[Fate of children born to HIV positive mothers followed in the context of preventing mother-to-child transmission of HIV in Togo. Study of 1042 infants]. / Devenir des enfants nés de mères séropositives au VIH suivis dans le cadre de la prévention de la transmission de la mère à l'enfant au Togo. Etude portant sur 1 042 nourrissons.

The purpose of this study is to analyze the fate of children born to HIV-positive mothers and to determine the impact of feeding options on the HIV status of the children in preventing mother-to-child transmission sites (PMTCT) in Togo. It was a retrospective and descriptive study, focused on medical files of 1042 children of both sexes aged from 0 to 59 months born to HIV-positive mothers and registered in the PMTCT sites between January 2004 and December 2008. Our study was conducted in seven PMTCT sites located in four of the six health regions in the country. We analyzed a total of 1042 medical files in seven PMTCT sites selected. The majority of children were born vaginally (77.4%). Antiretroviral prophylaxis most used in the mothers and/or the children was nevirapine in 86% of the cases. Breastfeeding (49%) was dominated by milk substitutes (50%). Globally, dropout rate was 52.2% (525), with 44.9% (408) at six months and 65.09% (483) at 12 months. At 12 months, 196 of 742 children (26.4%) had their retroviral serology. Among them, we have 5.6% overall rate of HIV infection. The transmission rate in the group of children breastfed was 5.9% (six children infected out of 102) and 8.5% in the group of children fed by formula milk (seven children out of 82). Death occurred in half of the cases (8 of 16) during the first two months of life. Follow-up was the major issue in monitoring children born to HIV-infected mothers. The HIV transmission rate is very high, irrespective of the feeding method.

TRIZAL study: switching from successful HAART to Trizivir (abacavir-lamivudine-zidovudine combination tablet): 48 weeks efficacy, safety and adherence results.

OBJECTIVE: To assess the antiviral efficacy, safety, and adherence in subjects who switched to Trizivir following long-term HIV-1 RNA suppression. STUDY DESIGN: A randomized, open-label, multicentre, 48-week comparative study in subjects who have received two nucleoside reverse transcriptase inhibitors plus a protease inhibitor or an nonnucleoside reverse transcriptase inhibitor or three nucleoside reverse transcriptase inhibitors for at least 6 months, with a history of undetectable plasma HIV-1 RNA since initiation of therapy and plasma viral load of < 50 HIV-1 RNA copies/mL at screening. METHODS: Subjects were randomized 1:1 to continue their current treatment or to switch to a simplified treatment with Trizivir administered twice daily. Assessments included plasma HIV-1 RNA, lymphocyte counts, clinical laboratory evaluations, adverse events, and adherence to treatment (obtained via subject self-report). Treatment failure was defined as a plasma viral load of >/= 400 HIV-1 RNA copies/mL on two consecutive occasions or premature discontinuation of randomized treatment. RESULTS: At week 48, the proportion of treatment failures in Trizivir arm (23/106, 22%) was noninferior to that observed in continued arm (23/103, 22%) with a treatment difference stratified by prior ART of 1.2%[-10.1; 12.5]. Incidence of adverse events was similar in both treatment groups. The incidence of possible hypersensitivity reaction in the Trizivir trade mark arm was 10%. Significant reductions in cholesterol and triglyceride plasma levels were observed in the Trizivir arm (P < 0.001 and P = 0.006, respectively). CONCLUSION: Switching to Trizivir offers a potent and simplified regimen with equivalent efficacy and significant improvement in lipid abnormalities compared to continued triple therapy.

Expanded Prussian blue analogues incorporating [Re6Se8(CN)6](3-/4-) clusters: adjusting porosity via charge balance.

Face-capped octahedral [Re(6)Se(8)(CN)(6)](3-/4-) clusters are used in place of octahedral [M(CN)(6)](3-/4-) complexes for the synthesis of microporous Prussian blue type solids with adjustable porosity. The reaction between [Fe(H(2)O)(6)](3+) and [Re(6)Se(8)(CN)(6)](4-) in aqueous solution yields, upon heating, Fe(4)[Re(6)Se(8)(CN)(6)](3).36H(2)O (4). A single-crystal X-ray analysis confirms the structure of 4 to be a direct expansion of Prussian blue (Fe(4)[Fe(CN)(6)](3).14H(2)O), with [Re(6)Se(8)(CN)(6)](4-) clusters connected through octahedral Fe(3+) ions in a cubic three-dimensional framework. As in Prussian blue, one out of every four hexacyanide units is missing from the structure, creating sizable, water-filled cavities within the neutral framework. Oxidation of (Bu(4)N)(4)[Re(6)Se(8)(CN)(6)] (1) with iodine in methanol produces (Bu(4)N)(3)[Re(6)Se(8)(CN)(6)] (2), which is then metathesized to give the water-soluble salt Na(3)[Re(6)Se(8)(CN)(6)] (3). Reaction of [Co(H(2)O)(6)](2+) or [Ni(H(2)O)(6)](2+) with 3 in aqueous solution affords Co(3)[Re(6)Se(8)(CN)(6)](2).25H(2)O (5) or Ni(3)[Re(6)Se(8)(CN)(6)](2).33H(2)O (6). Powder X-ray diffraction data show these compounds to adopt structures based on the same cubic framework present in 4, but with one out of every three cluster hexacyanide units missing as a consequence of charge balance. In contrast, reaction of [Ga(H(2)O)(6)](3+) with 3 gives Ga[Re(6)Se(8)(CN)(6)].6H(2)O (7), wherein charge balance dictates a fully occupied cubic framework enclosing much smaller cavities. The expanded Prussian blue analogues 4-7 can be fully dehydrated, and retain their crystallinity with extended heating at 250 degrees C. Consistent with the trend in the frequency of framework vacancies, dinitrogen sorption isotherms show porosity to increase along the series of representative compounds 7, Ga(4)[Re(6)Se(8)(CN)(6)](3).38H(2)O, and 6. Furthermore, all of these phases display a significantly higher sorption capacity and surface area than observed in dehydrated Prussian blue. Despite incorporating paramagnetic [Re(6)Se(8)(CN)(6)](3-) clusters, no evidence for magnetic ordering in compound 6 is apparent at temperatures down to 5 K. Reactions related to those employed in preparing compounds 4-6, but carried out at lower pH, produce the isostructural phases H[cis-M(H(2)O)(2)][Re(6)Se(8)(CN)(6)].2H(2)O (M = Fe (8), Co (9), Ni (10)). The crystal structure of 8 reveals a densely packed three-dimensional framework in which [Re(6)Se(8)(CN)(6)](4-) clusters are interlinked through a combination of protons and Fe(3+) ions.

Highly active antiretroviral treatment initiated early in the course of symptomatic primary HIV-1 infection: results of the ANRS 053 trial.

Highly active antiretroviral treatment (HAART) was given early to 64 patients with symptomatic primary human immunodeficiency virus (HIV)-1 infection. At the time of analysis, patients had been followed up for 9-21 months. No patient had died or developed an AIDS-defining event. Survival analysis showed that by month 21 the proportion of patients with plasma HIV-1 RNA <50 copies/mL was 72% (95% confidence interval, 58%-95%) in intention-to-treat analysis. After 18 months of treatment, 50% of the patients with undetectable plasma HIV-1 RNA also had undetectable HIV-1 RNA in peripheral blood mononuclear cells (PBMC). Only 1 of 3 patients had undetectable HIV-1 RNA in lymphoid tissue, while all patients had quantifiable HIV-1 DNA both in PBMC and lymphoid tissue. The median CD4 lymphocyte increase from baseline was 230 cells/microL. These preliminary results support the use of HAART in patients with primary HIV-1 infection.

[Rosacea]. / Rosacée.

Rosacea is a frequent disease which occurs mostly in women with dry skin and much more rarely in men with greasy skin. In women, rosacea is heralded, around the age of 20 years, by intermittent facial erythema, and this is followed by the gradual development of permanent erythema (erythrosis) with telangiectasia (couperose) and later on, around the age of 40, very unsightly papulo-pustules (papular rosacea, improperly called acne rosacea). In men, these successive stages are less frequent, but progressive dilatation of the nose due to sebaceous gland overgrowth may occur (rhinophyma). Rosacea is caused by vascular abnormalities not completely determined, and also, at the papulo-pustural stage, by a small parasite called Demodex folliculorum. Treatment rests on hygienic and dietary rules and vasoconstrictor drugs at the erythema stage, then on fine electrocoagulation or pulsed dye laser to suppress couperose and on the prescription of long-term low-dose tetracycline, sometimes preceded by a 2-month course of metronidazole to remove the papulo-pustules. Rhinophyma is treated by surgery. The results obtained are remarkable, at least on couperose, papulo-pustules and rhinophyma.

[Phototherapy of photodermatoses]. / Photothérapie des photodermatoses.

Paradoxical as it may seem, phototherapy, and in particular PUVA therapy, is of considerable interest in the treatment of such photodermatoses as polymorphous light eruptions, solar urticaria and remanent photosensitivity syndrome. When used rationally, with the appropriate therapeutic regimen and under close monitoring of the parameters, these treatments give very satisfactory results in preventing the occurrence of photo-induced skin eruptions.

[Does plasma exchange have a place in the treatment of necrotizing angiodermatitis?]. / Les échanges plasmatiques peuvent-ils avoir une place dans le traitement des angiodermites nécrosantes?

Necrotizing angiodermatitis is of characteristic clinical expression and is often difficult to treat. It is associated with microcirculatory disorders of hypertensive or diabetic origin. A particularly long course (m = 8 months) in 8 patients with necrotic angiodermatitis (of hypertensive origin in 6 cases and diabetes in 2) resulted in treatment by plasma exchange, two other patients with immunological angiodermatitis being treated similarly because of very similar symptomatology. The 10 patients (3 men, 7 women age range 55 to 80 years) received between 4 and 18 small volume plasma exchanges over 2 to 12 weeks. Results were evaluated from pain and duration of healing, absence of pain being reported by 7 patients and a beneficial effect on healing by 6 patients. No correlation existed between ESR and hematocrit values during treatment and the clinical course. The question arises as to whether the mode of action of plasma exchange in angiodermatitis is related to the purifying of serum factors or a rheological role.

Hydrogen bond equilibrium constants of some unusual nucleotide base pairs.

Approximate hydrogen bond association constants were determined for base pairs formed by an adenine derivative and a number of unusual pyrimidine bases. A series is found in which the H-bond strength in the base-pairs varies. In certain cases the H-bond equilibrium constant is larger than in the adenine-thymine pair. Inosine derivatives seem to have a non-negligible chance of replacing guanosine in the guanosine-cytosine pair. Infrared, near-infrared (overtone) and NMR spectra were used to determine the equilibrium constants.