ABSTRACT
The majority of patients with progressive HIV infection develop a severe hematopoietic failure which is aggravated by the hematotoxic effect of azidothymidine (AZT) treatment. Since it was shown in a mouse model that alpha-D-tocopherol (vitamin E derivative) antagonizes the inhibitory influence of AZT on the growth of burst-forming units-erythrocyte (BFU-E), it was the aim of this study to investigate whether alpha-D-tocopherol and high dosages of erythropoietin (EPO) increase the hematopoietic colony-forming capacity of bone marrow cells from patients with progressive HIV disease and especially if they reverse the inhibitory effects of AZT. The data demonstrate that tocopherol (1-100 mumol/l) significantly increases the growth of BFU-E and colony-forming units granulocyte-monocyte (CFU-GM) from HIV-infected patients. This stimulatory effect is dose-dependent (maximum at 30-100 mumol/l) and only occurs when the agent is present from the beginning of the cultures. EPO (5-10 U/ml) also augments the numbers of BFU-E from HIV-infected patients. Tocopherol equally ameliorates the growth of BFU-E and CFU-GM from the HIV-positive cohort in the presence of AZT (10-100 mumol/l). For healthy controls, no such increase was observed, either with tocopherol or with higher dosages of EPO. In conclusion, both tocopherol and EPO partially reverse the myelosuppressive action of AZT in HIV-positive patients.
Subject(s)
Erythropoietin/pharmacology , HIV Seropositivity/pathology , Hematopoietic Stem Cells/drug effects , Vitamin E/pharmacology , Adult , Cell Division , Cells, Cultured , Colony-Forming Units Assay , Erythroid Precursor Cells/drug effects , HIV Seropositivity/drug therapy , Hematopoietic Stem Cells/pathology , Humans , Male , Zidovudine/antagonists & inhibitors , Zidovudine/therapeutic useSubject(s)
Family Practice , Professional Practice , Puerperal Disorders/psychology , Female , Humans , Infant , Pregnancy , Puerperal Disorders/therapyABSTRACT
In view of the dramatic rise in the divorce rate, this paper proposes that separation and divorce be viewed as normal phases of the family life cycle and be reframed in positive terms, such as a couple "being ready for a new relationship" or children "being the lucky possessors of two families instead of one." It further makes a plea for more extensive family support services, with the goal of prevention and education rather than just amelioration of problems after they have become evident.
