Nutritional Status of HIV-Infected Adults on Antiretroviral Therapy and the Impact of Nutritional Supplementation in the Northern Cape Province; South Africa

Objectives: The study aimed to describe the nutritional status and determine the impact of current nutrition intervention strategies on weight changes in adult HIV-infected patients on antiretroviral (ARV) therapy.Design: A descriptive; prospective trial was performed. Setting: The investigation was conducted at ARV roll-out centres in Kimberley; Upington; Kuruman; Prieska and Springbok in the Northern Cape Province of South Africa. Subjects: Adult HIV-infected patients receiving ARV therapy were included in the study.Outcome measures: Each participants's body mass index (BMI) was determined before and after a four-month intervention period of nutritional supplementation with an instant; enriched maize product. Results: Data from 98 patients (mean age 39.7 years; standard deviation 8.9 years) were assessed. Prior to intervention; the median BMI was 20 kg/m2 (range 12.6-29.7 kg/m2); the patients from Kuruman had a greater incidence of underweight compared to the other towns; with a median BMI of 17.9 kg/m2. Of the 87 patients assessed during the final week; 49.4experienced weight gain and 40.2lost weight. Eighteen (20.7) patients gained more than 5of their baseline weight; which was significant. Only eight (9.2) patients lost more than 5of their baseline weight. Twenty-two patients who presented with a BMI 18.5 kg/m2 at baseline had a median weight gain of 1.13 kg during the intervention period; while the group with a BMI 18.5 kg/m2 presented with no change in median weight. Conclusions: Nutritional supplementation; provided according to provincial policy and combined with ARVs; nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape

Nutritional Status of HIV-Infected Adults on Antiretroviral Therapy and the Impact of Nutritional Supplementation in the Northern Cape Province; South Africa

Objectives: The study aimed to describe the nutritional status and determine the impact of current nutrition intervention strategies on weight changes in adult HIV-infected patients on antiretroviral (ARV) therapy.Design: A descriptive; prospective trial was performed. Setting: The investigation was conducted at ARV roll-out centres in Kimberley; Upington; Kuruman; Prieska and Springbok in the Northern Cape Province of South Africa. Subjects: Adult HIV-infected patients receiving ARV therapy were included in the study.Outcome measures: Each participants's body mass index (BMI) was determined before and after a four-month intervention period of nutritional supplementation with an instant; enriched maize product. Results: Data from 98 patients (mean age 39.7 years; standard deviation 8.9 years) were assessed. Prior to intervention; the median BMI was 20 kg/m2 (range 12.6-29.7 kg/m2); the patients from Kuruman had a greater incidence of underweight compared to the other towns; with a median BMI of 17.9 kg/m2. Of the 87 patients assessed during the final week; 49.4experienced weight gain and 40.2lost weight. Eighteen (20.7) patients gained more than 5of their baseline weight; which was significant. Only eight (9.2) patients lost more than 5of their baseline weight. Twenty-two patients who presented with a BMI 18.5 kg/m2 at baseline had a median weight gain of 1.13 kg during the intervention period; while the group with a BMI 18.5 kg/m2 presented with no change in median weight. Conclusions: Nutritional supplementation; provided according to provincial policy and combined with ARVs; nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape

Molecular epidemiology of Escherichia coli isolated from young South African children with diarrhoeal diseases.

Molecular techniques were used for studying the epidemiology of diarrhoeal infections due to Escherichia coli in the Gauteng region in South Africa. In total, 151 E. coli strains isolated from stools of patients with diarrhoea and 30 strains isolated from stools of healthy individuals were collected between March 1996 and May 1997. The E. coli isolates were characterized by serotyping, antimicrobial susceptibility testing, and adherence patterns. Polymerase chain reaction (PCR) was performed to determine the presence of the genes-encoding virulence factors. PCR showed that 59 (32.6%) of the E. coli isolates carried eaeA genes, 6 (3.3%) possessed bfpA genes, 4 (2.2%) CNF1, and 2 (1.1%) carried labile toxin and Stx2 genes. The eae genes were more prevalent in strains isolated from patients than in those from the control group (p < 0.001). Forty-eight (26.5%) strains belonged to enteropathogenic E. coli (EPEC) O serogroups and 14 (7.7%) to Shiga toxin-producing E. coli (STEC) O157 serotype. A high percentage (28.2%) of atypical EPEC strains possessing the eaeA but not the bfpA genes was isolated. Most isolates were susceptible to commonly-used antimicrobial agents. The adherence of the E. coli strains to HeLa cells was identified more in patients (69.4%) than in the control group (60%) and was more dominant in infants than in adults. PCR and tissue culture assays were shown to be useful techniques for the epidemiological study of E. coli where this organism is a major cause of diarrhoea.

Hallazgos inmunohistoquímicos en material histopatológico de abortos recurrentes espontáneos / Immunohistochemical findings in histopathological material of spontaneous recurrent abortions

En 1994 en un estudio realizado por nuestro grupo en colabaración con la Dra. Fuksman sobre 1.200 placentas correspondientes a embarazos de alto riesgo, se halló la presencia de villitis en el 5.6 por ciento de las mismas. La histopatología detectada en ese momento fue deciduitis linfocitaria y aumento de fibrina perirvellositaria asociada con hipoirrigación e infarto placentario. Hallamos que en el 55 por ciento de las placentas con villitis los recién nacidos presentaban RCIU con respecto al 10 por ciento de los controles, con un PA de 32 por ciento en las villitis y el 83 por ciento en los controles (3). En ese material se estudiaron 68 placentas con villitis y 68 placentas sin villitis como grupo control. En 1996 demostramos en ese mismo material mediante la técnica de anticuerpos monoclonales, sobre cortes de placenta estudiando las subpoblaciones linfocitarias de las villitis, que el 50 por ciento eran CD4 (linfocitos helper), 18 por ciento CD8 (linfocitos supresoreslcitotóxicos) y 10 por ciento Leu19 (Natural Killer) pero lo significativo y anormal es que hallamos que el 65 por ciento de los linfocitos expresaban antígenos de histocompatibilidad clase II DR (40). En 1998 Jacques y Col publicaron datos similares. En 1999 comunicamos que en el informe histopatológico de material de legrado de pacientes abortadoras de causa inmunológica la descripción de villitis en un 20 por ciento de los casos. Estudios realizados en colabaración con la Dra. Zenclussen con ese material nos permitió publicar recientemente la presencia de altos niveles de Interleuquina 6(IL-6) y receptor de IL-6 en suero. El objetivo de este estudio es investigar en placentas de pacientes abortadoras recurrentes la expresión de IL-6 y sus receptores gp80 y gp130 en trece muestras de material de raspado de abortos del primer trimestre mediante la técnica de inmunofluorescencia. Como control se utilizaron cortes de placentas de embarazos normales a término. Nuestros hallazgos muestran la presencia de depósitos de IL-6 y de receptores de IL-6 con un patrón granular para las tres moléculas especificamente en el sinciciotrofoblasto mientras que fue negativo para tres en el citotrofoblasto. En los cortes de placentas normales no se hallaron en ningún caso dichos depósitos. Concluímos de todos los hallazgos antes sintetizados...

Dynamique socio-geographique de l'infection a VIH1 : Region de Batouri (Cameroun) - Berberati (Centrafrique)

"Une enquete epidemiologique est realisee en 1992 sur la prevalence de l'infection a VIH dans cinq sites urbains et ruraux de la region de Batouri (Cameroun) - Berberati (Centrafrique). Les seroprevalences relevees varient sensiblement selon les collectivites et au sein de celles-ci. Une exploitation complementaire des resultats de cette enquete precise des aspects de la dynamique geographique et sociale de l'infection. Une etude descriptive de la population seropositive permet de caracteriser; pour chaque sexe; des erofils sociaux de l'infection. Une analyse comparee des groupes les plus et les moins exposes a une contamination souligne quelles sont les specificites des individus liees de facon significative a la diffusion du virus. Des aspects varies d'une ""vacance"" conjugale; une forme ou d'une autre de mobilite geographique tiendraient une place essentielle. Les discontinuites sociales et geographiques qui l'affectent; les discordances qu'elle presente par rapport a la syphilis; suggerent que la repartition de l'infection pourrait etre; a la date de l'enquete; principalement definie par la diversite des conditions offertes a l'introduction du virus"

Dynamique socio-geographique de l'infection a VIH 1 en Afrique Centrale : regions de Batouri (Cameroun) - Berberati (Centrafique)

"Une enquete realisee en 1992 dans cinq sites urbains ruraux de la region de Batouri (Cameroun) - Berberati (Centrafrique) etablit que les seroprevalences de l'infection a VIH varient sensiblement selon les collectivites et au sein de celles-ci. Une exploitation complementaire des resultats de cette enquete precise des elements de la dynamique geographique et sociale de l'infection. Une analyse comparee des groupes les plus et les moins exposes a une contamination souligne quelles sont les specificites des individus liees de facon significative a la diffusion du virus. Des aspects varies d'une ""vacance"" conjugale; une forme ou une autre de mobilite geographique tiendraient une place essentielle. Les discontinuites geographiques qui affectent la diffusion de l'infection seraient; a la date de l'enquete; principalement l'effet de la diversite des conditions offertes par les collectivites a des apports du virus; par le biais de la mobilite de leurs membres"

Dopamina: acción hemodinamica durante la cirurgia vascular periférica / Dopamine: hemodynamic effect during peripheral vascular surgery

En un grupo de 10 pacientes operados sobre el territorio vascular periférico, se practicó una vigilancia hemodinámica no invasiva. El gasto aórtico fue medido en forma continua con una sonda esofágica asociando la ecografía al efecto Doppler. Bajo hipnoanalgesia el gasto aórtico mostró una caída de 27% (inicial = X 3,13 + ou - 0,51 1/min - X 2,29 + ou - 0,59 1/min, p <0.01). El gasto no mejoró significativamente con relleno vascular (X 2,49 + ou - 0,58 1/min, NS). Bajo perfusión de dopamina a la dosis de 3,50 mcg/Kg.min el gasto se elevó a 134% del valor inicial (X 3,91 + ou - 0,60 1/min p <0.01). El volumen de eyección sistólico progresó en 136% (inicial = X 38 + ou - 4 ml - X 52 + ou - 7 ml, p <0.01). La resistencias vasculares sistémicas totales fueron 19% más bajas que las iniciales. La frecuencia cardíaca dismimuyó de X 81 + ou - 11 a x 75 + ou - 9 p/min, mientras que la presión arterial media y la presión venosa central no sufrieron cambios significativos. No hubo variación en la concentración de H+. La dopamina a bajas dosis parece ser una terapéutica interesante en la prevención del bajo gasto preoperatorio, sobre todo en los pacientes que presentan ciertos riesgos cardiovasculares