ABSTRACT
The effects of race and ethnicity on immunological function have not been fully studied in patients infected with HIV-1. To study such differences, 54 patients on virally suppressive highly active antiretroviral therapy (HAART) with CD4 counts >200 cells/microL had their peripheral blood lymphocytes (PBL) evaluated for response to recall antigen. Significant differences were found in the maximum responses for PBL from black individuals compared with those from white individuals, and the differences were highly significant when responses for African-Americans were compared with those for white-Hispanics. These findings support work delineating ethnicity and race as significant variables to be taken into account when looking at vaccination strategies and responsiveness to therapeutic pharmacological interventions.
Subject(s)
Black or African American/genetics , Genetic Predisposition to Disease , HIV Infections/genetics , Hispanic or Latino/genetics , Racial Groups/genetics , White People/genetics , Adult , Antiretroviral Therapy, Highly Active/methods , Cohort Studies , Female , HIV Infections/epidemiology , HIV Infections/immunology , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: To evaluate the methodology and cumulative evidence presented in systematic reviews of clinical trials comparing low-molecular-weight heparin (LMWH) with unfractionated heparin (UFH) for the treatment of venous thromboembolism. METHODS: We reviewed all systematic reviews of clinical trials published until March 2002. Fourteen systematic literature reviews were published between 1994 and 2000. Deficiencies in methodological quality were common, particularly in the description of search strategies, assessment of clinical trial quality, and methods used to combine results. RESULTS: Results of reviews indicate that LMWH is superior to UFH for the treatment of venous thromboembolism, particularly in reducing mortality. Patients with isolated deep venous thrombosis or deep venous thrombosis with concomitant pulmonary embolism seemed to have similar benefit. However, the benefits of LMWH over UFH were smaller in magnitude in reviews that included more recent clinical trials.
Subject(s)
Anticoagulants/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Pulmonary Embolism/drug therapy , Thromboembolism/drug therapy , Venous Thrombosis/drug therapy , Clinical Trials as Topic , Humans , Recurrence , Treatment OutcomeSubject(s)
Evidence-Based Medicine , Pulmonary Embolism/diagnosis , Pulmonary Embolism/drug therapy , Venous Thrombosis/diagnosis , Venous Thrombosis/drug therapy , Anticoagulants/therapeutic use , Heparin/therapeutic use , Humans , Pulmonary Embolism/diagnostic imaging , Radiography , United States , Venous Thrombosis/diagnostic imaging , Warfarin/therapeutic useABSTRACT
We report a case of enteropathy-associated T-cell lymphoma (EATL), diagnosed by small intestine and gastric biopsies, who presented with manifestations of hypocalcemia and malabsorption. Immunological assessment revealed increased expression levels of tumor necrosis factor system components and eotaxin, an observation that is consistent with the cytotoxic T-cell phenotype characteristic of EATL, and decreased numbers of circulating activated (CD8+CD38+ and CD4+CD25+) and suppressor (CD11b+) T cells, a feature which can contribute to lymphomagenesis in patients with celiac disease. The acute clinical presentation of the patient resolved with mineral and vitamin supplementation and a gluten-free diet. The novel immunological findings described are discussed in the context of a review of our current knowledge of the immunopathogenesis of celiac disease and associated intestinal neoplasia.