Food security in a sample of clients attending HIV clinics in New South Wales: A cross-sectional study.

AIM: The aim of this study was to determine the prevalence, demographics and location of food insecurity (FI) among people living with HIV at six health sites in Sydney, Australia and to identify the factors relating to FI. METHODS: This was a cross-sectional study recruiting people living with HIV receiving HIV care from six sites across the Sydney metropolitan area. The United States Department of Agriculture abbreviated six-item Subset Food Insecurity Tool was used to assess FI and a demographic questionnaire was completed. Bivariate analysis was conducted to investigate differences between variables. Descriptive and frequency statistics were used to collate the demographic questionnaire and determine the prevalence of FI. All tests performed were two sided with a P-value of less than 0.05, or 95% confidence interval not overlapping, indicating a statistically significant association. RESULTS: Of the 162 participants 47% (n = 76) reported FI. The percentage of FI was found to be higher among the females (61%, n = 8 out of 13), unemployed (65%), receiving a government pension (63%), with a lower perceived health status (68%), a lower CD4 T cell count (60%), a detectable or unknown viral load (67%), and missed taking their antiretroviral therapy either in the last week or month (64%). All of the six participants who were Australian Aboriginal were food insecure. CONCLUSIONS: The study finds evidence of associations between FI, employment, lower immune function and poorer health outcomes for people living with HIV in Sydney.

When pure is not so pure: chloramine-related hemolytic anemia in home hemodialysis patients.

Worldwide, chloramines are used as the preferred disinfectant for city water supplies. Although they have distinct advantages compared with chlorine and are deemed harmless to the general population, hemodialysis (HD) patients are at risk from chloramine-induced hemolytic anemia. In recent years, this has been highlighted in regional dialysis units but not as frequently in the home HD group. We report on 2 home HD patients who succumbed to severe oxidative hemolysis due to high mains water chloramine concentrations. Both patients were extensively investigated for other cause of anemia before a definitive diagnosis was reached. Delays in diagnosing this uncommon condition can be costly in terms of significant morbidity and excessive usage of recombinant erythropoietin and blood transfusion. Prevention primarily involves enforcing strict water quality control and establishing regular communication with water supply boards and home HD patients. Double (inline) carbon filters should be installed in patient's homes as an effective means for removing high incoming chloramine concentrations.

Systemic proteasomal inhibitor exposure enhances dopamine turnover and decreases dopamine levels but does not affect MPTP-induced striatal dopamine depletion in mice.

The validation of an in vivo proteasomal inhibitor (PSI) model to translate ubiquitin-proteasomal-system dysfunction involved in the pathogenesis of Parkinson's disease (PD) into a commonly accepted animal model is ongoing. Here we first report the effects of systemic administration of the proteasomal inhibitor Z-lle-Glu(OtBu)-Ala-Leu-CHO (3 mg/kg, s.c., six times over 2 weeks) alone to extend the rat model to mice. Second we investigate the consequences of PSI pretreatment 42 weeks before an acute treatment with the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in C57bl/6 mice. HPLC postmortem neurochemistry showed a significant increase in dopamine turnover and decrease of striatal dopamine levels, only 14 weeks after PSI treatment, but no enhancement of dopamine turnover or differences in striatal dopamine levels when comparing MPTP with MPTP plus PSI treatment. Behavioral analysis (rotarod, open field activity) did not indicate that PSI affects this type of motor behavior. Systemic PSI administration in mice appears not to be a valid animal model under the experimental conditions used. Potential solutions are discussed.