Oral Protocol for Successful Desensitization of Metronidazole

Trichomoniasis is the most prevalent nonviral sexually transmitted infection. Metronidazole and tinidazole are the only medications that are recommended by the Centers for Disease Control for the treatment of trichomoniasis. Alternative therapies are not standardized and limited in efficacy. Skin-prick testing to metronidazole is not validated. Three metronidazole desensitization protocols have been described, including one intravenous and two oral protocols. 

Centers for Disease Control and Prevention published a study documenting a total of 127 patients with suspected metronidazole hypersensitivity, among whom 15 patients underwent metronidazole desensitization2. Among those 15 patients, 7 patients underwent a 14-dose intravenous protocol3 and 8 patients underwent an 8-dose oral protocol5. All 15 patients achieved infection cure. More recently, a 12- dose modified oral desensitization protocol was described by Gendelman and colleagues in 2014. For more information Insights in Allergy, Asthma & Bronchitis.Read more.......

Adrenal Histoplasmosis- Keeping a High Index of Suspicion

Adrenal histoplasmosis is the most common adrenal granulomatous infection in the endemic areas of the world including some parts of the western United States.The adrenal gland is the most common endocrine organ to be affected by histoplasmosis, but the exact mechanism of localization of histoplasmosis toadrenal glands is unclear and is thought to be contributed by paucity of reticulo endothelial cells and presence of steroids in the adrenal glands.

Even though adrenal histoplamosis was initially thought to be a disease among the immuno compromised patient population such as those with immune deficiency syndromes, diabetes, those on steroids or transplant recipients, we are now seeing more cases in patients with intact immune systems. Adrenal histoplasmosis is also being diagnosed with increasing prevalence in the non-endemic regions of the world.There have been instances when adrenal histoplasmosis presented as a unilateral adrenal mass in otherwise asymptomatic patients who were initially diagnosed as adrenal carcinoma. These patients undergo adrenalectomy for fungal infections which could have been diagnosed with biopsies or serology if the index of suspicion was higher.Read more.......

Incidence of Oligohydramnios in Konaseema Area, EG-District

Amniotic fluid plays a major role in fetal growth and development. Abnormalities of fluid volume can interfere directly with fetal development causing structural anomalies such as pulmonary hypoplasia, fetal hypoxia, neural tube defect and gastrointestinal obstruction. Amniotic fluid surrounds and protects the fetus in the amniotic cavity. It provides a cushion against the constricting gravid uterus allowing the fetus room for movement, growth and protecting it from external trauma. The space around the fetus is necessary for the normal development, maturation of fetal lungs, and development of limbs. Amniotic fluid plays a major role in the homeostasis of fluid and electrolytes and fetal body temperature. 

Early period of fetal development a clear fluid collects in the amniotic cavity surrounding the embryo. The amount increases rapidly with the growth of the fetal products, averaging 50 ml at 12 weeks of pregnancy, 400 ml at 20 weeks of pregnancy. During the last few week of pregnancy the volume of amniotic fluid usually decreases.Composition Of Amniotic Fluid: Protein 0.5gm/100ml, Non protein nitrogen 24 mg/100ml, Uric acid 4.5 mg/100ml, Sugar 19 mg/ 100ml, Calcium 5.5 mg/100ml,Phosphorus 3.1mg/100ml.

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Female with Shortness of Breath

Chylothorax is characterized by pleural fluid with a turbid or milky appearance due to high triglyceride content in the form of chylomicrons that enters the pleural space as a chyle most commonly from the disruption of the thoracic duct. The chyle is rich in triglycerides, which produces the milky, opalescent appearance of the pleural fluid. Chyle also contains lymphocytes as the major cellular content. The electrolyte content ofthe chyle is similar to plasma and the protein content is usually greater than 3 g/dl. The diagnosis of chylothorax is made by the milky appearance of the pleural fluid and by measuring the pleural fluid triglyceride concentration which is typically more than 110 mg/dl or in cases in which the triglycerides are between 50-110 mg/dl by lipoprotein analysis of the pleural fluid which shows the presence of chylomicrons.

Malignancy is a leading cause of non-traumatic chylothorax responsible for 63% of non-traumatic causes. Lymphoma is the single most common cause responsible for 50% of the non-traumatic causes. Other common causes of chylothorax are Castleman's disease, sarcoidosis, histoplasmosis, lymphangioleiomyomatosis, Noonan syndrome, filariasis, heart failure, lymphangitis of the thoracic duct, aneurysm of the thoracic aorta that erodes the duct, Cirrhosis of the liver, childbirth and idiopathic.Surgical procedures and chest trauma are the most common causes of the traumatic chylothorax .Read more.......

Challenges in the Management of Malaria in Nigeria: A Healthcare System Preview

Malaria remains a huge global health burden with more than 90% of fatalities occurs in Africa and about half a million infant mortality each year. Malarial infection is of particular concern as it is a disease that can be both treated and prevented. Nigeria, biggest country by population in Africa, is responsible for about 25% of global health burden. While all local and international efforts aim to implement Nigeria’s current National Strategic Malaria Plan [NMSP 2014-2020] to have Nigeria free of Malaria by 2020, the current healthcaresystem in Nigeria remains a major system bottleneck to achieving such challenging objective but yet still achievable.

This report on Nigeria’s current malaria situation aims to highlight healthcare system challenges that face Nigeria as a country, and possible plans that integrate both local and international initiatives to reach 2020 with a malaria-free country.The studies used in this review were retrieved from CINAHL Plus, MEDLINE, ProQuest and PUBMED databases focusing on Malaria and healthcare challenges in Nigeria. Google scholar was used on one occasion to obtain one full-text article

Global Malaria Facts and Overview:

Malaria is a life-threatening disease that can be both prevented and treated which can dramatically reduce the burden of disease in the globe. There are about 3.2 billion people around the world at risk of infection, approximately half of the total world population, and about half a million people died in 2015 worldwide due to malaria infection .A comparison of incomes in a malarial versus non-malarial countries shows that income is five times higher in non-malarial countries. Where malaria infection flourishes, poverty and poor health outcome exist. Malaria-endemic countries have an impeding economic growth and development by both direct and indirect way such as productivity, healthcare cost, and infant mortality.Read more.....

Disease complexity – A Bird’s Eye View

Over the last few decades, biologists understood gradually that a set of complex interactions between the numerous constituents of a cell, gives rise to different biological phenotypes. Diseases serve as interesting examples of a great number of heterogeneous, interacting entities of biological systems. Though the ultimate goal is to understand the causes and effects along with the mechanisms of regulation, the precise simulation to mimic the real biological phenomena had been quite tough. The present talk encompasses a discussion on the model networks of few infectious diseases focused around identifying the proteins indispensable for virulence followed by probing into the structure function relation of the proteins involved there in and their molecular evolution. 

The diseases are either caused by bacterial infection like typhoid caused by Samonella enterica, nosocomial infection by Acinetobacter baumannii and fish pathogenesis by Edwardsiella tarda. On an initial note, the indispensability issue has been taken off for virulent proteins from the 28 Pathogenicity Alien Islands (PAI) causing the hospital borne infection caused by Acinetobacter. Taking down to the practical level, a conglomerate of secretion systems and signaling proteins of Edwardsiella were used for identifying an important candidate suitable for fish vaccination. Finally, a methodology has been figured out theoretically to focus on the indispensable virulent proteins amongst a barrage of Salmonella Pathogenecity Island (SPI) proteins and proven by microarray data for Salmonella. 

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Water and Health

Water is essential for basic survival as it constitutes up to 60% of the human adult body. However, contaminated water can spread disease and cause poisoning. Pathogens such as bacteria, viruses, and parasites can spread by water and cause communicable diseases. Most of these are considered communicable because they can spread from one person to another via contaminated water or other vectors. So water is a vehicle for spread of the pathogens and other environmental health hazards. The most common diseases are diarrheal diseases, such as cholera, typhoid,paratyphoid, salmonella, giardiasis, and cryptosporidiosis. Other environmental health hazards may be chemical and radioactive constituents of water. Indeed, some chemical substances dissolved in water as a result of natural processes may be essential ingredients of dietary intake, and some may be harmful when they exceed certain concentrations. 

These are metals, synthetic organics and essential elements such as fluoride,iodine and selenium. This is why the quality of the drinking water is a universal health concern,more so in developing nations.

Infectious diseases caused by pathogenic bacteria, viruses and parasites are the most common and widespread health risk associated with drinking water. The elimination of all these agents from drinking water has to be a high priority. The provision of a safe supply of drinking water depends upon use of either a protected high-quality ground water, surface water, or a properly selected and operated series of treatments capable to reduce pathogens and other contaminants to the negligible health risk. These diseases are usually classified according to the nature of the pathogen. However, a more useful way of classifying these diseases is according to the various aspects of the environment that human intervention can alter.

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Revisiting the Current Assays Associated to Host Immune Responses Against Tuberculosis Infection

As an ancient microbe, Mycobacterium tuberculosis (MTB) is an extremely successful pathogen. MTB causes more deaths worldwide now than at any previous time in history as the World Health Organization (WHO) estimates that approximately one-third of the world’s population (roughly 2 billion total) is infected with MTB. MTB is a major health threat, causing 9 million new infections and between 2 and 3 million deaths annually. Future prospects look bleak due to the increasing impact of HIV and drug resistance MTB strains (MDR) on the TB epidemic.

The clinical course of TB provides clues as to the mechanisms that underlie MTB’s success as a pathogen. First, MTB establishes infection with a small inoculum, suggesting that it inhibits innate immune responses. Second, it often persists throughout the life of the host, suggesting evasion of adaptive immunity. Third, the transmission of MTB from one host to another typically depends upon the formation of lung cavities in which aerosols are generated by coughing or sneezing.

The mechanisms of lung cavitation are complex but include bystander damage of healthy tissue by the host cellular immune response. It is generally thought that granuloma formation is a means by which the host controls certain pathogens, most notably mycobacteria and fungal species. Granulomas form in animal models of TB and in human infection the scarred result of the granulomatous response to initial infection is sometimes observed as a calcified lesion abutting the pleural in a lower lobe of the lung, the “Ghon lesion”. Although the granuloma limits the extent of early infection, it is ultimately cell-mediated immunity involving T-cells that control MTB replication.

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Incidences and Treatments for Buruli Ulcer

Buruli ulcer is a bacterial disease, alternatively called Bairnsdale ulcer, Searls ulcer, or Daintree ulcer. The tropical disease causes blood clots on the skin and, when untreated, leads to severe ulceration. The infectious disease caused by a bacterium called Mycobacterium ulcerans. It is the third most common mycobacterial disease after tuberculosis and leprosy.The necrotizing disease occurs in parts of West Africa,Australia and Southeast Asia, affecting around 5,000 people each year. Children aged under 15 are the most commonly infected demographic group and the region with the highest concentration of infections is, currently, Cote d'Ivoire.

Until the late 1990s, when World Health Organization (WHO) programs began, the disease was a 'neglected disease'.The current treatment option primarily involves courses of antibiotics. More serious or untreatable cases require surgical intervention. To improve current treatment regimes, scientists are investigating alternative approaches; this article assesses some of these approaches alongside current practices.

Infection with the M. ulcerans bacterium leads to skin nodules forming on the skin and within subcutaneous tissues. When unchecked these nodules and plaques lead to ulceration, of a characteristic white-yellowcoloration. This can extend to 15% of the skin surface. If the ulcer progresses skin is lost to the extent that bone is affected. Unlike comparable diseases there is an absence of an acute inflammatory response.

Pulmonary Hypertension

Pulmonary high blood pressure affects the arteries in the lungs and the right side of the heart. Pulmonary hypertension starts when pulmonary arteries and capillaries become narrowed, blocked or destroyed. This makes harder for blood to flow through lungs, and raisespressure within pulmonary arteries. Pulmonary hypertension is a serious illness that becomes progressively worse and is sometimes fatal. Pulmonary hypertension is not curable it is only treatable.

Pulmonary hypertension occurs in individuals of all ages, races, and ethnic backgrounds, although it is much more common in young adults and is approximately twice as common in women as in men.The first symptom of pulmonary hypertension is usually shortness of breath with everyday activities, such as climbing stairs. Fatigue, dizziness, and fainting spells also can be symptoms. Swelling in the ankles, abdomen or legs, bluish lips and skin, and chest pain may occur as strain on the heart increases.

Related Journals of Pulmonary Hypertension:

Pulmonary & Respiratory Medicine, Pulmonary Medicine, Pulmonary Pharmacology and Therapeutics, BMC Pulmonary Medicine, Clinical Pulmonary Medicine, COPD: Journal of Chronic Obstructive Pulmonary Disease, Current Opinion in Pulmonary Medicine.

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease Open Access Journal aim is to publish the work and reports on pulmonary related diseases and high unmet medical need are based on innovative research. Chronic Obstructive Pulmonary Disease Open Access Journal is an international journal for rapid dissemination of significant data related to pulmonary diseases and their other related research information.

The journal is an interdisciplinary medium serving several branches of medical sciences. COPD publishes original articles, short communications, notes, and mini reviews. Full length reviews are only published after invitation from the editorial board. Preliminary studies are inappropriate for publishing in Chronic Obstructive Pulmonary Disease Open Access Journal, unless the authors report the significance of their findings, in that case, the manuscript can be accepted. Average first decision of submitted manuscript is expected to be 14 days.

Prostate Cancer in the Pre and Post Diagnosis Phase ? A Population Based Study on Health Care Costs

Introduction:

Prostate cancer is globally the second most common malignancy in men. In Sweden it is the most frequently diagnosed cancer. The incidence is increasing, mainly because of an older population and the possibilities for earlier detection of the disease. Furthermore, a great number of patients live for a considerable time following the diagnosis as the disease often progresses slowly. Despite declining mortality rates, costs are thus expected to further raise in the future .Previous studies have shown that the cost burden of prostate cancer is high and varies according to treatment type. 

Costs are highest for patients treated with external-beam therapy and lowest for patients treated with watchful waiting. However, several aspects concerning the costs of prostate cancer have not yet been fully evaluated. To date, limited information exists regarding health carecosts for prostate cancer patients in the pre-diagnostic phase of the disease. Knowledge about costs in the last year of life for prostate cancer patients is also sparse; as such studies usually are conducted at an institutional level. Only one population-based study was found that focused on different phases of the disease. Results showed that costs are highest around two events, the cancer diagnosis and cancer death .

Prevalence and Risk Factors Associated with Adherence to Antiretroviral Therapy in HIV-Infected Adults in a Tertiary Care Hospital in Mexico

Introduction:

In Mexico, antiretroviral therapy (ART) coverage for human immunodeficiency virus (HIV) infection is about 85%; the aim is to achieve optimal and prolonged HIV-1 RNA viral load suppression, if possible to <50 copies/mL, and patient adherence is necessary . ART suppresses the HIV-1RNA viral load, leading to immunological recovery and clinical improvements . Success in achieving good outcomes relies on high levels of ART adherence: preferably 95% or more to suppress HIV replication, and 80% or more to protect the immune system.

The World Health Organization defines adherence as the degree to which people’s behavior taking medication, keeping on a diet, and changes in lifestyle corresponds with agreed recommendations from a health care provider. Poor adherence compromises health improvements and leads to the wastage of treatment resources that are already limited. Non-adherence to recommended therapies is a global problem and has been observed for all diseases, but adherence to ART differs among countries according to clinical, economic, and socio-demographic factors. A meta-analysis of 19 case-controlled studies found that adherence to ART was significantly lower in patients with adverse reactions to antiretroviral drugs than among those without them.

A cross-sectional study conducted in Barcelona, Spain, in 2002 used the simplified medication adherence questionnaire (SMAQ) to validate adherence and applied it to 3004 HIV-infected patients. The test consists of six questions and the study found a prevalence of ART adherence of 68% in that population . A study conducted in Mexico on 93 HIV-infected patients foundthat 43% of participants were nonadherent; however, factors associated with nonadherence were not evaluated. In our country, information about ART adherence, the impact that it has on HIV-infected patients, and the associated risk factors is still limited. The aim of this study was to determine the prevalence of ART adherence and the risk factors associated with nonadherence in this HIV-infected population.

Smoking cessation interventions

Introduction:

Smoking remains the leading preventable cause of morbidity and mortality. With an estimated 1.22 billion smokers worldwide, the World Health Organization (WHO) reported that the global mortality of smoking was 5.4 million in year 2004. Cigarette smoking greatly increases the risk of lungcancer and heart attacks (coronary heart disease and acute myocardial infarction). It is also a risk factor for chronic obstructive pulmonary disease and cancers, including pharyngeal, esophageal, bladder, laryngeal, and pancreatic cancer. Life expectancy of a regular smoker is roughly 7-13 years shorter than that of a non-smoker on average.

In China, approximately 3000 deaths/day were attributable to smoking in 2005, reaching almost seven million deaths caused by smoking. With a prevalence of 67% among males in China, smoking is estimated to kill approximately one-third of Chinese men who are under 30 years old . Annually, over 320 million smokers consume an approximate 1.7 trillion cigarettes accounting for 40% of cigarettes smoked all over the world, and costing five billion U.S. dollars in 2000, 3.1% of China’s national health expenditures.

Smoking cessation is highly recommended by public health departments of various organizations, like WHO and Centers for Disease Control (CDC) However, it leads to physiological symptoms of withdrawal caused by nicotine dependence, which involves craving for tobacco and may lead to failing an attempt to quit smoking.

There are mainly two categories of available smoking cessation interventions, pharmacologic and behavioral interventions. Pharmacologic methods consist of five forms of nicotine replacement therapy (NRT) and two prescription medications, an antidepressant and a nicotinic receptor agonist. Behavioral methods consist of consulting from health care programs or/and educational programs, and mass media interventions. Both of these two methods have been reported successful in helping a smoker quit smoking.

Determination of Neutral Lipid and Cluster Formation for Screening Neurocognitive Impairment in Human Immunodeficiency Virus Patients

Human immunodeficiency virus (HIV) is an infection that weakens the immune system, making it harder for the body to fight infections and disease. It has neurotoxic effects, thus it is not surprising that HIV infection can cause problems including neurocognitive impairment (NCI) anddementia. Prior to widespread availability of combination antiretroviral therapy (cART), the prevalence of HIVassociated dementia was estimated to be between 6 - 30% among HIV positive patients . With the advent of cART, the most severe forms of HIV-associated dementia significantly decreased in prevalence, but milder forms of impairment remain highly prevalent and increase with age, affecting about 30 - 60% of HIV patients. It has, however, to be noted that there is current discussion about the prevalence of neurocognitive dysfunction, which might be under- or overestimated, depending on the neurocognitive assessment tools used. In addition, compared to the first decade of the epidemic, a shift has occurred .

Standardcomprehensive neuropsychological test batteries exist for the assessment of NCI in HIV patients. However, more extensive neuropsychological test batteries, although very useful in highlighting neurocognitive impairment, are difficult to apply in every clinical setting, because they require neuropsychological and neurological expertise and are influenced by differences in education, culture, and language across borders, and there is a lack of appropriate normative data for many patient populations. 

Public Participation of Men Who Have Sex with Men in the Context of Community Empowerment in India

Introduction:

HIV epidemic in India is a major public health concern, featuring high prevalence and infection rates in many states and among high risk groups (HRGs) . Men who have sex with men (MSM) are a high-risk group(HRG) noted for high HIV prevelance and risk status globally and in India . Add latest reference. 

MSM in India remain largely hidden due to social and cultural stigma and the stigmatizing socio-cultural environment, hinders them from accessing essential preventive services from existing social spaces . MSM population has been prioritized under the National AIDS Control Programme but this population remains hard to reach due to high stigmatization, social stigma, and discrimination prevailing in the In

dian society. In addition criminalization of MSM activity by the Indian penal code under section 377 adds to their societieal vulnerability.

In this context of vulnerability, the “organized participation” of MSM in open public spaces, where they identify themselves as MSM without stigma or fear, could be a proxy factor of empowerment against structural barriers that criminalize and stigmatize them.

Studies have highlighted in general, the positive relation of HRG “participation”, with their practice of preventive sexual behaviors . We assessed the MSM “public participation” in an empowerment context, through which they address structural barriers. Our study pertains to the MSM participation in “public” spaces which is a first of its kind in distinguishing and assessing the so far theoretically defined participations in the contextsof community mobilization .

The study used a well represented high risk population which was undergoing wider “community mobilization” process in India. Thus it provided the opportunity to quantitatively verify and assess the transforming nature of participation from a “utilitarian tool” to an “empowerment tool” in a community mobilization process, the factors of community mobilization which influences such participations and other contextual factors.

Women want Pre-Exposure Prophylaxis but are Advised Against it by Their HIV-positive Counterparts

Introduction:

In 2013, nearly 20% of new HIV infections in the United States (US) occurred among women. Of these new infections, 86% resulted from heterosexual contact with a high-risk mal. Black and Latina women are at increased risk of acquiring HIV compared to all other racial/ethnic groups of women. In 2013, black and Latina women accounted for 63% and 15% of all new HIV infections among women in the US, respectively. 

The latest advancement in HIV prevention, Pre-Exposure Prophylaxis (PrEP), could potentially contribute to reducing HIV infection rates among women. PrEP is a biomedical method that uses antitretroviral medications (ARVs) to prevent HIV in uninfected individuals who are at high risk of becoming infected. In 2012, the US Food and Drug Administration (FDA) approved oral Truvada (tenofovir disoproxil fumarate and emtricitabine) for PrEP among sexually active adults at risk for HIV infection based on two clinical trial. The CDC developed interim guidance for PREP use between 2011 and 2013 for men who have sex with men (MSM), heterosexually active adults, and injection drug users (IDU), followed by comprehensive clinical practice guidelines in May 2014.

Since the approval of Truvada for PrEP in the US, its use has increased considerably among men but remained static for women; a nationwide analysis of PrEP uptake using pharmacy databases showed that the absolute number of females who started PrEP in Quarter 1 of 2012 was 159, and remained flat for 11 quarters (over 3 years) until quarter 3 of 2014; for the same time period, the number of male PrEP users rose from 153 to 1064. The investigators suggest that the increase in PrEP prescriptions in men relative to women is related to growing awareness of PrEP among the MSM population; however, it is not clear why awareness and use among women have not similarly increased.

Crime and Punishment in Ancient Surgery: An Examination of Assyrian and Egyptian Physicians

The history of surgery is a fascinating collection of knowledge from various civilizations dating back up to four thousand years. Some of the oldest writings on surgery and surgeons’ duties date back to the Hammurabi code and Egyptian papyri. The role of the surgeon, particularly, has always had a somewhat peculiar distinction from that of other physicians. 

In reality, the physician sphere rarely interacted or overlapped with the surgeon sphere of practice, and responsibilities and rewards assigned to the two groups were frequently completely different. We sought to examine and compare the scope of practice, risks, rewards, and punishments of surgeons in Ancient Assyria and Ancient Egyptian times.

The responsibilities of the surgeon were, interestingly, somewhat similar to those of surgeons now. Surgeons were responsible for evaluation of ailments that were considered mechanical in nature. Ophthalmologic surgeries are noted as being done as early as 3500 BC for 10 shekels, whereas members of the ruling class would frequently pay significantly reduced, and sometimes almost none, of the ordained fees. Other responsibilities for Assyrian surgeons included management of bowel obstructions. 

Descriptions of surgeons “opening the bowels” to let impacted contents spew out are described in these texts. While it is unclear whether these were enterotomies or early ostomies, the concept of decompression is delineated. Conservative management of bowel obstructions and impactions is also described by what appears to be orogastric lavage with ointments and oils, and later, enemas as well. Keeping patients nil per os (NPO) is also described, with various medicinal shrubs and herbs provided “without food”.

On the Origin of Syphilis and Contemporary Views of Disease Dynamics

Introduction:

Despite syphilis being a disease of antiquity, diagnosis and treatment remains problematic globally due to a complex biologic pathogen/host relationship and the spread of the disease embedded in human behavior. First documented as an independent disease in 1495, the origin of syphilis has been ambiguous for over 500 years. In the past century, there have been several approaches to investigate the origins of syphilis, but without definitive outcome. A viable syphilis control option became available in the 20th century with the discovery of penicillin, leading to cost effective and safer treatment compared to prior use of mercury- and arsenic-containing compounds. However, despite the availability of antibiotics that can successfully treat syphilis, the disease waxes and wanes at various times and among certain social groups or settings, due in part to risky sexual behavior, a complex clinical presentation (multiple clinical stages including a latent stage where there are no clinical signs), diagnostic challenges and spontaneous healing or unnoticed lesions resulting in failure to seek clinical care or sexual partners not being referred for treatment. Disease ecology of syphilis is highly dependent on human behavior and epidemiology remains the hallmark for surveillance of disease severity, transmission and intervention programs. Here we address contemporary aspects of the origin, control and treatment measures, and modern views of disease ecology of syphilis.

Historically, controversy surrounds the origin of syphilis (Treponema pallidum subsp. pallidum ) which is based on two theories, the Columbian and the pre-Columbian. The Columbian theory suggests that explorers in the late 1400s carried the disease back to Europe from the “New World” and triggered the first documented outbreak of syphilis in Naples during the invasion by King Charles VIII’s army in 1495. This view dominated thoughts on the subject until the 20th century when scientists began to recognize the similarities in clinical presentation between syphilis and other diseases such as leprosy, and proposed that syphilis existed in pre-Columbian Europe but was not recognized as a separate disease until 1495 (pre- Columbian hypothesis). 

Dyslipidemia and Fasting Glucose Impairment among HIV-Infected Patients 48-Weeks after the First Antiretroviral Regimen

With the increased survival of HIV-infected patients, there have emerged a number of unexpected consequences of chronic illness and drugs adverse events, especially in the form of metabolic disease .

Available data suggest the presence of an accelerated process of coronary atherosclerosis in this population due to multiple factors, including a higher prevalence (compared with non–HIV-infected patients) of conventional risk factors, emerging risk factors (chronic inflammation, immune activation, and senescence related to HIV infection itself), and the role of antiretroviral therapy (ART), regarding metabolic syndrome as one of the major problems . Some studies have showed that the prevalence of metabolic syndrome was higher among HIV-infected patients on ART than among non-HIV-infected healthy controls (15.8 vs. 3.2%). A high incidence of diabetes mellitus (DM) and impaired fasting glucose (IFG) has been detected in HIV-infected patients receiving ART. Another studies have found relationship between some classes of antiretroviral (ARV) drugs such as protease inhibitors (PIs) and nucleos(t)ide retrotranscriptase inhibitors (NRTIs) with a higher frequency of new-onset DM and IFG.

We conducted a retrospective cohort from 1 June 2014 to 30 December 2014 of HIV-1 treatment naïve-infected adults who started therapy for the first time. Dyslipidemia (total cholesterol and triglycerides) and fasting plasma glucose, before and 48 weeks after starting ART were collected.

Patients

The hospital institutional review board and ethics committee reviewed and approved this study (reference number R-2015-3502-70).

Differences in the Development of Restenosis Over Time for Various Drug-Eluting

Introduction: Restenosis after stent implantation is one of the major limitations of percutaneous coronary intervention (PCI). Compared to bare metal stents (BMS), drug-eluting stents (DES) have a reduced incidence of restenosis. However, the temporal pattern of restenosis development in patients implanted with DES has not been clearly defined.

Aim: This study aims to compare the efficacy of sirolimus-eluting stents (SES), paclitaxel-eluting stents (PES), zotarolimus-eluting stents (ZES), and everolimus eluting stents (EES) via sequential angiographic follow-up and to reveal the development of restenosis over time.

Material and methods: Patients were randomized to receive SES, PES, ZES, or EES, and follow-up angiography was performed at 6, 12 and 24months after percutaneous coronary intervention. We analyzed late loss (LL) at each time point and defined 2 time periods: “early” (within first year of follow-up) and “late” (after the first year).

Results: In all groups, mean minimal lumen diameter decreased slightly during the 2-year period after the procedure. Compared with the SES group, the PES and the ZES groups showed significantly greater late loss (LL) within 1 year. However, the SES group showed significantly greater LL compared with the other drug-eluting stents (DES) between 1 and 2 years.

Conclusions: Serial angiographic analysis revealed differences in the rate of restenosis development over time for various DES. Of the studied DES, EES showed the best results in both early and late LL.

Is The Time Coming for Plant-Made Vaccines?

Magnetic resonance imaging (MRI) is widely used as an essential imaging modality for diagnosis in dentistry and medicine. MRI is noninvasive and does not require exposure to any ionizing radiation. This is in contrast to X-ray computed tomography, X-ray angiography, and positron emission tomography (PET) by gamma rays. MR can create high-quality images of detailed anatomical structures because of its excellent soft tissue resolution.

Zika Virus (ZIKA: New Emerging Pathogen Transmitted by Aedes Mosquitoes (Diptera: Culicidae) in the Latin American Subcontinent

Aedes aegypti and Aedes albopictus (Diptera: Culicidae) are two species of mosquitoes commonly found in urban and periurban environments in the Latin American subcontinent. Ae. aegypti was introduced around the seventeenth or eighteenth centuries, when the trade of slaves between Africa and America was intense.The introduction of Ae. albopictus into the Latin American subcontinent occurred between the years 1985 and 1986, when this vector was detected in the United States and Brazil for the first time .It is believed that this introduction was related to the importation of bamboo plants (Dracaena sp.) or used tires from Southeast-Asia. Both Ae. aegypti and Ae. albopictus are biological vectors of viral diseases that affect human beings. Ae. aegypti is recognized as the world’s most important vector in the transmission of dengue virus (DENV). Additionally, it can also transmit chikungunya (CHIKV), yellow fever (YFV) and Venezuela equine encephalitis (VEE) viruses. On the other hand, Ae. albopictus is a known vector of viruses like DENV, CHIKV, Japanese encephalitis, La Crosse, among others . Regarding Zika virus (ZIKV), both species of Aedes have been implicated in its transmission. The infection by ZIKV usually generates a less severe clinical picture compared to DENV and CHIKV, but the association of this virosis with neurological syndromes such as Guillain-Barre, and with congenital problems such as microcephaly, represents a new point of interest in public health . Thus, the presence of this emerging disease in the Latin American subcontinent constitutes a new challenge for local health systems .This territory has environmental and urban conditions that are very appropriate for the dissemination of ZIKV. The absence of ZIKV immunity in the population and the high levels of Ae. aegypti and Ae. albopictus infestation make efficient circulation of ZIKV likely, along with DENV and CHIKV .The aim of this review is to analyze the role of Ae. aegypti and Ae. albopictus in ZIKV transmission and to provide a brief overview of this virosis.

The first report of human infection by ZIKV occurred in 1964 , and the first isolations from human beings were documented in Nigeria in 1968 . Although there are several studies based on serological evidence that demonstrate the continuous circulation of ZIKV in human populations of Asia and Africa, it was not until 2007 that the first important outbreak was documented. This outbreak occurred in Yap Island in Micronesia: 49 cases were confirmed and 59 of them were classified as probable. In 2013, another important outbreak occurred in French Polyneia, in which around 10,000 cases of ZIKV were reported and 70 of them presented neurological and autoimmune complications . ZIKV is a flavivirus, similar to the Spondweni virus, and it is related to other viruses transmitted by mosquitoes such as DENV, YFV, West Nile virus (WNV), St. Louis encephalitis virus (SLE), and Japanese encephalitis virus (JE). The viral particle contains a positive-strand RNA-genome comprising 10,794 nucleotides, and it encodes for 3,419 amino acids .The gene organization is similar to other flaviviruses. The genome encodes for several proteins, including the capsid (C), premembrane (prM), envelope (E), and seven nonstructural proteins denominated as NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5 Molecular biology studies have recognized the existence of two lineages, the African and the Asian one