Evolution of glomerular filtration rate in HIV‐infected,HIV–HBV‐coinfected and HBV‐infected patients receiving tenofovir disoproxil fumarate

We aimed to compare the evolution of estimated glomerular filtration rate (eGFR) in HIV‐, HIV–HBV‐ and HBV‐infected patients treated with tenofovir disoproxil fumarate (TDF). Three groups of patients receiving TDF > 12 months were recruited: 194 HIV‐infected patients, 85 HIV–HBV‐coinfected patients and 50 HBV‐infected patients. eGFR was estimated using the Modification of the Diet in Renal Disease (MDRD) equation. Multivariate regression models were constructed to estimate factors associated with eGFR decrease from baseline. A total of 329 patients were studied. Median follow‐up was 2.7 years. Median eGFR decrease was ?4.9 (?16.6 to +7.2) mL/min/1.73 m². After multivariate stepwise regression analysis, age (P = 0.0002), non‐African origin (P < 0.0001), baseline eGFR (P < 0.0001) and TDF duration (P = 0.02) were associated with eGFR decrease in the whole population, while hypertension, diabetes and type of infection were not. Age (P < 0.0001), non‐African origin (P = 0.0004), baseline eGFR (P < 0.0001) and TDF duration (P = 0.007) remained associated with eGFR decline in HIV and HIV–HBV‐infected patients, while other variables including HIV risk factor, CDC stage, CD4 and HIV‐RNA levels were not. Age (P = 0.03), non‐African origin (P = 0.004), baseline eGFR (P < 0.0001) and baseline HBV–DNA > 2000 IU/mL (P = 0.04) were associated with eGFR decline in HBV and HIV–HBV‐infected patients, while other variables including HBV risk factor and fibrosis stage were not. Estimated glomerular filtration rate decline under TDF therapy appears mainly associated with older age, non‐African origin, higher baseline eGFR and longer TDF administration but not with the type of viral infection. Regular follow‐up of renal function, especially tubular function is recommended during TDF therapy.     

Prévalence du reflux gastro-œsophagien typique à Abidjan

Aim

To determine in Abidjan, Cote d’Ivoire, prevalence of typical gastro-esophageal reflux disease.

Patients and methods

Cross-sectional study from June 15 to September 30, 2003.Thousand nine hundred forty (1,940) persons from five health zones of the city Abidjan, were included after their agreement. Socio demographic and clinical parameters were collected using a questionnaire in an interview format. Typical gastro-esophageal reflux was defined as one of the three following association: heartburn and regurgitation, heartburn and postural syndrome, postural syndrome and regurgitation.

Results

Among 1940 respondents (mean age 28 + years ? 9 years; sex-ratio 0.86), 281 had a typical gastro-esophageal reflux disease (prevalence of 14.5% [13% CI 95%-16%]). Heartburn and/or regurgitation occurred weekly in 178 people (9.17% [8%–10% 95%]). Heartburn and regurgitation were more common in deprived areas (p=0.00). Intensity was somewhat annoying or troublesome in 56% of cases (p=0.00). Independent factors favoring episodes of gastroesophageal reflux were eating chocolate (p=0.04) and pregnancy (p=0.03). The typical gastro-esophageal reflux disease was significantly associated with cough (p=0.005) angina (p=0.001) and non cardiac chest pain (p=0.016).

Conclusion

Typical gastro-esophageal reflux disease is fairly common in Abidjan without any particularity.     

Cold agglutinin titers in psychiatric patients

Cold agglutinin titers were obtained from the serum of 41 psychiatric patients. The 21 chronic schizophrenic patients tended to have positive cold agglutinin titers; the authors suggest that this immunological finding may be associated with long-term neuroleptic treatment.     

Renal pseudotumour following treatment of wilms' tumour

A 9 1/2-year-oId boy was found to have a mass occupying the lower pole of his left kidney, six years after his right kidney had been removed because of a Wilms' tumour. Investigation of the mass included angiography which demonstrated a mass with pathological arteries. Open biopsy of the mass revealed histological changes of nonspecific nephritis. It is probable that this nephritis was a result of radiation damage potentiated by concurrent treatment with actinomycin D, which he had received six years ago.     

The role of prostaglandins in experimental arthritis in the rat.

In the experimental model of streptococcal CFE-induced arthritis, PGE and PGF concentrations rise significantly. This is due to an increase both in the substrate concentration and the enzyme activity for PG biosynthesis. Indomethacin therapy inhibited PG synthesis and diminished some of the gross, but not the histological, features of the inflammatory response. These results lend further support to the contention that the beneficial effect of indomethacin in arthritis is due to inhibition of PG biosynthesis.     

Diurnal variations of the glycogen and fat stores in the liver and breast muscle of the fruit bat, Eidolon helvum (Kerr)

A study of the glycogen and fat levels of the liver and breast muscles of the fruit bat, Eidolon helvum was carried out in relation to their feeding and roosting behaviour. The glycogen concentrations in the liver were highest in the mornings, and lowest in the evenings. In contrast, the concentrations of liver fat were lowest in the mornings and highest in the evenings. Muscle glycogen and fat were higher in the mornings and evenings than in the afternoons. These findings are discussed in relation to the food habits and roosting activities of Eidolon helvum.     

Malignant fibrous histiocytoma of the conjunctiva.

Malignant fibrous histiocytoma (MFH) of the conjunctiva is an extremely rare tumour, and only three previous cases have been reported. We describe two patients with MFH of the conjunctiva: a 58-year-old white male with epibulbar tumour who had exenteration and is alive after five years' follow-up, and a 3 1/2-year-old African girl with xeroderma pigmentosum and an MFH of her right eye conjunctiva, the first reported case of this association. The characteristics and the methods of diagnosis of MFH are discussed.     

Hyperuricemia: A possible etiologic factor in chronic recurrent parotitis

Chronic recurrent parotitis is a common salivary gland disease. It is often associated with such clinical conditions as antecedent pyogenic infections, mumps, debilitation, intense fluid restriction and drugs. A case of chronic recurrent parotitis in a patient with hyperuricemia is presented, the presumptive pathophysiology is discussed, and an interrelationship between these two entities is suggested.