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Find video protocols related to scientific articles indexed in Pubmed.
Psychosocial predictors of quality of life in hematological cancer.
Behav Med
PUBLISHED: 12-17-2014
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The improvement of health related Quality of Life (QOL) has become one of the main objectives of psychological interventions in cancer. The aim of this study was to analyze sociodemographic and psychosocial variables that predict the different components of QOL in a sample of 69 hemato-oncological patients. Depression, social support, disease-related stress situations, coping strategies and optimism were taken as psychosocial predictors. QOL was evaluated with the Short-Form Health Survey (SF-36). With respect to sociodemographic variables, results showed that age and time from the diagnosis were associated with a decrease in QOL, while educational level and having a partner were associated with less pain and better mental health. With respect to negative-affecting psychosocial variables, depression was associated with general health and social functioning, the coping strategy of stoicism was associated with physical and emotional roles, the number of disease-related stress situations was associated with pain, and the feeling of negative emotions associated with the illness was associated with mental health. Social support and optimism were positively associated with vitality. These results have clear clinical implications for psychological interventions aimed to improve QOL in hemato-oncological patients.
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HIV-1 Drug Resistance Surveillance in Antiretroviral Treatment-Naive Individuals from a Reference Hospital in Guatemala, 2010-2013.
AIDS Res. Hum. Retroviruses
PUBLISHED: 10-28-2014
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Abstract The recent expansion of antiretroviral treatment (ART) coverage in middle/low-income countries has been associated with increasing prevalence of HIV pre-ART drug resistance (PDR). We assessed PDR prevalence, patterns, and trends in Guatemala. Blood samples from 1,084 ART-naive individuals, enrolled from October 2010 to December 2013 at the Roosevelt Hospital in Guatemala City, were obtained. PDR was evaluated using the WHO mutation list for transmitted drug resistance (TDR) surveillance. An overall PDR prevalence of 7.3% (95% CI 5.8-9.0%) was observed for the whole study period. TDR to nonnucleoside reverse transcriptase inhibitors (NNRTI) was the highest (4.9%, p<0.001), followed by nucleoside RT inhibitors (1.8%) and protease inhibitors (1.0%). No significant trends in PDR prevalence were observed during the study period. However, higher NNRTI PDR levels were found in individuals with >500 and 350-500 CD4(+) T cells/?l (7.4% and 8.7%, respectively) compared to individuals with <350 CD4(+) T cells/?l (3.7%; p=0.039 and p=0.007, respectively), as well as a tendency of higher levels of NNRTI transmitted drug resistance (DR) in individuals with recent infection determined by HIV incidence tests (9.7%), suggesting increasing trends in time. Clusters of viruses with NNRTI PDR suggesting complex transmission networks were observed. No associations between PDR and demographic variables were found. PDR in Guatemala remains at an intermediate level. Nevertheless, we have shown evidence suggesting increasing trends in NNRTI PDR, which need to be taken into account in national HIV management policies.
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Potential antigenic explanation for atypical H1N1 infections among middle-aged adults during the 2013-2014 influenza season.
Proc. Natl. Acad. Sci. U.S.A.
PUBLISHED: 10-20-2014
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Influenza viruses typically cause the most severe disease in children and elderly individuals. However, H1N1 viruses disproportionately affected middle-aged adults during the 2013-2014 influenza season. Although H1N1 viruses recently acquired several mutations in the hemagglutinin (HA) glycoprotein, classic serological tests used by surveillance laboratories indicate that these mutations do not change antigenic properties of the virus. Here, we show that one of these mutations is located in a region of HA targeted by antibodies elicited in many middle-aged adults. We find that over 42% of individuals born between 1965 and 1979 possess antibodies that recognize this region of HA. Our findings offer a possible antigenic explanation of why middle-aged adults were highly susceptible to H1N1 viruses during the 2013-2014 influenza season. Our data further suggest that a drifted H1N1 strain should be included in future influenza vaccines to potentially reduce morbidity and mortality in this age group.
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Intralesional bevacizumab in patients with Human immunodeficiency virus-associated Kaposi's sarcoma in the upper airway.
Laryngoscope
PUBLISHED: 09-05-2014
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The aim of this study was to evaluate the efficacy and safety of intralesional bevacizumab, a monoclonal antibody against vascular endothelial growth factor, in patients with human immunodeficiency virus (HIV)-associated Kaposi's sarcoma of the upper airway receiving antiretroviral therapy.
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Aberrant Cerebral Blood Flow Responses During Cognition: Implications for the Understanding of Cognitive Deficits in Fibromyalgia.
Neuropsychology
PUBLISHED: 08-25-2014
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Objective: There is ample evidence for cognitive deficits in fibromyalgia syndrome (FMS). The present study investigated cerebral blood flow responses during arithmetic processing in FMS patients and its relationship with performance. The influence of clinical factors on performance and blood flow responses were also analyzed. Method: Forty-five FMS patients and 32 matched healthy controls completed a mental arithmetic task while cerebral blood flow velocities in the middle (MCA) and anterior (ACA) cerebral arteries were measured bilaterally using functional transcranial Doppler sonography (fTCD). Results: Patients' cognitive processing speeds were slower versus healthy controls. In contrast to patients, healthy controls showed a pronounced early blood flow response (during seconds 4-6 after the warning signal) in all assessed arteries. MCA blood flow modulation during this period was correlated with task performance. This early blood flow response component was markedly less pronounced in FMS patients in both MCAs. Furthermore, patients displayed an aberrant pattern of lateralization, with right hemispheric dominance especially observed in the ACA. Severity of clinical pain in FMS patients was correlated with cognitive performance and cerebral blood flow responses. Conclusions: Cognitive impairment in FMS is associated with alterations in cerebral blood flow responses during cognitive processing. These results suggest a potential physiological pathway through which psychosocial and clinical factors may affect cognition. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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Impact of HLA selection pressure on HIV fitness at a population level in Mexico and Barbados.
J. Virol.
PUBLISHED: 07-09-2014
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Previous studies have demonstrated that effective cytotoxic T lymphocyte (CTL) responses drive the selection of escape mutations that reduce viral replication capacity (VRC). Escape mutations, including those with reduced VRC, can be transmitted and accumulate in a population. Here we compared two antiretroviral therapy (ART)-naive HIV clade B-infected cohorts, in Mexico and Barbados, in which the most protective HLA alleles (HLA-B*27/57/58:01/81:01) are differentially expressed, at 8% and 34%, respectively. Viral loads were significantly higher in Mexico than in Barbados (median, 40,774 versus 14,200; P < 0.0001), and absolute CD4(+) T-cell counts were somewhat lower (median, 380/mm(3) versus 403/mm(3); P = 0.007). We tested the hypothesis that the disparate frequencies of these protective HLA alleles would be associated with a higher VRC at the population level in Mexico. Analysis of VRC in subjects in each cohort, matched for CD4(+) T-cell count, revealed that the VRC was indeed higher in the Mexican cohort (mean, 1.13 versus 1.03; P = 0.0025). Although CD4 counts were matched, viral loads remained significantly higher in the Mexican subjects (P = 0.04). This VRC difference was reflected by a significantly higher frequency in the Barbados cohort of HLA-B*27/57/58:01/81:01-associated Gag escape mutations previously shown to incur a fitness cost on the virus (P = 0.004), a difference between the two cohorts that remained statistically significant even in subjects not expressing these protective alleles (P = 0.01). These data suggest that viral set points and disease progression rates at the population level may be significantly influenced by the prevalence of protective HLA alleles such as HLA-B*27/57/58:01/81:01 and that CD4 count-based guidelines to initiate antiretroviral therapy may need to be modified accordingly, to optimize the effectiveness of treatment-for-prevention strategies and reduce HIV transmission rates to the absolute minimum.
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The effect of baroreceptor stimulation on pain perception depends on the elicitation of the reflex cardiovascular response: evidence of the interplay between the two branches of the baroreceptor system.
Biol Psychol
PUBLISHED: 07-02-2014
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We examined the impact of baroreceptor stimulation on pain and cardiovascular responses in 39 healthy participants. Carotid baroreceptors were stimulated with external suction (-50 mmHg, stimulation) or pressure (+8 mmHg, control). Pain was induced by pressure to the nail of the left-index finger and quantified by a visual analog scale. Pain decreased heart rate (HR) and increased blood pressure (BP). Baroreceptor stimulation further decreased HR and reduced the BP increase. Pain experience failed to differ between baroreceptor stimulation conditions. However, significant results were obtained when trials were categorized according to the magnitude of the HR deceleration elicited by baroreceptor stimulation. In trials with strong baroreceptor-elicited HR deceleration pain intensity was lower than in trials both with inactive baroreceptor stimulation (pressure trials) or trials with small baroreceptor-elicited HR responses. Anti-nociceptive effects of baroreceptor stimulation depend on the activation of the reflex cardiovascular response. Central nervous inhibition due to baroreceptor stimulation only occurs if the peripheral cardiovascular response is engaged.
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Impact of HLA-B*35 subtype differences on HIV disease outcome in Mexico.
AIDS
PUBLISHED: 05-24-2014
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HLA-B35 has consistently been associated with rapid HIV disease progression, particularly alleles of the Px group. As B35 is the most prevalent HLA-B in Mexico, we investigated HIV disease outcome in relation to HLA expression in a large cohort (n=976) of Mexicans. Contrary to the previous studies, no impact on viral load or CD4 cell count was observed in association with the B35 PY/Px groups. However, we observed differences in HIV disease outcome associated with specific HLA-B35 alleles.
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Autonomic cardiovascular regulation and cortical tone.
Clin Physiol Funct Imaging
PUBLISHED: 05-09-2014
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This study aimed to investigate interactions between tonic cortical arousal and features of autonomic cardiovascular regulation. In 50 healthy subjects, the power spectrum of the spontaneous EEG was obtained at resting state. Concurrently, respiratory sinus arrhythmia (RSA), baroreflex sensitivity (BRS) and R-wave to pulse interval (RPI) were recorded as indices of cardiovascular control. At the bivariate level, only a negative correlation between beta power recorded at frontal electrode positions and RPI was found. However, when common variance of BRS and RSA was controlled for in multiple regression analyses, a positive association between alpha power and RSA, and an inverse relationship with BRS, also arose. The findings concerning RPI and RSA are suggestive of a relationship between higher levels of cortical tone and increased sympathetic and reduced vagal cardiac influences. The inverse association between BRS and alpha activity may reflect bottom-up modulation of cortical arousal by baroreceptor afferents.
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Proposed clinical case definition for cytomegalovirus-immune recovery retinitis.
Clin. Infect. Dis.
PUBLISHED: 04-24-2014
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Cytomegalovirus (CMV) retinitis has been extensively described in patients with advanced or late human immunodeficiency virus (HIV) disease under ineffective treatment of opportunistic infection and antiretroviral therapy (ART) failure. However, there is limited information about patients who develop active cytomegalovirus retinitis as an immune reconstitution inflammatory syndrome (IRIS) after successful initiation of ART. Therefore, a case definition of cytomegalovirus-immune recovery retinitis (CMV-IRR) is proposed here.
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Deep sequencing: becoming a critical tool in clinical virology.
J. Clin. Virol.
PUBLISHED: 04-09-2014
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Population (Sanger) sequencing has been the standard method in basic and clinical DNA sequencing for almost 40 years; however, next-generation (deep) sequencing methodologies are now revolutionizing the field of genomics, and clinical virology is no exception. Deep sequencing is highly efficient, producing an enormous amount of information at low cost in a relatively short period of time. High-throughput sequencing techniques have enabled significant contributions to multiples areas in virology, including virus discovery and metagenomics (viromes), molecular epidemiology, pathogenesis, and studies of how viruses to escape the host immune system and antiviral pressures. In addition, new and more affordable deep sequencing-based assays are now being implemented in clinical laboratories. Here, we review the use of the current deep sequencing platforms in virology, focusing on three of the most studied viruses: human immunodeficiency virus (HIV), hepatitis C virus (HCV), and influenza virus.
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Attention interference for emotional stimuli in cardiac interoceptive awareness.
Psychophysiology
PUBLISHED: 01-16-2014
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Previous research has shown that individuals with good perception of cardiac signals, referred to as cardiac interoceptive awareness, experience emotions more intensely. To investigate if emotional experience in high cardiac interoceptive awareness arises from biases in attention, we compared the performance of participants with high versus regular cardiac interoceptive awareness in an emotional Stroop task. Participants with high cardiac interoceptive awareness showed attention interference for negative words, whereas participants with regular cardiac interoceptive awareness showed attention facilitation for positive words. Our data provide further evidence for the emotion information process associated with cardiac interoceptive awareness. The results support the notion that better access to cardiac changes accompanying negative emotional conditions results in automatic vigilance for negative information and may interfere with cognitive processing.
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Activation of NK cells is associated with HIV-1 disease progression.
J. Leukoc. Biol.
PUBLISHED: 01-07-2014
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The main predictor of HIV-1 disease progression is CD8(+) T cell activation, characterized by elevated expression of CD38 and HLA-DR. NK cells are also activated in viremic HIV-1-infected individuals. However, the relationship between NK cell activation and HIV-1 disease progression remains undefined. We characterized NK cell activation and its association with disease progression in treatment of naive HIV-1-infected individuals, who naturally maintained low/undetectable viremia (elite and viremic controllers), compared with progressors and AIDS subjects, and treated individuals. Our results show that CD38 expression on NK cells, predominantly in the cytotoxic CD56(dim)CD16(+) subset, is associated with HIV-1 disease progression (CD4(+) T cell count and pVL), T cell activation (percentage of CD38(+)HLA-DR(+) T cells), sCD14, inflammation, and innate immune activation. Moreover, NK cell activation is increased in HIV-1-infected subjects progressing to AIDS but not in elite and viremic controllers. ART partially reduces the proportion of activated NK cells. Furthermore, our results show that individuals, who naturally control viremia, maintain low levels of innate immune activation similar to those of uninfected controls.
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Human immunodeficiency virus type 1 (HIV-1) subtype B epidemic in Panama is mainly driven by dissemination of country-specific clades.
PLoS ONE
PUBLISHED: 01-01-2014
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The Human immunodeficiency virus type-1 (HIV-1) subtype B is the most predominant clade in Central America; but information about the evolutionary history of this virus in this geographic region is scarce. In this study, we reconstructed the spatiotemporal and population dynamics of the HIV-1 subtype B epidemic in Panama. A total of 761 HIV-1 subtype B pol sequences obtained in Panama between 2004 and 2013 were combined with subtype B pol sequences from the Americas and Europe. Maximum Likelihood phylogenetic analyses revealed that HIV-1 subtype B infections in Panama derived from the dissemination of multiple founder viruses. Most Panamanian subtype B viruses (94.5%) belong to the pandemic viral strain proposed as originated in the US, whereas others (5.5%) were intermixed among non-pandemic Caribbean strains. The bulk (76.6%) of subtype B sequences from Panama grouped within 12 country-specific clades that were not detected in other Central American countries. Bayesian coalescent-based analyses suggest that most Panamanian clades probably originated between the early 1970s and the early 1980s. The root location of major Panamanian clades was traced to the most densely populated districts of Panama province. Major Panamanian clades appear to have experienced one or two periods of exponential growth of variable duration between the 1970s and the 2000s, with median growth rates from 0.2 to 0.4 year(-1). Thus, the HIV-1 subtype B epidemic in Panama is driven by the expansion of local viral strains that were introduced from the Caribbean and other American countries at an early stage of the AIDS pandemic.
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Molecular epidemiology of HIV-1 in Panama: origin of non-B subtypes in samples collected from 2007 to 2013.
PLoS ONE
PUBLISHED: 01-01-2014
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Phylogenetic studies have suggested that the HIV-1 epidemic in the Americas is mainly dominated by HIV subtype B. However, countries of South America and the Caribbean have recently reported changes in their circulating HIV-1 genetic profiles. The aim of this study was to characterize the molecular profile of the HIV-1 epidemic in Panama by the analysis of 655 polymerase gene (pol) sequences that were obtained from HIV-infected Panamanians diagnosed between 1987 and 2013. Blood samples were collected from recently infected, antiretroviral drug-naïve and treatment-experienced subjects since mid-2007 to 2013. Viral RNA from plasma was extracted and sequences of HIV protease and reverse transcriptase genes were obtained. Bootscanning and phylogenetic methods were used for HIV subtyping and to trace the putative origin of non-B subtype strains. Our results showed that HIV-1 infections in Panama are dominated by subtype B (98.9%). The remaining 1.1% is represented by a diverse collection of recombinant variants including: three URFs_BC, one CRF20_BG, and one CRF28/29_BF, in addition to one subtype F1 and one subtype C, none of which were previously reported in Panama. The non-B subtype variants detected in Panama were probably introduced from Brazil (subtype F1 and CRF28/29_BF), Cuba (CRF20_BG), Dominican Republic (URFs_BC) and India (subtype C). Panama is the geographical vertex that connects the North with South America and the Caribbean through trade and cultural relations, which may explain the observed introductions of non-B subtype HIV-1 variants from both the Caribbean and South America into this Central American country.
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The influence of emotional factors on the report of somatic symptoms in patients on chronic haemodialysis: the importance of anxiety.
Nefrologia
PUBLISHED: 08-28-2013
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To evaluate the prevalence of different somatic symptoms in chronic haemodialysis patients compared with a control group and to analyse the predictive capacity of some psychological variables (namely anxiety, depression, social support, self-efficacy and coping strategies) in the reporting of these symptoms.
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Highly pathogenic avian influenza A(H7N3) virus in poultry workers, Mexico, 2012.
Emerging Infect. Dis.
PUBLISHED: 08-23-2013
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We identified 2 poultry workers with conjunctivitis caused by highly pathogenic avian influenza A(H7N3) viruses in Jalisco, Mexico. Genomic and antigenic analyses of 1 isolate indicated relatedness to poultry and wild bird subtype H7N3 viruses from North America. This isolate had a multibasic cleavage site that might have been derived from recombination with host rRNA.
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Oropharyngeal syphilis among patients infected with human immunodeficiency virus.
Ann. Otol. Rhinol. Laryngol.
PUBLISHED: 08-20-2013
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There has been a reemergence of syphilis among men who have sex with men over the past decade, especially in patients infected with human immunodeficiency virus (HIV). This study was aimed at describing the oropharyngeal manifestations of secondary syphilis in HIV-infected patients. We also sought to determine the clinical risk factors for the development of oropharyngeal syphilitic lesions in patients with secondary syphilis.
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Xpert MTB/RIF for diagnosis of tuberculous cervical lymphadenitis in HIV-infected patients.
Laryngoscope
PUBLISHED: 07-10-2013
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The World Health Organization endorsed the Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis (TB), but there is limited information about the utility of this assay for the diagnosis of TB lymphadenitis. Therefore, the objective of this study was to assess the diagnostic accuracy of Xpert MTB/RIF assay in HIV-infected patients with palpable cervical lymph nodes.
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The behavioral impact of baroreflex function: A review.
Psychophysiology
PUBLISHED: 04-12-2013
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The baroreflex consists of a negative feedback loop adjusting heart activity to blood pressure fluctuations. This review is concerned with interactions between baroreflex function and behavior. In addition to changes in baroreflex cardiac control subject to behavioral manipulations, interindividual differences in reflex function predicted psychological and central nervous features. The sensitivity of the reflex was inversely related to cognitive performance, evoked potential amplitudes, experimental pain sensitivity, and the severity of clinical pain. Possible variables moderating the strength of the associations are tonic blood pressure, gender, and psychiatric disease. It is suggested that these observations reflect inhibition of higher brain function by baroreceptor afferents. While in many cases increased baroreflex function implies stronger inhibition, individual and situational factors modulate the behavioral impact of cardiac regulation.
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Heart rate correlates of utilitarian moral decision-making in alcoholism.
Drug Alcohol Depend
PUBLISHED: 04-12-2013
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Recent studies of moral reasoning in patients with alcohol use disorders have indicated a utilitarian bias, whereby patients are more likely to endorse emotionally aversive actions in favor of aggregate welfare (e.g., to kill a person in order to save a group of people). The aim of the present study was to examine psychophysiological correlates of this tendency indexed by heart rate.
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Proneness to worry is negatively associated with blood pressure and baroreflex sensitivity: Further evidence of the blood pressure emotional dampening hypothesis.
Biol Psychol
PUBLISHED: 04-05-2013
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This study analyzes differences in blood pressure (BP) and baroreflex sensitivity (BRS) in relation to trait worry. 36 high worry and 21 low worry females were selected from scores on the Penn State Worry Questionnaire. Cardiovascular parameters were obtained during rest, a self-induced worry period, and defense reflex to intense auditory stimulation. Low worry participants exhibited greater BP during baseline and greater BRS both during baseline and the self-induced worry period than high worry participants. During the defense reflex, low worries present a greater increase in BP. It is concluded that low proneness to worry is associated with greater BP and BRS. Increases in BP during aversive stimulation activated a negative feedback mechanism to inhibit distress and emotional reactivity to negative stimulation. These results support the BP-emotional dampening hypothesis and suggest that the baroreflex can be a relevant mechanism in mediating this effect.
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The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: a review with emphasis on a reanalysis of previous studies.
Psychophysiology
PUBLISHED: 02-27-2013
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This article evaluates the suitability of low frequency (LF) heart rate variability (HRV) as an index of sympathetic cardiac control and the LF/high frequency (HF) ratio as an index of autonomic balance. It includes a comprehensive literature review and a reanalysis of some previous studies on autonomic cardiovascular regulation. The following sources of evidence are addressed: effects of manipulations affecting sympathetic and vagal activity on HRV, predictions of group differences in cardiac autonomic regulation from HRV, relationships between HRV and other cardiac parameters, and the theoretical and mathematical bases of the concept of autonomic balance. Available data challenge the interpretation of the LF and LF/HF ratio as indices of sympathetic cardiac control and autonomic balance, respectively, and suggest that the HRV power spectrum, including its LF component, is mainly determined by the parasympathetic system.
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A (H1N1) pdm09 HA D222 variants associated with severity and mortality in patients during a second wave in Mexico.
Virol. J.
PUBLISHED: 01-28-2013
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Pandemic type A (H1N1) influenza arose in early 2009, probably in Mexico and the United States, and reappeared in North America in September for seven more months. An amino acid substitution in the hemagglutinin (HA), D222G, has been reported in a significant proportion of patients with a severe and fatal outcome. We studied the prevalence of HA222 substitutions in patients in Mexico during the second wave and its association with clinical outcome and pathogenicity in a mouse model.
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Interactions between autonomic cardiovascular regulation and cortical activity: a CNV study.
Psychophysiology
PUBLISHED: 01-25-2013
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The study investigated interactions between autonomic cardiovascular regulation and cortical activity. In 54 healthy subjects, baroreflex sensitivity (BRS) and respiratory sinus arrhythmia (RSA) were assessed at resting conditions. As an EEG indicator of cortical excitability, the contingent negative variation (CNV) was induced using a constant foreperiod reaction time task. At bivariate level, only RSA showed a moderate positive correlation with the CNV recorded at frontal electrodes. However, when common variance of BRS and RSA was controlled for in multiple regression analysis, an inverse association between BRS and the frontal CNV also arose. The inverse association between BRS and the CNV is discussed as reflecting bottom-up modulation of cortical excitability by baroreceptor afferents. The positive correlation between RSA and the CNV may relate to the interplay between prefrontal processing and cardiac vagal tone.
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Discovering human immunodeficiency virus mutational pathways using temporal Bayesian networks.
Artif Intell Med
PUBLISHED: 01-12-2013
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The human immunodeficiency virus (HIV) is one of the fastest evolving organisms in the planet. Its remarkable variation capability makes HIV able to escape from multiple evolutionary forces naturally or artificially acting on it, through the development and selection of adaptive mutations. Although most drug resistance mutations have been well identified, the dynamics and temporal patterns of appearance of these mutations can still be further explored. The use of models to predict mutational pathways as well as temporal patterns of appearance of adaptive mutations could greatly benefit clinical management of individuals under antiretroviral therapy.
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Transient expansion of activated CD8+ T cells characterizes tuberculosis-associated immune reconstitution inflammatory syndrome in patients with HIV: a case control study.
J Inflamm (Lond)
PUBLISHED: 01-01-2013
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BACKGROUND: CD4+ T cell activation indicators have been reported to be a common phenomenon underlying diverse manifestations of immune reconstitution inflammatory syndrome (IRIS). However, we have found that a high frequency of circulating CD8+ T cells is a specific risk factor for mycobacterial IRIS. Therefore, we investigated whether CD8+ T cells from patients who develop TB IRIS were specifically activated.MethodsWe obtained PBMCs from HIV + patients prior to and 4, 8, 12, 24, 52 and 104 weeks after initiating antiretroviral therapy. CD38 and HLADR expression on naive, central memory and effector memory CD8+ and CD4+ T cells were determined by flow cytometry. Absolute counts and frequencies of CD8+ T cell subsets were compared between patients who developed TB IRIS, who developed other IRIS forms and who remained IRIS-free. RESULTS: TB IRIS patients showed significantly higher counts of naive CD8+ T cells than the other groups at most time points, with a contraction of the effector memory subpopulation occurring later in the follow-up period. Activated (CD38+ HLADR+) CD8+ T cells from all groups decreased with treatment but transiently peaked in TB IRIS patients. This increase was due to an increase in activated naive CD8+ T cell counts during IRIS. Additionally, the CD8+ T cell subpopulations of TB IRIS patients expressed HLADR without CD38 more frequently and expressed CD38 without HLADR less frequently than cells from other groups. CONCLUSIONS: CD8+ T cell activation is specifically relevant to TB IRIS. Different IRIS forms may involve different alterations in T cell subsets, suggesting different underlying inflammatory processes.
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Relationships between baroreceptor cardiac reflex sensitivity and cognitive performance: modulations by gender and blood pressure.
Psychophysiology
PUBLISHED: 09-06-2011
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This study aimed at replicating and extending previous results on the association between baroreceptor reflex sensitivity (BRS) and cognitive performance. Thirty men and 31 women performed an arithmetic task. After adjusting for numerical aptitude and effort, no predictors of performance were found in men. In women, the relationships between BRS and parameters related to correct responses were modulated by blood pressure (BP). BRS was inversely associated with these parameters for participants with BP>1 SD above the mean, whereas the associations were positive in participants with BP<1 SD below the mean. Also for women, BRS was positively associated with number of errors during the task. These results suggest that the relation between BRS and performance varies as a function of the type of cognitive processes assessed and that the central nervous system effects of the baroreceptors on cognitive functioning are modulated by gender and BP.
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Self-regulation of cerebral blood flow by means of transcranial Doppler sonography biofeedback.
Ann Behav Med
PUBLISHED: 07-14-2011
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Transcranial Doppler sonography (TCD) allows the continuous non-invasive assessment of intracranial blood flow velocities with high temporal resolution. It may therefore prove suitable for biofeedback of cerebral perfusion.
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National prevalence and trends of HIV transmitted drug resistance in Mexico.
PLoS ONE
PUBLISHED: 06-29-2011
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Transmitted drug resistance (TDR) remains an important concern for the management of HIV infection, especially in countries that have recently scaled-up antiretroviral treatment (ART) access.
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Strong human endogenous retrovirus-specific T cell responses are associated with control of HIV-1 in chronic infection.
J. Virol.
PUBLISHED: 04-27-2011
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Eight percent of the human genome is composed of human endogenous retroviruses (HERVs), which are thought to be inactive remnants of ancient infections. Previously, we showed that individuals with early HIV-1 infection have stronger anti-HERV T cell responses than uninfected controls. In this study, we investigated whether these responses persist in chronic HIV-1 infection and whether they have a role in the control of HIV-1. Peripheral blood mononuclear cells (PBMCs) from 88 subjects diagnosed with HIV-1 infection for at least 1 year (median duration of diagnosis, 13 years) were tested for responses against HERV peptides in gamma interferon (IFN-?) enzyme immunospot (ELISPOT) assays. Individuals who control HIV-1 viremia without highly active antiretroviral therapy (HAART) had stronger and broader HERV-specific T cell responses than HAART-suppressed patients, virologic noncontrollers, immunologic progressors, and uninfected controls (P < 0.05 for each pairwise comparison). In addition, the magnitude of the anti-HERV T cell response was inversely correlated with HIV-1 viral load (r(2) = 0.197, P = 0.0002) and associated with higher CD4(+) T cell counts (r(2) = 0.072, P = 0.027) in untreated patients. Flow cytometric analyses of an HLA-B51-restricted CD8(+) HERV response in one HIV-1-infected individual revealed a less activated and more differentiated phenotype than that stimulated by a homologous HIV-1 peptide. HLA-B51 tetramer dual staining within this individual confirmed two different T cell populations corresponding to these HERV and HIV-1 epitopes, ruling out cross-reactivity. These findings suggest a possible role for anti-HERV immunity in the control of chronic HIV-1 infection and provide support for a larger effort to design an HIV-1 vaccine that targets conserved antigens such as HERV.
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Prevalence and patterns of HIV transmitted drug resistance in Guatemala.
Rev. Panam. Salud Publica
PUBLISHED: 04-09-2011
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To assess human immunodeficiency virus (HIV) diversity and the prevalence of transmitted drug resistance (TDR) in Guatemala.
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Dissociation of CD154 and cytokine expression patterns in CD38+ CD4+ memory T cells in chronic HIV-1 infection.
J. Acquir. Immune Defic. Syndr.
PUBLISHED: 10-08-2010
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Expression of the activation antigen CD38 on T cells is a strong predictor of the risk of HIV disease progression, but it is not known whether CD38 is a marker or mediator of dysfunction. We examined the relationship between CD38 expression and responses to T-cell receptor stimulation in central memory and effector memory CD4 T cells in HIV-infected persons and in healthy controls. Basal CD38 expression was preserved by blocking golgi transport with brefeldin A. Intracellular expression of interleukin 2, interferon ?, and CD154 was measured after stimulating peripheral blood mononuclear cells with the superantigen staphylococcal enterotoxin B with or without anti-CD28 costimulation. Interferon-? responses were comparable or increased in stimulated CD38 memory cells, and the interleukin 2 responses of costimulated CD38 central memory cells were decreased in HIV infection. In CD38 cells and especially in CD38 cells of HIV-infected persons, stimulated memory cells more often failed to express CD154 (CD40 ligand) when induced to express cytokine. A dissociated cytokine and CD154 expression by memory CD4 T cells may impair interactions between T cells and antigen-presenting cells, contribute to impaired immunity and help explain the relationship between CD38 expression and disease progression in chronic HIV infection.
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Aberrances in autonomic cardiovascular regulation in fibromyalgia syndrome and their relevance for clinical pain reports.
Psychosom Med
PUBLISHED: 05-13-2010
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To investigate autonomic cardiovascular regulation in fibromyalgia syndrome (FMS).
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Treating chronic worry: Psychological and physiological effects of a training programme based on mindfulness.
Behav Res Ther
PUBLISHED: 05-06-2010
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The present study examines psychological and physiological indices of emotional regulation in non-clinical high worriers after a mindfulness-based training programme aimed at reducing worry. Thirty-six female university students with high Penn State Worry Questionnaire scores were split into two equal intervention groups: (a) mindfulness, and (b) progressive muscle relaxation plus self-instruction to postpone worrying to a specific time of the day. Assessment included clinical questionnaires, daily self-report of number/duration of worry episodes and indices of emotional meta-cognition. A set of somatic and autonomic measures was recorded (a) during resting, mindfulness/relaxation and worrying periods, and (b) during cued and non-cued affective modulation of defence reactions (cardiac defence and eye-blink startle). Both groups showed equal post-treatment improvement in the clinical and daily self-report measures. However, mindfulness participants reported better emotional meta-cognition (emotional comprehension) and showed improved indices of somatic and autonomic regulation (reduced breathing pattern and increased vagal reactivity during evocation of cardiac defense). These findings suggest that mindfulness reduces chronic worry by promoting emotional and physiological regulatory mechanisms contrary to those maintaining chronic worry.
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Comparison of baroreceptor cardiac reflex sensitivity estimates from inter-systolic and ECG R-R intervals.
Psychophysiology
PUBLISHED: 04-23-2010
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Baroreceptor reflex sensitivity (BRS) is frequently evaluated using the spontaneous sequence method. Many of these studies use the inter-systolic interval (ISI) derived from a blood pressure monitor (e.g., Finapres) as interbeat interval measure instead of the traditionally recommended R-R series derived from the ECG. In this study, we examine possible differences between estimates of BRS from ISI and ECG R-R intervals. BRS was evaluated in 35 participants under three conditions: rest, mental arithmetic, and recovery periods. Although correlations between the two estimates are very high (all rs>.9), small but significant differences were found: the measures from ISI systematically yield higher BRS values and result in the detection of a greater number of reflex sequences. The higher BRS values from measures of ISI are due to the effects of pulse transit time fluctuations associated with the sequences of change in blood pressure.
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Short communication: preferential concentration of hydroxychloroquine in adenoid tissue of HIV-infected subjects.
AIDS Res. Hum. Retroviruses
PUBLISHED: 03-26-2010
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Hydroxychloroquine (HCQ) anti-HIV activity is well documented. To evaluate its distribution in lymphoid tissues, which are considered sanctuaries of HIV reservoirs and targets of early massive depletion of CD4(+) T cells, we assessed HCQ concentrations in adenoid tissue and plasma of HIV-infected subjects. A daily oral dose of 400 or 800 mg of HCQ was administered to eight HIV-infected subjects for 8 days. HCQ concentrations were measured in plasma and adenoid tissue by high-performance liquid chromatography. Mean concentrations of HCQ in adenoid tissue of subjects treated with 400 and 800 mg were 87,210 +/- 17,817 and 167,472 +/- 93,793 ng/g, respectively. In plasma, these values corresponded to 329 +/- 133 and 278 +/- 68 ng/g, respectively. HCQ concentrations were significantly higher in adenoid tissue than in plasma in both groups. The potential use of HCQ as adjuvant in the therapy of HIV deserves to be explored, as the drug accumulates in relevant tissues for HIV replication and immunopathogenesis.
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Physical training and the dynamics of the cardiac baroreflex: a comparison when blood pressure rises and falls.
Int J Psychophysiol
PUBLISHED: 03-09-2010
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In the analysis of baroreceptor reflex sensitivity (BRS) through the sequence method, spontaneous cardiac sequences are sought in which systolic blood pressure (SBP) increases are accompanied by an increase in inter-beat interval (IBI) ("up" sequences), or in which a decrease in SBP is accompanied by a decrease in IBI ("down" sequences). The regression line between the SBP and the IBI values produces an estimate of BRS in ms/mm Hg. The "up" sequences are mainly associated with vagal activation and the "down" sequences with vagal inhibition. This study evaluated the effect of regular exercise on BRS assessed differentially for the "up" and "down" sequences. Thirty two regular exercisers and 27 sedentary students performed a serial arithmetic task after a baseline period. Results show that BRS in the "up" sequences was greater for the physically active group than for the sedentary group. For the physically active group, BRS in the "up" sequences was higher than BRS in the "down" sequences. The arithmetic task produced a significant BRS decrease in the "up" sequences for the physically active group but not for the sedentary group. These results show that regular exercise modulates the dynamics of the cardiac baroreflex. The differences between the "up" and "down" sequences suggest that the physically active group displays high parasympathetic cardiac control and autonomic cardiac adjustment to stressful conditions in which vagal withdrawal plays a key role in the cardiac response.
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Novel presentation of immune reconstitution inflammatory syndrome: folliculitis secondary to Malassezia spp.
Mycoses
PUBLISHED: 02-19-2010
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Folliculitis, as a manifestation of immune reconstitution inflammatory syndrome (IRIS) during antiretroviral therapy, has only been described in its aseptic form. Here, we describe folliculitis associated with Malassezia spp. as a distinct manifestation of IRIS. The distinction between these two types of IRIS folliculitis is relevant for treatment.
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Maraviroc versus efavirenz, both in combination with zidovudine-lamivudine, for the treatment of antiretroviral-naive subjects with CCR5-tropic HIV-1 infection.
J. Infect. Dis.
PUBLISHED: 02-16-2010
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The MERIT (Maraviroc versus Efavirenz in Treatment-Naive Patients) study compared maraviroc and efavirenz, both with zidovudine-lamivudine, in antiretroviral-naive patients with R5 human immunodeficiency virus type 1 (HIV-1) infection.
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Autonomic cardiovascular control and responses to experimental pain stimulation in fibromyalgia syndrome.
J Psychosom Res
PUBLISHED: 01-23-2010
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This study involves a comprehensive investigation of autonomic cardiovascular regulation in fibromyalgia syndrome (FMS) at rest and during painful stimulation and its association with pain indices.
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Modulations of autonomic cardiovascular control following acute alpha-adrenergic treatment in chronic hypotension.
Hypertens. Res.
PUBLISHED: 08-07-2009
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Chronic low blood pressure is typically accompanied with symptoms such as fatigue, reduced drive, dizziness, headaches and cold limbs. Alterations in autonomic cardiovascular regulation are assumed to be involved in the etiology of this condition, that is, increased baroreflex sensitivity (BRS) as well as reduced sympathetic and augmented parasympathetic influences on cardiovascular regulation. In this study, the acute effects of the blood pressure-enhancing alpha-adrenergic agonist, midodrine, on autonomic cardiovascular control were investigated in 50 hypotensive persons (mean blood pressure 96/61 mm Hg) based on a placebo-controlled double blind design. BRS was determined using sequence analysis. Spectral analysis of heart rate variability was carried out to quantify sympathetic and parasympathetic cardiac control. Parameters were obtained at rest and during mental stress. Drug application led to marked increases in blood pressure, BRS and respiratory sinus arrhythmia (RSA), whereas heart rate and power in the low frequency (LF) band of the heart rate variability spectrum decreased. The augmentation of RSA and reduction of LF power indicate a shift of the sympathovagal balance toward increased parasympathetic and reduced sympathetic influences on heart rate. Like the increase in BRS, these modulations represent a counter-regulatory autonomic response to the blood pressure elevation, which is initiated to return blood pressure to the initial value or to an individual set point. The finding challenges the use of alpha-sympathomimetics in the treatment of chronic hypotension as they may not reduce but may instead exacerbate the autonomic dysbalance related to this condition.
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Tonic blood pressure modulates the relationship between baroreceptor cardiac reflex sensitivity and cognitive performance.
Psychophysiology
PUBLISHED: 05-26-2009
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This study explored the effects of tonic blood pressure on the association between baroreceptor cardiac reflex sensitivity and cognitive performance. Sixty female participants completed a mental arithmetic task. Baroreceptor reflex sensitivity was assessed using sequence analysis. An interaction was found, indicating that the relationship between baroreceptor reflex sensitivity and cognitive performance is modulated by blood pressure levels. Reflex sensitivity was inversely associated to performance indices in the subgroup of participants with systolic blood pressure above the mean, whereas the association was positive in participants with systolic values below the mean. These results are in accordance with the findings in the field of pain perception and suggest that tonic blood pressure modulates the inhibitory effects of baroreceptor stimulation on high central nervous functions.
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Unique features of HLA-mediated HIV evolution in a Mexican cohort: a comparative study.
Retrovirology
PUBLISHED: 04-25-2009
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Mounting evidence indicates that HLA-mediated HIV evolution follows highly stereotypic pathways that result in HLA-associated footprints in HIV at the population level. However, it is not known whether characteristic HLA frequency distributions in different populations have resulted in additional unique footprints.
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Increased sensitivity to heat pain in chronic low blood pressure.
Eur J Pain
PUBLISHED: 04-11-2009
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While in elevated blood pressure reduced sensitivity to acute pain has been well established, little is known about possible alterations in pain perception within the lower range of blood pressure. In this study, sensitivity to heat pain was assessed in 40 subjects with chronic hypotension (mean blood pressure 96.5/57.7 mmHg) and 40 normotensive control persons (mean blood pressure 121.8/77.2 mmHg). Employing a contact thermode, heat stimuli were applied to the forearm. Pain threshold and tolerance were determined. Participants furthermore rated subjective intensities and unpleasantness of tonic heat stimuli (45.5-47.5 degrees C) on visual analogue scales and in a questionnaire. Possible confounding of sensitivity to heat pain with skin temperature, temperature sensitivity and mood was controlled for. In addition to blood pressure, functional features of the arterial baroreceptor system were related to pain experience. Therefore, estimates for the input on the baroreceptors, as well as baroreflex sensitivity were obtained. Hypotensive individuals exhibited markedly reduced pain threshold and pain tolerance, as well as increased sensory and affective pain experience. The measures related to the baroreceptor system were not associated with pain experience, suggesting that no significant modulation of heat pain occurs through this system. The results of this study complete the findings on hypertension-related hypoalgesia and suggest an inverse relationship between blood pressure and pain sensitivity across the whole blood pressure spectrum. Furthermore, increased proneness of hypotensive individuals to clinical pain may be discussed.
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Hemodynamic determinants of chronic hypotension and their modification through vasopressor application.
J Physiol Sci
PUBLISHED: 04-03-2009
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Chronic low blood pressure is typically accompanied by symptoms such as fatigue, reduced drive, dizziness, headaches and cold limbs. Reduced cognitive performance, diminished cerebral blood flow and autonomic dysregulation have been furthermore documented in this condition. The present contribution reports two studies exploring systemic hemodynamics in chronic hypotension and their modification through vasopressor application. In study I, effects of the alpha-sympathomimetic midodrine were examined in 54 hypotensive individuals using a placebo-controlled double-blind design. Hemodynamic parameters were assessed at rest and during mental stress. They were derived from continuous blood pressure recordings using Modelflow analysis. The drug led to marked increases in blood pressure, total peripheral resistance and stroke volume. However, due to strong heart rate deceleration, cardiac output remained virtually unchanged. In study II, 40 hypotensive and 40 normotensive control persons were compared with respect to hemodynamics. While groups did not differ in total peripheral resistance, hypotensives exhibited markedly diminished stroke volume and heart rate, resulting in a reduction in cardiac output of 25% at rest and of 33% during mental stress. The data provide relevant knowledge about the hemodynamic mediation of chronic hypotension. In contrast to elevated blood pressure, which is mainly determined by increased peripheral resistance, reduced cardiac output may be the cardinal hemodynamic aberration in chronic hypotension. Midodrine proved to be effective in elevating blood pressure. However, given the cardiac origin of chronic hypotension and the lack of drug effect on cardiac output, alpha-sympathomimetic treatment may be suboptimal.
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APOBEC3G mRNA expression in exposed seronegative and early stage HIV infected individuals decreases with removal of exposure and with disease progression.
Retrovirology
PUBLISHED: 03-02-2009
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APOBEC3G is an antiretroviral factor that acts by inducing G to A mutations. In this study, we examined the expression of APOBEC3G in uninfected HIV-1 exposed individuals at the time of their partners diagnosis and one year later. We then compared this expression with that of infected individuals at different disease stages. APOBEC3G mRNA was measured in PBMCs from three groups: healthy controls with no known risk factor to HIV infection (n = 26), exposed uninfected individuals who had unprotected sex with their HIV+ partners for at least 3 months (n = 37), and HIV infected patients at various disease stages (n = 45), including 8 patients with low HIV viral loads < 10,000 copies/mL (LVL) for at least 3 years. Additionally, we obtained sequences from the env, gag, pol, nef, vif and the LTR of the patients virus.
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Relationships between features of autonomic cardiovascular control and cognitive performance.
Biol Psychol
PUBLISHED: 01-14-2009
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The study investigated relationships between autonomic cardiovascular control and attentional performance. In 60 healthy subjects R-wave to pulse interval (RPI), respiratory sinus arrhythmia (RSA), heart rate variability in the mid-frequency (MF) band and sensitivity of the cardiac baroreflex (BRS) were assessed at rest and during a visual attention test. All parameters decreased markedly during test execution. Lower values of resting BRS predicted increased performance. On-task RPI, RSA, MF power and BRS were inversely related to attentional functioning, with RSA accounting for the largest portion of test score variance. The inverse association between resting BRS and performance is discussed as reflecting the bottom-up modulation of cerebral function by baroreceptor activity. The results concerning the on-task measures suggest that a pattern of cardiovascular adjustment including enhanced sympathetic and reduced vagal cardiovascular influences, as well as baroreflex inhibition may induce an adaptive state associated with improved cognitive-attentional functioning.
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Molecular characterization of the predominant influenza A(H1N1)pdm09 virus in Mexico, December 2011-February 2012.
PLoS ONE
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When the A(H1N1)pdm09 pandemic influenza virus moved into the post-pandemic period, there was a worldwide predominance of the seasonal influenza A(H3N2) and B viruses. However, A(H1N1)pdm09 became the prevailing subtype in the 2011-2012 influenza season in Mexico and most of Central America. During this season, we collected nasopharyngeal swabs of individuals presenting with influenza-like illness at our institution in Mexico City. Samples were tested for seasonal A(H3N2) and B influenza viruses, as well as A(H1N1)pdm09 by real-time reverse transcription-polymerase chain reaction. Of 205 samples tested, 46% were positive to influenza, all of them A(H1N1)pdm09. The clinical characteristics of patients showed a similar pattern to the 2009 pandemic cases. Using next generation sequencing, we obtained whole genome sequences of viruses from 4 different patients, and in 8 additional viruses we performed partial Sanger sequencing of the HA segment. Non-synonymous changes found in the Mexican isolates with respect to the prototype isolate H1N1 (A/California/04/2009) included HA S69T, K163R and N260D unique to 2012 Mexican and North American isolates and located within or adjacent to HA antigenic sites; HA S143G, S185T, A197T and S203T previously reported in viruses from the 2010-2011 season, located within or adjacent to HA antigenic sites; and HA E374K located in a relevant site for membrane fusion. All Mexican isolates had an oseltamivir-sensitive genotype. Phylogenetic analysis with all 8 influenza gene segments showed that 2012 Mexican sequences formed a robust, distinct cluster. In all cases, 2012 Mexican sequences tended to group with 2010-2011 Asian and European sequences, but not with 2009 Mexican sequences, suggesting a possible recent common ancestor between these latter regions and the 2012 Mexican viruses. It remains to be defined if these viral changes represent an important antigenic drift that would enable viral immune evasion and/or affect influenza vaccine effectiveness.
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Crusted scabies-associated immune reconstitution inflammatory syndrome.
BMC Infect. Dis.
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Despite the widely accepted association between crusted scabies and human immunodeficiency virus (HIV)-infection, crusted scabies has not been included in the spectrum of infections associated with immune reconstitution inflammatory syndrome in HIV-infected patients initiating antiretroviral therapy.
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Improvement in onychomycosis after initiation of combined antiretroviral therapy.
Int. J. Dermatol.
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Onychomycosis is frequent in patients with late and advanced HIV disease; immunocompromised patients may develop atypical clinical presentations that can be difficult to control. Current treatment for onychomycosis is based on the prolonged administration of antifungal therapies that may have significant interactions with combined antiretroviral therapy (cART). An improvement in certain HIV-associated opportunistic infections has been associated with initiation of cART.
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Differential clade-specific HLA-B*3501 association with HIV-1 disease outcome is linked to immunogenicity of a single Gag epitope.
J. Virol.
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The strongest genetic influence on immune control in HIV-1 infection is the HLA class I genotype. Rapid disease progression in B-clade infection has been linked to HLA-B*35 expression, in particular to the less common HLA-B*3502 and HLA-B*3503 subtypes but also to the most prevalent subtype, HLA-B*3501. In these studies we first demonstrated that whereas HLA-B*3501 is associated with a high viral set point in two further B-clade-infected cohorts, in Japan and Mexico, this association does not hold in two large C-clade-infected African cohorts. We tested the hypothesis that clade-specific differences in HLA associations with disease outcomes may be related to distinct targeting of critical CD8(+) T-cell epitopes. We observed that only one epitope was significantly targeted differentially, namely, the Gag-specific epitope NPPIPVGDIY (NY10, Gag positions 253 to 262) (P = 2 × 10(-5)). In common with two other HLA-B*3501-restricted epitopes, in Gag and Nef, that were not targeted differentially, a response toward NY10 was associated with a significantly lower viral set point. Nonimmunogenicity of NY10 in B-clade-infected subjects derives from the Gag-D260E polymorphism present in ?90% of B-clade sequences, which critically reduces recognition of the Gag NY10 epitope. These data suggest that in spite of any inherent HLA-linked T-cell receptor repertoire differences that may exist, maximizing the breadth of the Gag-specific CD8(+) T-cell response, by the addition of even a single epitope, may be of overriding importance in achieving immune control of HIV infection. This distinction is of direct relevance to development of vaccines designed to optimize the anti-HIV CD8(+) T-cell response in all individuals, irrespective of HLA type.
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Central Nervous System Strongyloidiasis and Cryptococcosis in an HIV-Infected Patient Starting Antiretroviral Therapy.
Case Rep Med
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We report a case of Strongyloides stercoralis hyperinfection syndrome with central nervous system involvement, in a patient with late human immunodeficiency virus (HIV) infection starting antiretroviral therapy, in whom Strongyloides stercoralis larvae and Cryptococcus neoformans were isolated antemortem from cerebrospinal fluid. Our patient was not from an endemic region for the parasite, so strongyloidiasis was not originally suspected. For this reason, we conclude that Strongyloides stercoralis infection should be suspected in HIV-infected patients starting antiretroviral therapy in order to avoid potential fatal outcomes.
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Human endogenous retrovirus expression is inversely associated with chronic immune activation in HIV-1 infection.
PLoS ONE
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Human endogenous retroviruses (HERV) are remnants of ancestral retroviral infections integrated into the germ line, and constitute approximately 8% of the genome. Several autoimmune disorders, malignancies, and infectious diseases such as HIV-1 are associated with higher HERV expression. The degree to which HERV expression in vivo results in persistent inflammation is not known. We studied the association of immune activation and HERV-K expression in 20 subjects with chronic, untreated progressive HIV-1 infection and 10 HIV-1 negative controls. The mean HERV-K gag and env RNA expression level in the HIV-1 infected cohort was higher than in the control group (p = 0.0003), and was negatively correlated with the frequency of activated CD38+HLA-DR+CD4+ T cells (Rho = -0.61; p = 0.01) and activated CD38+HLA-DR+CD8+ T cells (Rho = -0.51; p = 0.03). Although HIV-infected persons had higher levels of HERV-K RNA expression (as expected), the level of RNA expression was negatively associated with level of T cell activation. The mechanism for this unexpected association remains to be defined.
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Palatal Actinomycosis and Kaposi Sarcoma in an HIV-Infected Subject with Disseminated Mycobacterium avium-intracellulare Infection.
Case Rep Med
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Actinomyces and Mycobacterium avium-intracellulare are facultative intracellular organisms, members of the bacterial order actinomycetales. Although Actinomyces can behave as copathogen when anatomic barriers are compromised, its coinfection with Mycobacterium avium-intracellulare has not previously been reported. We present the first reported case of palatal actinomycosis co-infection with disseminated MAC, in an HIV-infected subject with Kaposi sarcoma and diabetes. We discuss the pathogenesis of the complex condition of this subject.
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Psychosocial predictors of immune response following bone marrow transplantation.
Behav Med
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This study analyzed the relationship between some psychosocial variables (depression, anxiety, stress, coping strategies, social support, optimism, rationality, and need for harmony) and clinical parameters indicative of immunological response after bone marrow transplantation (BMT; day of engraftment, number of infections and hemoglobin level) while controlling for demographic variables (age, educative level, civil state, and time from cancer diagnosis). Thirty-one post BMT hematological cancer patients were evaluated. Results show that higher educative levels are associated to lower number of infections, while age is associated with a delay in the time of engraftment; coping strategies, specially redefinition of the situation, relaxation, stoicism and passivity, are positively associated with the three clinical indices; depression is positively associated to number of infections during the hospitalization period; and rationality is associated with lower hemoglobin levels. These results suggest that psychosocial variables, especially coping strategies, play an important role in determining the immunological response after BMT.
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Head and neck manifestations of the immune reconstitution syndrome in HIV-infected patients: a cohort study.
Otolaryngol Head Neck Surg
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To describe head and neck manifestations of immune reconstitution inflammatory syndrome (IRIS) in a cohort of HIV-infected patients receiving combined antiretroviral therapy (cART). After initiation of cART, some HIV-infected patients present a paradoxical worsening and clinical deterioration due to pathological inflammatory reactions to infectious or noninfectious antigens, a condition known as IRIS.
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Cerebral blood flow dynamics during pain processing investigated by functional transcranial Doppler sonography.
Pain Med
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Functional transcranial Doppler sonography (fTCD) enables reliable quantification of cerebral blood flow modulation during neural activation processes. Its high-time resolution, relatively simple technical arrangement, and low costs could make fTCD a useful tool in the investigation of brain activity underlying pain experience in fundamental and clinical research. The present pilot study explored the suitability of this technique to investigate cerebral hemodynamics during the processing of experimental heat pain.
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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.