Enhanced levels of CCL19 in patients with advanced acquired immune deficiency syndrome (AIDS).

Based on the ability to recruit lymphocytes and dendritic cells to lymphoid tissue and to promote inflammation, we hypothesized a role for dysregulated CCL19 and CCL21 levels in human immunodeficiency virus (HIV)-infected patients with advanced immunodeficiency, and in particular in those with accompanying Mycobacterium avium complex (MAC) infection. The hypothesis was explored by studies in HIV-infected patients with and without MAC infection, as well as in vitro, examining the ability of proteins from MAC to promote CCL19 and CCL21 responses in peripheral blood mononuclear cells (PBMC) during highly active anti-retroviral therapy (HAART). Our main findings were: (i) raised serum levels of CCL19 in HIV-infected patients with CD4(+) T cell count <50 cells/µl compared with HIV-infected patients with CD4(+) T cell count >500 cells/µl and healthy controls, with particularly high levels in those with MAC infection; (ii) elevated plasma levels of CCL19 predicted a higher mortality in acquired immune deficiency syndrome (AIDS)-patients, independent of ongoing MAC infection; and (iii) marked production of CCL19 in MAC-stimulated peripheral blood mononuclear cells (PBMC) and pronounced disturbances in MAC-induced CCL19 production in PBMC from HIV patients that was partly reversed during HAART. Our findings suggest the involvement of CCL19 in AIDS patients with advanced immunodeficiency, potentially mediating both adaptive and maladaptive responses.

[Abdominal tuberculosis and amebic abscess. Simultaneous diagnosis of 2 rare infections of same localization]. / Abdominal tuberkulose og amøbeabscess. Samtidig påvisning av to sjeldne infeksjoner med samme lokalisasjon.

A 26-year-old Indian male was admitted to hospital with loss of weight and vague abdominal pain of several weeks duration. Ultrasonography and computed tomography showed several expansive lesions near the pancreatic head, probably representing enlarged lymph nodes. A few milliliters of yellowish pus were aspirated by ultrasound guided aspiration. Microscopic examination of the pus showed trophozoits, and Mycobacterium tuberculosis subsequently grew from the pus culture. Abdominal tuberculosis is a rare condition, particularly in the pancreas and the peripancreatic region. The report stresses the importance of considering the possible coexistence of more than one infectious disease in patients from endemic areas.

[Glyceryl trinitrate patches during continuous intravenous infusions]. / Glyseryltrinitratplaster ved kontinuerlige intravenøse infusjoner.

A randomized, double blind comparison of the incidence of removal of patches because of venous occlusion was performed in patients on continuous intravenous fluid therapy using 2.5 mg trinitroglycerine or placebo patches attached to the thorax. The sample comprised 90 patients, of whom nine were excluded for administrative reasons. Of the remaining 81,41 received active and 40 received placebo patches. Within one week 11 venflones occluded; ten in patients on placebo, and one in a patient with an active trinitroglycerine patch. Finally 14 (11 placebo and three trinitroglycerine) patches occluded. This tendency in favour of trinitroglycerine patches was statistically significant (p = 0.018). No difference in frequency of thrombophlebitis was observed: (14 versus 18 not leading to occlusion). Seven patients on trinitroglycerine and one on placebo developed moderate headache which did not necessitate withdrawal of treatment. It is concluded that 2.5 mg trinitroglycerine patches seem to improve survival of venflones used for continuous, intravenous fluid therapy, even when applied to the thorax.

Pesticides and heavy metals as food contaminants.

From the general pollution, contaminants spread along a variety of routes, many of which lead to our food. Pesticides and heavy metals as food contaminants have raised strong public concern and contributed to the general uneasiness associated with the pollution boom of the last two decades. Pesticides in food are predominantly residues from their application on growing crops, less often from post harvest use on stored agriculatural products, whereas heavy metals contaminate the food at various stages along the food production line. Both groups of contaminants exhibit in the number of their members a spectrum of health hazards. A few examples of these will be dealth with, and thought will be given to some features in the philosophies behind the current practices of risk assessment and management in this area. A widespread shortage of toxicological expertice maintain a level of ignorance sufficient to make risk evaluation very often a dilemma. This distressing shortcoming at least partly arises form a common neglect of toxicology as a university discipline. Some international efforts to control food contamination will also be touched upon.