Lack of Polarized Type 1 or Type 2 Cytokine Profile in Asymptomatic HIV‐1‐Infected Patients During a Two‐Year Bimonthly Follow‐Up

Latent Autoimmune Diabetes in the Adult, LADA has been investigated less than “classical” type 1 and type 2 diabetes and the criteria for and the relevance of a LADA diagnosis has been challenged. Despite the absence of a genetic background that is exclusive to LADA, this form of diabetes displays phenotypic characteristics that distinguish it from other forms of diabetes. LADA is heterogeneous in terms of the impact of autoimmunity and lifestyle factors, something that poses problems as to therapy and follow-up perhaps particularly in those with marginal positivity. Yet, there appears to be clear clinical utility in classifying individuals as LADA.

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Serum urate and cardiovascular events in the DCCT/EDIC study

Scientific Reports ◽

10.1038/s41598-021-90785-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Alicia J. Jenkins ◽

Barbara H. Braffett ◽

Arpita Basu ◽

Ionut Bebu ◽

Samuel Dagogo-Jack ◽

...

Keyword(s):

Cardiovascular Events ◽

Serum Urate ◽

Continuous Variable ◽

Major Adverse Cardiovascular Events ◽

Normal Range ◽

The Metabolic Syndrome ◽

Routine Measurement

AbstractIn type 2 diabetes, hyperuricemia is associated with cardiovascular disease (CVD) and the metabolic syndrome (MetS), but associations in type 1 diabetes (T1D) have not been well-defined. This study examined the relationships between serum urate (SU) concentrations, clinical and biochemical factors, and subsequent cardiovascular events in a well-characterized cohort of adults with T1D. In 973 participants with T1D in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC), associations were defined between SU, measured once in blood collected 1997–2000, and (a) concurrent MetS and (b) incident ‘any CVD’ and major adverse cardiovascular events (MACE) through 2013. SU was higher in men than women [mean (SD): 4.47 (0.99) vs. 3.39 (0.97) mg/dl, respectively, p < 0.0001], and was associated with MetS features in both (men: p = 0.0016; women: p < 0.0001). During follow-up, 110 participants (11%) experienced “any CVD”, and 53 (5%) a MACE. Analyzed by quartiles, SU was not associated with subsequent CVD or MACE. In women, SU as a continuous variable was associated with MACE (unadjusted HR: 1.52; 95% CI 1.07–2.16; p = 0.0211) even after adjustment for age and HbA1c (HR: 1.47; 95% CI 1.01–2.14; p = 0.0467). Predominantly normal range serum urate concentrations in T1D were higher in men than women and were associated with features of the MetS. In some analyses of women only, SU was associated with subsequent MACE. Routine measurement of SU to assess cardiovascular risk in T1D is not merited.Trial registration clinicaltrials.gov NCT00360815 and NCT00360893.

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Insulin Dose Adjustment Following Bariatric Surgery, a Review of Available Literature

Journal of Diabetes Science and Technology ◽

10.1177/19322968211028886 ◽

2021 ◽

pp. 193229682110288

Author(s):

Lynn E. Kassel ◽

Jessica J. Berei ◽

Jamie M. Pitlick ◽

Joel E. Rand

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Type 2 Diabetes Mellitus ◽

Dose Adjustment ◽

Insulin Dose ◽

Appraisal Tool

Bariatric surgery is a known and effective treatment for type 2 diabetes mellitus. Patients with type 1 diabetes mellitus and exogenous insulin-requiring type 2 diabetes mellitus require adjusted insulin dosing after surgery to avoid hypoglycemia. This review describes insulin dose adjustments following a variety of bariatric procedures. After searching the available literature and assessing for eligibility, 8 articles were included. The Johns Hopkins Research Evidence Appraisal Tool for literature appraisal was used. The results of this review reveal insulin dose adjustment varies based upon surgical procedure type and time of follow-up from the procedure.

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Heart involvement in type 1 and type 2 myotonic dystrophy. Insights from a 10-year follow-up study

European Heart Journal ◽

10.1093/ehjci/ehaa946.3145 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

F Fioravanti ◽

P.G Golzio ◽

M.L Carbone ◽

A Panarelli ◽

M Gagliardi ◽

...

Keyword(s):

Myotonic Dystrophy ◽

Cardiac Involvement ◽

Type I ◽

Device Therapy ◽

Cardiac Symptom ◽

Conduction Disorders ◽

Reliable Marker

Abstract Background and aim Myotonic Dystrophy (MD) is the most common inherited muscular dystrophy of the adult. Cardiac manifestation, including arrhythmias and conduction disorders, contributes significantly to the morbidity and mortality of the disease. The transition from a subclinical form of cardiac involvement to potentially life-threating manifestations is highly variable and not yet entirely understood. Aim of this work is to evaluate whether PQ interval (PQi) prolongation could be a reliable marker to predict left and right ventricle impairment and the necessity of a stricter monitoring. Methods In this retrospective cohort study, we selected all consecutive patients with a confirmed diagnosis of MD (type 1 and type 2) referred to our Centre. We performed clinical, laboratoristic and instrumental assessments (every 3, 6 or 12 months), tailored on each patient's features. Every patient was treated according to the latest guidelines for pharmacological and device therapy. ECG (recorded at 25 and 50 mm/sec), 24h ECG Holter and transthoracic echocardiography were performed at least yearly. Cardiac Magnetic Resonance was requested to better stratify intermediate risk patients to implantable device therapy. Results A total of 72 patients (age 48±15 years, 39% female) were included in the analysis. Patients with MD type 1 and type 2 were referred to our Centre after a mean period of 12 years (SD ±8 years) from initial diagnosis. After a mean follow-up of 5 years (±4 years), 8 patients died (mean age at death: 60±12.4 years), all of them for respiratory insufficiency. We evaluated PQ interval (PQi) evolution and type I AVB onset. No statistically significant differences emerged when stratifying for type I AVB. Nevertheless, a PQi increase of more than 20 ms during the follow-up (even if PQ <200 ms) is significantly associated with lower values of TAPSE and greater LVEDD, while no differences emerged for LVEF, dyastolic function and other echocardiographic parameters. Moreover, the evolution of PQ interval is associated with an increasing number of supraventricular arrhythmias and a worse prognosis (shorter interval from first cardiac symptom to death, p 0.025), despite optimal medical therapy. Conclusions Although relatively rare, MD is a challenge for present Cardiologists. How and when to treat those patients is not codified in guidelines or consensus papers. This study suggests PQi variation as a proxy for critical evolution of MD cardiac involvement. ECG and its modification during lifetime seem pivotal for these patients' care, qualifying as a red flag for stringent follow-up. Further evidences, on larger cohorts, are needed to validate these findings. Funding Acknowledgement Type of funding source: None

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Highly Productive Infection with Pseudotyped Human Immunodeficiency Virus Type 1 (HIV-1) Indicates No Intracellular Restrictions to HIV-1 Replication in Primary Human Astrocytes

Journal of Virology ◽

10.1128/jvi.75.17.7925-7933.2001 ◽

2001 ◽

Vol 75 (17) ◽

pp. 7925-7933 ◽

Cited By ~ 82

Author(s):

Mario Canki ◽

Janice Ngee Foong Thai ◽

Wei Chao ◽

Anuja Ghorpade ◽

Mary Jane Potash ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Human Immunodeficiency Virus Type ◽

Productive Infection ◽

Human Astrocytes ◽

Immunodeficiency Virus ◽

Infected Cells ◽

Virus Expression ◽

Hiv 1

ABSTRACT Human astrocytes can be infected with human immunodeficiency virus type 1 (HIV-1) in vitro and in vivo, but, in contrast to T lymphocytes and macrophages, virus expression is inefficient. To investigate the HIV-1 life cycle in human fetal astrocytes, we infected cells with HIV-1 pseudotyped with envelope glycoproteins of either amphotropic murine leukemia virus or vesicular stomatitis virus. Infection by both pseudotypes was productive and long lasting and reached a peak of 68% infected cells and 1.7 μg of viral p24 per ml of culture supernatant 7 days after virus inoculation and then continued with gradually declining levels of virus expression through 7 weeks of follow-up. This contrasted with less than 0.1% HIV-1 antigen-positive cells and 400 pg of extracellular p24 per ml at the peak of astrocyte infection with native HIV-1. Cell viability and growth kinetics were similar in infected and control cells. Northern blot analysis revealed the presence of major HIV-1 RNA species of 9, 4, and 2 kb in astrocytes exposed to pseudotyped (but not wild-type) HIV-1 at 2, 14, and 28 days after infection. Consistent with productive infection, the 9- and 4-kb viral transcripts in astrocytes infected by pseudotyped HIV-1 were as abundant as the 2-kb mRNA during 4 weeks of follow-up, and both structural and regulatory viral proteins were detected in infected cells by immunoblotting or cell staining. The progeny virus released by these cells was infectious. These results indicate that the major barrier to HIV-1 infection of primary astrocytes is at virus entry and that astrocytes have no intrinsic intracellular restriction to efficient HIV-1 replication.

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Abstract 555: The Universal Clinical Classification of Acute Myocardial Infarction is a Better Predictor of Long Term Outcomes than ST Segment Classification

Circulation ◽

10.1161/circ.118.suppl_18.s_579-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Manuel A Gonzalez ◽

Dana Eilen ◽

Rana A Marzouq ◽

Saed Awadallah ◽

Hiren R Patel ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Inverse Relationship ◽

Long Term Outcomes ◽

St Segment ◽

Vascular Beds

Introduction: The universal classification (UC) of AMI aims to facilitate cross-study analysis, yet the long-term outcomes using UC are largely unknown. Hypothesis: We tested the hypothesis that the long-term outcome of patients with AMI is better predicted by UC than ST segment classification. Methods: We conducted a prospective study of 348 consecutive patients with AMI with mean follow-up of 30.6 months. The primary outcome was the major adverse cardiovascular events (MACE) [composite of all causes of mortality, recurrent AMI, and stroke]. Multivariate and survival analysis of MACE was performed. Results: The study population was STEMI=168, NSTEMI=180, Type 1=278, Type 2=55, Type 3=5, Type 4a=2, Type 4b=5, and Type 5=3. During follow-up 80 patients died, 31 had an AMI, and 7 had a stroke. UC correlates with the ST segment classification (p<0.005). MACE free survival was different for Type 1 and Type 2 (p=0.043), but not for STEMI and NSTEMI. There was a positive association between MACE and the quartile of peak Troponin, number of cardiovascular risk factors, and number of vascular beds affected, and an inverse relationship with the utilization of discharge cardiovascular protective medications (all p≤0.01). No such inverse relationship existed for Type 2. Conclusions: UC of AMI is a better long-term predictor of MACE. The quartile of peak Troponin levels, cardiovascular risk factors, and number of vascular beds affected are independent predictors of MACE, while cardiac medications protect against MACE, except in Type 2 patients.

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Neuropsychological studies of asymptomatic Human Immunodeficiency Virus-Type-1 infected individuals

Journal of the International Neuropsychological Society ◽

10.1017/s1355617700000308 ◽

1995 ◽

Vol 1 (3) ◽

pp. 304-315 ◽

Cited By ~ 72

Author(s):

Desirée A. White ◽

Robert K. Heaton ◽

Andreas U. Monsch ◽

Keyword(s):

Test Battery ◽

Neuropsychological Impairment ◽

Ongoing Debate ◽

Immunodeficiency Virus ◽

Type Test ◽

Hiv Type 1 ◽

Hiv 1 ◽

Asymptomatic Human Immunodeficiency Virus ◽

Asymptomatic Hiv

AbstractThe current review was conducted to address the ongoing debate regarding the presence or absence of neuropsychological impairment in asymptomatic HIV-Type 1 (HIV-1) seropositive individuals. Results were summarized from 57 studies that compared the performances of seropositive asymptomatic and seronegative individuals. Overall, the differences observed between median rates of impairment for asymptomatic (35%) and seronegative (12%) groups provided the clearest indication of deficits in asymptomatics. In addition, five variables were examined as possible contributors to inconsistencies found in the literature: mode of infection, test battery type, test battery size, sample size, and method of data analysis. Of these variables, only mode of infection and test battery size appeared to substantially influence the outcome of the studies reviewed with regard to identifying neuropsychological impairment in asymptomatics. (JINS, 1995, I, 304–315.)

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False Negative Tuberculin Skin Test (TST) Response in Asymptomatic HIV-1 Infected Blood Donors with Subclinical Iron Overload Developing High Incidence of Pulmonary Tuberculosis on Follow Up

International Journal of Virology and AIDS ◽

10.23937/2469-567x/1510070 ◽

2020 ◽

Vol 7 (3) ◽

Author(s):

Verghese Alice ◽

Singh Naveen Kumar ◽

Chattopadhya Debasish

Keyword(s):

Pulmonary Tuberculosis ◽

Iron Overload ◽

Blood Donors ◽

False Negative ◽

Infected Blood ◽

Negative Tuberculin Skin Test ◽

High Incidence ◽

Hiv 1 ◽

Asymptomatic Hiv

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Early Detection of Human Immunodeficiency Virus Type 1-Specific B-Lymphocyte-Derived Antibodies in a High-Risk Population

Clinical and Vaccine Immunology ◽

10.1128/cvi.00280-08 ◽

2009 ◽

Vol 16 (7) ◽

pp. 1060-1065 ◽

Cited By ~ 1

Author(s):

Odd Odinsen ◽

David Parker ◽

Frans Radebe ◽

Mikey Guness ◽

David A Lewis

Keyword(s):

Human Immunodeficiency Virus ◽

Viral Load ◽

B Cell ◽

Immunodeficiency Virus ◽

Hiv Antibodies ◽

P24 Antigen ◽

Anti Hiv ◽

Hiv 1

ABSTRACT Diagnosis of acute human immunodeficiency virus (HIV) infection, a key driver of the HIV epidemic, remains a public health challenge. The PlasmAcute technology offers an opportunity to detect early anti-HIV antibody responses. B lymphocytes (B cells) were isolated from the blood of seronegative miners in South Africa by using the PlasmAcute method. B-cell lysates and paired sera were tested for anti-HIV-1 antibodies by two different enzyme-linked immunosorbent assays; immunoreactivity was confirmed by Western blotting. All volunteers were tested for HIV type 1 (HIV-1) viral load, p24 antigen, and CD4 count. Sera from HIV-seronegative men who had positive viral loads and were positive for p24 antigen were retested for anti-HIV antibodies after immune complex dissociation. Anti-HIV antibodies were detected in lysates from 16/259 subjects without immunoreactivity in paired sera. Four subjects, one of whom had a positive viral load initially, subsequently seroconverted. Six subjects showed transient anti-HIV-1 antibodies in the lysates and tested negative for all markers at the follow-up. Five subjects without follow-up data initially had lysate-positive/serum-negative samples, and these cases were classified as inconclusive. One subject had lysate antibodies and a detectable viral load but was seronegative at follow-up. In conclusion, lysate-derived anti-HIV-1 B-cell antibodies can be detected prior to seroconversion and earlier than or contemporary with HIV-1 RNA detection.

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