Vaccination induces broadly neutralizing antibody precursors to HIV gp41.

A key barrier to the development of vaccines that induce broadly neutralizing antibodies (bnAbs) against human immunodeficiency virus (HIV) and other viruses of high antigenic diversity is the design of priming immunogens that induce rare bnAb-precursor B cells. The high neutralization breadth of the HIV bnAb 10E8 makes elicitation of 10E8-class bnAbs desirable; however, the recessed epitope within gp41 makes envelope trimers poor priming immunogens and requires that 10E8-class bnAbs possess a long heavy chain complementarity determining region 3 (HCDR3) with a specific binding motif. We developed germline-targeting epitope scaffolds with affinity for 10E8-class precursors and engineered nanoparticles for multivalent display. Scaffolds exhibited epitope structural mimicry and bound bnAb-precursor human naive B cells in ex vivo screens, protein nanoparticles induced bnAb-precursor responses in stringent mouse models and rhesus macaques, and mRNA-encoded nanoparticles triggered similar responses in mice. Thus, germline-targeting epitope scaffold nanoparticles can elicit rare bnAb-precursor B cells with predefined binding specificities and HCDR3 features.

Spiritual Healing in a Hospice Veteran Led to a Successful Opioid Taper: A Case Report.

Addressing "total pain" is a concept commonly practiced in palliative care. Spiritual healing in a Navy Veteran led to a significant improvement in pain allowing a voluntary taper of opioid medication. The Veteran was able to reconcile his faith in God and participated in several spiritual practices daily. The palliative care pharmacist assisted the team in developing an opioid taper process per Veteran's request as he had a strong conviction that he was spiritually healed. A reduction in opioid morphine equivalent daily doses (MEDD) were 87.5% without any symptoms from the clinical opioid withdrawal scale (COWS). The Veteran died peacefully during an opioid taper in hospice care.

Cosmetovigilance: A review of the current literature.

The term "pharmacovigilance" defines the activities related to the collection, detection, assessment, monitoring, and prevention of adverse reactions occurring with medications. Recently, the spectrum of "-vigilance" has broadened to include safety of herbal products and cosmetic products as well. "Cosmetovigilance" was introduced as a new term used for defining surveillance carried out by industry to address the safety of cosmetic products. It was first used in literature by Vigan (1997) to refer to the monitoring of cosmetic product safety. Today, it is recognized globally as a concept of public health. For this systematic review, a PubMed search was conducted in July 2018 for the term "cosmetovigilance."

Primary Pulmonary Lymphoid Lesions: Radiologic and Pathologic Findings.

The pulmonary lymphoid system is complex and is composed of two compartments: the pulmonary lymphatics and the bronchus-associated lymphoid tissue (BALT). Additional important cells that function in the pulmonary lymphoid system include dendritic cells, Langherhans cells, macrophages, and plasma cells. An appreciation of the normal lymphoid anatomy of the lung as well as its immunology is helpful in understanding the radiologic and pathologic findings of the primary pulmonary lymphoid lesions. Primary lymphoid lesions of the lung arise from the BALT and are uncommon. However, they are increasingly recognized within the growing number of posttransplant patients as well as other patients who are receiving immunosuppressive therapies. Primary lymphoid lesions encompass a wide range of benign and malignant lesions. Benign lymphoid lesions of the lung include reactive lymphoid hyperplasia, follicular bronchiolitis, lymphoid interstitial pneumonia, and nodular lymphoid hyperplasia. Malignant lymphoid lesions of the lung include low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), other non-Hodgkin lymphomas, and Hodgkin lymphoma. Last, a miscellaneous group of primary lymphoid lesions includes lymphomatoid granulomatosis, posttransplant lymphoproliferative disorders, acquired immunodeficiency syndrome (AIDS)-related lymphoma, and intravascular lymphoma/lymphomatosis. These lesions are best evaluated with multidetector chest computed tomography. The radiologic findings of the primary lymphoid lesions are often nonspecific and are best interpreted in correlation with clinical data and pathologic findings. The purpose of this article is to review pulmonary lymphoid anatomy as well as the most common primary pulmonary lymphoid disorders.

Sonographic evaluation of common peroneal neuropathy in patients with foot drop.

The common peroneal nerve arises from the sciatic nerve and is subject to a variety of abnormalities. Although diagnosis is often is based on the clinical findings and electrodiagnostic tests, high-resolution sonography has an increasing role in determining the type and location of common peroneal nerve abnormalities and other peripheral nerve disorders. This article reviews the normal sonographic appearance of the common peroneal nerve and the findings in 21 patients with foot drop related to common peroneal neuropathy.

Imaging of choledochal cysts.

Choledochal cysts are rare cystic dilatations of the intrahepatic and/or extrahepatic biliary tree, which may be mistaken for other cystic lesions if their characteristic features are not recognized. The etiology is unknown, and likely multifactorial, and it is uncertain whether they are congenital or acquired. Multiple imaging modalities can be used to diagnose choledochal cysts, including ultrasound, computed tomography, magnetic resonance (MR) cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography, and percutaneous transhepatic cholangiography. MRCP has replaced the more invasive techniques as the gold standard of diagnosis. In addition, MRCP is helpful in detecting an abnormal pancreaticobiliary junction, which is seen in the majority of choledochal cysts. Reaching a correct diagnosis is essential, given the associated risk of complications, including cholangitis, biliary strictures, stones, and malignancy, and accurately assessing the location and length of involvement is important for surgical planning. This review aims to familiarize radiologists with the different types of choledochal cysts and their imaging features according to the Todani classification.

Reasons for ineffective pre-pregnancy contraception use in patients seeking abortion services.

BACKGROUND: We sought to better understand reasons for not obtaining desired contraception among women presenting for a pregnancy termination. STUDY DESIGN: A survey was completed by women prior to having an abortion procedure. Reasons for lack of access were categorized as institutional, individual and compliance issues. Descriptive statistics were calculated and variables compared using chi(2) tests. RESULTS: Participants (n=298) ranged in age from 18 to 48 years. One third reported contraceptive use prior to pregnancy (37%). Approximately 72% of women reported some reason for not obtaining desired contraception, while 34% reported two or more. The distribution of reported individual, institutional, and compliance reasons were 44%, 28%, and 24%, respectively. Report of at least one reason was associated with a 35% increase in non-use (RR=1.35; 95% CI, 1.02-1.80) after adjusting for age, race, education, parity, and prior abortion. CONCLUSIONS: Many reasons for not obtaining desired contraception exist and are associated with non-use of contraception. Removing these reasons may help reduce unintended pregnancies and rates of pregnancy termination.

Viral sexually transmitted infections and bacterial vaginosis: 2001-2004 National Health and Nutrition Examination Survey data.

BACKGROUND: Bacterial vaginosis (BV) is a common condition believed to be associated with sexually transmitted infection (STI) susceptibility. Most studies of BV and STIs have come from treatment-seeking or high-risk populations. This study examines the association between 5 viral STIs, human papilloma virus (HPV), HIV, herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2), and Hepatitis C (HCV), and BV among women in the general US population. METHODS: Data from the 2001 and 2003-2004 National Health and Nutrition Examination Surveys were combined. Crude and adjusted relative risks and 95% confidence intervals were estimated from logistic regression analyses for rare outcomes (<10%) and from Poisson regression with robust error variance for common outcomes. Complex survey design was taken into consideration using the survey functions in Stata. RESULTS: Crude analyses found an association between BV and the prevalence of all 5 STIs. After adjustment for important confounders, only HSV-1 and HSV-2 were significantly associated with the presence of BV. Moreover, crude analyses stratified by race/ethnicity suggested that associations between BV and viral STIs may not be consistent across race/ethnicity subgroups. CONCLUSION: This population-based study found that BV was significantly associated with the prevalence of HSV-1 and HSV-2 and potentially associated with HIV and HPV. Given the frequency of BV in US women, small increases in STI susceptibility may have important impacts on STI transmission.

Consideraciones éticas en la publicación de investigaciones científicas / Ethical considerations in the publications of scientific research

It is presented throughout this study some of the most common examples of ethic violationsthat are committed when publishing scientific articles, such as violations due to lack ofknowledge or those done because it is “believed” it’s necessary to commit them. We arereferring by them, to the editorial process, ethic issues, real concept of “author” and theexplanation of the peer review process. All of this, being the steps by which each and everyone of the investigations must pass by, in order to be validated before being published. It isalso mentioned the topic related to those ethic violations that are most commonly and easilycommitted when there is lack of familiarity with this issues, such as Plagiarism and DoublePublication. Anyhow, throughout this article there are also shown a series of practical guidesby which authors may prevent such violations. At last we expose some final considerationssuch as the interest conflicts and informed consent which both are important topics at themoment of validating the information that is exposed in an article.