Human Immunodeficiency Virus-infected men who have sex with men with syphilis: A 5-year multicentre study in Malaysia.

OBJECTIVES: High rates of syphilis have been reported worldwide among men who have sex with men (MSM). This study aims to describe the clinical pattern and treatment response of syphilis among human immunodeficiency virus (HIV)-infected MSM in Malaysia. METHODS: This is a retrospective study on all HIV-infected MSM with syphilis between 2011 and 2015. Data was collected from case notes in five centres namely Hospital Kuala Lumpur, Hospital Sultanah Bahiyah, Hospital Umum Sarawak, University of Malaya Medical Centre and Hospital Sungai Buloh. RESULTS: A total of 294 HIV seropositive MSM with the median age of 29 years (range 16-66) were confirmed to have syphilis. Nearly half (47.6%) were in the age group of 20-29 years. About a quarter (24.1%) was previously infected with syphilis. Eighty-three patients (28.2%) had other concomitant sexually transmitted infection with genital warts being the most frequently reported (17%). The number of patients with early and late syphilis in our cohort were almost equal. The median pre-treatment non-treponemal antibody titre (VDRL or RPR) for early syphilis (1:64) was significantly higher than for late syphilis (1:8) (p<0.0001). The median CD4 count and the number of patients with CD4 <200/µl in early syphilis were comparable to late syphilis. Nearly four-fifth (78.9%) received benzathine-penicillin only, 5.8% doxycycline, 1.4% Cpenicillin, 1% procaine penicillin, and 12.4% a combination of the above medications. About 44% received treatment and were lost to follow-up. Among those who completed 1 -year follow-up after treatment, 72.3% responded to treatment (serological non-reactive - 18.2%, four-fold drop in titre - 10.9%; serofast - 43.6%), 8.5% failed treatment and 17% had re-infection. Excluding those who were re-infected, lost to follow-up and died, the rates of treatment failure were 12.1% and 8.8% for early and late syphilis respectively (p=0.582). CONCLUSION: The most common stage of syphilis among MSM with HIV was latent syphilis. Overall, about 8.5% failed treatment at 1-year follow-up.

Fabricated germanium-doped fibres for computed tomography dosimetry.

For a range of doses familiarly incurred in computed tomography (CT), study is made of the performance of Germanium (Ge)-doped fibre dosimeters formed into cylindrical and flat shapes. Indigenously fabricated 2.3 mol% and 6 mol% Ge-dopant concentration preforms have been used to produce flat- and cylindrical-fibres (FF and CF) of various size and diameters; an additional 4 mol% Ge-doped commercial fibre with a core diameter of 50 µm has also been used. The key characteristics examined include the linearity index f(d), dose sensitivity and minimum detectable dose (MDD), the performance of the fibres being compared against that of lithium-fluoride based TLD-100 thermoluminescence (TL) dosimeters. For doses in the range 2-40 milligray (mGy), delivered at constant potential of 120 kilovoltage (kV), both the fabricated and commercial fibres demonstrate supralinear behaviours at doses < 2 mGy, while a value of close to f(D) = 1 (linear) has been obtained for all dosimeters for doses > 4 mGy. In terms of dose sensitivity, all of the fibres show superior TL sensitivity when compared against TLD-100, the 2.3 mol% and 6 mol% Ge-doped FF demonstrating the greatest TL sensitivity at 84 and 87 times that of TLD-100. The TL yields for the novel Ge-doped silica glass render them appealing for use within the present medical imaging dose range, offering linearity at high sensitivity down to less than 2 mGy.

Dosimetric response of fabricated Ge-doped optical fibres in computed tomography RQT beam quality x-ray beams.

Novel germanium (Ge)-doped silica glass fibres tailor-made in Malaysia are fast gaining recognition as potential media for thermoluminescence (TL) dosimetry, with active research ongoing into exploitation of their various beneficial characteristics. Investigation is made herein of the capability of these media for use in diagnostic imaging dosimetry, specifically at the radiation dose levels typically obtained in conduct of Computed Tomography (CT). As a first step within such efforts, there is need to investigate the performance of the fibres using tightly defined spectra, use being made of a Philips constant potential industrial x-ray facility, Model MG165, located at the Malaysian Nuclear Agency Secondary Standards Dosimetry Lab (SSDL). Standard radiation beam qualities (termed RQT) have been established for CT, in accord with IEC 61267: 2003 and IAEA Technical Reports Series No. 457: 2007. A calibrated ionisation chamber has also been utilised, forming a component part of the SSDL equipment. The fabricated fibres used in this study are 2.3 mol% flat fibre (FF) of dimensions 643 × 356 µm2 and 2.3 mol% cylindrical fibre (CF) of 481 µm diameter, while the commercial fibre used is 4 mol% with core diameter of 50 µm. The dopant concentrations are nominal preform values. The fibres have been irradiated to doses of 20, 30 and 40 milligray (mGy) for each of the beam qualities RQT 8, RQT 9 and RQT 10. For x-rays generated at constant potential values from 100 to 150 kV, a discernible energy-dependent response is seen, comparisons being made with that of lithium fluoride (LiF) thermoluminescence dosimeters (TLD-100). TL yield versus dose has also been investigated for x-ray doses from 2 to 40 mGy, all exhibiting linearity. Compared to TLD-100, greater sensitivity is observed for the fibres.

Photon irradiation response of photonic crystal fibres and flat fibres at radiation therapy doses.

Radiation effects of photon irradiation in pure Photonic Crystal Fibres (PCF) and Flat fibres (FF) are still much less investigated in thermoluminescense dosimetry (TLD). We have reported the TL response of PCF and FF subjected to 6 MV photon irradiation. The proposed dosimeter shows good linearity at doses ranging from 1 to 4 Gy. The small size of these detectors points to its use as a dosimeter at megavoltage energies, where better tissue-equivalence and the Bragg-Gray cavity theory prevails.

Modification of protein transfer across blood/cerebrospinal fluid barrier in response to altered plasma protein composition during development.

A developmentally regulated protein-specific transfer mechanism across choroid plexus epithelial cells has previously been proposed to contribute to the characteristically high concentration of protein in cerebrospinal fluid (CSF) in the immature brain. Here we demonstrate that this mechanism is sensitive to protein variations in plasma resulting in changed numbers of transferring cells for individual proteins and altered transfer into the CSF. Pups of Monodelphis domestica at postnatal day (P)9, P65 and P110 were injected intraperitoneally with either adult Monodelphis plasma or exogenous bovine fetuin. Samples of CSF, blood and brain were collected from terminally anaesthetized animals 3-48 h later. The concentration of total protein was measured and levels of albumin, hemopexin, α-fetoprotein and bovine fetuin were estimated by western blotting. Numbers of lateral ventricular choroid plexus cells positive for total and individual plasma proteins were counted in paraffin sections of brains stained with appropriate antibodies. Following intraperitoneal injections, the content of proteins in the CSF increased at all three ages, but the concentration increased only in the CSF of older animals. The total numbers of plexus cells positive for plasma protein did not change significantly, but cells positive for individual proteins did. Fetuin was detected in all protein-positive cells, but apparently displaced α-fetoprotein and, to a lesser degree, hemopexin. The results indicate that protein transfer across the blood/CSF barrier appears to be regulated by a molecular recognition mechanism that is probably saturable but may not be as specific for individual proteins as previously suggested.

Work and family roles in relation to women's well-being: a longitudinal study.

Previous research on women has focused on the influence of the overall work- or family-role experiences rather than on the specific characteristics of each role. Using multidimensional measures of work- and family-role experiences, this study first examined (Time 1) the additive cumulative contributions of role experiences in the prediction of women's well-being (happiness and symptoms of psychological distress). While work overload significantly predicted distress at Time 2, none of the family-role variables were related to well-being. Second, as the sample was made up of two groups of women who differed in occupational status (secretaries and professional women), it was possible that the effects of overload on distress might be conditioned by occupational status. The group X overload interaction term was found to be highly significant (p < .007); high occupational status moderated the negative effects of work overload. By contrast, secretaries were adversely affected by work overload. These results are discussed in relation to the existing literature, with reference to women's work and family roles in relation to well-being, and the effects of occupational status on health outcomes.

Changing sensitivity to H1 and H2 receptor antagonists in the growing vasculature.

1. Resting albumin efflux is greater from immature vessels than from mature and this is associated with a greater blood flow in immature vessels. 2. Both resting blood flow and albumin efflux in immature vessels are reduced by an H2 antagonist. 3. Histamine produces a greater albumin efflux from mature vessels than from immature and the associated increase in blood flow in response to histamine was also greater in mature vessels. 4. Blood flow and permeability increase produced by histamine are separately mediated via H2 and H1 receptors respectively in mature vessels. 5. In immature vessels, H2 receptors appear to mediate both responses.