BACKGROUND & AIMS: Malnutrition is a common complication of HIV infection and plays a significant and independent role in morbidity and mortality. Many studies have been conducted to assess the appropriate role of nutrition in the clinical management of HIV infection. The complex nature of AIDS wasting, however, requires individualized strategies when providing nutritional support. Algorithms to assist in the diagnosis and treatment of malnutrition in HIV infection serve as general guidelines.

背景与目标： 营养不良是艾滋病毒感染的常见并发症，在发病率和死亡率中起着重要而独立的作用。已经进行了许多研究，以评估营养在HIV感染的临床管理中的适当作用。然而，浪费艾滋病的复杂性，在提供营养支持时需要个性化的策略。辅助诊断和治疗HIV感染中营养不良的算法为一般准则。

BACKGROUND & AIMS: :Few details are known about how the human immunodeficiency virus type 1 (HIV-1) genomic RNA is trafficked in the cytoplasm. Part of this process is controlled by the activity of heterogeneous nuclear ribonucleoprotein A2 (hnRNP A2). The role of hnRNP A2 during the expression of a bona fide provirus in HeLa cells is investigated in this study. Using immunofluorescence and fluorescence in situ hybridization techniques, we show that knockdown of hnRNP A2 expression in HIV-1-expressing cells results in the rapid accumulation of HIV-1 genomic RNA in a distinct, cytoplasmic space that corresponds to the microtubule-organizing center (MTOC). The RNA exits in the nucleus and accumulates at the MTOC region as a result of hnRNP A2 knockdown even during the expression of a provirus harboring mutations in the hnRNP A2-response element (A2RE), the expression of which results in nuclear retention of genomic RNA. We also demonstrate that hnRNP A2 expression is required for downstream trafficking of genomic RNA from the MTOC in the cytoplasm. Genomic RNA localization at the MTOC that was both the result of hnRNP A2 knockdown and the overexpression of Rab7-interacting lysosomal protein had little effect on pr55Gag synthesis but negatively influenced virus production and infectivity. These data indicate that altered HIV-1 genomic RNA localization modulates viral assembly and that the MTOC serves as a central site to which HIV-1 genomic RNA converges following its exit from the nucleus, with the host protein, hnRNP A2, playing a central role in taking it to and from this site in the cell.

背景与目标： 关于人类免疫缺陷病毒1型（HIV-1）基因组RNA如何在细胞质中运输的信息鲜为人知。该过程的一部分由异质核糖核蛋白A2（hnRNP A2）的活性控制。这项研究调查了hnRNP A2在HeLa细胞中表达真正的原病毒的过程中的作用。使用免疫荧光和荧光原位杂交技术，我们显示敲低表达HIV-1的细胞中hnRNP A2表达的表达导致HIV-1基因组RNA在与微管组织中心相对应的独特细胞质空间中的快速积累（ MTOC）。即使hnRNP A2反应元件（A2RE）中携带有突变的原病毒表达，RNA仍会通过hnRNP A2敲除而留在细胞核中并在MTOC区域积聚，其表达会导致基因组RNA的核保留。我们还证明hnRNP A2表达是从细胞质MTOC下游运输基因组RNA所必需的。基因组RNA在MTOC处的定位既是hnRNP A2敲除的结果，又是与Rab7相互作用的溶酶体蛋白的过表达，对pr55Gag的合成影响很小，但对病毒的产生和感染性产生负面影响。这些数据表明，改变的HIV-1基因组RNA定位可调节病毒装配，MTOC充当HIV-1基因组RNA从细胞核退出后向其汇聚的中心位点，宿主蛋白hnRNP A2发挥着核心作用。将其带入和移出该单元格中的此站点。

BACKGROUND & AIMS: OBJECTIVE:To evaluate the maternal and neonatal outcomes of pregnancies complicated with isolated oligohydramnios at term, managed by induction of labor. METHODS:We conducted a retrospective case-control study. 138 women with uncomplicated oligohydramnios at term [amniotic fluid index (AFI) < or =5 cm] and a low Bishop score (< or =6) underwent induction of labor with prostaglandin E2. These women were compared to 67 women who underwent induction of labor at 42 weeks' gestation and 276 women at low-risk pregnancy and spontaneous onset of labor, matched for parity and race. RESULTS:Cesarean section (CS) rate was similar in the study and the post-date group (17.4 and 17.9%, respectively), but significantly higher than the spontaneous labor group (5.8%, OR 3.42, 95% CI 1.75-6.68). No differences were found with other outcomes. CONCLUSION:Pregnancies with isolated oligohydramnios at term apparently are not at higher risk of perinatal complications, but induction of labor is associated with increased rate of CS.

背景与目标： 目的：评估足月妊娠并通过引产管理的妊娠合并轻度羊水过少的孕妇和新生儿的结局。
方法：我们进行了一项回顾性病例对照研究。 138名足月[羊水指数（AFI）<或= 5 cm]且Bishop评分低（<或= 6）的单纯性羊水过少的妇女接受前列腺素E2引产。将这些妇女与67名在42周妊娠时引产的妇女和276名在低危妊娠和自发性发作的妇女进行比较，以实现同等和种族匹配。
结果：剖宫产（CS）率在研究中和后期组相似（分别为17.4和17.9％），但显着高于自然分娩组（5.8％，或3.42，95％CI 1.75-6.68） 。与其他结果无差异。
结论：足月妊娠少羊水过少的孕妇显然没有围产期并发症的高风险，但是引产与CS发生率增加有关。

BACKGROUND & AIMS: OBJECTIVES:Cases of hypophosphataemia (often coincident with renal dysfunction) have been reported in HIV-infected patients taking tenofovir disoproxil fumarate (TDF), but randomized placebo-controlled trials of HIV-infected persons with normal baseline renal function have found a comparable incidence of hypophosphataemia in the TDF and placebo groups. We assessed the incidence of grade 2 and higher hypophosphataemia in the HIV Outpatient Study (HOPS). METHODS:We analysed a prospective cohort of patients who initiated either a TDF-containing highly active antiretroviral therapy (HAART) regimen [TDF-exposed (TDF+) group; n = 165] or a TDF-sparing HAART regimen [TDF-unexposed (TDF-) group; n = 90], and who had normal baseline phosphate and creatinine values. RESULTS:The TDF+ and TDF- groups had comparable median follow-up times (10.9 vs 8.8 months, respectively; P = 0.18) and number of phosphate measurements (median = 3 for both) and were similar on most clinical and demographic factors. During follow up, 12.7% of TDF+vs 6.7% of TDF-patients developed grade 2 hypophosphataemia (2.0-2.4 mg/dL), and 2.4% of TDF+ patients vs 0% of TDF-patients developed grade 3 hypophosphataemia (1.0-1.9 mg/dL); none developed grade 4 hypophosphataemia (<1.0 mg/dL). The incidence of grade 2 or higher hypophosphataemia was 16.7 per 100 person-years among TDF+ patients vs 8.0 per 100 person-years among TDF-patients (P = 0.11). CONCLUSIONS:The incidence of hypophosphataemia was somewhat elevated in HOPS patients who took TDF-containing HAART compared with those who took TDF-sparing HAART during the first 1 to 2 years of observation, but the difference was not statistically significant. Longer follow-up of a larger population is needed to determine if this trend towards an association achieves statistical significance and to evaluate the clinical consequences of hypophosphataemia.

背景与目标： 目的：已经报道了接受替诺福韦二富马酸富马酸酯（TDF）感染HIV的患者发生低血磷的情况（通常与肾功能不全同时发生），但基线肾功能正常的HIV感染者的随机安慰剂对照试验发现TDF和安慰剂组的低磷血症。我们在HIV门诊研究（HOPS）中评估了2级和更高的低血磷的发生率。
方法：我们分析了开始采用含TDF的高活性抗逆转录病毒疗法（HAART）方案[TDF暴露（TDF）组）的患者的前瞻性队列研究。 n = 165]或保留TDF的HAART方案[未暴露TDF（TDF-）的组； n = 90]，并且基线磷酸盐和肌酐值正常。
结果：TDF和TDF-组的中位随访时间（分别为10.9和8.8个月； P = 0.18）和磷酸盐测量次数（两者的中位数= 3）具有可比性，并且在大多数临床和人口统计学因素上相似。在随访期间，TDF的12.7％与TDF的患者的6.7％发生了2级低血磷（2.0-2.4 mg / dL），TDF的2.4％vs TDF的患者中出现了3级的低血磷（1.0-1.9 mg） / dL）;没有一个发生4级低血磷（<1.0 mg / dL）。 TDF患者中2级或更高水平低血磷的发生率为每100人年16.7人，而TDF患者为每100人年8.0人（P = 0.11）。
结论：在观察的头1至2年中，与含TDF的HAART的HOPS患者相比，接受含TDF的HAART的HOPS患者的低磷酸盐血症发生率有所升高，但差异无统计学意义。需要对更大的人群进行更长时间的随访，以确定这种联系趋势是否达到统计学意义并评估低血磷的临床后果。

BACKGROUND & AIMS: :A new inhibitor of human immunodeficiency virus (HIV) has been isolated and purified to homogeneity from the seeds and fruits of the Momordica charantia. This compound, MAP 30 (Momordica Anti-HIV Protein), is a basic protein of about 30 kDa. It exhibits dose-dependent inhibition of cell-free HIV-1 infection and replication as measured by: (i) quantitative focal syncytium formation on CEM-ss monolayers; (ii) viral core protein p24 expression; and (iii) viral-associated reverse transcriptase (RT) activity in HIV-1 infected H9 cells. The doses required for 50% inhibition (ID50) in these assays were 0.83, 0.22 and 0.33 nM, respectively. No cytotoxic or cytostatic effects were found under the assay conditions. These data suggest that MAP 30 may be a useful therapeutic agent in the treatment of HIV-1 infections. The sequence of the N-terminal 44 amino acids of MAP 30 has been determined.

背景与目标： ：已从苦瓜种子和果实中分离出一种新的人类免疫缺陷病毒（HIV）抑制剂并将其纯化至同质。该化合物MAP 30（Momordica抗HIV蛋白质）是约30 kDa的碱性蛋白质。它通过以下方式表现出对无细胞HIV-1感染和复制的剂量依赖性抑制作用：（i）在CEM-ss单层上的定量局灶性合胞体形成； （ii）病毒核心蛋白p24表达； （iii）HIV-1感染的H9细胞中的病毒相关逆转录酶（RT）活性。在这些试验中，抑制50％（ID50）所需的剂量分别为0.83、0.22和0.33 nM。在测定条件下未发现细胞毒性或细胞抑制作用。这些数据表明，MAP 30可能是治疗HIV-1感染的有用治疗剂。已经确定了MAP 30的N-末端44个氨基酸的序列。

BACKGROUND & AIMS: :Japanese people in both Japan and in Hawaii have a lower incidence of hip fractures than white people in Hawaii or on the mainland of the United States. Hip fractures usually occur after a fall, and differing incidence rates of falls might contribute to the observed differences in hip fracture rates. To investigate this possibility we undertook a prospective study of falls among elderly Japanese men and women living in Hawaii using intensive surveillance methods similar to those used in studies of predominantly white populations. For our Japanese participants, the incidence rates of total falls were 139 per 1000 person years for men and 276 per 1000 person years for women. Age adjusted rate ratios of falls for predominantly white populations compared with our Japanese participants ranged from 1.8 to 2.3 for women and from 2.6 to 4.7 for men. The risk of injuries when they did fall, however, was not lower for our Japanese participants than reported for white participants. For our Japanese population, past falls, female gender, and daytime hours were associated with an increased incidence of falls.

背景与目标： ：在日本和夏威夷，日本人的髋部骨折发生率比夏威夷或美国大陆的白人低。髋部骨折通常在跌倒后发生，跌倒的发生率不同可能会导致观察到的髋部骨折发生率的差异。为了调查这种可能性，我们进行了一项前瞻性研究，研究了居住在夏威夷的日本老年男性和女性跌倒的情况，采用了与主要针对白人人口的研究相似的强化监视方法。对于我们的日本参与者，男性总跌倒发生率是每千人年139例，女性每千人年276例。与日本人相比，以白人为主的年龄调整后的跌倒比率，女性为1.8到2.3，男性为2​​.6到4.7。但是，我们的日本参与者跌倒时受伤的风险并不比白人参与者低。对于我们的日本人口来说，以往的跌倒，女性性别和白天营业时间与跌倒发生率增加相关。

BACKGROUND & AIMS: INTRODUCTION:STDs are a significant cause of illness throughout the world. Female sex workers (FSWs) are commonly perceived as belonging to a social group which may engage in high-risk behaviour for acquiring or transmitting HIV and other STDs. The number of immigrant women engaged in sex work has increased in Catania, Sicily, over the last 10 years. This study aims to estimate the prevalence of HIV, HBV, HCV and syphilis among Colombian and Dominican FSWs. METHODS:In total 118 (63.78%) of the FSWs contacted in the course of the project agreed to participate in the study. All women enrolled were counselled on STDs/HIV, safer sex practices and the use of condoms. Blood samples were taken and tested for HIV, HBV, HCV and syphilis. RESULTS:Of the 118 FSWs enrolled, all were negative for both HIV and HCV infection. Two women (1.6%) were positive for hepatitis B (HbsAg). Syphilis testing by VDRL showed three positive results (2.5%), which was confirmed by TPHA. DISCUSSION:This study showed that HIV, HBV, HCV and syphilis seroprevalence among Colombian and Dominican FSWs remains low or very rare. It also indicates that these women were healthy when they arrived in Italy and that condom use with clients is high.

背景与目标： 简介：性病是世界范围内引起疾病的重要原因。女性性工作者（FSWs）通常被认为属于一个社会群体，该群体可能会为获取或传播艾滋病毒和其他性传播疾病而从事高风险行为。在过去的十年中，西西里岛卡塔尼亚从事性工作的移民妇女人数有所增加。这项研究的目的是估计哥伦比亚和多米尼加的FS​​W中HIV，HBV，HCV和梅毒的患病率。
方法：在该项目过程中，总共有118名（63.78％）的FSW同意参与研究。为所有入选妇女提供性传播疾病/艾滋病毒，更安全的性行为和使用安全套方面的咨询。抽取血样并测试HIV，HBV，HCV和梅毒。
结果：在118个FSW中，所有的HIV和HCV感染均为阴性。两名女性（1.6％）的乙型肝炎（HbsAg）阳性。 VDRL进行的梅毒测试显示三项阳性结果（2.5％），这已被TPHA证实。
讨论：这项研究表明，哥伦比亚和多米尼加地区FSW中的HIV，HBV，HCV和梅毒血清阳性率仍然很低或非常罕见。这也表明这些妇女到达意大利后就很健康，而且与客人一起使用避孕套的比例很高。

BACKGROUND & AIMS: :Descriptions of primary HIV-1 infection have so far been based on Caucasians living in industrialized nations. Due to studies of leptospirosis in the predominantly black population of Barbados, serum was available for patients admitted with acute febrile illnesses to the Queen Elizabeth Hospital (QEH). By searching the medical records of 510 adult patients with known HIV-1 infection we identified 10 patients who had stored serum from an admission for an acute febrile illness that predated or coincided with their first HIV-1-positive test. Serological testing confirmed primary HIV-1 infection in 9 and was suggestive in the 10th patient. The clinical features of these 10 patients were in keeping with previous descriptions of primary HIV-1 infection but differed from leptospirosis cases seen at the QEH. One patient died during his seroconversion illness and another died 3 months after seroconversion. The findings suggest that severe primary HIV-1 infection could be a relatively uncommon occurrence, that the condition may be misdiagnosed, and that cases may not occur until the AIDS epidemic is established. :A retrospective review was conducted of the medical records of 510 HIV-1-positive adult patients who had attended the Queen Elizabeth Hospital (QEH) to determine whether any had been admitted for an illness compatible with a diagnosis of primary HIV-1 infection. A serum bank, created from patients who had been admitted with acute febrile illnesses and investigated for leptospirosis, provided serological evidence for primary HIV-1 infection in 10 patients. Serological testing of the serum samples confirmed primary HIV-1 infection in nine patients and was suggestive in the tenth. The clinical features of the 10 patients fit the earlier descriptions of primary HIV-1 infection, but differed from the leptospirosis cases seen at the QEH. One patient died during his seroconversion illness and another died 3 months after seroconversion. These findings suggest that severe primary HIV-1 infection could be a relatively uncommon occurrence, that the condition may be misdiagnosed, and that cases may not occur until the AIDS epidemic is established.

背景与目标： ：到目前为止，主要针对HIV-1感染的描述都是基于生活在工业化国家中的高加索人。由于对巴巴多斯主要是黑人人群的钩端螺旋体病进行了研究，因此伊丽莎白女王医院（QEH）接受了急性发热性疾病的患者可获得血清。通过搜索510例已知HIV-1感染的成年患者的病历，我们确定了10例在首次发热HIV-1阳性测试之前或与其同时发生的急性发热疾病患者入院时就储存了血清的患者。血清学检查证实了9例原发性HIV-1感染，并提示第10例患者。这10例患者的临床特征与原发性HIV-1感染的先前描述相符，但与QEH所见的钩端螺旋体病病例有所不同。一名患者在血清转化疾病中死亡，另一名患者在血清转化后3个月死亡。研究结果表明，严重的原发性HIV-1感染可能是相对罕见的事件，该病可能被误诊，只有在AIDS流行之前，病例才可能发生。
：回顾性分析了510例曾在伊丽莎白女王医院（QEH）住院的HIV-1阳性成年患者的病历，以确定是否有人因与原发性HIV-1感染诊断相符的疾病而入院。由被接纳患有急性发热性疾病的患者创建的血清库，并研究了钩端螺旋体病，为10例患者的原发性HIV-1感染提供了血清学证据。血清样本的血清学检测证实了9名患者的原发性HIV-1感染，而第十名患者则具有启发性。这10例患者的临床特征符合原发性HIV-1感染的早期描述，但与QEH所见的钩端螺旋体病病例有所不同。一名患者在血清转化疾病中死亡，另一名患者在血清转化后3个月死亡。这些发现表明，严重的原发性HIV-1感染可能是相对罕见的事件，可能会误诊该病，并且直到艾滋病流行才可能发生。

BACKGROUND & AIMS: :Zalcitabine is a dideoxynucleoside antiretroviral agent that is phosphorylated to the active metabolite 2',3'-dideoxycytidine 5'-triphosphate (ddCTP) within both uninfected and HIV-infected cells. At therapeutic concentrations, ddCTP inhibits HIV replication by inhibiting the enzyme reverse transcriptase and terminating elongation of the proviral DNA chain. The results of 3 large pivotal trials comparing zidovudine monotherapy with combination therapy have now clearly established that zalcitabine plus zidovudine combination with an improvement in viral load and CD4+ cell count compared with zidovudine monotherapy. More recently, clinical end-point and surrogate marker data have established the efficacy of zalcitabine in combination with the protease inhibitor saquinavir in zidovudine-experienced patients. Other studies have demonstrated the utility of zalcitabine in combination with ritonavir and the nucleoside analogue lamivudine. Importantly, early use of zalcitabine in the treatment sequence does not appear to limit the therapeutic efficacy of subsequent therapy with other nucleoside analogues such as lamivudine. Peripheral neuropathy is the most frequent dose-limiting adverse effect associated with zalcitabine therapy and is generally reversible on discontinuation of treatment. Stomatitis and mouth ulcers may occur frequently with zalcitabine therapy but tend to resolve with continuing treatment. Haematological toxicity, which is a common adverse effect associated with zidovudine, is reported infrequently with zalcitabine. Overall, combination therapy with zalcitabine plus zidovudine or saquinavir has been shown to have a tolerability profile comparable to that of either agent alone, although treatment with zidovudine plus zalcitabine was associated with a significant increase in the incidence of haematological toxicity compared with zidovudine monotherapy in one study. Therefore, current data suggest that zalcitabine is a useful antiretroviral agent for inclusion as a component of initial double combination therapy with zidovudine or as part of triple combination therapy including zidovudine plus a protease inhibitor in the management of patients with HIV infection.

背景与目标： 扎西他滨是一种双脱氧核苷抗逆转录病毒药，在未感染和感染HIV的细胞中均被磷酸化为活性代谢物2'，3'-二脱氧胞苷5'-三磷酸（ddCTP）。在治疗浓度下，ddCTP通过抑制酶逆转录酶并终止原病毒DNA链的延伸来抑制HIV复制。齐多夫定单一疗法与联合疗法比较的3个大型关键试验的结果现已清楚地确定，与齐多夫定单一疗法相比，齐西他滨加齐多夫定联合疗法可改善病毒载量和CD4细胞计数。最近，临床终点和替代标记数据已经确定了扎西他滨与蛋白酶抑制剂沙奎那韦联合在齐多夫定患者中的疗效。其他研究表明扎西他滨与利托那韦和核苷类似物拉米夫定联合使用。重要的是，在治疗顺序中早期使用扎西他滨似乎没有限制后续用其他核苷类似物如拉米夫定进行治疗的疗效。周围神经病变是与扎西他滨治疗相关的最常见的剂量限制性不良反应，通常在停药后可逆。扎西他滨治疗可能会经常发生口腔炎和口腔溃疡，但继续治疗后往往会缓解。扎西他滨很少报道血液毒性，这是与齐多夫定有关的常见不良反应。总的来说，与齐多夫定单一疗法相比，齐多夫定+齐多夫定或沙奎那韦联合治疗的耐受性与单独使用任一种药物相当，尽管与齐多夫定单一疗法相比，齐多夫定+齐西他滨治疗的血液学毒性发生率显着增加。学习。因此，目前的数据表明，扎西他滨是一种有用的抗逆转录病毒药物，可作为包含齐多夫定的初始双重联合疗法的组成部分或包含齐多夫定加蛋白酶抑制剂在内的三重联合疗法的一部分用于治疗HIV感染患者。

BACKGROUND & AIMS: :An inverse relationship between age and human papillomavirus (HPV) prevalence has been reported in many developed countries, but information on this relationship is scarce in many other parts of the world. We carried out a cross-sectional study of sexually active women from the general population of 15 areas in 4 continents. Similar standardised protocols for women's enrolment, cervical specimen collection and PCR-based assays for HPV testing were used. HPV prevalence in different age groups was compared by study area. 18,498 women aged 15-74 years were included. Age-standardised HPV prevalence varied more than 10-fold between populations, as did the shape of age-specific curves. HPV prevalence peaked below age 25 or 35, and declined with age in Italy, the Netherlands, Spain, Argentina, Korea and in Lampang, Thailand and Ho Chi Minh, Vietnam. This was not the case in Songkla, Thailand nor Hanoi, Vietnam, where HPV prevalence was low in all age groups. In Chile, Colombia and Mexico, a second peak of HPV prevalence was detected among older women. In the poorest study areas in Asia (Shanxi, China and Dindigul, India), and in Nigeria, HPV prevalence was high across all age groups. The substantial differences observed in age-specific curves of HPV prevalence between populations may have a variety of explanations. These differences, however, underline that great caution should be used in inferring the natural history of HPV from age-specific prevalences.

背景与目标： ：许多发达国家已经报告了年龄与人乳头瘤病毒（HPV）患病率之间的反比关系，但世界上其他许多地方都缺乏有关这种关系的信息。我们对来自四大洲15个地区的总人口中的性活跃妇女进行了横断面研究。使用了类似的标准化协议进行女性入组，子宫颈标本采集和基于PCR的HPV检测方法。通过研究区域比较了不同年龄组的HPV患病率。其中包括18,498名15-74岁的女性。年龄标准化的HPV患病率在不同人群之间变化超过10倍，特定年龄曲线的形状也是如此。 HPV感染率在25岁或35岁以下达到峰值，在意大利，荷兰，西班牙，阿根廷，韩国以及泰国南邦和越南胡志明市随着年龄的增长而下降。在泰国的宋卡和越南的河内，情况并非如此，那里的所有年龄段的人乳头瘤病毒感染率都很低。在智利，哥伦比亚和墨西哥，在老年妇女中发现了HPV感染率的第二高峰。在亚洲最贫困的研究地区（中国山西和印度的丁迪古尔）以及尼日利亚，所有年龄段的人乳头瘤病毒感染率都很高。在人群之间HPV流行的年龄特定曲线中观察到的实质差异可能有多种解释。但是，这些差异强调，应根据年龄特定的患病率推断HPV的自然病史时应格外谨慎。

BACKGROUND & AIMS: :A prospective collection of positive antimicrobial cultures was performed over 12 consecutive months in the medical intensive care unit of a cancer hospital. In all, 144 infections and 163 pathogens were documented during 87 of the 528 admissions. Lung, urinary, ENT (ear, nose and throat) infections and bacteraemia were the most frequently documented. Staphylococcus species, Streptococcus species, Escherichia coli, Klebsiella species and Pseudomonas species were the most common pathogens. Gram-positive strains were observed predominantly during monomicrobial bacteraemia (48.9%). Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE) were found in 58% and 92% of the isolated strains respectively. No particular outbreak was identified. A further prospective study will be necessary to evaluate the impact of the antibiotic use on the selection of resistant strains in our ICU.

背景与目标： ：在癌症医院的医疗重症监护室连续12个月进行了前瞻性抗菌药物阳性培养。在528例入院病例中，总共记录了144例感染和163种病原体。肺，尿，耳鼻喉（耳，鼻和喉）感染和菌血症的记录最频繁。葡萄球菌，链球菌，大肠杆菌，克雷伯菌和假单胞菌是最常见的病原体。革兰氏阳性菌株主要在单微生物菌血症期间观察到（48.9％）。分别在58％和92％的分离菌株中发现了耐甲氧西林的金黄色葡萄球菌（MRSA）和表皮葡萄球菌（MRSE）。没有发现特定的爆发。有必要进行进一步的前瞻性研究，以评估抗生素使用对我们ICU中耐药菌株选择的影响。

BACKGROUND & AIMS: PURPOSE:Consistent condom use is critical to efforts to prevent sexually transmitted infections among adolescents, but condom use may decline as relationships and contraceptive needs change. The purpose of this research is to assess changes in condom non-use longitudinally in the context of changes in relationship quality, coital frequency and hormonal contraceptive choice. METHODS:Participants were women (aged 14-17 years at enrollment) recruited from three urban adolescent medicine clinics. Data were collected at three-month intervals using a face-to-face structured interview. Participants were able to contribute up to 10 interviews, but on average contributed 4.2 interviews over the 27-month period. Independent variables assessed partner-specific relationship quality (five items; scale range 5-25; alpha = .92, e.g., this partner is a very important person to me); and, number of coital events with a specific partner. Additional items assessed experience with oral contraceptive pills (OCP) use and injected depo medroxy-progesterone acetate (DMPA). The outcome variable was number of coital events without condom use during the past three months. Analyses were conducted as a three-level hierarchical linear growth curve model using HLM 6. The Level 1 predictor was time, to test the hypothesis that condom non-use increases over time. Level 2 predictors assessed relationship quality and coital frequency across all partners to assess hypotheses that participants' condom non-use increases over time as a function of relationship quality and coital frequency. Level 3 predictors assessed the participant-level influence of OCP or DMPA experience on time-related changes in condom non-use. RESULTS:A total of 176 women reported 279 sex partners and contributed 478 visits. Both average coital frequency and average condom non-use linearly increased during the 27-month follow-up. At any given follow-up, about 35% reported recent OCP use, and 65% reported DMPA use. HLM analyses showed that condom non-use increased as a function of time (beta = .12; p = .03, Level 1 analysis). Increased condom non-use over time was primarily a function of increased coital frequency (beta = .01; p = .00), although higher levels of relationship quality were associated with increased condom non-use at enrollment (beta = .44; p = .00, Level 2 analysis). The temporal rise in condom non-use significantly increased among DMPA users (beta = .06; p = .00) but not OCP users (Level 3 analysis) (beta = -.04; p = .06). CONCLUSIONS:Developmentally, relationship characteristics and coital frequency appear to have increasing weight in decisions about condom use. Hormonal contraceptive methods are not equivalently associated with the overall temporal decline in condom use. Future research associated with dual contraceptive/condom use should address differential factors associated condom use in combination with different hormonal methods.

背景与目标： 目的：持续使用避孕套对于预防青少年性传播感染至关重要，但是随着人际关系和避孕需求的变化，避孕套的使用可能会减少。这项研究的目的是在关系质量，性交频率和激素避孕选择的变化的背景下，纵向评估未使用安全套的变化。
方法：参与者是从三个城市青少年医学诊所招募的女性（入学年龄为14-17岁）。使用面对面的结构化访谈，每三个月收集一次数据。参加者最多可以贡献10个访谈，但在27个月内平均贡献了4.2个访谈。自变量评估了特定于伴侣的关系质量（五个项目；等级范围5-25；α= 0.92，例如，这个伴侣对我来说是非常重要的人）；以及与特定伴侣发生性行为的次数。其他项目评估了口服避孕药（OCP）的使用经验和注射醋酸去甲羟孕酮（DMPA）的经验。结果变量是在过去三个月中未使用安全套的性交事件的数量。使用HLM 6作为三级分层线性增长曲线模型进行了分析。1级预测因子是时间，以检验安全套不使用随时间增加的假设。 2级预测变量评估了所有伴侣之间的关系质量和性交频率，以评估以下假设：参与者不使用安全套会随着时间的推移而增加，这是关系质量和性交频率的函数。 3级预测变量评估了OCP或DMPA经验对安全套不使用时间相关变化的参与者水平影响。
结果：总共176名妇女报告了279个性伴侣，并贡献了478次探视。在27个月的随访中，平均性交频率和平均不使用安全套均呈线性增加。在任何给定的随访中，约35％的患者报告了最近的OCP使用，而65％的患者报告了DMPA的使用。 HLM分析表明，不使用安全套随时间增加（β= .12； p = .03，1级分析）。随着时间的推移，不使用安全套的增加主要是性交频率增加的函数（β= .01； p = .00），尽管较高的关系质量与入学时不使用安全套的增加有关（β= .44； p = .00，第2级分析）。在DMPA用户中，未使用安全套的时间增加显着增加（β= .06； p = .00），但在OCP用户中则没有（水平3分析）（β= -.04； p = .06）。
结论：在发展上，关系特征和性交频率似乎在有关使用安全套的决策中具有越来越大的重要性。激素避孕方法与使用避孕套的总体时间下降没有同等的联系。与双重避孕/避孕套使用相关的未来研究应解决与不同激素方法结合使用避孕套相关的差异因素。

BACKGROUND & AIMS: The exact mechanism for the decrease in intestinal calcium absorption with age is not yet understood. A decrease with age in serum 1,25-dihydroxyvitamin D (1,25(OH)2D) or a decrease in the intestinal vitamin D receptor (VDR) protein concentration are possible causes. The objective of this study was to examine the effect of age on these factors. Fifty-nine young women age 25-35 years were compared with 41 elderly women age 65-83 years who underwent measurements of VDR, calcium absorption using a 20 mg and 100 mg calcium carrier, and calciotropic hormones. Calcium absorption by both tests was lower in the elderly women compared with the young women (p < 0.05). Serum 1,25(OH)2D and duodenal VDR protein concentration were not significantly different between the two age groups. Serum 1,25(OH)2D correlated with the 20 mg calcium absorption test in both young (r = 0.35, p < 0.007) and elderly women (r = 0.58, p < 0.0001) and with the 100 mg calcium absorption in the elderly (r = 0.32; p < 0.05). VDR did not correlate with calcium absorption in young women or elderly women, nor did VDR correlate with serum 1,25(OH)2D and serum 25-hydroxyvitamin D. In summary, the decrease in calcium absorption cannot be explained by a decrease in intestinal VDR. The correlation between serum 1,25(OH)2D and both calcium absorption tests only accounts for 12-30% of the variance in the age-related change in the calcium absorption tests. Other factors, not yet understood, are responsible for the decline in calcium absorption with age.

背景与目标： 随着年龄的增长，肠道钙吸收减少的确切机制尚不清楚。血清1,25-二羟基维生素D（1,25（OH）2D）随年龄的减少或肠道维生素D受体（VDR）蛋白质浓度的减少是可能的原因。这项研究的目的是研究年龄对这些因素的影响。比较了59名年龄在25-35岁之间的年轻女性与41位年龄在65-83岁之间的女性，这些女性进行了VDR测量，使用20 mg和100 mg钙载体的钙吸收量以及亲钙性激素。与年轻女性相比，老年女性的两种测试中的钙吸收均较低（p <0.05）。在两个年龄组之间，血清1,25（OH）2D和十二指肠VDR蛋白浓度无显着差异。血清1,25（OH）2D与年轻（r = 0.35，p <0.007）和老年妇女（r = 0.58，p <0.0001）的20 mg钙吸收测试以及老年人的100 mg钙吸收相关（r ＝ 0.32； p ＜0.05）。 VDR与年轻妇女或老年妇女的钙吸收无关，也不与血清1,25（OH）2D和血清25-羟维生素D相关。 VDR。血清1,25（OH）2D与两种钙吸收试验之间的相关性仅占钙吸收试验中与年龄相关的变化方差的12％至30％。钙吸收随着年龄的增长而下降的其他原因尚不明确。

BACKGROUND & AIMS: :The TIM (T cell/transmembrane, immunoglobulin and mucin) proteins are crucial regulators of Th1/Th2 immune responses and have been implicated in several diseases including HIV-1/AIDS. The TIM1 exon 4 that codes for mucin domain is highly diverse, with sequence variants associated with varying phenotypes. In this study, TIM1 exon 4 was sequenced among 227 HIV-1 seroprevalent and 288 healthy non infected individuals from North Indian population and haplotypes established. A novel but rare haplotype D1(∗) was identified among the healthy and differed from D1 by a synonymous substitution G>T at Thr208Thr. The TIM1 haplotype diversity showed no association with susceptibility to HIV-1 infection. The seroprevalent individuals carrying D3A had relatively higher median CD4+T cell counts (368/μl) than those without (313/μl; p=0.02). A comparison of CD4+T counts between D3-A individuals on ART or ART naïve did not show any significant difference plausibly due to confounding nature of ART and other factors.

背景与目标： TIM（T细胞/跨膜，免疫球蛋白和粘蛋白）蛋白是Th1 / Th2免疫反应的关键调节剂，并与包括HIV-1 / AIDS在内的多种疾病有关。编码粘蛋白结构域的TIM1外显子4高度多样化，具有与不同表型相关的序列变体。在这项研究中，TIM1外显子4在来自北印度人口的227个HIV-1血清流行和288个健康的未感染个体中进行了测序，并建立了单倍型。在健康人群中鉴定出一种新颖但罕见的单倍型D1（∗），与D1的区别在于在Thr208Thr处的同义替代G> T。 TIM1单倍型多样性表明与HIV-1感染的易感性无关。携带D3A的血清流行个体的CD4 T细胞计数中位数相对较高（不含313 /μl； p = 0.02）。由于ART和其他因素的混杂，D3-A个体或未接受过ART的D3-A个体之间CD4 T计数的比较似乎没有显示任何显着差异。

BACKGROUND & AIMS: :While antiretroviral therapy (ART) can reduce HIV-1 to undetectable levels, the virus generally reappears if treatment is stopped. Resurgence of the virus is due to the reactivation of T cells harboring latent integrated provirus, and recent studies indicate that proliferation of these latently infected cells helps maintain the HIV-1 reservoir. In this issue of the JCI, Lee et al. evaluated CD4+ T cell subsets to determine whether certain populations are more likely to harbor full-length, replication-competent provirus. The authors identified an enrichment of clonally expanded Th1 cells containing intact HIV-1 proviruses, suggesting that this polarized subset contributes to the persistence of the reservoir. Strategies to target these provirus-harboring cells need to be considered for future therapies aimed toward HIV-1 cure.

背景与目标： ：尽管抗逆转录病毒疗法（ART）可以将HIV-1降至无法检测的水平，但是如果停止治疗，病毒通常会重新出现。病毒的复发归因于带有潜伏性整合前病毒的T细胞的重新活化，最近的研究表明，这些潜伏感染的细胞的增殖有助于维持HIV-1的储存。在本期JCI中，Lee等人。评估了CD4 T细胞亚群，以确定某些人群是否更有可能携带全长，具有复制能力的原病毒。作者确定了含有完整HIV-1前病毒的克隆扩增Th1细胞的富集，表明该极化的子集有助于水库的持久性。在未来针对HIV-1的治疗中，需要考虑针对这些携带前病毒的细胞的策略。