Guidelines for the treatment of cytomegalovirus diseases in patients with AIDS in the era of potent antiretroviral therapy: recommendations of an international panel. International AIDS Society-USA

OBJECTIVE: To provide recommendations for the treatment of acquired immunodeficiency syndrome-related cytomegalovirus (CMV) end-organ diseases, including retinitis, colitis, pneumonitis, and neurologic diseases. PARTICIPANTS: A 17-member panel of physicians with expertise in clinical and virological research and inpatient care in the field of CMV diseases. EVIDENCE: Available clinical and virological study results. Recommendations are rated according to the quality and strength of available evidence. Recommendations were limited to the treatment of CMV diseases; prophylaxis recommendations are not included. PROCESS: The panel was convened in February 1997 and met regularly through November 1997. Subgroups of the panel summarized and presented available information on specific topics to the full panel; recommendations and ratings were determined by group consensus. CONCLUSIONS: Although the epidemiological features of CMV diseases are changing in the setting of potent, combination antiretroviral therapy, continued attention must be paid to CMV diseases in patients infected with the human immunodeficiency virus to prevent irreversible endorgan dysfunction. The initial and maintenance treatment of CMV retinitis must be individualized based on the characteristics of the lesions, including location and extent, specific patient factors, and characteristics of available therapies among others. Management of relapse or refractory retinitis must be likewise individualized. Ophthalmologic screening for patients at high risk for retinitis or who have a prior diagnosis of extraretinal disease is recommended. Recommendations for gastrointestinal, pulmonary, and neurologic manifestations are included.     

A randomized phase-II study of BB-10010 (macrophage inflammatory protein- 1alpha) in patients with advanced breast cancer receiving 5-fluorouracil, adriamycin, and cyclophosphamide chemotherapy

BB-10010 is a variant of the human form of macrophage inflammatory protein-1alpha (MIP-1alpha), which has been shown in mice to block the entry of hematopoietic stem cells into S-phase and to increase their self-renewal capacity during recovery from cytotoxic damage. Its use may constitute a novel approach for protecting the quality of the stem cell population and its capacity to regenerate after periods of cytotoxic treatment. Thirty patients with locally advanced or metastatic breast cancer were entered into the first randomized, parallel group controlled phase II study. This was designed to evaluate the potential myeloprotective effects of a 7-day regimen of BB-10010 administered to patients receiving six cycles of 5-fluorouracil (5-FU), adriamycin, and cyclophosphamide (FAC) chemotherapy. Patients were randomized, 10 receiving 100 microgram/kg BB-10010, 11 receiving 30 microgram/kg BB-10010, and nine control patients receiving no BB-10010. BB-10010 was well-tolerated in all patients with no severe adverse events related to the drug. Episodes of febrile neutropenia complicated only 4% of the treatment cycles and there was no difference in incidence between the treated and nontreated groups. Studies to assess the generation of progenitor cells in long-term bone marrow cultures were performed immediately preceding chemotherapy and at the end of six dosing cycles in 18 patients. Circulating neutrophils, platelets, CD 34(+) cells, and granulocyte/macrophage colony-forming cell (GM-CFC) levels were determined at serial time points in cycles 1, 3, and 6. The results showed similar hemoglobin and platelet kinetics in all three groups. On completion of the six treatment cycles, the average pretreatment neutrophil levels were reduced from 5.3 to 1.7 x 10(9)/L in the control patients and from 4.3 to 1.9 and 4.5 to 2.5 x 10(9)/L in the 30/100 microgram/kg BB-10010 groups, respectively. Relative to their pretreatment values, 50% of the patients receiving BB-10010 completed the treatment with neutrophil values significantly higher than any of the controls (P = .02). Mobilization of GM-CFC was enhanced by BB-10010 with an additional fivefold increase over that generated by chemotherapy alone, giving a maximal 25-fold increase over pretreatment values. Bone marrow progenitor assays before and after this standard regimen of chemotherapy indicated little long-term cumulative impairment to recovery from chemotherapy. Despite the limited cumulative damage to the bone marrow, which may have minimized the protective value of BB-10010 during this regimen of chemotherapy, better recovery of neutrophils in the later treatment cycles with BB-10010 was indicated in a number of patients.     

Whole grains — impact of consuming whole grains on physiological effects of dietary fiber and starch

Much of the present research on the physiological effects of dietary fiber and starch has been done on sources isolated from the parent material, and it is not clear whether they have the same effects if fed in the intact or whole grain. For dietary fiber, physiological effect depends on extent of fermentation in the large intestine, and this is influenced by chemical composition, solubility, physical form, and presence of lignin or other compounds. All of these factors are altered by isolation of a fiber source from the whole grain, and hence effects of eating fiber vary. Similarly, physical form and presence in the whole grain will affect digestibility of starch in the small intestine, which in turn influences the glycemic response and colonic effects determined by the extent of malabsorption and entry into the colon. Starch that enters the colon is fermented and produces short‐chain fatty acids, particularly butyrate, which is necessary to maintain a healthy mucosa. Hence, their presence within the whole grain may have important implications for health for both dietary fiber and starch. Evidence indicates that such effects are beneficial and that whole‐grain consumption should be encouraged.     

Tissue spectroscopy with electrical impedance tomography: computersimulations

A method is proposed by which bioelectrical spectroscopy could be combined with electrical impedance tomography (EIT) to provide noninvasive characterization of tissue. Multifrequency (2-200 kHz) EIT measurements were simulated with a numerical model for a volume of porcine liver immersed in an electrolytic tank. From the reconstructed EIT images the tissue characterization method was then applied enabling a plot of complex resistivity to be drawn for any selected pixel in the image. Simulations were performed for a small volume of degraded tissue embedded in the normal tissue to examine its effect on the derived spectroscopic parameters. The method could have an application in transplant surgery for screening organs for tissue degradation     

Beta-COP is essential for biosynthetic membrane transport from the endoplasmic reticulum to the Golgi complex in vivo

Experimental glomerulonephritis was induced in rats to investigate the consequence of the antigen-antibody interaction on the surface of glomerular endothelial cells (GENs). A lectin, Lens culinaris hemoagglutinin (LCH), was first planted in the left kidney by isolated perfusion of a left kidney, and then the circulation was reestablished. Rabbit anti-LCH antibodies were injected from the tail vein 3 minutes after the recirculation of the left kidney, and acute glomerulonephritis ensued. Fifteen minutes after the injection, rabbit immunoglobulin G (IgG), rat C3, and LCH were observed exclusively on the surface of GENs. Accumulation of platelets was prominent. Three hours later, the immune deposits were seen in the subendothelial space, and the polymorphonuclear cells were the dominant infiltrate in the glomeruli. Up to the seventh day, immune deposits were seen in the subendothelial space, and the widening of this area was increasingly observed. Fourteen days later, immune deposits containing rat IgG were observed in the subepithelial area, but they were only occasionally seen in the subendothelial space and in the mesangial area. No crescent formation was seen at day 14, but the mesangial area was expanded, with an increased number of cells. The number of nuclei in the cross-section of a glomerulus increased after the induction of glomerulonephritis, but the number of leukocyte common antigen-positive cells (infiltrating cells) decreased gradually from day 4 to day 14. The staining of Thy-1.1, a marker of mesangial cell, was markedly enlarged in the glomerulus at day 14. These data suggest that mesangial proliferative glomerulonephritis can be induced by the antigen-antibody interaction on the surface of GENs.     

Job postings and the decision to interview: A verbal protocol analysis.

Investigated the process of deciding whether or not to apply for jobs, using the verbal protocol analysis (VPA) technique. Verbal reports provided by participants as they evaluated job postings and decided whether or not to interview for jobs were analyzed to assess what information was heeded, the impact of incomplete or unusual information, and the role of inferences regarding job characteristics and probability of hire. Results indicated that location and compensation received the most attention and that participants also responded to the amount of information provided. In addition, participants made inferences about unobserved characteristics and probability of hire, although the latter played little role in the decision to interview. The study also provided support for the usefulness of VPA by demonstrating that neither the verbal protocol process nor the use of prompts significantly influenced participants' decisions (as compared with the decisions of control groups). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological functioning and behavior of sexually abused girls.

The psychological functioning and behavior of 46 sexually abused girls (ages 6–14) was compared with that of 46 nonabused girls who were matched on age, race, family income, and family constellation. Sexually abused children demonstrated heightened sexual preoccupation and behavior problems, lower cognitive abilities and school achievement, and more stressful past histories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of brief exposure to symbolic model behavior on the information-processing strategies of internally and externally oriented children.

Conducted a study with 120 externally and 120 internally oriented 4th graders (as measured by the Intellectual Achievement Responsibility Scale) to examine the modifiability of children's information-processing strategies. Ss observed a constraint-seeking model or a change (contrasting response patterns) model which provided either minimal or augmented verbal cues and associated reinforcement contingencies. Ss in augmented modeling conditions required fewer questions to reach a solution and asked a higher proportion of constraint-seeking questions relative to the nonaugmented and no-model control groups. The effects of augmentation were more pronounced for the constraint-seeking than for the change model. Internals in augmented conditions required fewer questions to solution and asked a higher proportion of constraint-seeking questions than did externals, but there were no significant differences between internals and externals in nonaugmented conditions. The major findings on the immediate posttest were maintained on a transfer task administered 1 wk later, demonstrating the short-term stability and generality of the modeling effects. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early-life maternal separation and social isolation produce an increase in impulsive action but not impulsive choice.

Early life environment, events, and context, such as mother–offspring relationship, can have profound effects on future behavior and physiology. We investigated the effects of long-term maternal and social separation, through artificial rearing, on adult impulsivity. Rats were maternally reared (MR) or artificially reared (AR) and half of the AR rats were provided with replacement somatosensory stimulation intended to simulate maternal licking. There are at least 2 forms of impulsivity and we compared rats on 1 test of impulsive action (differential reinforcement of low rates of responding—DRL-20s) and 2 tests of impulsive choice (delay discounting and fixed consecutive number schedule—FCN). We found that AR rats are more action impulsive; however, this effect can be reduced by maternal licking-like stimulation. In contrast, AR rats did not display an increase in impulsive choice. Overall, these experiments show that early life maternal and social separation have different effects on the 2 forms of impulsivity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)