past five years had similar levels of happiness as those with only different-sex partners since age 18. Additional tests showed that the majority of these happiness differences became non-significant when economic and social resources were included, indicating that the lower happiness was a product of structural and societal forces. Our findings clearly and robustly underscored the importance of taking a multi-faceted approach to understanding sexuality and well-being, demonstrating that not all sexual minority groups experience disadvantaged happiness. Our study calls for more attention to positive aspects of well-being such as happiness in examinations of sexual minorities and suggests that positive psychology and other happiness subfields should consider the role of sexual minority status in shaping happiness. PMID:27102605

  20. Reducing status quo bias in choice experiments

    DEFF Research Database (Denmark)

    Bonnichsen, Ole; Ladenburg, Jacob

    In stated preference literature, the tendency to choose the alternative representing the status quo situation seems to exceed real life status quo effects. Accordingly, status quo bias can be a problem. In Choice Experiments, status quo bias is found to be strongly correlated with protest attitudes...... toward the cost attribute. If economic values are to be elicited, this problem is difficult to remedy. In a split sample framework we test a novel ex-ante entreaty aimed specifically at the cost attribute and find that it effectively reduces status quo bias and improves the internal validity...

  1. Renewables 2005. Global status report

    International Nuclear Information System (INIS)

    2005-01-01

    This report provides an overview of the status of renewable energy worldwide in 2005. It covers markets, investments, industries, policies, and rural (off-grid) renewable energy in developing countries. By design, the report does not provide analysis, recommendations, or conclusions. An extensive research and review process over several months involving more than 100 researchers and contributors has kept inaccuracies to a minimum. REN21 sees this report as the beginning of an active exchange of views and information. This report reveals some surprising facts about renewable energy, many reflecting strong growth trends and increasing significance relative to conventional energy. (au)

  2. Renewables 2007 - Global status report

    International Nuclear Information System (INIS)

    Martinot, Eric; Mastny, Lisa; Rosbotham, Lyle; Suding, Paul; Sonntag-O'Brien, Virginia; Lempp, Philippe

    2007-01-01

    In 2007, more than $100 billion was invested in new renewable energy capacity, manufacturing plants, and research and development-a true global milestone. Yet perceptions lag behind the reality of renewable energy because change has been so rapid in recent years. This report captures that reality and provides an overview of the status of renewable energy worldwide in 2007. The report covers trends in markets, investments, industries, policies, and rural (off-grid) renewable energy. (By design, the report does not provide analysis, discuss current issues, or forecast the future.) Many of the trends reflect increasing significance relative to conventional energy

  3. Renewables 2005. Global status report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This report provides an overview of the status of renewable energy worldwide in 2005. It covers markets, investments, industries, policies, and rural (off-grid) renewable energy in developing countries. By design, the report does not provide analysis, recommendations, or conclusions. An extensive research and review process over several months involving more than 100 researchers and contributors has kept inaccuracies to a minimum. REN21 sees this report as the beginning of an active exchange of views and information. This report reveals some surprising facts about renewable energy, many reflecting strong growth trends and increasing significance relative to conventional energy. (au)

  4. Renewables 2005 - Global status report

    International Nuclear Information System (INIS)

    Martinot, Eric

    2005-01-01

    This report provides an overview of the status of renewable energy worldwide in 2005. It covers markets, investments, industries, policies, and rural (off-grid) renewable energy in developing countries. By design, the report does not provide analysis, recommendations, or conclusions. An extensive research and review process over several months involving more than 100 researchers and contributors has kept inaccuracies to a minimum. REN21 sees this report as the beginning of an active exchange of views and information. This report reveals some surprising facts about renewable energy, many reflecting strong growth trends and increasing significance relative to conventional energy

  5. GEO600: status and plans

    International Nuclear Information System (INIS)

    Willke, B

    2007-01-01

    The GEO600 gravitational wave detector located near Hannover in Germany is one of the four detectors of the LIGO Scientific Collaboration (LSC). For almost the entire year of 2006, GEO600 participated in the S5 science run of the LSC. Overall an equivalent of about 270 days of science data with an average peak sensitivity of better than 3 x 10 -22 Hz -1/2 have been acquired so far. In this paper, we describe the status of the GEO600 project during the period between January 2006 and February 2007. In addition, plans for the near-term and medium-term future are discussed

  6. Status of the VIRGO experiment

    International Nuclear Information System (INIS)

    Yvert, M.

    1994-07-01

    The VIRGO experiment was approved in September 1993. The goal of the French-Italian collaboration is to detect Gravitational Waves using a 3 km arm-length Michelson interferometer. The construction of this detector, which will be installed in Pisa, is under way. The experiment is planned to take data, in a large bandwidth (10Hz-10kHz), at the beginning of year 2000 with nominal sensitivity close to h=3x10 -23 /√Hz. The motivations, detection principle, main sources of noise and status of the experiment are presented. (author). 14 refs., 4 figs

  7. Status of the VIRGO experiment

    International Nuclear Information System (INIS)

    Caron, B.; Dominjon, A.; Marion, F.

    1995-01-01

    The VIRGO experiment was approved in September 1993. The goal of the French-Italian collaboration is to detect gravitational waves using a 3 km arm-length Michelson interferometer. The construction of this detector, which will be installed in Pisa, is under way. The experiment is planned to take data, in a large bandwidth (10 Hz-10 kHz), at the beginning of the year 2000 with nominal sensitivity close to h=3x10 -23 /√(Hz). The motivations, detection principle, main sources of noise and status of the experiment are presented. (orig.)

  8. Taxonomic status of Anastrepha fraterculus

    International Nuclear Information System (INIS)

    Steck, G.J.

    1999-01-01

    There has long been speculation that nominal Anastrepha fraterculus comprises more than a single biological species. Herein is a review of data supporting the hypothesis that multiple cryptic species are present. Evidence includes unusual variation in pest status, morphology, karyotypes, isozymes, mitochondrial DNA and cuticular hydrocarbon. The data strongly support the notion of multiple cryptic species. However, it is not yet possible to state how many species may be involved or to delineate them by diagnostic morphology, distribution, host plants or behavior. A combination of methodologies will be needed to resolve the complex. (author)

  9. Product Operations Status Summary Metrics

    Science.gov (United States)

    Takagi, Atsuya; Toole, Nicholas

    2010-01-01

    The Product Operations Status Summary Metrics (POSSUM) computer program provides a readable view into the state of the Phoenix Operations Product Generation Subsystem (OPGS) data pipeline. POSSUM provides a user interface that can search the data store, collect product metadata, and display the results in an easily-readable layout. It was designed with flexibility in mind for support in future missions. Flexibility over various data store hierarchies is provided through the disk-searching facilities of Marsviewer. This is a proven program that has been in operational use since the first day of the Phoenix mission.

  10. Renewables 2012. Global Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Sawin, J. L. [and others

    2012-08-15

    Renewable energy markets and policy frameworks have evolved rapidly in recent years. This report provides a comprehensive and timely overview of renewable energy market, industry, investment, and policy developments worldwide. It relies on the most recent data available, provided by a network of more than 400 contributors and researchers from around the world, all of which is brought together by a multi-disciplinary authoring team. The report covers recent developments, current status, and key trends; by design, it does not provide analysis or forecast the future.

  11. MIRAGE: system overview and status

    Science.gov (United States)

    Robinson, Richard M.; Oleson, Jim; Rubin, Lane; McHugh, Stephen W.

    2000-07-01

    Santa Barbara Infrared's (SBIR) MIRAGE (Multispectral InfraRed Animation Generation Equipment) is a state-of-the-art dynamic infrared scene projector system. Imagery from the first MIRAGE system was presented to the scene simulation community during last year's SPIE AeroSense 99 Symposium. Since that time, SBIR has delivered five MIRAGE systems. This paper will provide an overview of the MIRAGE system and discuss the current status of the MIRAGE. Included is an update of system hardware, and the current configuration. Proposed upgrades to this configuration and options will be discussed. Updates on the latest installations, applications and measured data will also be presented.

  12. Status of the experiment ASYEOS

    Energy Technology Data Exchange (ETDEWEB)

    Kupny, Sebastian [GSI Helmholtzzentrum GmbH Darmstadt (Germany); Collaboration: ASYEOS-Collaboration

    2012-07-01

    Neutron-proton squeeze-out is predicted to provide quantitative information on the symmetry term of the nuclear Equation of State at supra-saturation densities. Hence we designed an experiment consisting out of the CHIMERA charged particle detector for impact parameter determination and reaction plane reconstruction, the LAND neutron detector to measure neutron and proton squeeze-out and a Triple Telescope Array to identify light fragments. Measurements of 197Au+197Au, 96Ru+96Ru and 96Zr+96Zr collisions at 400 A MeV have been accomplished in May 2011 at the GSI facility. Current status of the analysis, first results and future plans are presented.

  13. LHC Status and Upgrade Challenges

    Science.gov (United States)

    Smith, Jeffrey

    2009-11-01

    The Large Hadron Collider has had a trying start-up and a challenging operational future lays ahead. Critical to the machine's performance is controlling a beam of particles whose stored energy is equivalent to 80 kg of TNT. Unavoidable beam losses result in energy deposition throughout the machine and without adequate protection this power would result in quenching of the superconducting magnets. A brief overview of the machine layout and principles of operation will be reviewed including a summary of the September 2008 accident. The current status of the LHC, startup schedule and upgrade options to achieve the target luminosity will be presented.

  14. Network management, status and directions

    International Nuclear Information System (INIS)

    Cottrell, R.L.A.; Streater, T.C.

    1992-09-01

    It has been said that the ''network is the system''. This implies providing levels of service, reliability, predictability and availability that are commensurate with or better than those that individual computers provide today. To provide this requires integrated network management for interconnected networks of heterogeneous devices covering both the local campus and across the world and spanning many administrative domains. This talk will review the status of existing tools to address management for networks. It draws on experience from both within and outside the HEP community

  15. Experimental status of unified theories

    International Nuclear Information System (INIS)

    Bilen'kij, S.M.

    1979-01-01

    A standard SU(2)xU(1) theory is discussed. It is based on an assumption that the left components of fields form doublets, and the rignt ones - singlets. From the weak interaction lagrangian an expression is obtained for the effective hamiltonian describing neutrino-lepton processes. The results of discussing the experimental status of the unified theories of weak and electromagnetic interactions are in agreement with the simplest version of the unified theories - the Weinberg-Salam theory. It has been noted that the accuracy of the experiments (not exceeding 20%) is insufficient and no information is available on diagonal terms of the hamiltonian

  16. Pathological buying and partnership status.

    Science.gov (United States)

    Müller, Astrid; de Zwaan, Martina; Mitchell, James E; Zimmermann, Tanja

    2016-05-30

    This pilot study investigated the partnership status and the level of pathological buying (PB) in 157 female patients with PB and 1153 women from a German population-based sample. Slightly more than half of both samples were currently living with a partner. The results suggest a protective effect of being in a couple relationship in the representative sample. In contrast, having a partner was not related to the severity of PB among patients. Future studies should address the question of whether the characteristics and quality of partnership have an impact on the severity and course of PB, and vice versa. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Status of LLNL granite projects

    International Nuclear Information System (INIS)

    Ramspott, L.D.

    1980-01-01

    The status of LLNL Projects dealing with nuclear waste disposal in granitic rocks is reviewed. This review covers work done subsequent to the June 1979 Workshop on Thermomechanical Modeling for a Hardrock Waste Repository and is prepared for the July 1980 Workshop on Thermomechanical-Hydrochemical Modeling for a Hardrock Waste Repository. Topics reviewed include laboratory determination of thermal, mechanical, and transport properties of rocks at conditions simulating a deep geologic repository, and field testing at the Climax granitic stock at the USDOE Nevada Test Site

  18. Status of food irradiation worldwide

    International Nuclear Information System (INIS)

    Loaharanu, P.

    1992-01-01

    The past four decades have witnessed the steady development of food irradiation technology - from laboratory-scale research to full-scale commercial application. The present status of this technology, approval for processing food items in 37 countries and commerical use of irradiated food in 24 countries, will be discussed. The trend in the use of irradiation to overcome certain trade barriers such as quarantine and hygiene will be presented. Emphasis will be made on the use of irradiation as an alternative to chemical treatments of food. (orig.) [de

  19. Lattice QCD: Status and Prospect

    International Nuclear Information System (INIS)

    Ukawa, Akira

    2006-01-01

    A brief review is given of the current status and near-future prospect of lattice QCD studies of the Standard Model. After summarizing a bit of history, we describe current attempts toward inclusion of dynamical up, down and strange quarks. Recent results on the light hadron mass spectrum as well as those on the heavy quark quantities are described. Recent work on lattice pentaquark search is summarized. We touch upon the PACS-CS Project for building our next machine for lattice QCD, and conclude with a summary of computer situation and the physics possibilities over the next several years

  20. Current Status of HPV Vaccines

    Science.gov (United States)

    Ma, Barbara; Roden, Richard; Wu, T.C.

    2010-01-01

    Cervical cancer is the second largest cause of cancer deaths in women worldwide, with ~500,000 diagnoses and 274,000 deaths annually. It remains a significant source of morbidity and mortality despite effective screening tools and treatments for its precursor high-grade cervical intraepithelial neoplasia (CIN). Increased understanding of cervical pathogenesis has led to the identification of human papillomavirus (HPV) as the etiological agent for cervical cancer and the development of preventive and therapeutic vaccines targeting HPV antigens for the control of cervical cancer. Herein, we discuss the current status of HPV vaccines. PMID:20677402

  1. Dark Matter Detection: Current Status

    International Nuclear Information System (INIS)

    Akerib, Daniel S.

    2011-01-01

    Overwhelming observational evidence indicates that most of the matter in the Universe consists of non-baryonic dark matter. One possibility is that the dark matter is Weakly-Interacting Massive Particles (WIMPs) that were produced in the early Universe. These relics could comprise the Milky Way's dark halo and provide evidence for new particle physics, such as Supersymmetry. This talk focuses on the status of current efforts to detect dark matter by testing the hypothesis that WIMPs exist in the galactic halo. WIMP searches have begun to explore the region of parameter space where SUSY particles could provide dark matter candidates.

  2. Health status among elderly Hungarians and Americans.

    Science.gov (United States)

    Buss, T F; Beres, C; Hofstetter, C R; Pomidor, A

    1994-07-01

    Selected health status data for elderly populations from similar industrial cities-Youngstown, Ohio, USA, and Debrecen, Hungary-were compared. Because of their impoverished health care system, unregulated heavily industrialized society, and unhealthful life-styles Hungarians were hypothesized to have poorer health status than Americans, even after taking into account demographic mediating factors. The study provides a health status baseline for elderly Hungarians shortly after communism's fall in 1989-1990 and shows how great a gap exists between Hungarian health status and that in the West. Hungarians were in much poorer health as measured by functional status, symptomatology, medical condition, depression, and subjective health status. Distinctions persisted when controlling for gender, age, and education. Poverty-level (and income) did not explain health status differences. The paper concludes that Hungary should pay more attention to health promotion, prevention, and primary care, as well as to reforming patient management in hospitals, nursing homes, and home care programs.

  3. Status Configurations, Military Service and Higher Education.

    Science.gov (United States)

    Wang, Lin; Elder, Glen H; Spence, Naomi J

    2012-12-01

    The U.S. Armed Forces offer educational and training benefits as incentives for service. This study investigates the influence of status configurations on military enlistment and their link to greater educational opportunity. Three statuses (socioeconomic status of origin, cognitive ability and academic performance) have particular relevance for life course options. We hypothesize that young men with inconsistent statuses are more likely to enlist than men with consistent status profiles, and that military service improves access to college for certain configurations. Analyses of the National Longitudinal Study of Adolescent Health (Add Health) show (1. that several status configurations markedly increased the likelihood of military enlistment and (2. within status configurations, recruits were generally more likely to enroll in higher education than nonveterans, with associate degrees being more likely.

  4. Status Configurations, Military Service and Higher Education

    Science.gov (United States)

    Wang, Lin; Elder, Glen H.; Spence, Naomi J.

    2012-01-01

    The U.S. Armed Forces offer educational and training benefits as incentives for service. This study investigates the influence of status configurations on military enlistment and their link to greater educational opportunity. Three statuses (socioeconomic status of origin, cognitive ability and academic performance) have particular relevance for life course options. We hypothesize that young men with inconsistent statuses are more likely to enlist than men with consistent status profiles, and that military service improves access to college for certain configurations. Analyses of the National Longitudinal Study of Adolescent Health (Add Health) show (1. that several status configurations markedly increased the likelihood of military enlistment and (2. within status configurations, recruits were generally more likely to enroll in higher education than nonveterans, with associate degrees being more likely. PMID:24511161

  5. Subjective social status and health.

    Science.gov (United States)

    Euteneuer, Frank

    2014-09-01

    Subjective social status (SSS) predicts health outcomes above and beyond traditional objective measures of social status, such as education, income and occupation. This review summarizes and integrates recent findings on SSS and health. Current studies corroborate associations between low SSS and poor health indicators by extending previous findings to further populations and biological risk factors, providing meta-analytic evidence for adolescents and by demonstrating that negative affect may not confound associations between SSS and self-rated health. Recent findings also highlight the relevance of SSS changes (e.g. SSS loss in immigrants) and the need to consider cultural/ethnical differences in psychological mediators and associations between SSS and health. SSS is a comprehensive measure of one's social position that is related to several poor health outcomes and risk factors for disease. Future investigation, particularly prospective studies, should extend research on SSS and health to further countries/ethnic groups, also considering additional psychological and biological mediators and dynamic aspects of SSS. Recently developed experimental approaches to manipulate SSS may also be promising.

  6. Food and families' socioeconomic status.

    Science.gov (United States)

    Kinsey, J D

    1994-09-01

    This paper explores the relationship between food expenditures and consumption patterns and families' socioeconomic status in the United States. Three themes follow through the paper. One is that as income rises over time and across socioeconomic groups, a smaller percent of that income is spent of food. Simultaneously, a larger percent of the food dollar buys services and food preparation moves farther away from the home. Second, characteristics of people like age and ethnicity contribute to diversity in food consumption but labor force participation by women has led the trend in away-from-home-food preparation. New scientific information and technology have changed attitudes about nutrition and food safety and their linkages to health. Finally, the continuous introduction of affordable new foods into the diet and culture of families in all socioeconomic groups has been a quiet evolution. Trying to differentiate socioeconomic groups in the United States by their food and nutritional status is almost a nonstory except for fascinating intragroup diversities that change rapidly in the postmodern society.

  7. Worldwide status of HTR development

    International Nuclear Information System (INIS)

    1978-06-01

    The International Atomic Energy Agency convened a technical committee meeting on high temperature reactors (HTRs) from 12-14 Dec. 1977 at Agency Headquarters to provide a forum for the exchange of information on the status of HTR development programmes and to receive advice on the Agency programme in this field. The continuing high level of international interest in HTRs was evidenced by the participation from 11 countries and 2 organizations: Austria, Belgium, France, Federal Republic of Germany, Japan, Netherlands, Poland, Switzerland, Union of Soviet Socialist Republics, United Kingdom of Great Britain, United States of America, Commission of the European Communities, and the OECD Nuclear Energy Agency. In order to promote the continuing exchange of technical information through the offices of the IAEA, a recommendation was made that the Agency establish a standing International Working Group on High Temperature Reactors (IWGHTR). This recommendation is being implemented in 1978. Considerable information on recent progress in HTR development was present at the technical committee meeting in technical reports and in progress reports on HTR development programmes. Since this material will not be published, this summary report on the worldwide status of HTR development at the beginning of 1978 has been prepared, based primarily on information presented at the December 1977 meeting

  8. renewables 2011 - Global status report

    International Nuclear Information System (INIS)

    Sawin, Janet L.; Martinot, Eric; Barnes, Douglas; Martinot, Eric; McCrone, Angus; Roussell, Jodie; Sawin, Janet L.; Sims, Ralph; Sonntag-O'Brien, Virginia; Adib, Rana; Skeen, Jonathan; Musolino, Evan; Riahi, Lily; Mastny, Lisa

    2011-01-01

    Changes in renewable energy markets, investments, industries, and policies have been so rapid in recent years that perceptions of the status of renewable energy can lag years behind the reality. This report captures that reality and provides a unique overview of renewable energy worldwide as of early 2011. The report covers both current status and key trends; by design, it does not provide analysis or forecast the future. Global energy consumption rebounded in 2010 after an overall downturn in 2009. Renewable energy, which experienced no downturn in 2009, continued to grow strongly in all end-use sectors - power, heat and transport - and supplied an estimated 16% of global final energy consumption. Renewable energy accounted for approximately half of the estimated 194 gigawatts (GW) of new electric capacity added globally during the year. Renewables delivered close to 20% of global electricity supply in 2010, and by early 2011 they comprised one quarter of global power capacity from all sources. In several countries, renewables represent a rapidly growing share of total energy supply, including heat and transport

  9. Status of the CBM experiment

    Directory of Open Access Journals (Sweden)

    Heuser Johann M.

    2015-01-01

    Full Text Available The Compressed Baryonic Matter (CBM experiment at the Facility for Anti-Proton and Ion Research (FAIR will explore the phase diagram of strongly interacting matter at highest net baryon densities and moderate temperatures. The CBM physics program will be started with beams delivered by the SIS 100 synchrotron, providing energies from 2 to 11 GeV/nucleon for heavy nuclei, up to 14 GeV/nucleon for light nuclei, and 29 GeV for protons. The highest net baryon densities will be explored with ion beams up to 45 GeV/nucleon energy delivered by SIS 300 in the next stage of FAIR. Collision rates up to 107 per second are required to produce very rare probes with unprecedented statistics in this energy range. Their signatures are complex. These conditions call for detector systems designed to meet the extreme requirements in terms of rate capability, momentum and spatial resolution, and a novel DAQ and trigger concept which is not limited by latency but by throughput. The article discusses the development status of the CBM sub-systems for charged particle tracking, vertex detection, electron/muon identification, hadron/time-of-flight measurement, electromagnetic and zero-degree calorimetry, in terms of prototypes and expected physics performance. The concept and development status of CBM’s central detector, the Silicon Tracking System STS are presented in somewhat more detail.

  10. Repository development status in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Beceiro, Alvaro; Zuloaga, Pablo [ENRESA (Spain)

    2009-06-15

    The paper describes the status of repository development for the different waste categories. Low and Intermediate Waste Disposal facility of El Cabril was commissioned in 1992 and is in normal operation. The major modifications and activities during the last years are the adaptation to waste streams not initially foreseen such as some decommissioning waste or waste from steel industry, and the improvement of its performance assessment, supported by a R and D and refined models. As part of this facility, a new disposal facility specifically intended for very low activity waste has been constructed and commissioned in July 2008. Its design is based on the European Directive for hazardous waste disposal. National policy for Nuclear Spent Fuel and High-Level waste is focused on the development of a centralized storage facility of the vault type, whose site location would be selected through a volunteering process. Meanwhile, with the aim of solving specific problems, three individual storage facilities are in different status at reactor sites. Research on final solution, including some repository aspects as well as separation and transmutation are being carried out in accordance to ENRESA's R and D program. ENRESA has developed conceptual designs for non site specific repositories, both in granite and clay, and has carried out their corresponding performance assessment exercises. (authors)

  11. Global status of hydrogen research

    Energy Technology Data Exchange (ETDEWEB)

    Lakeman, J.B.; Browning, D.J.

    2001-07-01

    This report surveys the global status of hydrogen research and identifies technological barriers to the implementation of a global hydrogen economy. It is concluded that there will be a 30 year transition phase to the full implementation of the hydrogen economy. In this period, hydrogen will be largely produced by the reformation of hydrocarbons, particularly methane. It will be necessary to ensure that any carbonaceous oxides (and other unwanted species) formed as by-products will be trapped and not released into the atmosphere. Following the transition phase, hydrogen should be largely produced from renewable energy sources using some form of water cracking, largely electrolysis. Target performances and costs are identified for key technologies. The status of hydrogen research in the UK is reviews and it is concluded that the UK does not have a strategy for the adoption of the hydrogen economy, nor does it have a coherent and co-ordinated research and development strategy addressing barriers to the hydrogen economy. Despite this fact, because of the long transition phase, it is still possible for the UK to formulate a coherent strategy and make a significant contribution to the global implementation of the hydrogen economy, as there are still unresolved technology issues. The report concludes with a number of recommendations. (Author)

  12. MENA Renewables Status Report 2013

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-15

    The MENA Renewables Status Report is an outcome of ADIREC, the Abu Dhabi International Renewable Energy Conference. The report provides a status overview of renewable energy markets, industry, policy and investment trends in the region, drawing on the most recent data available. It is produced in cooperation with over 50 contributors and researchers in the region and reveals massive growth in the renewable energy markets of the Middle East and North Africa (MENA). Regional investment topped US$2.9 billion in 2012, up 40% from 2011 and 650% from 2004. With over 100 projects under development, the region could see a 450% increase in non-hydro renewable energy generating capacity in the next few years. For the report, the 21 MENA countries were clustered into two sub-groups: Net Oil-Exporting Countries (NOEC) -- Algeria, Bahrain, Egypt, Iran, Iraq, Kuwait, Libya, Oman, Qatar, Saudi Arabia, Syria, United Arab Emirates, and Yemen; and Net Oil-Importing Countries (NOIC) -- Djibouti, Israel, Jordan, Lebanon, Malta, Morocco, Palestine, and Tunisia.

  13. Periodontal Status of Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Timur V. Melkumyan

    2014-06-01

    Full Text Available The objective of this study was to compare the periodontal status in postmenopausal women with osteopenia and osteoporosis. Material and Methods: We examined 43 postmenopausal women aged from 55 to 74 years. Material assessment of bones in every patient was performed by means of dual energy X-ray absorptiometry (DXA from two points on the skeleton – part of the femur neck and between the first and fourth lumbar vertebrae. A lipid blood test was done for patients of both groups. All patients were divided into two groups (the 1st with osteopenia, and the 2nd with osteoporosis. All patients were subjected to an oral clinical examination: the periodontal examination was composed of Plaque Index (PI, Pocket Score (PS, and Papillary Bleeding Index (PBI. X-ray analysis was performed for every patient. Results: The results of the clinical periodontal examination demonstrated that the mean PBI in patients in the 1st group had no significant differences from the PBI in patients in the 2nd group. PI value and PS findings in patients with general osteoporosis also had no statistical differences from the same parameters in patients with osteopenia. Conclusion: Under the circumstances of these patients’ characteristics and within the limits of the present study, we concluded that there is no significant difference in the periodontal status of postmenopausal women with systemic osteopenia and with osteoporosis.

  14. Treatment of Convulsive Status Epilepticus.

    Science.gov (United States)

    Grover, Eric H; Nazzal, Yara; Hirsch, Lawrence J

    2016-03-01

    Convulsive status epilepticus (CSE) is a medical emergency with an associated high mortality and morbidity. It is defined as a convulsive seizure lasting more than 5 min or consecutive seizures without recovery of consciousness. Successful management of CSE depends on rapid administration of adequate doses of anti-epileptic drugs (AEDs). The exact choice of AED is less important than rapid treatment and early consideration of reversible etiologies. Current guidelines recommend the use of benzodiazepines (BNZ) as first-line treatment in CSE. Midazolam is effective and safe in the pre-hospital or home setting when administered intramuscularly (best evidence), buccally, or nasally (the latter two possibly faster acting than intramuscular (IM) but with lower levels of evidence). Regular use of home rescue medications such as nasal/buccal midazolam by patients and caregivers for prolonged seizures and seizure clusters may prevent SE, prevent emergency room visits, improve quality of life, and lower health care costs. Traditionally, phenytoin is the preferred second-line agent in treating CSE, but it is limited by hypotension, potential arrhythmias, allergies, drug interactions, and problems from extravasation. Intravenous valproate is an effective and safe alternative to phenytoin. Valproate is loaded intravenously rapidly and more safely than phenytoin, has broad-spectrum efficacy, and fewer acute side effects. Levetiracetam and lacosamide are well tolerated intravenous (IV) AEDs with fewer interactions, allergies, and contraindications, making them potentially attractive as second- or third-line agents in treating CSE. However, data are limited on their efficacy in CSE. Ketamine is probably effective in treating refractory CSE (RCSE), and may warrant earlier use; this requires further study. CSE should be treated aggressively and quickly, with confirmation of treatment success with epileptiform electroencephalographic (EEG), as a transition to non-convulsive status

  15. Central Nervous System Strongyloidiasis and Cryptococcosis in an HIV-Infected Patient Starting Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Mónica Rodríguez

    2012-01-01

    Full Text Available We report a case of Strongyloides stercoralis hyperinfection syndrome with central nervous system involvement, in a patient with late human immunodeficiency virus (HIV infection starting antiretroviral therapy, in whom Strongyloides stercoralis larvae and Cryptococcus neoformans were isolated antemortem from cerebrospinal fluid. Our patient was not from an endemic region for the parasite, so strongyloidiasis was not originally suspected. For this reason, we conclude that Strongyloides stercoralis infection should be suspected in HIV-infected patients starting antiretroviral therapy in order to avoid potential fatal outcomes.

  16. Clinical and microbiological characteristics of cryptococcosis in Singapore: predominance of Cryptococcus neoformans compared with Cryptococcus gattii

    Directory of Open Access Journals (Sweden)

    Monica Chan

    2014-09-01

    Conclusion: C. neoformans var. grubii, subtype VN I, was the predominant subtype in Singapore, infecting younger, mainly immunocompromised hosts with HIV. C. gattii was uncommon, causing pulmonary manifestations in older, immunocompetent patients and were RFLP type VG II.

  17. Upgrade programs. Status and prospective

    International Nuclear Information System (INIS)

    Loyer, F.

    1998-01-01

    Arguments for launching a renovation program for GANIL system, taking into account aging and wear, are analyzed. A statistics of failures related to vacuum systems, power supplies, electronics, cooling systems, beam dumps and other equipment is given. The renovation program is targeted to: replacement of obsolete components, introduction of advanced systems of failure diagnosis, augmentation of performances of the new regulating and control system and improvement in the performance characteristics of certain fundamental equipment. The first results and to date status of the program development is reported. Mentioned are the works related to control of HF cavities and the associated amplifiers, electronics, the system of cavity synchronization, power supply, RMN, system commutation grid, pumping equipment, etc. Also, improvements concerning the machine data acquisition and online processing are referred to as well as program cost estimations

  18. Status of the LMFBR development

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, J J

    1975-01-01

    The development of any new power generation system which can make a major contribution to our energy needs is a multi-faceted task involving the utilization of major human and material resources. The LMFBR development, which has the potential for supplying abundant energy for generations, is therefore a large, multi-faceted program. This summary will cover (1) the need for the liquid metal fast breeder reactor, (2) an overall perspective of its development throughout the world, (3) a brief look at the in-depth technological development program in the United States, (4) a description and status of the two major projects now under way in the program, the Fast Flux Test Facility and the Clinch River Breeder Reactor Plant, and (5) a review of the plans for continued development to achieve a reliable, safe and economic power generation system for practical commercial use on the utility networks of the country.

  19. Hyper-X Program Status

    Science.gov (United States)

    McClinton, Charles R.; Reubush, David E.; Sitz, Joel; Reukauf, Paul

    2001-01-01

    This paper provides an overview of the objectives and status of the Hyper-X program, which is tailored to move hypersonic, airbreathing vehicle technology from the laboratory environment to the flight environment. The first Hyper-X research vehicle (HXRV), designated X-43, is being prepared at the Dryden Flight Research Center for flight at Mach 7. Extensive risk reduction activities for the first flight are completed, and non-recurring design activities for the Mach 10 X-43 (third flight) are nearing completion. The Mach 7 flight of the X-43, in the spring of 2001, will be the first flight of an airframe-integrated scramjet-powered vehicle. The Hyper-X program is continuing to plan follow-on activities to focus an orderly continuation of hypersonic technology development through flight research.

  20. PISC: Introduction and status overview

    International Nuclear Information System (INIS)

    Crutzen, S.; Nichols, R.W.

    1994-01-01

    Inspection will be able to play its role in the Structural Integrity assessment scheme and therefore in Pressure Components Safety Assessment. Inspection techniques are or will soon be able to furnish in a reliable way the information needed on the 'Status of the structure' for what concerns the presence, location, size and characteristics of defects. The effectiveness and reliability of these inspections will depend very much on the way in which they will be qualified and PISC III contributes much to the development of qualification schemes and in particular to performance demonstration of inspection procedures. The experimental work of PISC III is now ended and with it the funding of the PISC programme. However, the evaluation and use of PISC data generated by the different Round Robin Tests will certainly continue for several years as well as the cooperation spirit which characterized these 20 years of NDE effectiveness evaluation. (orig.)

  1. Molecular magnetism, status and perspectives

    Science.gov (United States)

    Gatteschi, Dante; Bogani, Lapo; Cornia, Andrea; Mannini, Matteo; Sorace, Lorenzo; Sessoli, Roberta

    2008-12-01

    A short review is made of molecular magnetism, trying to discuss what is alive and well, with perspectives for the future. All the main fields of activity are mentioned, ranging from the so-called spin cross-over systems to the quest for organic (molecular) ferromagnets. Particular attention is devoted to some of the recent advances in these fields, highlighting also the opportunities for the development of applications. Low dimensional magnets are perhaps the best opportunity to use molecules, and the status of single-molecule and single chain magnets is discussed. The last part is devoted to the organization of magnetic molecules and to the development of techniques which allow to measure the magnetic properties of thin layers and, in perspective, of single molecules.

  2. Energy status 2010; Energistatus 2010

    Energy Technology Data Exchange (ETDEWEB)

    Skaansar, Ellen

    2011-07-01

    In the new report, Energy Status NVE provides a unified presentation of statistics and facts about the Norwegian energy system. It gives an overview of the production, transmission and consumption of electricity in the Norwegian society, and shows energy use for various purposes and the relationship between energy and the environment. Norway is the sixth largest hydropower producer in the world and, together with Iceland the highest portion of renewable electricity production of all countries in Europe. In comparison, is about 17 percent of all electricity in the EU based on renewable resources. In Sweden, renewable energy resources account for about half of all electricity production, while the corresponding share in Denmark is about 29 percent. The good supply of water power has contributed to the fact that Norway has a consumption pattern that differs from the countries around us. (AG)

  3. Experimental status of quantum electrodynamics

    International Nuclear Information System (INIS)

    Drell, S.D.

    1980-01-01

    The speech of Drell S. on the symposium dedicated to 60th anniversary of Schwinger J. is presented. The fundamental status of the hero of the day in quantum field theory, which turned into quantum electrodynamics, are stated. The theory has been perfectly experimentally confirmed and now is the main model permitting to explain weak and strong interactions. The attention is paid on the difference between theoretical and experimental values of the electron anomalous magnetic moment (asub(e)) obtained in the sixth order of perturbation theory. It is necessary to carry out calculations in the octic order of the perturbation theory in order to obtain more precise value of asub(e). The theory and the experimental difference is demonstrated on the example of estimation of fine and hyperfine structure of hydrogen, muonium, and positronium

  4. RTNS-II: present status

    International Nuclear Information System (INIS)

    Heikkinen, D.W.; Logan, C.M.

    1980-10-01

    The present status of the RTNS-II facility is described and typical operating parameters are given. A brief discussion is given of the methods used in production of the TiT 2 targets as well as their performance and tritium handling at RTNS-II. The various types of non-interactive beam diagnostics presently in use at the neutron sources are outlined. The on-line computer system which provides a time history of an irradiation and records target performance is described. Examples are listed of several representative experimental programs which have been carried out thus far at RTNS-II. These include both active and passive experiments. Finally, several of the major improvements to the facility made since the beginning of the experimental program are given

  5. Nuclear energy - status and outlook

    Energy Technology Data Exchange (ETDEWEB)

    Rogner, Hans-Holger; MacDonald, Alan

    2007-07-01

    Rising expectations best characterize the current prospects of nuclear power in a world that is confronted with a burgeoning demand for energy, higher energy prices, energy supply security concerns and growing environmental pressures. It appears that the inherent economic and environmental benefits of the technology and its excellent performance record over the last twenty years are beginning to tilt the balance of political opinion and public acceptance in favour of nuclear power. Nuclear power is a cost-effective supply-side technology for mitigating climate change and can make a substantial contribution to climate protection. This paper reviews the current status of nuclear power and its fuel cycle and provides an outlook on where nuclear power may be headed in the short-to-medium run (20 to 40 years from now). (auth)

  6. Status of fission yield data

    International Nuclear Information System (INIS)

    England, T.R.; Blachot, J.

    1988-01-01

    In this paper we summarize the current status of the recent US evaluation for 34 fissioning nuclides at one or more neutron incident energies and for spontaneous fission. Currently there are 50 yields sets, and for each we have independent and cumulative yields and uncertainties for approximately 1100 fission products. When finalized the recommended data will become part of Version VI of the US ENDF/B. Other major evaluations in progress that are included in a recently formed IAEA Coordinated Research Program are also summarized. In a second part we review two empirical models in use to estimate independent yields. Comparison of model estimates with measured data is presented, including a comparison with some recent data obtained from Lohengrin (Cf-249 T). 18 refs., 13 figs., 3 tabs

  7. NA64 Status Report 2018

    CERN Document Server

    Gninenko, Sergei

    2018-01-01

    The experiment NA64 is aimed at a search for a sub-GeV vector mediator (called dark photon A′) of Dark Matter production at the CERN SPS. . The main goal in 2017 was to probe a region of the A′ parameter space of the thermal dark matter model. Ongoing activities on the detector and data analysis are reviewed. The status and results from the NA64 runs in 2016 and 2017 are reported. First results on the search for the X->e+e− decay of a 17 MeV X boson, which could explain the recently observed excess of e+e-pairs from the excited 8Be nucleus transitions, and A'-> e+e- decays are also presented. Ongoing analysis on the decays of axion-like particles and plans for further searches beyond LS2 are also discussed.

  8. Reactor pressure vessel status report

    International Nuclear Information System (INIS)

    Strosnider, J.; Wichman, K.; Elliot, B.

    1994-12-01

    This report gives a brief description of the reactor pressure vessel (RPV), followed by a discussion of the radiation embrittlement of RPV beltline materials and the two indicators for measuring embrittlement, the end-of-license (EOL) reference temperature and the EOL upper-shelf energy. It also summarizes the GL 92-01 effort and presents, for all 37 boiling water reactor plants and 74 pressurized water reactor plants in the United States, the current status of compliance with regulatory requirements related to ensuring RPV integrity. The staff has evaluated the material data needed to predict neutron embrittlement of the reactor vessel beltline materials. These data will be stored in a computer database entitled the reactor vessel integrity database (RVID). This database will be updated annually to reflect the changes made by the licensees in future submittals and will be used by the NRC staff to assess the issues related to vessel structural integrity

  9. ATLAS construction: A status report

    CERN Document Server

    Sfyrla, Anna

    2006-01-01

    ATLAS is a general purpose p-p collider detector being constructed for the CERN Large Hadron Collider (LHC). It is located in one of the two high luminosity bunch crossing points (peak luminosity of 1 0 3 4 c m - 2 s _ 1 ) of the LHC. It consists of 3 main sections. Located close to the beam axis, the tracking system employs pixel detectors, silicon microstrip modules and transition radiation straws, all within a 2 Tesla superconducting solenoid. The tracker is surrounded by the electromagnetic and hadronic calorimeters. In the outer part of the detector, 8 superconducting coils define an open toroidal magnetic field for muon detection. The construction status of the ATLAS detector towards being ready for the first collisions in 2007 will be presented, with particular emphasis on the construction and projected performance of the tracking system.

  10. Plant status monitor system description

    International Nuclear Information System (INIS)

    Prather, W.A.; Sly, G.A.

    1987-01-01

    In today's regulatory and financial environment, improving plant efficiency and safety are necessary elements of plant operations. Public utility commissions are making rate rulings based, in part, on plant availability performance; and the NRC is putting more emphasis on plant operational aspects. This comes at a time when operating, maintaining, and managing a plant are becoming increasingly complex; moreover, the desired number of experienced plant personnel are becoming more difficult to find. This situation can be partially resolved by using computer software tools to assist operations, maintenance, engineering, and management personnel. These software tools provide information and interpretations based on plant and equipment status. They support improved plant availability, technical specification compliance, and administrative functions. A key element or computerization is the ability to operate on integrated information

  11. Status of the DIRAC Project

    International Nuclear Information System (INIS)

    Casajus, A; Ciba, K; Fernandez, V; Graciani, R; Hamar, V; Mendez, V; Poss, S; Sapunov, M; Stagni, F; Tsaregorodtsev, A; Ubeda, M

    2012-01-01

    The DIRAC Project was initiated to provide a data processing system for the LHCb Experiment at CERN. It provides all the necessary functionality and performance to satisfy the current and projected future requirements of the LHCb Computing Model. A considerable restructuring of the DIRAC software was undertaken in order to turn it into a general purpose framework for building distributed computing systems that can be used by various user communities in High Energy Physics and other scientific application domains. The CLIC and ILC-SID detector projects started to use DIRAC for their data production system. The Belle Collaboration at KEK, Japan, has adopted the Computing Model based on the DIRAC system for its second phase starting in 2015. The CTA Collaboration uses DIRAC for the data analysis tasks. A large number of other experiments are starting to use DIRAC or are evaluating this solution for their data processing tasks. DIRAC services are included as part of the production infrastructure of the GISELA Latin America grid. Similar services are provided for the users of the France-Grilles and IBERGrid National Grid Initiatives in France and Spain respectively. The new communities using DIRAC started to provide important contributions to its functionality. Among recent additions can be mentioned the support of the Amazon EC2 computing resources as well as other Cloud management systems; a versatile File Replica Catalog with File Metadata capabilities; support for running MPI jobs in the pilot based Workload Management System. Integration with existing application Web Portals, like WS-PGRADE, is demonstrated. In this paper we will describe the current status of the DIRAC Project, recent developments of its framework and functionality as well as the status of the rapidly evolving community of the DIRAC users.

  12. Status report on radionuclide transfer

    International Nuclear Information System (INIS)

    1980-01-01

    At the suggestion of the Federal Minstry of the Interior, in June 1978, a group of scientists from several institutions who are active in the field of radionuclide transfer or are interested in these problems got together. During the discussions of the work team, especially the transfer soil/plants was emphasized. Then the work team set up a status report on the transfer of the radionuclides relevant in the sense of the radiation protection act. The nuclides H 3 and C14, the isotopes of the Sr, J, and Cs, Tc99, the so-called corrosion nuclides Mn54, Fe59, co-isotopes and Zn65, and isotopes of Pu, Am, and Cm were regarded as important for a possible radiation exposition. Recent investigations revealed that also the natural radionuclides Ra226, Po210, and Pb210 should be covered by the investigations. The goal of this status report is to present the level of knowledge on the transfer of these radionuclides to man in a brief form, giving hints at the most important literature. It was requested by the Federal Ministry of the Interior, as fas as possible, to indicate transfer factors which are necessary for the radio-occology act to be decreed according to Para. 45 of the radiation protection act. Another goal of the report was to show the gap in the knowledge on the radio nuclide transfer. This was thought to help to create a basis for the decisions of the Federal Ministry concerning the support of other investigation projects in the field of transfer of radionuclides. (orig./MG) [de

  13. LSST telescope and site status

    Science.gov (United States)

    Gressler, William J.

    2016-07-01

    The Large Synoptic Survey Telescope (LSST) Project1 received its construction authorization from the National Science Foundation in August 2014. The Telescope and Site (T and S) group has made considerable progress towards completion in subsystems required to support the scope of the LSST science mission. The LSST goal is to conduct a wide, fast, deep survey via a 3-mirror wide field of view optical design, a 3.2-Gpixel camera, and an automated data processing system. The summit facility is currently under construction on Cerro Pachón in Chile, with major vendor subsystem deliveries and integration planned over the next several years. This paper summarizes the status of the activities of the T and S group, tasked with design, analysis, and construction of the summit and base facilities and infrastructure necessary to control the survey, capture the light, and calibrate the data. All major telescope work package procurements have been awarded to vendors and are in varying stages of design and fabrication maturity and completion. The unique M1M3 primary/tertiary mirror polishing effort is completed and the mirror now resides in storage waiting future testing. Significant progress has been achieved on all the major telescope subsystems including the summit facility, telescope mount assembly, dome, hexapod and rotator systems, coating plant, base facility, and the calibration telescope. In parallel, in-house efforts including the software needed to control the observatory such as the scheduler and the active optics control, have also seen substantial advancement. The progress and status of these subsystems and future LSST plans during this construction phase are presented.

  14. Status Epilepticus in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Jonathan Lee

    2017-04-01

    Full Text Available Audience: This simulation can be used for EM learners of any level including medical students, junior residents and senior residents. Introduction: Seizures are the result of abnormal or disorganized cortical electrical activity in the brain. Status epilepticus is a dangerous complication of seizures. In adults and children older than five years old, generalized, convulsive status epilepticus refers to greater than 5 minutes of a continuous seizure OR two or more discrete seizures between which there is incomplete recovery of consciousness As with all emergency situations treatment must occur simultaneously while the physician manages primary assessment and resuscitation and determines the underlying cause. Objectives: At the end of this simulation session, the learner will: 1 Demonstrate the management of status epilepticus 2 Justify when airway intervention is needed for status epilepticus 3 Describe risk factors for status epilepticus 4 Prepare a differential diagnosis for the causes in status epilepticus. Method: This educational session is a high-fidelity simulation.

  15. Renewables 2014. Global status report 2014

    International Nuclear Information System (INIS)

    Sawin, Janet L.; Sverrisson, Freyr; Chawla, Kanika; Lins, Christine; Adib, Rana; Hullin, Martin; Leitner, Sarah; Mazzaccaro, Stefano; Murdock, Hannah; Williamson, Laura E.; Wright, Glen; McCrone, Angus; Musolino, Evan; Mastny, Lisa; Lily Riahi; Sims, Ralph; Jonathan Skeen; Sverrisson, Freyr; Martinot, Eric

    2014-01-01

    The Renewables Global Status Report provides a comprehensive and timely overview of renewable energy market, industry, investment, and policy developments worldwide. It enables policy-makers, industry, investors, and civil society to make informed decisions. The report covers recent developments, current status, and key trends; by design, it does not provide analysis or forecast. The Renewables Global Status Report relies on up-to-date renewable energy data, provided by an international network of more than 500 contributors, researchers, and authors

  16. Emergency Surgery for Refractory Status Epilepticus.

    Science.gov (United States)

    Botre, Abhijeet; Udani, Vrajesh; Desai, Neelu; Jagadish, Spoorthy; Sankhe, Milind

    2017-08-15

    Management of refractory status epilepticus in children is extremely challenging. Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan. Emergency hemispherotomy performed in both patients. A complete, sustained seizure freedom obtained postoperatively. Emergency surgery is a treatment option in selected cases of drug refractory status epilepticus with lesional pathology and concordant data.

  17. Less Common Etiologies of Status Epilepticus

    Science.gov (United States)

    Bleck, Thomas P

    2010-01-01

    Status epilepticus is treated as a neurologic emergency and only later are the potential etiologies assessed. While sometimes the cause for status epilepticus is apparent (e.g., antiepileptic drug withdrawal), all too often it is not identified, even after extensive diagnostic testing has been performed. With emphasis on the less-common etiologies, this review will cover various probable and known causes of status epilepticus among adults, children, and those patients with refractory epilepsy. PMID:20231917

  18. Nuclear status report for western Europe 1984

    International Nuclear Information System (INIS)

    Krejsa, P.; Laurent, L.; Lauridsen, K.

    1985-01-01

    The status report embraces the following countries: Austria, Belgium, Denmark, Finland, France, Federal Republic of Germany, Greece, Italy, The Netherlands, Spain, Sweden, Switzerland, United Kingdom, Yugoslavia

  19. Predictors of dropout from care among HIV-infected patients initiating antiretroviral therapy at a public sector HIV treatment clinic in sub-Saharan Africa.

    Science.gov (United States)

    Asiimwe, Stephen B; Kanyesigye, Michael; Bwana, Bosco; Okello, Samson; Muyindike, Winnie

    2016-02-01

    In sub-Saharan Africa (SSA), antiretroviral therapy (ART) can prolong life for HIV-infected patients. However, patients initiating ART, especially in routine treatment programs, commonly dropout from care either due to death or loss to follow-up. In a cohort of HIV-infected patients initiating ART at a public sector clinic in Uganda, we assessed predictors of dropout from care (a composite outcome combining death and loss to follow-up). From a large set of socio-demographic, clinical, and laboratory variables routinely collected at ART initiation, we selected those predicting dropout at P dropout at P dropout was 26.9% (established cumulative mortality = 2.3%, loss to follow-up = 24.6%), 5.6% were transferred to other service providers, and 67.5% were retained in care. A diagnosis of Kaposi's sarcoma (hazard ratio (HR) = 3.3, 95% CI 2.5 to 4.5); HIV-associated dementia (HR = 2.6, 95% CI 1.5 to 4.6); history of cryptococcosis (HR = 2.2, 95% CI 1.4 to 3.3); and reduced hemoglobin concentration (dropout. Other independent predictors of dropout were: year of ART initiation; weight loss ≥10%; reduced total lymphocyte count; chronic diarrhea; male sex; young age (≤28 years); and marital status. Among HIV-infected patients initiating ART at a public sector clinic in SSA, biological factors that usually predict death were especially predictive of dropout. As most of the dropouts were lost to follow-up, this observation suggests that many losses to follow-up may have died. Future studies are needed to identify appropriate interventions that may improve both individual-level patient outcomes and outcome ascertainment among HIV-infected ART initiators in this setting.

  20. Anxiety, Depression, and Functional Status Are the Best Predictors of Health Status Patients With Heart Failure

    National Research Council Canada - National Science Library

    DeJong, Marla

    2004-01-01

    .... Therefore, health status is an increasingly important concept in the management of HF. In fact, most symptomatic patients are more concerned about their everyday health status than the length of their life...

  1. When status is grabbed and when status is granted: Getting ahead in dominance and prestige hierarchies.

    Science.gov (United States)

    de Waal-Andrews, Wendy; Gregg, Aiden P; Lammers, Joris

    2015-09-01

    What type of behaviour affords status, agentic, or communal? Research to date has yielded inconsistent answers. In particular, the conflict view holds that agentic behaviour permits the imperious to grab status through overt force, whereas the functional view holds that communal behaviour permits the talented to earn status through popular appeal. Here, we synthesize both views by taking into account the moderating role played by group hierarchy. Group hierarchy can range from being dominance based (where status is grabbed) to prestige based (where status is granted). In a field study (Study 1), and a laboratory experiment (Study 2), we demonstrate that in different groups, status can be achieved in different ways. Specifically, agentic behaviour promotes status regardless of hierarchy type, whereas the effect of communal behaviour on status is moderated by hierarchy type: it augments it in more prestige-based hierarchies but diminishes it in more dominance-based hierarchies. © 2014 The British Psychological Society.

  2. MARS Validation Plan and Status

    International Nuclear Information System (INIS)

    Ahn, Seung-hoon; Cho, Yong-jin

    2008-01-01

    The KINS Reactor Thermal-hydraulic Analysis System (KINS-RETAS) under development is directed toward a realistic analysis approach of best-estimate (BE) codes and realistic assumptions. In this system, MARS is pivoted to provide the BE Thermal-Hydraulic (T-H) response in core and reactor coolant system to various operational transients and accidental conditions. As required for other BE codes, the qualification is essential to ensure reliable and reasonable accuracy for a targeted MARS application. Validation is a key element of the code qualification, and determines the capability of a computer code in predicting the major phenomena expected to occur. The MARS validation was made by its developer KAERI, on basic premise that its backbone code RELAP5/MOD3.2 is well qualified against analytical solutions, test or operational data. A screening was made to select the test data for MARS validation; some models transplanted from RELAP5, if already validated and found to be acceptable, were screened out from assessment. It seems to be reasonable, but does not demonstrate whether code adequacy complies with the software QA guidelines. Especially there may be much difficulty in validating the life-cycle products such as code updates or modifications. This paper presents the plan for MARS validation, and the current implementation status

  3. Status epilepticus in scrub typhus.

    Science.gov (United States)

    Kalita, Jayantee; Mani, Vinita E; Bhoi, Sanjeev K; Misra, Usha K

    2016-07-01

    Scrub typhus is an emerging infection, and there is little information about status epilepticus (SE) in scrub typhus. We report the clinical spectrum and outcome of SE in scrub typhus. In a 3-year prospective hospital-based observational study, all scrub typhus patients with SE were included. Scrub typhus was diagnosed by immunochromatography assay. SE was defined if convulsions lasted longer than 5 min. The patients' demographic, clinical, computed tomography (CT), magnetic resonance imaging (MRI), and electroencephalography (EEG) findings were noted. Response to antiepileptic drugs (AEDs) and outcome at 1 month and 1 year were recorded. Between 2012 and 2014, there were 66 patients with scrub typhus admitted with central nervous system (CNS) involvement, 10 (15.2%) of whom had SE (generalized convulsions in 5, secondary generalized in one). The median age of the patients was 34 (range 18-71) years and seven were female. The duration of SE ranged between 10 min and 48 h. SE responded to one AED in five patients, two AEDs in three patients, and more than two AEDs in two patients. Cranial MRI findings were normal. All patients recovered completely with doxycycline by 1 month and AED was withdrawn by 8 months in all. Although 15% patients with scrub typhus may have SE, they have good outcome. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  4. Status report on geochemical modelling

    International Nuclear Information System (INIS)

    Read, D.

    1991-12-01

    This report describes the findings of a review undertaken on behalf of the project management group of the programme 'Endlagersicherheit in der Nachbetriebsphase' based at GSF-IfT (Forschungszentrum fuer Umwelt und Gesundheit - Institut fuer Tieflagerung) to establish the current status of research into the simulation of geochemical processes relevant to radiological assessment. The review is intended to contribute to Stage 1 of a strategy formulated to enhance the use of geochemical models in Germany. Emphasis has been placed on processes deemed to be of greatest relevance to performance assessment for a HLW-repository in a salt dome principally, speciation-solubility in high salinity solutions, complexation by natural organics and generation-transport of colloids. For each of these and other topics covered, a summary is given of fundamental concepts, theoretical representations and their limitations, highlighting, where appropriate, the advantages and disadvantages of alternative approaches. The availability of data to quantify any given representation is addressed, taking into account the need for information at elevated temperatures and pressures. Mass transfer is considered in terms of aqueous, particulate and gas-mediated transport, respectively. (orig.) [de

  5. Status of the GERDA experiment

    International Nuclear Information System (INIS)

    Medinaceli, E.

    2016-01-01

    The GERDA experiment is designed to search for neutrinoless double beta decay (0νββ) using "7"6Ge, therefore asses the nature of neutrinos (Dirac or Majorana). In the so-called Phase I, with an exposure of 21.6 kr yr, GERDA reached a background index (BI) of 10"−"2 cts/(keV kg yr) at 90% CL No signal was found during this phase and a lower limit on the process half-life of 2.1 × 10"2"5 yr was derived (90% CL). GERDA is currently being upgraded to its Phase II, where the "7"6Ge mass will be double, and it is expected to reduce by an order of magnitude the BI. For 0νββ half-lives at the order of 10"2"6 yr will be derived in the absence of signal. The experimental techniques used by GERDA will be depicted and the most relevant results from Phase I will be shown; as well as details on the upgrades of Phase II, including the status of the additional detectors deployed recently, and the new background reduction techniques using the active liquid Argon veto.

  6. Status of Gerda Phase II

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Victoria [Max-Planck-Institut fuer Kernphysik, Heidelberg (Germany); Collaboration: GERDA-Collaboration

    2016-07-01

    The GERDA experiment is designed to search for neutrinoless double beta (0νββ) decay of {sup 76}Ge. In Phase I of the experiment a background index (BI) of 10{sup -2} cts/(keV.kg.yr) was reached. No signal has been found and a lower limit on the half-life of 2.1.10{sup 25} yr (at 90% C.L.) is extracted. The aim of Phase II is to double the Ge mass and further reduce the BI by an order of magnitude to explore half-lives of about 10{sup 26} yr. Thirty new Broad Energy Germanium (BEGe) detectors have been produced. These detectors are distinct for their improved energy resolution and enhanced pulse shape discrimination of signal from background events. Further background reduction will be reached by an active veto to read out argon scintillation light. The Phase II commissioning showed that two of the major background components, external γ-rays from {sup 214}Bi and {sup 208}Tl decays, can be suppressed up to two orders of magnitude. This talk presents the current status of the GERDA Phase II upgrade.

  7. Status of the GERDA experiment

    Science.gov (United States)

    Medinaceli, E.; Gerda Collaboration

    2017-07-01

    The GERDA experiment is designed to search for neutrinoless double beta decay (0νββ) using ^{76} Ge, therefore asses the nature of neutrinos (Dirac or Majorana). In the so-called Phase I, with an exposure of 21.6kr yr, GERDA reached a background index (BI) of 10^{-2}{ cts/(keV kg yr)} at 90% CL No signal was found during this phase and a lower limit on the process half-life of 2.1×10^{25}{ yr} was derived (90% CL). GERDA is currently being upgraded to its Phase II, where the ^{76} Ge mass will be double, and it is expected to reduce by an order of magnitude the BI. For 0νββ half-lives at the order of 10^{26}{ yr} will be derived in the absence of signal. The experimental techniques used by GERDA will be depicted and the most relevant results from Phase I will be shown; as well as details on the upgrades of Phase II, including the status of the additional detectors deployed recently, and the new background reduction techniques using the active liquid Argon veto.

  8. WFIRST: Project Overview and Status

    Science.gov (United States)

    Kruk, Jeffrey; WFIRST Formulation Science Working Group, WFIRST Project Team

    2018-01-01

    The Wide-Field InfraRed Survey Telescope (WFIRST) will be the next Astrophysics flagship mission to follow JWST. The observatory payload consists of a Hubble-size telescope aperture with a wide-field NIR instrument and a coronagraph operating at visible wavelengths and employing state-of-the-art wavefront sensing and control. The Wide-field instrument is optimized for large area NIR imaging and spectroscopic surveys, with performance requirements driven by programs to study cosmology and exoplanet detection via gravitational microlensing. All data will be public immediately, and a substantial guest observer program will be supported.The WFIRST Project is presently in Phase A, with a transition to Phase B expected in early to mid 2018. Candidate observing programs are under detailed study in order to inform the mission design, but the actual science investigations will not be selected until much closer to launch. We will present an overview of the present mission design and expected performance, a summary of Project status, and plans for selecting the observing programs.

  9. Industry outreach a status report

    Energy Technology Data Exchange (ETDEWEB)

    Surek, D.; Sen, R. [R.K. Sen & Associates, Inc., Bethesda, MD (United States)

    1995-09-01

    The Outreach Project was initiated in October 1994 with the objective of developing a multi-year plan for the U.S. Department of Energy (DOE) for targeted outreach activities for stakeholders in industry and the general public. This status report summarizes the work on industry outreach that has been completed since the inception of the project in October 1994. A three-pronged approach was taken to ascertain issues related to industry outreach. First, there was a review of on-going and past industry outreach activities at DOE and NHA. Next, a series of meetings with industry decision makers was arranged to get a better understanding of industry interests and concerns, and to discuss how DOE and industry could work collaboratively to develop hydrogen energy systems. Third, a workshop is scheduled where representatives from industry, DOE and other federal agencies can identify issues that would enhance partnering between the federal government and industry in the development of hydrogen energy systems. At this tiny, the review of on-going and past activities has been completed. Industry interviews are in progress and a majority of meetings have been held. Analysis of the information gained is in progress. The preliminary analysis of this information indicates that for appropriate near-term demonstration-type projects, the level of interest for collaboration between DOE and industry is high. The data also identifies issues industry is concerned with which impact the commercialization of hydrogen energy systems.

  10. Renewables 2012 - Global status report

    International Nuclear Information System (INIS)

    Sawin, Janet L.; Bhattacharya, Sribas Chandra; Galan, Ernesto Macias; McCrone, Angus; Moomaw, William R.; Sims, Ralph; Sonntag-O'Brien, Virginia; Sverrisson, Freyr; Chawla, Kanika; Adib, Rana; Musolino, Evan; Mastny, Lisa; Skeen, Jonathan; Martinot, Eric; Hinrichs-Rahlwes, Rainer

    2012-01-01

    Renewable energy markets and policy frameworks have evolved rapidly in recent years. This report provides a comprehensive and timely overview of renewable energy market, industry, investment, and policy developments worldwide. It relies on the most recent data available, provided by a network of more than 400 contributors and researchers from around the world, all of which is brought together by a multi-disciplinary authoring team. The report covers recent developments, current status, and key trends; by design, it does not provide analysis or forecast the future. As such, this report and subsequent editions will serve as a benchmark for measuring global progress in the deployment of renewable energy, which is of particular interest in this International Year of Sustainable Energy for All. UN Secretary-General Ban Ki-moon has marked the occasion with a new global initiative, Sustainable Energy for All, which seeks to mobilise global action on three inter-linked objectives to be achieved by 2030: universal access to modern energy services, improved rates of energy efficiency, and expanded use of renewable energy sources

  11. Vitamin D Status in Korea

    Directory of Open Access Journals (Sweden)

    Han Seok Choi

    2013-03-01

    Full Text Available The majority of the vitamin D in our body is produced by cutaneous synthesis in response to sunlight. As more and more people live in cities and spend the bulk of their time indoors, it can be difficult to get sufficient sun exposure for adequate cutaneous production of vitamin D. Therefore, vitamin D insufficiency has become a very common health problem worldwide. The Korea National Health and Nutrition Examination Survey IV 2008 showed that the prevalence of vitamin D insufficiency, defined as a serum 25-hydroxyvitamin D [25(OHD] level below 50 nmol/L, was 47.3% in males and 64.5% in females. Only 13.2% of males and 6.7% of females had a serum 25(OHD level of greater than 75 nmol/L. In Korea, vitamin D insufficiency was more prevalent in young adults than in elderly people, likely due to the indoor lifestyle of younger people. Compared with the United States and Canada, Korea has a lower mean 25(OHD level and a higher prevalence of vitamin D insufficiency. To improve the vitamin D status of the Korean population, more aggressive policies on food fortification and vitamin D supplementation are needed.

  12. Current Status of RENO Experiment

    International Nuclear Information System (INIS)

    Kim, Soo-Bong

    2010-01-01

    The RENO (Reactor Experiment for Neutrino Oscillation) is under construction to measure the value of the smallest and unknown neutrino mixing angle θ 13 . The experiment will compare the measured fluxes of electron antineutrinos at two detectors located at 290 m and 1.4 km distances from the center of the Yonggwang nuclear reactors in Korea, with world-second largest thermal power output of 16.4 GW. Construction of experimental halls and access tunnels for both near and far detector sites was completed in early 2009. The detectors are near completion, and data-taking is planned to start in mid 2010. An expected number of observed antineutrino is roughly 510 and 80 per day in the near detector and far detector, respectively. An estimated systematic uncertainty associated with the measurement is less than 0.6%, and an expected statistical error is about 0.3%. With three years of data, the experiment will search for the mixing angle values of sin 2 (2θ 13 ) down to 0.02 in 90% C.L. limit. In this talk, the construction status will be presented. (author)

  13. Status of uranium in Brazil

    International Nuclear Information System (INIS)

    Majdalani, S.A.; Tavares, A.M.

    2001-01-01

    Uranium exploration in Brazil was started in 1952 by the Brazilian National Research Council. This led to the discovery of the first uranium deposits in Pocos de Caldas and Jacobina. These activities was later continued by the National Energy Commission/Comissao Nacional de Energia Nuclear (CNEN), formed in 1962. The founding of NUCLEBRAS at the end of 1974 marked the increasing effort of the country's uranium exploration programme. At this time only the Pocos de Caldas deposit was known with measurable resources. Due to the reorganization of the Brazilian nuclear programme in 1988, all uranium exploration in the country was stopped. By then, eight areas with uranium reserves has been identified. Brazil uranium resources in the RAR category at ≤ $80/kg U cost range are estimated to be 162,000 tonnes U, out of which 56,100 tonnes are in the ≤ $40/kg U cost range. Additional resources in the EAR-I category and the cost range ≤ 80/kg U are in the order of 100,200 tonnes U. The first production of uranium in Brazil, at the Osamu Utsumi mine (Pocos de Caldas deposit), started in 1982. Because of escalated costs and reduced demand, this activity was put on stand-by status between 1990 and 1992. The mine was restarted in 1993, but was stopped again in October 1995. The cumulative production of the mine to 1996 was 1241 tonnes U. The Lagoa Real deposit is currently being prepared as a new producing mine. (author)

  14. Status of rod consolidation, 1988

    International Nuclear Information System (INIS)

    Bailey, W.J.

    1989-01-01

    It is estimated that the spent fuel storage pools at some domestic light-water reactors will run out of space before 2003, the year that the US Department of Energy currently predicts it will have a repository available. Of the methods being studied to alleviate the problem, rod consolidation is one of the leading candidates for achieving more efficient use of existing space in spent fuel storage pools. Rod consolidation involves mechanically removing all the fuel rods from the fuel assembly hardware (i.e., the structural components) and placing the fuel rods in a close-packed array in a canister without space grids. A typical goal of rod consolidation systems is to insert the fuel rods from two fuel assemblies into a canister that has the same exterior dimensions as one standard fuel assembly (i.e., to achieve a consolidation or compaction ratio of 2:1) and to compact the nonfuel-bearing structural components from those two fuel assemblies by a factor of 10 to 20. This report provides an overview of the current status of rod consolidation in the United States and a small amount of information on related activities in other countries. 85 refs., 36 figs., 5 tabs

  15. [Management of pediatric status epilepticus].

    Science.gov (United States)

    Vargas L, Carmen Paz; Varela E, Ximena; Kleinsteuber S, Karin; Cortés Z, Rocío; Avaria B, María de Los Ángeles

    2016-01-01

    Pediatric Status Epilepticus (SE) is an emergency situation with high morbidity and mortality that requires early and aggressive management. The minimum time criterion to define SE was reduced from 30 to 5 minutes, defined as continuous seizure activity or rapidly recurrent seizures without resumption of consciousness for more than 5 minutes. This definition considers that seizures that persist for > 5 minutes are likely to do so for more than 30 min. Those that persist for more than 30 minutes are more difficult to treat. Refractory SE is the condition that extends beyond 60-120 minutes and requires anesthetic management. Super-refractory SE is the state of no response to anesthetic management or relapse during withdrawal of these drugs. The aim of this review is to provide and update on convulsive SE concepts, pathophysiology, etiology, available antiepileptic treatment and propose a rational management scheme. A literature search of articles published between January 1993 and January 2013, focused on pediatric population was performed. The evidence about management in children is limited, mostly corresponds to case series of patients grouped by diagnosis, mainly adults. These publications show treatment alternatives such as immunotherapy, ketogenic diet, surgery and hypothermia. A 35% mortality, 26% of neurological sequelae and 35% of recovery to baseline condition is described on patient’s evolution.

  16. Current status of nuclear power

    International Nuclear Information System (INIS)

    Behnke, W.B.

    1984-01-01

    The decision to devote the 1984 conference to nuclear power is timely and appropriate. Illinois has a long, and distinguished history in the development of civilian nuclear power. The concept was born at the University of Chicago, developed at Argonne National Laboratory and demonstrated on the Commonwealth Edison system at our pioneer Dresden Nuclear Station. Today, Illinois ranks number one in the nation in nuclear generation. With over a quarter century of commercial operating experience, nuclear power has proven its worth and become a significant and growing component of electric power supply domestically and throughout the world. Despite its initial acceptance, however, the nuclear power industry in the U.S. is now in the midst of a difficult period of readjustment stemming largely from the economic and regulatory problems of the past decade. As a result, the costs of plants under construction have increased dramatically, causing serious financial difficulties for several projects and their owners. At the same time, the U.S. is facing hard choices concerning its future energy supplies. Conferences such as this have an important role in clarifying the issues and helping to find solutions to today's pressing energy problems. This paper summarizes the status of nuclear power both here and abroad, discussing the implications of current events in the context of national energy policy and economic development here in Illinois

  17. Status and prospects for CUORE

    Science.gov (United States)

    Canonica, L.; Alduino, C.; Alfonso, K.; Artusa, D. R.; Avignone, F. T., III.; Azzolini, O.; Banks, T. I.; Bari, G.; Beeman, J. W.; Bellini, F.; Bersani, A.; Biassoni, M.; Branca, A.; Brofferio, C.; Bucci, C.; Camacho, A.; Caminata, A.; Cao, X. G.; Capelli, S.; Cappelli, L.; Carbone, L.; Cardani, L.; Carniti, P.; Casali, N.; Cassina, L.; Chiesa, D.; Chott, N.; Clemenza, M.; Copello, S.; Cosmelli, C.; Cremonesi, O.; Creswick, R. J.; Cushman, J. S.; D'Addabbo, A.; Dafinei, I.; Davis, C. J.; Dell'Oro, S.; Deninno, M. M.; Di Domizio, S.; Di Vacri, M. L.; Drobizhev, A.; Fang, D. Q.; Faverzani, M.; Fernandes, G.; Ferri, E.; Ferroni, F.; Fiorini, E.; Franceschi, M. A.; Freedman, S. J.; Fujikawa, B. K.; Giachero, A.; Gironi, L.; Giuliani, A.; Gladstone, L.; Gorla, P.; Gotti, C.; Gutierrez, T. D.; Haller, E. E.; Han, K.; Hansen, E.; Heeger, K. M.; Hennings-Yeomans, R.; Hickerson, K. P.; Huang, H. Z.; Kadel, R.; Keppel, G.; Kolomensky, Yu G.; Leder, A.; Ligi, C.; Lim, K. E.; Liu, X.; Ma, Y. G.; Maino, M.; Marini, L.; Martinez, M.; Maruyama, R. H.; Mei, Y.; Moggi, N.; Morganti, S.; Mosteiro, P. J.; Napolitano, T.; Nones, C.; Norman, E. B.; Novati, V.; Nucciotti, A.; O'Donnell, T.; Orio, F.; Ouellet, J. L.; Pagliarone, C. E.; Pallavicini, M.; Palmieri, V.; Pattavina, L.; Pavan, M.; Pessina, G.; Pettinacci, V.; Piperno, G.; Pirro, S.; Pozzi, S.; Previtali, E.; Rosenfeld, C.; Rusconi, C.; Sangiorgio, S.; Santone, D.; Scielzo, N. D.; Singh, V.; Sisti, M.; Smith, A. R.; Taffarello, L.; Tenconi, M.; Terranova, F.; Tomei, C.; Trentalange, S.; Vignati, M.; Wagaarachchi, S. L.; Wang, B. S.; Wang, H. W.; Wilson, J.; Winslow, L. A.; Wise, T.; Woodcraft, A.; Zanotti, L.; Zhang, G. Q.; Zhu, B. X.; Zimmermann, S.; Zucchelli, S.

    2017-09-01

    CUORE is a cryogenic detector consisting of 988 TeO2 crystals, 750 g each, and will be operated at a temperature of ˜10 mK, to search for neutrinoless double beta decay (0νββ) of 130Te. The detector, in the final stages of construction at the Laboratori Nazionali del Gran Sasso (Italy), will start its operations in 2016. CUORE-0, its pilot experiment, has proven the feasibility of CUORE, demonstrating that the target background of 0.01 counts/keV/kg/y and the energy resolution of 5 keV are within reach. CUORE-0 also made the most precise measurement of the 2νββ decay. The expected sensitivity of CUORE to the 0νββ 130Te half-life is 9 ·1025y, for 5 years of data taking. Here, we report the most recent results of CUORE-0, their implications for CUORE, and the current status of the CUORE experiment.

  18. Pinon Pine IGCC project status

    International Nuclear Information System (INIS)

    Higginbotham, E.B.; Lamarre, L.J.; Glazer, M.

    1993-01-01

    Sierra Pacific Power Company (SPPCo) intends to build the Pinon Pine Power Project, an integrated coal gasification combined cycle (IGCC) plant at its Tracy Power Station near Reno, Nevada. The plant will burn approximately 800 tons of coal per day to generate electricity in a base load application. The Pinon Project was selected by the U.S. Department of Energy (DOE) for funding under Round IV of the Clean Coal Technology Program. The project will demonstrate the use of the KRW agglomerating fluidized bed gasifer operating in the air blown mode. Hot gas cleanup consisting of particulate and sulfur removal will also be demonstrated. The Cooperative Agreement between SPPCo and the DOE was executed in August 1992. Foster Wheeler USA Corporation (FWUSA) will provide engineering and construction management services. The M.W. Kellogg Company (MWK) will provide engineering of the gasifer and hot gas cleanup systems. A discussion of project progress since the 1992 Clean Coal Technology Conference, design and economic considerations, and current project status is presented

  19. Status report of PEP-4

    International Nuclear Information System (INIS)

    Kamae, Tuneyoshi

    1982-01-01

    The present status of PEP-4 is reported. The cosmic ray test of a TPC without magnetic field was done in July, 1981, and tracks were observed on the first day of the test. The entire PEP-4 detector was tested with 3.9 kG magnetic field in November, 1981, and various trigger configurations were tested. The TPC performed well during the test, and a preliminary analysis gave an encouraging position resolution which is expected to be improved with the correction for various non-uniformity and by refining the fitting procedure. Furthermore, the detection efficiency of the muon chamber was about 99 %. In November and December, 1981, the cosmic ray test of the hexagonal calorimeter was carried out. The performance was just as expected. Noise did not pose any problem, and the peak of the Fourier coefficient gave a nice overall calibration of the calorimeter. There are some problems to be solved in future. With the TPC, the impurities in the gas, the electronic noise, the hooks and the magnetic coil should be improved. In addition, there are some problems with the inner drift chamber, the hexagonal calorimeter and the relativistic rise measured by the TPC. The very recent results with the first e + e - beam obtained in February, 1982, are briefly reported, although the events have not been fully analyzed. (Ito, K.)

  20. Status and prospects for reprocessing

    International Nuclear Information System (INIS)

    Rossney, G.K.

    1977-01-01

    Following the formation of United Reprocessors (U.R.G.) in 1976 by British Nuclear Fuels Limited (B.N.F.L.) in the United Kingdom, the Commissariat a l'Energie Atomique (C.E.A.) in France and K.E.W.A. Kernbrennstoff-Wiederaufarbeitungs-Gesellschaft MBH (K.E.W.A.) in Germany, collaboration is now well established for the marketing of their reprocessing services for irradiated oxide fuel from thermal reactors. In addition collaboration in the continued evolution of the technology has progressed and an extensive research and development programme has been established, the results of which are exchanged between the shareholders. During 1976 the U.K. Government has given approval to B.N.F.L. to sign further contracts with foreign customers, subject to certain conditions. In France, the fuel cycle activities of the C.E.A. have been vested in a new company (Compagnie Generale Des Matieres Nucleaires (C.O.G.E.M.A.)) and their La Hague plant has commenced reprocessing operations on irradiated oxide fuel. In Germany, an agreement has been signed between K.E.W.A. and P.W.K. for the pre-project study for the proposed German plant. Against this background this paper reviews the present status of reprocessing by the shareholders of U.R.G. and the prospects for reprocessing

  1. Aging, Nutritional Status and Health

    Directory of Open Access Journals (Sweden)

    Wilma Leslie

    2015-07-01

    Full Text Available The older population is increasing worldwide and in many countries older people will outnumber younger people in the near future. This projected growth in the older population has the potential to place significant burdens on healthcare and support services. Meeting the diet and nutrition needs of older people is therefore crucial for the maintenance of health, functional independence and quality of life. While many older adults remain healthy and eat well those in poorer health may experience difficulties in meeting their nutritional needs. Malnutrition, encompassing both under and over nutrition increases health risks in the older population. More recently the increase in obesity, and in turn the incidence of chronic disease in older adults, now justifies weight management interventions in obese older adults. This growing population group is becoming increasingly diverse in their nutritional requirements. Micro-nutrient status may fluctuate and shortfalls in vitamin D, iron and a number of other nutrients are relatively common and can impact on well-being and quality of life. Aging presents a number of challenges for the maintenance of good nutritional health in older adults.

  2. Status of the SXFEL Facility

    Directory of Open Access Journals (Sweden)

    Zhentang Zhao

    2017-06-01

    Full Text Available The Shanghai soft X-ray Free-Electron Laser facility (SXFEL is being developed in two steps; the SXFEL test facility (SXFEL-TF, and the SXFEL user facility (SXFEL-UF. The SXFEL-TF is a critical development step towards the construction a soft X-ray FEL user facility in China, and is under commissioning at the Shanghai Synchrotron Radiation Facility (SSRF campus. The test facility is going to generate 8.8 nm FEL radiation using an 840 MeV electron linac passing through the two-stage cascaded HGHG-HGHG or EEHG-HGHG (high-gain harmonic generation, echo-enabled harmonic generation scheme. The construction of the SXFEL-TF started at the end of 2014. Its accelerator tunnel and klystron gallery were ready for equipment installation in April 2016, and the installation of the SXFEL-TF linac and radiator undulators were completed by the end of 2016. In the meantime, the SXFEL-UF, with a designated wavelength in the water window region, began construction in November 2016. This was based on upgrading the linac energy to 1.5 GeV, and the building of a second undulator line and five experimental end-stations. Construction status and the future plans of the SXFEL are reported in this paper.

  3. Monitor for status epilepticus seizures

    Science.gov (United States)

    Johnson, Mark; Simkins, Thomas

    1994-01-01

    This paper describes the sensor technology and associated electronics of a monitor designed to detect the onset of a seizure disorder called status epilepticus. It is a condition that affects approximately 3-5 percent of those individuals suffering from epilepsy. This form of epilepsy does not follow the typical cycle of start-peak-end. The convulsions continue until medically interrupted and are life threatening. The mortality rate is high without prompt medical treatment at a suitable facility. The paper describes the details of a monitor design that provides an inexpensive solution to the needs of those responsible for the care of individuals afflicted with this disorder. The monitor has been designed as a cooperative research and development effort involving the United States Army Armament Research, Development, and Engineering Center's Benet Laboratories (Benet) and the Cerebral Palsy Center for the Disabled (Center), in association with the Department of Neurology at Albany Medical College (AMC). Benet has delivered a working prototype of the device for field testing, in collaboration with Albany Medical College. The Center has identified several children in need of special monitoring and has agreed to pursue commercialization of the device.

  4. Environmental status 2009; Miljoestatus 2009

    Energy Technology Data Exchange (ETDEWEB)

    2009-07-01

    The environment and climate has in recent years received their deserved place high on the public agenda. Still many important issues and contexts make little or no attention in the debates. As environmental directorates one of the most important tasks is to contribute reliable, relevant and understandable information about the state of the environment and development. Environmental status 2009 provides a thematic and comprehensive overview of environmental challenges in Norway. Where are we today, and what are the biggest challenges ahead? What are the national goals? And what have we achieved? The information is based on facts and analysis from their own work and from various research and knowledge communities co-working with the directorate.Climate change has been given much space because it is the biggest threat to the environment. Loss of biological diversity - a major problem compounded by climate change - and the fight against environmental toxins that affect animal and human health, are also high priority. Directorate for Nature Management and Norwegian Pollution Control Authority are responsible for the report and the contents of the chapters on biodiversity and pollution. The chapter on cultural heritage is written by the Cultural Heritage. (AG)

  5. Predictors of Sociometric Status for Low Socioeconomic Status Elementary Mainstreamed Students with and without Special Needs

    Science.gov (United States)

    Baydik, Berrin; Bakkaloglu, Hatice

    2009-01-01

    The purpose of the present study is to compare the sociometric status of low socioeconomic status elementary school students with and without special needs and investigate the effects of different variables (gender, age, physical appearance, social skills, behavior problems, and academic competence) on students' sociometric status. Elementary…

  6. association between health status and visual functioning

    African Journals Online (AJOL)

    2014-01-31

    Jan 31, 2014 ... High blood pressure and abnormal body mass have been observed to correlate negatively with health status. Of interest in this study, is the impact such health status have on visual function indicated by near point of convergence. In this community based cross sectional study, 250 randomly selected ...

  7. Status consumption and poverty in developing countries

    NARCIS (Netherlands)

    van Kempen, L.A.C.M.

    2005-01-01

    This thesis investigates the scope, nature and welfare effects of status consumption by the poor in developing countries, a phenomenon that is virtually unexplored in the development economics literature. It addresses questions such as: why do the poor buy status-intensive goods, while they suffer

  8. Status of the tau one prong problem

    International Nuclear Information System (INIS)

    Hayes, K.G.

    1989-08-01

    The present status of the tau one prong problem is reviewed. Emphasis is placed on recent published branching fraction measurements, the status and implications of tau lifetime measurements, and measurements which constrain the sum of branching fractions to be unity. 29 refs., 10 figs., 2 tabs

  9. Energy status and ovarian follicular development

    NARCIS (Netherlands)

    Meng, Li

    2016-01-01

    Female reproduction is tightly linked to body energy status and it has become increasingly clear that disturbed energy metabolism can negatively affect reproductive performance. Nevertheless, the way how a disturbed energy status affects ovarian follicular reserve as well as follicular

  10. Preliminary Integrated Safety Analysis Status Report

    International Nuclear Information System (INIS)

    Gwyn, D.

    2001-01-01

    This report provides the status of the potential Monitored Geologic Repository (MGR) Integrated Safety Analysis (EA) by identifying the initial work scope scheduled for completion during the ISA development period, the schedules associated with the tasks identified, safety analysis issues encountered, and a summary of accomplishments during the reporting period. This status covers the period from October 1, 2000 through March 30, 2001

  11. Vitamin a status in children with diarrhoea

    OpenAIRE

    Abrol, Pankaj; Mehta, Umesh; Lal, Harbans

    2002-01-01

    Vitamin A status was measured in 50 pre-school children with acute and persistent diarrhoea. It was measured by (a) Fluorometric micromethod and (b) Conjunctival impression cytology (CIC). The results were compared with 25 normal children. Vitamin A status was lower in children with persistent diarrhoea whereas the results were comparable between the children with acute diarrhoea and control subjects.

  12. Socioeconomic status and risk of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Pedersen, Line Merete Blak; Jacobsen, Søren; Klarlund, Mette

    2006-01-01

    To examine whether markers of socioeconomic status (SES) are associated with risk of rheumatoid arthritis (RA), and if so, whether selected lifestyle-related factors could explain this association.......To examine whether markers of socioeconomic status (SES) are associated with risk of rheumatoid arthritis (RA), and if so, whether selected lifestyle-related factors could explain this association....

  13. 49 CFR 1572.105 - Immigration status.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Immigration status. 1572.105 Section 1572.105... ASSESSMENTS Standards for Security Threat Assessments § 1572.105 Immigration status. (a) An individual... to an order of removal under the immigration laws of the United States is not eligible to apply for a...

  14. Preoperative Smoking Status and Postoperative Complications

    DEFF Research Database (Denmark)

    Pedersen, Marie Grønkjær; Eliasen, Marie; Skov-Ettrup, Lise Skrubbeltrang

    2014-01-01

    To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type.......To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type....

  15. The impact of migraine on health status

    NARCIS (Netherlands)

    Essink-Bot, M L; van Royen, L; Krabbe, P; Bonsel, G J; Rutten, F F

    PROBLEMS: What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than

  16. The impact of migraine on health status

    NARCIS (Netherlands)

    Essink-Bot, M. L.; van Royen, L.; Krabbe, P.; Bonsel, G. J.; Rutten, F. F.

    1995-01-01

    PROBLEMS--What is the effect of migraine on health status, defined as the patient's physical, psychological, and social functioning? And, suppose that the health status of migraine sufferers appears to be impaired, to what extent is this a consequence of migraine-associated comorbidity rather than

  17. Status of (US) High Energy Physics Networking

    International Nuclear Information System (INIS)

    Montgomery, H.E.

    1987-02-01

    The current status of Networking to and between computers used by the High Energy Physics community is discussed. Particular attention is given to developments over the last year and to future prospects. Comparison between the current status and that of two years ago indicates that considerable strides have been made but that much remains to be done to achieve an acceptable level of functionality

  18. Regulatory Circuits Linking Energy Status to Growth

    NARCIS (Netherlands)

    Jansen, W.M.

    2017-01-01

    Plant growth and development critically depend on carbon nutrient status. Over the past years several core regulatory systems that link plant carbon status to growth have emerged. The core regulatory systems studied include the trehalose 6-phosphate (T6P) signaling system and the Target of Rapamycin

  19. Who values the status of the entrepreneur?

    NARCIS (Netherlands)

    van Praag, M.

    2009-01-01

    Parker and Van Praag (2009) showed, based on theory, that the group status of the profession 'entrepreneurship' shapes people's occupational preferences and thus their choice behavior. The current study focuses on the determinants and consequences of the group status of a profession,

  20. Status and neutron scattering experiments at KENS

    International Nuclear Information System (INIS)

    Watanabe, N.; Sasaki, H.; Ishikawa, Y.; Endoh, Y.; Inoue, K.

    1983-01-01

    This paper reports present status of the KENS facility, progress in neutron scattering experiments and instrumental developments, and status of the KENS-I' program. A design study of a high intensity rapid-cycle 800 MeV proton synchrotron for proposed new pulsed neutron (KENS-II) and meson source is also descirbed

  1. Materialism, status consumption, and consumer independence.

    Science.gov (United States)

    Goldsmith, Ronald Earl; Clark, Ronald A

    2012-01-01

    Materialism influences many people. We focus on two aspects of this influence: reactions to prestige products and to the influence of others. A study of 187 U.S. student consumers shows that materialism is positively related to buying products that confer status. In contrast, materialism is negatively related to consumer independence, an enduring tendency to pay minimal attention to the prescribed norms of other consumers and to make product and brand decisions according to personal preferences. Consuming products for status is also negatively related to consumer independence. Moreover, the association between materialism and consumer independence is completely mediated by consuming for status. Materialism urges consumers to be status conscious so that they follow social norms in purchasing, but seeking status through goods is avoided by less materialistic, independent consumers. A second study (n = 258) also using student consumers confirmed these results.

  2. SEMATECH EUVL mask program status

    Science.gov (United States)

    Yun, Henry; Goodwin, Frank; Huh, Sungmin; Orvek, Kevin; Cha, Brian; Rastegar, Abbas; Kearney, Patrick

    2009-04-01

    As we approach the 22nm half-pitch (hp) technology node, the industry is rapidly running out of patterning options. Of the several lithography techniques highlighted in the International Technology Roadmap for Semiconductors (ITRS), the leading contender for the 22nm hp insertion is extreme ultraviolet lithography (EUVL). Despite recent advances with EUV resist and improvements in source power, achieving defect free EUV mask blank and enabling the EUV mask infrastructure still remain critical issues. To meet the desired EUV high volume manufacturing (HVM) insertion target date of 2013, these obstacles must be resolved on a timely bases. Many of the EUV mask related challenges remain in the pre-competitive stage and a collaborative industry based consortia, such as SEMATECH can play an important role to enable the EUVL landscape. SEMATECH based in Albany, NY is an international consortium representing several of the largest manufacturers in the semiconductor market. Full members include Intel, Samsung, AMD, IBM, Panasonic, HP, TI, UMC, CNSE (College of Nanoscience and Engineering), and Fuller Road Management. Within the SEMATECH lithography division a major thrust is centered on enabling the EUVL ecosystem from mask development, EUV resist development and addressing EUV manufacturability concerns. An important area of focus for the SEMATECH mask program has been the Mask Blank Development Center (MBDC). At the MBDC key issues in EUV blank development such as defect reduction and inspection capabilities are actively pursued together with research partners, key suppliers and member companies. In addition the mask program continues a successful track record of working with the mask community to manage and fund critical mask tools programs. This paper will highlight recent status of mask projects and longer term strategic direction at the MBDC. It is important that mask technology be ready to support pilot line development HVM by 2013. In several areas progress has been

  3. Current status of diuretic renography

    International Nuclear Information System (INIS)

    O'Reilly, P.H.

    1987-01-01

    Percutaneous antegrade perfusion studies constitute a valuable contribution to the investigation of obstructive uropathy. In 1978, the first report of application of diuretic renogram techniques to this problem appeared in the literature. This was the first systematic report of a standardized protocol to be applied to a specific surgical problem. The purpose of the procedure, as with perfusion pressure-flow studies, is to help distinguish between a dilated urinary tract that is obstructed and requires surgery and a nonobstructed system in which urographic dilation and stasis mimic obstruction, but no genuine impedance to urine flow exists, and surgery is not required. The technique provides dual information. It gives quantitative data on individual renal function that perfusion pressure-flow studies do not, and it gives time-activity curves reflecting the urodynamics through the individual upper urinary tracts at normal and high urinary flow rates. In the early days, this information was obtained from probe studies, but the procedure is now almost exclusively performed using the gamma camera, images from which give additional information on the site of any suspected obstruction. In some ways, the development of diuretic renography and that of perfusion pressure-flow studies have proceeded in a competitive fashion, both attempting to answer the same questions by different means. In practice, however, the two tests would be regarded as complementary, as will be shown later in this chapter. The following sections describe the technique of diuretic renography, its current clinical application and status in surgical and nuclear medicine practice, and its role in comparison with other available tests for management of the dilated upper urinary tract

  4. GRACE Status at Mission End

    Science.gov (United States)

    Tapley, B. D.; Flechtner, F. M.; Watkins, M. M.; Bettadpur, S. V.

    2017-12-01

    The twin satellites of the Gravity Recovery and Climate Experiment (GRACE) were launched on March 17, 2002 and have operated for nearly 16 years. The mission objectives are to observe the spatial and temporal variations of the Earth's mass through its effects on the gravity field at the GRACE satellite altitude. The mass changes observed are related to both the changes within the solid earth and the change within and between the Erath system components. A significant cause of the time varying mass is water motion and the GRACE mission has provided a continuous decade long measurement sequence which characterizes the seasonal cycle of mass transport between the oceans, land, cryosphere and atmosphere; its inter-annual variability; and the climate driven secular, or long period, mass transport signals. The fifth reanalysis on the mission data set, the RL05 data, were released in mid-2013. With the planned launch of GRACE Follow-On in early 2018, plans are underway for a reanalysis that will be consistent with the GRACE FO processing standards. The mission is entering the final phases of its operation life with mission end expected to occur in early 2018. The current mission operations strategy emphasizes extending the mission lifetime to obtain an overlap with the GRACE FO. This presentation will review the mission status and the projections for mission lifetime, describe the current operations philosophy and its impact on the science data, discuss the issues related to achieving the GRACE and GRACE FO connection and discuss issues related to science data products during this phase of the mission period.

  5. Stone composition and metabolic status.

    Science.gov (United States)

    Bibilash, B S; Vijay, Adarsh; Fazil Marickar, Y M

    2010-06-01

    This paper aims to study the correlation between biochemical risk factors of the stone former and the type of oxalate stone formed, namely calcium oxalate monohydrate (COM) and calcium oxalate dehydrate (COD). A retrospective study of 487 patients who had been attending the urinary stone clinic, Trivandrum during 1998-2007 was conducted. The stones retrieved from them were subjected to chemical analysis and FTIR spectrographic analysis. They were categorized into COM, COD, mixed COM+COD and others. Of 142 pure calcium oxalate stone patients, 87 were predominantly COM stone formers and 55 COD stone formers. Their metabolic status of 24 h urine and serum was assessed. The values of urine calcium, phosphorus, uric acid, magnesium, creatinine, oxalate, citric acid, sodium and potassium, serum values of calcium, phosphorus, uric acid, magnesium and creatinine and calculated values of creatinine clearance, tubular reabsorption of phosphate, calcium magnesium ratio and calcium oxalate ratio were recorded. Comparison was made between the COM stone group and the COD stone group. Patients forming COM stones had significantly higher mean values for urine calcium (P stone forming patients. All other values failed to show significant difference. Patients, with higher urine oxalate, formed COM stones. Those with low magnesium (which is an inhibitor) formed more of COD stones. Urine calcium was high in both groups without showing significant variation from the mean. In patients with high calcium-oxalate and calcium-magnesium ratios, there is higher chance of forming a COD stone than COM. Identification of the crystallization pattern of the calcium stone will help in selecting treatment modalities.

  6. Genetic mutations associated with status epilepticus.

    Science.gov (United States)

    Bhatnagar, M; Shorvon, S

    2015-08-01

    This paper reports the results of a preliminary search of the literature aimed at identifying the genetic mutations reported to be strongly associated with status epilepticus. Genetic mutations were selected for inclusion if status epilepticus was specifically mentioned as a consequence of the mutation in standard genetic databases or in a case report or review article. Mutations in 122 genes were identified. The genetic mutations identified were found in only rare conditions (sometimes vanishingly rare) and mostly in infants and young children with multiple other handicaps. Most of the genetic mutations can be subdivided into those associated with cortical dysplasias, inborn errors of metabolism, mitochondrial disease, or epileptic encephalopathies and childhood syndromes. There are no identified 'pure status epilepticus genes'. The range of genes underpinning status epilepticus differs in many ways from the range of genes underpinning epilepsy, which suggests that the processes underpinning status epilepticus differ from those underpinning epilepsy. It has been frequently postulated that status epilepticus is the result of a failure of 'seizure termination mechanisms', but the wide variety of genes affecting very diverse biochemical pathways identified in this survey makes any unitary cause unlikely. The genetic influences in status epilepticus are likely to involve a wide range of mechanisms, some related to development, some to cerebral energy production, some to diverse altered biochemical pathways, some to transmitter and membrane function, and some to defects in networks or systems. The fact that many of the identified genes are involved with cerebral development suggests that status epilepticus might often be a system or network phenomenon. To date, there are very few genes identified which are associated with adult-onset status epilepticus (except in those with preexisting neurological damage), and this is disappointing as the cause of many adult

  7. Primary status, complementary status, and organizational survival in the U.S. venture capital industry.

    Science.gov (United States)

    Bothner, Matthew S; Kim, Young-Kyu; Lee, Wonjae

    2015-07-01

    We introduce a distinction between two kinds of status and examine their effects on the exit rates of organizations investing in the U.S. venture capital industry. Extending past work on status-based competition, we start with a simple baseline: we describe primary status as a network-related signal of an organization's quality in a leadership role, that is, as a function of the degree to which an organization leads others that are themselves well regarded as lead organizations in the context of investment syndicates. Combining Harary's (1959) image of the elite consultant with Goffman's (1956) concept of "capacity-esteem," we then discuss complementary status as an affiliation-based signal of an organization's quality in a supporting role. We measure complementary status as a function of the extent to which an organization is invited into syndicates by well-regarded lead organizations-that is, by those possessing high levels of primary status. Findings show that, conditioning on primary status, complementary status reduces the rate at which venture capital organizations exit the industry. Consistent with the premise that these kinds of status correspond to different roles and market identities, we also find that complementary status attenuates (and ultimately reverses) the otherwise favorable effect of primary status on an organization's life chances. Theoretically and methodologically oriented scope conditions, as well as implications for future research, are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Spread of status value: Rewards and the creation of status characteristics.

    Science.gov (United States)

    Harkness, Sarah K

    2017-01-01

    Rewards have social significance and are highly esteemed objects, but what does their ownership signify to others? Prior work has demonstrated it may be possible for these rewards to spread their status to those who possess them, such that individuals gain or lose status and influence by virtue of the rewards they display. Yet, is this spread enough to produce entirely new status characteristics by virtue of their association with rewards? I propose a theoretical extension of the spread of status value theory and offer an experimental test considering whether the status value conveyed by rewards spreads to a new, nominal characteristic of those who come to possess these objects. The results indicate that states of a nominal characteristic do gain or lose status value and behavioral influence through their association with differentially valued rewards. Thus, rewards can create new status characteristics with resulting behavioral expectations. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Hierarchy and social status in Budongo chimpanzees.

    Science.gov (United States)

    Newton-Fisher, Nicholas E

    2004-04-01

    The status hierarchy is fundamental in the lives of male chimpanzees. This study describes the dominance interactions and social status among adult male chimpanzees of the Sonso community in the Budongo Forest Reserve, Uganda, during the period that they were first studied (1994 and 1995). Social dominance is typically measured using the behaviour of either the subordinate or the dominant individual, but a relationship is dependent on the behaviour of both parties and this study explicitly used both subordinate and dominant behaviours to investigate the status hierarchy. Among adult males of the Sonso community, agonistic interactions occurred at a low rate and pant-grunts were rare, but males could be ranked into separate hierarchies of agonistic dominance and pant-grunting (labelled 'respect') using ratios of behaviour performed/behaviour received. These hierarchies were combined to form a single hierarchy of social status that divided the males among five distinct status levels. The highest status level was held by an alliance between two males who replaced the previous alpha male during the first part of the study. Neither male in this alliance partnership pant-grunted to the other, although the reason for cooperative behaviour was unclear. Although the nominally beta male was treated as such by other adult males, he achieved surprisingly little mating success. Budongo Forest chimpanzees do not warrant the sometimes-expressed view that they are non-aggressive and peaceable and the broad pattern of their status interactions matches with that seen in other chimpanzee populations.

  10. Decoupling social status and status certainty effects on health in macaques: a network approach

    Directory of Open Access Journals (Sweden)

    Jessica J. Vandeleest

    2016-09-01

    Full Text Available Background Although a wealth of literature points to the importance of social factors on health, a detailed understanding of the complex interplay between social and biological systems is lacking. Social status is one aspect of social life that is made up of multiple structural (humans: income, education; animals: mating system, dominance rank and relational components (perceived social status, dominance interactions. In a nonhuman primate model we use novel network techniques to decouple two components of social status, dominance rank (a commonly used measure of social status in animal models and dominance certainty (the relative certainty vs. ambiguity of an individual’s status, allowing for a more complex examination of how social status impacts health. Methods Behavioral observations were conducted on three outdoor captive groups of rhesus macaques (N = 252 subjects. Subjects’ general physical health (diarrhea was assessed twice weekly, and blood was drawn once to assess biomarkers of inflammation (interleukin-6 (IL-6, tumor necrosis factor-alpha (TNF-α, and C-reactive protein (CRP. Results Dominance rank alone did not fully account for the complex way that social status exerted its effect on health. Instead, dominance certainty modified the impact of rank on biomarkers of inflammation. Specifically, high-ranked animals with more ambiguous status relationships had higher levels of inflammation than low-ranked animals, whereas little effect of rank was seen for animals with more certain status relationships. The impact of status on physical health was more straightforward: individuals with more ambiguous status relationships had more frequent diarrhea; there was marginal evidence that high-ranked animals had less frequent diarrhea. Discussion Social status has a complex and multi-faceted impact on individual health. Our work suggests an important role of uncertainty in one’s social status in status-health research. This work also

  11. The influence of status on satisfaction with relative rewards

    DEFF Research Database (Denmark)

    Albrecht, Konstanze; Essen, Emma von; Falk, Armin

    2014-01-01

    This study investigates how induced relative status affects satisfaction with different relative payoffs. We find that participants with lower status are more satisfied with disadvantageous payoff inequalities than equal or higher status participants. In contrast, when receiving an advantageous...... payoff, status does not affect satisfaction. Our findings suggest that relative social status has important implications for the acceptance of income inequalities....

  12. The influence of status on satisfaction with relative rewards

    Science.gov (United States)

    Albrecht, Konstanze; von Essen, Emma; Fliessbach, Klaus; Falk, Armin

    2013-01-01

    This study investigates how induced relative status affects satisfaction with different relative payoffs. We find that participants with lower status are more satisfied with disadvantageous payoff inequalities than equal or higher status participants. In contrast, when receiving an advantageous payoff, status does not affect satisfaction. Our findings suggest that relative social status has important implications for the acceptance of income inequalities. PMID:24198802

  13. Status of radiation-based measurement technology

    International Nuclear Information System (INIS)

    Moon, B. S.; Lee, J. W.; Chung, C. E.; Hong, S. B.; Kim, J. T.; Park, W. M.; Kim, J. Y.

    1999-03-01

    This report describes the status of measurement equipment using radiation source and new technologies in this field. This report includes the development status in Korea together with a brief description of the technology development and application status in ten countries including France, America, and Japan. Also this report describes technical factors related to radiation-based measurement and trends of new technologies. Measurement principles are also described for the equipment that is widely used among radiation-based measurement, such as level measurement, density measurement, basis weight measurement, moisture measurement, and thickness measurement. (author). 7 refs., 2 tabs., 21 figs

  14. The current status of radiosurgery

    International Nuclear Information System (INIS)

    Mehta, Minesh P.

    1996-01-01

    Objectives: Review the role of radiosurgery in recurrent malignant gliomas for palliative purposes. Review the role of radiosurgery in newly diagnosed malignant glioma as boost therapy and emphasize the randomized clinical trials underway. Review the role of radiosurgery in the management of patients with brain metastases and emphasize the major prognostic factors. Review the recently initiated clinical trials for brain metastases using radiosurgery. Review the role of radiosurgery in the management of benign tumors with specific emphasis on meningioma and acoustic neuroma. Emphasize the rationale for fractionation and present the preliminary results of fractionated stereotactic radiation. Stereotactic localization techniques, originally designed for neurosurgery, have been used to delivery high single doses of radiation to small intracranial targets for more than 25 years, a technique referred to as stereotactic radiosurgery. Radiosurgery has proven to be an attractive alternative to surgery in the management of several benign tumors, such as vestibular schwannomas with better preservation of hearing and facial nerve function than microsurgical resection. For other benign tumors such as meningioma and pituitary adenoma, preliminary results are promising, but longer range studies to confirm high tumor control rates are necessary. For patients with malignant glioma, radiosurgery has been used to escalate the radiation dose to enhance tumor control following surgery and radiation therapy. The rationale for this is grounded in the recent confirmatory randomized prospective trial verifying the value of brachytherapy in this disease. The results of radiosurgery from single institutional experiences for primary and recurrent malignant glioma indicate a palliative benefit as well as a potential survival benefit in a select sub-group of patients based on the appropriate mix of prognostic criteria such as patient age, performance status, tumor size and extent of resection

  15. NPAR program - Status and accomplishments

    International Nuclear Information System (INIS)

    Vora, J.P.

    1991-01-01

    Upon completing the early scoping studies, the US NRC Office of Nuclear Regulatory Research took a lead worldwide in 1985 by publishing a comprehensive program plan for Nuclear Plant aging Research (NPAR). The plan identified significant technical safety issues related to plant aging; discussed a phased approach to aging and life assessment of components systems, and structures; and recommended the utilization of research results for, (i) the selection and the prioritization of components and structures, (ii) where to focus inspection and maintenance, (iii) what type of data collection and record keeping would be useful, (iv) how to perform technical evaluation of mothballed units for reactivation, (v) the determination of risk significance of aging, (vi) the development of technical bases for license renewal and extended plant life considerations, (vii) the ongoing regulatory issues, and (viii) recommendations to the national codes and standards groups involved in activities related to aging. Since the publication of the NPAR program plan in 1985 significant progress has been made in completing the initial phase of the NPAR activities and substantial new initiatives have been undertaken expanding the overall scope. Also, by recognizing the NRC's leadership role for emphasizing the need for aging management significant developments are taking place worldwide in implementing dedicated programs related to understanding and managing aging in older operating nuclear power plants. In fact, in some countries, aging management programs are being implemented now for relatively new plants so as to eventually realize the potential benefits of extended plant life beyond the originally conceived design and service life. This paper briefly describe the major elements of the NPAR program, its status and results or accomplishments. In the process the author emphasizes the need for total industry commitment and participation in implementing programs for understanding and managing

  16. Renewables 2010 - Global status report

    International Nuclear Information System (INIS)

    Sawin, Janet L.; Martinot, Eric; Sonntag-O'Brien, Virginia; McCrone, Angus; Roussell, Jodie; Barnes, Douglas; Flavin, Christopher; Mastny, Lisa; Kraft, Diana; Wang, Shannon; Ellenbeck, Saskia; Ilieva, Lili; Griebenow, Christof; Adib, Rana; Lempp, Philippe; Welker, Bettina

    2010-01-01

    Changes in renewable energy markets, investments, industries, and policies have been so rapid in recent years that perceptions of the status of renewable energy can lag years behind the reality. This report captures that reality and provides a unique overview of renewable energy worldwide as of early 2010. The report covers both current status and key trends. By design, the report does not provide analysis, discuss current issues, or forecast the future. Many of the trends reflect the increasing significance of renewable energy relative to conventional energy sources (including coal, gas, oil, and nuclear). By 2010, renewable energy had reached a clear tipping point in the context of global energy supply. Renewables comprised fully one quarter of global power capacity from all sources and delivered 18 percent of global electricity supply in 2009. In a number of countries, renewables represent a rapidly growing share of total energy supply-including heat and transport. The share of households worldwide employing solar hot water heating continues to increase and is now estimated at 70 million households. And investment in new renewable power capacity in both 2008 and 2009 represented over half of total global investment in new power generation. Trends reflect strong growth and investment across all market sectors-power generation, heating and cooling, and transport fuels. Grid-connected solar PV has grown by an average of 60 percent every year for the past decade, increasing 100-fold since 2000. During the past five years from 2005 to 2009, consistent high growth year-after-year marked virtually every other renewable technology. During those five years, wind power capacity grew an average of 27 percent annually, solar hot water by 19 percent annually, and ethanol production by 20 percent annually. Biomass and geothermal for power and heat also grew strongly. Much more active policy development during the past several years culminated in a significant policy milestone

  17. Cryptococcal meningitis: epidemiology, immunology, diagnosis and therapy.

    Science.gov (United States)

    Williamson, Peter R; Jarvis, Joseph N; Panackal, Anil A; Fisher, Matthew C; Molloy, Síle F; Loyse, Angela; Harrison, Thomas S

    2017-01-01

    HIV-associated cryptococcal meningitis is by far the most common cause of adult meningitis in many areas of the world that have high HIV seroprevalence. In most areas in Sub-Saharan Africa, the incidence of cryptococcal meningitis is not decreasing despite availability of antiretroviral therapy, because of issues of adherence and retention in HIV care. In addition, cryptococcal meningitis in HIV-seronegative individuals is a substantial problem: the risk of cryptococcal infection is increased in transplant recipients and other individuals with defects in cell-mediated immunity, and cryptococcosis is also reported in the apparently immunocompetent. Despite therapy, mortality rates in these groups are high. Over the past 5 years, advances have been made in rapid point-of-care diagnosis and early detection of cryptococcal antigen in the blood. These advances have enabled development of screening and pre-emptive treatment strategies aimed at preventing the development of clinical infection in patients with late-stage HIV infection. Progress in optimizing antifungal combinations has been aided by evaluation of the clearance rate of infection by using serial quantitative cultures of cerebrospinal fluid (CSF). Measurement and management of raised CSF pressure, a common complication, is a vital component of care. In addition, we now better understand protective immune responses in HIV-associated cases, immunogenetic predisposition to infection, and the role of immune-mediated pathology in patients with non-HIV associated infection and in the context of HIV-associated immune reconstitution reactions.

  18. POLA KONSUMSI, STATUS KESEHATAN DAN HUBUNGANNYA DENGAN STATUS GIZI DAN PERKEMBANGAN BALITA

    Directory of Open Access Journals (Sweden)

    Engkun Rohimah

    2016-01-01

    Full Text Available ABSTRACTThis study was aimed to analyze relationship between patterns of consumption and health status with nutritional status and development of children under five years. The design of this study was cross sectional. Subject in this study were 63 children under five years. Food consumption data was collected using Food Frequency Questionnaire (FFQ and child development data using Bina Keluarga Balita instruments. The results showed severe wasting and wasting existed in the under three years children but not in preschool. Under three years children had an average growth rate greater than preschool. There is a significant relationship between maternal employment and health caregiving pattern with nutritional status (WHZ (p=0.015, income with nutritional status (HAZ (p=0.009, and disease history within a month with nutritional status (WAZ (p=0.022. Mothers should pay more attention to children’s health caregiving pattern and provide sufficient time for the children.Keywords: consumption, development, health, nutritional statusABSTRAKPenelitian ini bertujuan untuk menganalisis hubungan pola konsumsi dan status kesehatan dengan status gizi dan perkembangan balita. Desain penelitian adalah cross sectional dengan subjek sebanyak 63 balita. Data pola konsumsi diambil menggunakan Food Frequency Questionnaire (FFQ dan data perkembangan balita diambil menggunakan instrumen Bina Keluarga Balita. Hasil penelitian menunjukkan bahwa status gizi sangat kurus dan kurus masih ada pada usia batita tetapi tidak ada di usia prasekolah. Sebagian besar subjek yang berusia batita memiliki rata-rata nilai perkembangan lebih besar dibandingkan subjek yang berusia prasekolah. Terdapat hubungan yang signifikan antara pekerjaan ibu dan pola asuh kesehatan dengan status gizi (BB/TB (p=0,015, pendapatan per kapita dengan status gizi (TB/U (p=0,009, dan riwayat penyakit sebulan dengan status gizi (BB/U (p=0,022. Ibu sebaiknya lebih memperhatikan pola asuh kesehatan anak

  19. ATLAS @ LHC: status and recent results

    CERN Document Server

    McPherson, Robert; The ATLAS collaboration

    2017-01-01

    The status and data taking summary of the ATLAS experiment at the CERN Large Hadron Collider is reviewed. Recent physics analysis results are presented, and the detector upgrade program is briefly summarized.

  20. Status of nuclear energy in Slovakia

    International Nuclear Information System (INIS)

    Tomek, J.

    2008-01-01

    In this work author presents the status of nuclear energy in Slovakia. There are the electricity production; NPP operating results in 2007; ENEL-SE vision, mission and strategy, Continuous improvement programs as well as public acceptance of nuclear presented.