Long-term efficacy and safety of once-daily fosamprenavir 1400 mg boosted by ritonavir 100 mg: the BOLD100 study.

In a retrospective database study at two HIV treatment centres, medical records were accessed to evaluate long-term efficacy and safety parameters in all HIV-infected adults who had achieved HIV-1 RNA <50 copies/mL following the initiation of fosamprenavir (FPV)/ritonavir (RTV) 1400 mg/100 mg once-daily (QD)-containing regimens between January 2004 and January 2006. Data were available for 20 antiretroviral (ARV)-naïve patients (baseline median HIV-1 RNA 5.0 log(10) copies/mL; CD4+ cell count 307 cells/mm(3)), 30 protease inhibitor (PI)-naïve, ARV-experienced patients (HIV-1 RNA 3.6 log(10) copies/mL; CD4+ count 348 cells/mm(3)) and 25 PI-experienced patients switching to FPV/RTV100 for reasons other than virological failure (HIV-1 RNA 2.7 log(10) copies/mL; CD4+ count 328 cells/mm(3)). HIV-1 RNA <50 copies/mL was achieved in 100% of the ARV-naïve cohort (median monitoring period, 2.4 years; range, 1.4-3.2 years), 87% of the PI-naïve cohort (2.4 years; range, 1.2-3.4 years) and 88% of the PI-experienced cohort (2.2 years; range, 1.0-3.2 years). Virological failure occurred in 0%, 7% and 8% of the cohorts, respectively, and median CD4+ count increased above baseline by 224, 155 and 115 cells/mm(3), respectively. Change from baseline in median fasting lipids was: total cholesterol +12, -6, -2 mg/dL; low-density lipoprotein-cholesterol 0, -5, +12 mg/dL; high-density lipoprotein-cholesterol +4, +2, +7 mg/dL; triglycerides +9, -21, -65 mg/dL, respectively. In conclusion, FPV/RTV 1400/100 mg QD-containing regimens remained effective long-term in all ARV-naïve and most PI-naïve and PI-experienced HIV-infected patients.

Making the transition to topical anesthesia.

The transition to topical anesthesia and clear corneal cataract surgery can be made safe, effective, and less stressful through proper preparation and training as a surgical team. Sharing experiences with other practices will help in this process, as will visiting other practices and seeing them in action.

A phenomenological variant of ecological systems theory (PVEST): a self-organization perspective in context.

A framework that emphasizes and integrates individuals' intersubjective experiences with Bronfenbrenner's ecological systems theory (PVEST) is introduced and compared with self-organizational perspectives. Similarities, differences and advantages of each framework are described. In a demonstration of PVEST's utility, a subset of data from the 3rd year of a longitudinal study (14- to 16-year-old middle adolescent African-Americans) is used for examining an achievement variable: negative learning attitude. Explored separately by gender, a regression model that contained risk, stress, and a reactive coping variable for the prediction of negative learning attitudes was investigated. For boys, stress was an independent stressor across steps independent of the other variables entered; social support variable, perceived unpopularity with peers, that was a significant predictor of girls' negative learning attitude. Particularly for boys, the findings suggest critically important roles for teachers and peers in the negative learning attitude of midadolescent economically disadvantaged African-American students.

Spatial reference systems in the comprehension of rotational motion.

In certain simple rotations of objects, the orientation of the axis and planes of rotation can determine whether people are able to visualize the motion or perceive it as simple and coherent. This finding affords the opportunity to investigate the spatial reference systems used to define the orientation of the axis and planes of rotation. The results of two experiments suggest that the permanent environment is the primary reference system, apart from the rotating object, used for this purpose. Subjects also were able to use a local spatial environment to determine the orientation of the motion; some subjects were particularly adept at this. The viewer perspective, in contrast, was irrelevant as a reference system in these experiments. These results argue strongly for the primacy of environmental reference systems in the perception and imagination of orientation and extend the set of findings common between the comprehension of rotational motion and orientation-sensitive form perception.

Bilateral traumatic chylothorax.

We report the case of a 27-year-old man with bilateral chylothorax. The patient presented with shortness of breath and bilateral pleural effusions three days after a motor vehicle accident. The diagnosis was established when tube thoracostomy revealed chylous drainage. During hospitalization approximately 8 L of chyle were removed. Bilateral chylothorax secondary to blunt trauma has rarely been reported. The etiology, pathogenesis, clinical presentation, and recommended therapy are reviewed.

A modified solid ankle brace for the treatment of arthritides.

A modified solid ankle short leg brace is presented for use in patients with ankle joint and hind foot arthritides. Thirty-five patients were followed up for an average of 2 1/2 years. Thirty patients had marked relief of pain; three, moderate relief; and two, no relief. Thirty-two patients had improved cosmesis of their gait patterns.