ABSTRACT
The secrecy surrounding HIV continues to be a major concern for older people living with HIV (OPWH) despite their long-term experience of HIV and the presence of other chronic diseases. Our study aims to highlight how the secrecy surrounding HIV can affect the management of the other conditions. The results of this socio-anthropological sub-study of the ANRS EP66 SEPTAVIH study, which assesses frailty in OPWH, are based on in-depth interviews conducted with 20 OPWH with multimorbidities aged 70 years and over and 9 caregivers. Based on a cross-sectional thematic analysis, this study shows that HIV infection differs from other chronic diseases due to the secrecy and stigma associated with HIV. These specific issues associated with HIV complicate the lives of OPWH, depriving them of support from loved ones and forcing them to exclude their general practitioner from their care system. This then causes OPWH with multiple chronic diseases to become socially vulnerable and isolated. Interventions that support the sharing of information on HIV among OPWH and also among caregivers need to be identified as a matter of urgency in order to improve the lives and management of OPWH with multimorbidities.Trial Registration: ClinicalTrials.gov identifier: NCT03958786.
Subject(s)
Caregivers , HIV Infections , Multimorbidity , Social Stigma , Aged , Aged, 80 and over , Female , Humans , Male , Caregivers/psychology , Chronic Disease/psychology , Confidentiality , Cross-Sectional Studies , HIV Infections/psychology , Qualitative ResearchABSTRACT
Acute fatty liver of pregnancy (AFLP) is a specific but rare hepatopathy that can usually complicate the third trimester of pregnancy. It is potentially fatal for the mother and the fetus. To our knowledge, only eight cases of recurrence have been published, we report a new case. The first episode presented by our 23-year-old patient was suspected in front of a cutaneous-mucosal jaundice with vomiting occurring on pregnancy of 35weeks of gestation (WG). Hyperleucytosis, abnormalities of the hepatic balance, as well as a hypoglycemia were biological elements supporting the diagnostic beam. On the other hand, medical imaging could not bring a clear confirmation. The evolution was favorable after deferred delivery by caesarean section for pulmonary maturation. Three years later, she presented to the obstetrical emergency room at 36weeks and six days of gestation, with a clinical and biological picture almost similar to that of the first episode. A caesarean section was then indicated for suspicion of recurrence. The evolution is favorable for the mother and her children. The interest of the communication on the risk of recurrence, the clinical and biological monitoring in particular in the third trimester of the subsequent pregnancy are imperative, in order to improve the prognosis of this pathology.
Subject(s)
Fatty Liver , Pregnancy Complications , Adult , Cesarean Section , Child , Fatty Liver/complications , Fatty Liver/diagnosis , Female , Humans , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Trimester, Third , Young AdultABSTRACT
BACKGROUND: Individuals presenting for care with severe immunosuppression typically have high plasma HIV viral load (pVL) and may transmit HIV before and after initiation of combination antiretroviral therapies (cART). PATIENTS AND METHODS: Using risk equations and data collected in the IMEA 040 DATA trial on sexual behaviour and pVL level of 84 HIV-infected patients (23 women), we estimated monthly rates of HIV transmission for each virologically unsuppressed participant (pVL >50 copies/mL) who reported sex with HIV-negative or unknown serostatus (HNUS) partners at cART initiation, 24 weeks (W24) and W48 after; rates were considered negligible for other participants. RESULTS: At cART initiation, median pVL was 5.4 log10 copies/mL. The percentage of virologically unsuppressed patients decreased, from 100% at cART initiation to 27% (95% CI 16%-43%) for heterosexuals and 8% (95% CI 2%-22%) for MSM at W48 (P < 0.001). The percentage of patients reporting sex with HNUS partners increased between cART initiation and W48, from 23% (95% CI 10%-42%) to 42% (95% CI 25%-61%) for heterosexuals (P = 0.042) and from 41% (95% CI 21%-64%) to 73% (95% CI 52%-88%) for MSM (P = 0.004). Median monthly HIV transmission rates were 0.0540 (IQR 0.0339-0.0742) for MSM and 0.0018 (IQR 0.0014-0.0191) for heterosexuals at cART initiation, and were reduced by 95% (95% CI 87%-100%) for heterosexuals and 98% (95% CI 95%-100%) for MSM as early as W24. CONCLUSIONS: Risk of onward transmission for severely immunosuppressed individuals is high before and within the first weeks of cART, and persists, at a substantially reduced level, beyond 24 weeks of cART for some individuals. Earlier cART and protecting HIV-negative partners until full viral suppression is achieved could reduce HIV transmission.
Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/drug therapy , HIV Infections/transmission , Immunocompromised Host , Adult , Female , HIV Infections/virology , HIV-1/drug effects , HIV-1/physiology , Humans , Male , Middle Aged , Risk Factors , Sexual Behavior , Sexual Partners , Viral Load/drug effectsABSTRACT
INTRODUCTION: Necrotizing sialometaplasia is a benign inflammatory lesion involving most frequently the minor salivary gland of the hard palate. Involvement of the parotid gland is rare, involvement of the parotid gland associated with facial palsy is exceptional. CASE REPORT: A 56-year-old male patient with Marfan syndrome presented with swelling and inflammation of the left parotid gland associated with progressively complete facial nerve paralysis. CT scan and MRI showed a parotid collection with hyper signal of the nearest tissues associated with erosion of the styloid process. A malignant tumor was suspected. The histological examination of a biopsy showed a lobulocentric process with necrosis, squamous metaplasia, and inflammation. The immunohistochemical examination supported a final diagnosis of necrotizing sialometaplasia. DISCUSSION: Necrotizing sialometaplasia of the parotid gland associated with facial nerve paralysis presents like a malignant neoplasm, both clinically and histologically. Only advanced immunohistochemical examination can really confirm the diagnosis.
Subject(s)
Facial Nerve/pathology , Facial Paralysis/complications , Parotid Diseases/etiology , Sialometaplasia, Necrotizing/etiology , Anti-Bacterial Agents/therapeutic use , Facial Paralysis/diagnosis , Humans , Male , Middle Aged , Parotid Diseases/diagnosis , Prednisolone/therapeutic use , Sialometaplasia, Necrotizing/diagnosisABSTRACT
BACKGROUND: Body piercing has become widespread and is associated with increased complications. Post-piercing chondritis may lead to severe residual deformity. We aimed to report case patients presenting with post-piercing chondritis in our department and to describe clinical features and treatment. PATIENTS AND METHODS: We conducted a retrospective study of patients presenting with post-piercing chondritis in the infectious disease department of Tenon Hospital, Paris, France. RESULTS: We included 21 patients. Fifteen bacteriological cultures were positive (7 Pseudomonas aeruginosa, 5 Staphylococcus aureus, and three other). Dual intravenous antibiotic therapy was administered to 13 patients for a median duration of six days [2-8], replaced by an oral antibiotic therapy for a median duration of 15 days [7-40]. Eight patients received oral antibiotic monotherapy for 10 days [7-30]. Median duration of antibiotic therapy was 16 days. Earring removal was performed for 18 patients. No ear deformity or general complication was reported. CONCLUSION: Transcartilaginous ear piercing may lead to infectious complications or deformity. In case of chondritis, early administration of an antibiotic therapy active against P. aeruginosa and S. aureus is recommended. Specific guidelines are needed.
Subject(s)
Bacterial Infections/etiology , Body Piercing/adverse effects , Cartilage Diseases/etiology , Ear Cartilage , Inflammation/etiology , Adolescent , Adult , Female , Humans , Male , Retrospective Studies , Young AdultABSTRACT
Intraosseous lipoma is a benign tumor of the bone. It is mostly seen in the metaphyses of the long bones and calcaneus. There are few documented cases of intraosseous lipomas in the jaw. Clinically, the lesion is usually silent and radiologically it appears as a radiolucent area rarely including some radio-opacities. Diagnosis is based on clinical, radiological and histopathological features. Surgical removal of the lesion is the recommended treatment.
Subject(s)
Jaw Neoplasms , Lipoma , Diagnosis, Differential , Diagnostic Imaging/methods , Humans , Jaw Neoplasms/diagnosis , Jaw Neoplasms/epidemiology , Jaw Neoplasms/therapy , Lipoma/diagnosis , Lipoma/epidemiology , Lipoma/therapyABSTRACT
INTRODUCTION: Many authors have reported the possible malignant transformation of oral lichen. The incidence of this event remains controversial. Many authors make a distinction between the "true" oral lichen planus (OLP) and lichenoid lesions (LL) according to the WHO clinical and histological classification. For these authors an increased risk of development of oral cancer could occur only on LL. Our aim was to check this hypothesis on a cohort followed for 10 years. MATERIAL AND METHODS: We included patients who were referred to our team for the first time between 1995 and 1997, still followed in 2010, with a histological diagnosis of buccal lichen planus. We classified lesions as OLP or LL according to the WHO clinical and histological classification: the two clinical criteria for OLP were a reticulated aspect and bilateral and symmetric lesions. Three histological criteria were necessary for the diagnosis: dense inflammatory infiltrate in the upper lamina propria, liquefaction degeneration of basal keratinocytes, and no signs of dysplasia. The final diagnosis was OLP, when all clinical ad histological criteria were met otherwise it was LL. We studied the patient's outcome between their first consultations and May 2010. RESULTS: Thirty-two patients, whose data was available, met inclusion criteria. Eight were diagnosed with OLP and 24 with LL. The mean follow-up was 164 months [154-183]. No oral cancer was observed in the OLP group. Two patients in the LL group presented with oral cancer after 45 and 143 months of follow-up. DISCUSSION: Malignant transformations were observed only in the LL group. Our results correlate with those of Van Der Meij et al. published in 2006. The strict use of the WHO diagnostic criteria seems to allow identifying patients at risk of developing oral cancer (LL) and others with only a benign course of this chronic oral mucosal disease. These results need to be confirmed by prospective multicentric studies.
Subject(s)
Cell Transformation, Neoplastic , Lichen Planus, Oral/pathology , Lichenoid Eruptions/pathology , Mouth Neoplasms/etiology , Adult , Aged , Cohort Studies , Disease Progression , Female , Humans , Lichen Planus, Oral/epidemiology , Lichenoid Eruptions/classification , Lichenoid Eruptions/diagnosis , Lichenoid Eruptions/epidemiology , Male , Middle Aged , Mouth Neoplasms/epidemiology , Mouth Neoplasms/pathologyABSTRACT
OBJECTIVE: The authors had for aim to assess the prevalence of hepatitis B co-infection in a cohort of HIV-infected patients, routinely followed-up at the Day Care Unit of the Bobo Dioulasso Sanou Souro University Hospital, Burkina Faso. PATIENTS AND METHODS: The Elisa technique was used to dose HBs antigen (AgHBs), antibodies anti-HBs and anti-HBc in all the patients followed by the biological laboratory, from October to December 2008. RESULTS: The AgHBs prevalence was 12.7% [CI at 95%: 10.7-15.0%] and men were slightly more likely to be positive for AgHBs than women (16.5% [12.0-21.9%] versus 11.6% [9.4-14.1%]; P=0.047); 83.3% of the patients [80.8-85.6%] were positive for hepatitis B core antibody, and 32.6% [29.7-35.6%] for hepatitis B surface antibody; 29.9% of the patients [27.1-32.8%] had a complete profile of former hepatitis B infection, 41.3% [38.2-44.4%] expressed core antibodies only; 13.8% [11.7-16.0%] had a negative serological test, and 2.3% [1.5-3.4%] presented a vaccinal immunity. CONCLUSION: These results stress the usefulness of screening for hepatitis B in all HIV-infected patients, along with the initial biological tests. This would help adapt HIV treatment to co-infected patients and to build an expanded program of vaccination for non-immune patients.
Subject(s)
Day Care, Medical/statistics & numerical data , HIV Infections/epidemiology , Hepatitis B Antibodies/blood , Hepatitis B/epidemiology , Outpatient Clinics, Hospital/statistics & numerical data , Adult , Aged , Alanine Transaminase/blood , Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active , Antiviral Agents/therapeutic use , Burkina Faso/epidemiology , Carrier State/epidemiology , Coinfection , Enzyme-Linked Immunosorbent Assay , Female , HIV Infections/drug therapy , Hepatitis B/drug therapy , Hepatitis B Antigens/immunology , Hepatitis B Vaccines/immunology , Hospitals, University , Humans , Male , Mass Screening , Middle Aged , Seroepidemiologic Studies , Young AdultSubject(s)
Congresses as Topic/organization & administration , Oral Medicine/organization & administration , Oral Medicine/trends , Societies, Medical/organization & administration , Surgery, Oral/methods , Education, Medical, Continuing/organization & administration , Education, Medical, Continuing/trends , France , Humans , Oral Medicine/education , Organizational Innovation , Practice Guidelines as Topic , Societies, Medical/trends , Surgery, Oral/legislation & jurisprudence , Surgery, Oral/trendsABSTRACT
OBJECTIVES: The aim of the study was to evaluate fat tissue distribution in HIV-infected patients with suppressed viraemia treated with darunavir/ritonavir (darunavir/r) monotherapy versus darunavir/r triple therapy. METHODS: This study was a substudy of the randomized, multicentre, open-label MONOI-ANRS 136 trial. Body fat distribution and metabolic parameters were measured at baseline, week 48 and week 96. RESULTS: In total, 156 patients of the 225 initially enrolled in the MONOI trial participated in this study, 75 in the darunavir/r monotherapy arm and 81 in the darunavir/r triple-therapy arm. The median limb fat increase from baseline was +0.34 kg [interquartile range (IQR) -0.040 to +1.140 kg; P < 0.001] at week 48 and +0.33 kg (IQR -0.14 to +1.26 kg; P = 0.001) at week 96 in the monotherapy arm, while there was no change (-0.02 kg; IQR -0.53 to +0.52 kg) at week 48 and then an increase of +0.23 kg (IQR -0.45 to +0.87 kg; P = 0.046) at week 96 in the triple-therapy arm. The two arms differed significantly at week 48 (P = 0.001) but not at week 96. The median increase in trunk fat was +0.73 kg (IQR -0.24 to +1.60 kg; P < 0.001) and 0.60 kg (IQR -0.41 to +1.49 kg; P = 0.03) at week 48 and +1.16 kg (IQR -0.17 to +2.75 kg; P < 0.001) and +0.90 kg (IQR -0.51 to +2.34 kg; P = 0.001) at week 96 in the monotherapy and triple-therapy arms, respectively, with no difference between arms. At week 96, the only biological change was a glucose level elevation in the monotherapy arm (median +4.0 mg/dL; IQR -4.0 to +7.0 mg/dL) compared with the triple-therapy arm (P = 0.012). CONCLUSIONS: Overall, body fat tissue increased in patients on darunavir/r monotherapy and triple therapy, with no difference between the arms over 96 weeks. The only difference found was a delayed increase in limb fat tissue in the triple-therapy arm compared with the monotherapy arm in the first year.
Subject(s)
Body Fat Distribution , HIV Infections/drug therapy , HIV Protease Inhibitors/administration & dosage , HIV Protease Inhibitors/adverse effects , HIV-Associated Lipodystrophy Syndrome/chemically induced , Reverse Transcriptase Inhibitors/administration & dosage , Ritonavir/administration & dosage , Sulfonamides/administration & dosage , Adult , Darunavir , Drug Therapy, Combination/methods , Female , France , HIV Infections/physiopathology , Humans , Male , Middle Aged , Reverse Transcriptase Inhibitors/adverse effects , Ritonavir/adverse effects , Sulfonamides/adverse effectsSubject(s)
Congresses as Topic/organization & administration , Oral Medicine/organization & administration , Oral Surgical Procedures/trends , Societies, Medical/organization & administration , Africa, Northern , France , Humans , International Cooperation , Oral Surgical Procedures/methods , Paris , WorkforceABSTRACT
OBJECTIVES: Long-term results at week 96 are needed to evaluate the capacity of the darunavir/ritonavir monotherapy strategy to maintain a sustained control of the HIV-1 viral load. METHODS: MONOI is a prospective, open-label, non-inferiority, randomized, 96 week trial comparing darunavir/ritonavir monotherapy versus a darunavir/ritonavir triple-therapy strategy to maintain HIV-1 viral load suppression in HIV-1-infected patients. CLINICAL TRIAL REGISTRATION: NCT00412551. RESULTS: From 225 randomized patients, 219 patients reached the 48 week follow-up and 211 reached the 96 week follow-up (106 patients in the darunavir monotherapy arm and 105 in the darunavir triple-therapy arm). Baseline characteristics were well balanced between the two treatment groups. At week 96, in intent-to-treat analysis, 91/103 patients (88%, 95% CI 81-94) allocated to the darunavir/ritonavir monotherapy arm and 87/104 patients (84%, 95% CI 75-90) allocated to the darunavir triple-therapy arm achieved an HIV-1 viral load <50 copies/mL, with no statistical difference between the two groups. Throughout the 96 week follow-up, 66/112 patients (59%, 95% CI 49-68) and 79/113 patients (70%, 95% CI 61-78) consistently had HIV-1 RNA <50 copies/mL with darunavir/ritonavir monotherapy and darunavir/ritonavir triple therapy, respectively. CONCLUSIONS: The MONOI study establishes darunavir/ritonavir monotherapy as durable and efficacious for maintaining virological suppression in HIV-1 patients. Darunavir/ritonavir monotherapy should be considered as a (tailored) treatment option for standard triple-therapy patients who have had a substantial period of viral suppression.
Subject(s)
Anti-HIV Agents/administration & dosage , HIV Infections/drug therapy , HIV-1/isolation & purification , Ritonavir/administration & dosage , Sulfonamides/administration & dosage , Viral Load , Darunavir , Humans , Prospective Studies , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVES: The aim of the study was to compare the effects on lipids, body composition and renal function of once-daily ritonavir-boosted saquinavir (SQV/r) or atazanavir (ATV/r) in combination with tenofovir/emtricitabine (TDF/FTC) over 48 weeks. METHODS: An investigator-initiated, randomized, open-label, multinational trial comparing SQV/r 2000/100 mg and ATV/r 300/100 mg once daily, both in combination with TDF/FTC, in 123 treatment-naïve HIV-1-infected adults was carried out. The primary endpoint was to demonstrate noninferiority of SQV/r compared with ATV/r with respect to the change in fasting cholesterol after 24 weeks. Secondary outcome measures were changes in metabolic abnormalities, body composition, renal function, and virological and immunological efficacy over 48 weeks. Patients who had used at least one dose of trial drug were included in the analysis. RESULTS: Data for 118 patients were analysed (57 patients on SQV/r and 61 on ATV/r). At week 24, changes in lipids were modest, without increases in triglycerides, including a significant rise in high-density lipoprotein (HDL) cholesterol and a nonsignificant decrease in the total:HDL cholesterol ratio in both arms with no significant difference between arms. Lipid changes at week 48 were similar to the changes observed up to week 24, with no significant change in the homeostasis model assessment (HOMA) index. Adipose tissue increased regardless of the regimen, particularly in the peripheral compartment and to a lesser extent in the central abdominal compartment, with an increase in adipose tissue reaching statistical significance in the ATV/r arm. A slight decline in the estimated glomerular filtration rate (eGFR) was observed in both arms during the first 24 weeks, with no progression thereafter. The immunological and virological responses were similar over the 48 weeks. CONCLUSIONS: Combined with TDF/FTC, both SQV/r 2000/100 mg and ATV/r 300/100 mg had comparable modest effects on lipids, had little effect on glucose metabolism, conserved adipose tissue, and similarly reduced eGFR. The virological efficacy was similar.
Subject(s)
Adenine/analogs & derivatives , Deoxycytidine/analogs & derivatives , Dyslipidemias/etiology , HIV Infections/complications , HIV Infections/metabolism , Oligopeptides/pharmacokinetics , Organophosphonates/pharmacokinetics , Pyridines/pharmacokinetics , Saquinavir/pharmacokinetics , Adenine/administration & dosage , Adenine/pharmacokinetics , Adult , Atazanavir Sulfate , Deoxycytidine/administration & dosage , Deoxycytidine/pharmacokinetics , Drug Administration Schedule , Dyslipidemias/chemically induced , Dyslipidemias/metabolism , Emtricitabine , Female , Glomerular Filtration Rate , HIV Infections/drug therapy , Humans , Kidney Diseases , Male , Oligopeptides/administration & dosage , Organophosphonates/administration & dosage , Pyridines/administration & dosage , Saquinavir/administration & dosage , Tenofovir , Treatment OutcomeABSTRACT
Introducción. Este estudio tenía por finalidad precisar las modalidades de utilización y el mecanismo de acción antiinflamatoria de la enoxolona contenida en un dentífrico y en una solución bucal. Material y método. Por medio de un modelo de encía humana mantenida con sobrevida, se pudo inducir una reacción inflamatoria mediante la aplicación de mediadores proinflamatorios (SP y LPS) y realizar, en doble ciego contra placebo, una evaluación de los parámetros histológicos y bioquímicos (IL8) de la inflamación previa aplicación del dentífrico. Para la solución bucal, la evaluación bioquímica se realizó por dosificación del IL 1. Resultados. El dentífrico generó una disminución significativa del edema, de la dilatación de los capilares y de la excreción del IL8. La solución generó una disminución de la excreción del IL l. Discusión. La enoxolona ejerce un efecto antiinflamatorio, cualquiera sea el vehículo utilizado.
Subject(s)
Humans , Glycyrrhetinic Acid/therapeutic use , Gingiva , Gingivitis/drug therapy , Glycyrrhetinic Acid/pharmacology , Edema , Histological Techniques , Interleukins/physiology , Data Interpretation, Statistical , Culture Techniques/methodsABSTRACT
INTRODUCTION: Our aim was to compare the anti-inflammatory activity of two toothpastes, one including enoxolone 1%, the other including plant extracts and sodium bicarbonate. MATERIAL AND METHODS: Gingival fragments were kept alive ex-vivo. Inflammation, inflammatory mediators (SP and LPS) were applied to culture medium on contact with corium to induce inflammation. The effect of both toothpastes was assessed with histological and biochemical parameters (inflammatory cytokine IL8) of inflammation on the synthesis of collagen and cellular viability. RESULTS: Both toothpaste "A" including enoxolone at 1% and "P" including plant extracts and sodium bicarbonate were effective on edema and vasodilatation. "A" acted on IL8 synthesis, unlike "P". Both toothpastes boosted collagen synthesis by fibroblasts. The percentage of cellular viability for "A" was superior to the currently admitted standard (80%), unlike to "P". DISCUSSION: The mechanisms of action of each toothpaste seem to be different. "A" modulates pro-inflammatory cytokine IL8 expression, unlike "P". The toothpaste "A" seems to be better tolerated.
Subject(s)
Anti-Inflammatory Agents/pharmacology , Gingiva/drug effects , Toothpastes/pharmacology , Capillaries/drug effects , Cell Culture Techniques , Cell Survival/drug effects , Cells, Cultured , Collagen/drug effects , Colorimetry , Edema/pathology , Gingiva/blood supply , Gingiva/cytology , Glycyrrhetinic Acid/pharmacology , Humans , Inflammation Mediators/pharmacology , Interleukin-8/analysis , Interleukin-8/drug effects , Lipopolysaccharides/pharmacology , Plant Extracts/pharmacology , Sodium Bicarbonate/pharmacology , Spectrophotometry , Substance P/pharmacology , Wound Healing/drug effectsABSTRACT
The last WHO expert workgroup recommended abandoning the distinction between potentially malignant lesions and conditions. The term to use is "potentially malignant disorders". Leukoplakia is the most common of these disorders, while erythroplakia is rather rare. The diagnosis is still made by excluding other documented white or red lesions. Despite progress in molecular biology, no marker allows predicting malignant transformation. These lesions are treated surgically with or without dysplasia. It is unknown if this surgery can really prevent transformation into squamous cell carcinoma. The potential malignancy of oral lichen planus is still debated. The risk of malignant transformation is lower than that of leukoplakia. No treatment may prevent this. Other potentially malignant conditions such as oral submucous fibrosis, actinic cheilitis, lupus, and immunodeficiency are rare.
Subject(s)
Mouth Neoplasms/classification , Precancerous Conditions/classification , Biomarkers, Tumor/analysis , Biopsy , Carcinoma in Situ/classification , Carcinoma in Situ/pathology , Carcinoma, Squamous Cell/classification , Carcinoma, Squamous Cell/pathology , Cell Transformation, Neoplastic/classification , Cell Transformation, Neoplastic/pathology , Cheilitis/classification , Cheilitis/pathology , Erythroplasia/classification , Erythroplasia/pathology , Humans , Keratosis, Actinic/classification , Keratosis, Actinic/pathology , Leukoplakia, Oral/classification , Leukoplakia, Oral/pathology , Lichen Planus, Oral/classification , Lichen Planus, Oral/pathology , Lupus Erythematosus, Discoid/classification , Lupus Erythematosus, Discoid/pathology , Mouth Diseases/classification , Mouth Diseases/pathology , Mouth Neoplasms/pathology , Neoplasm Invasiveness , Oral Submucous Fibrosis/classification , Oral Submucous Fibrosis/pathology , Precancerous Conditions/pathology , Terminology as TopicSubject(s)
Isocitrate Dehydrogenase/genetics , Mutation/genetics , Myelodysplastic Syndromes/genetics , Myeloproliferative Disorders/genetics , Aged , Aged, 80 and over , Base Sequence , DNA-Binding Proteins/genetics , Dioxygenases , Humans , Janus Kinase 2/genetics , Middle Aged , Molecular Sequence Data , Myelodysplastic Syndromes/pathology , Myeloproliferative Disorders/pathology , Proto-Oncogene Proteins/geneticsABSTRACT
INTRODUCTION: Our aim was to assess the modalities of use and the anti-inflammatory activity of enoxolone included in toothpaste and in a mouthwash solution. MATERIAL AND METHODS: We used gingival fragments kept alive during 3 days at 37 degrees C. To induce inflammation, inflammatory mediators (SP and LPS) were applied to culture medium on contact with corium. The toothpaste versus placebo was applied on epithelium, in double blind. Histological analysis was then performed on hematoxylin and eosin stained slides. Edema was evaluated with semi-quantitative scores. Vasodilatation was studied by counting the percentage of dilated vessels according to scores and the surface of these dilated vessels by morphometrical image analysis. An inflammatory cytokine, IL8, was measured in culture supernatants. Dosing IL1alpha tested the mouth solution. RESULTS: The toothpaste induced a significant decrease of edema, vasodilatation, and IL8 excretion. The enoxolone solution induced a decrease of IL1alpha. DISCUSSION: Enoxolone demonstrated an anti-inflammatory property whatever the carrier was.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Gingivitis/drug therapy , Glycyrrhetinic Acid/therapeutic use , Dentifrices/chemistry , Dentifrices/therapeutic use , Diffusion Chambers, Culture , Gingivitis/chemically induced , Humans , Interleukin-1alpha/analysis , Interleukin-8/analysis , Mouth Mucosa , Mouthwashes/chemistry , Mouthwashes/therapeutic use , Polysaccharides, Bacterial , Substance P , Tissue Culture TechniquesABSTRACT
OBJECTIVES: To assess the impact of switching to tenofovir disoproxil fumarate + emtricitabine on lipid parameters. METHODS: HIV-infected patients with plasma viral load <400 copies/mL, fasted triglycerides from 2.3 to 11.4 mmol/L and/or fasted low-density lipoprotein (LDL)-cholesterol >4.1 mmol/L were randomized to switch the nucleoside reverse transcriptase inhibitor (NRTI) backbone to fixed-dose combination tenofovir disoproxil fumarate + emtricitabine or to maintain the baseline antiretroviral regimen (the control group). The study has been registered with ClinicalTrials.gov under the identifier NCT00323492. RESULTS: Ninety-one patients were included in the intent-to-treat (ITT) analysis with triglycerides 2.4 mmol/L and LDL-cholesterol 4.0 mmol/L (median values). At week 12, the median changes from baseline of triglycerides were -0.5 mmol/L (-25%; n = 46) and -0.1 mmol/L (-6%; n = 45) in the tenofovir disoproxil fumarate + emtricitabine and control groups, respectively, indicating a difference of -0.4 mmol/L (P = 0.034) [95% confidence interval (CI): -0.9 to -0.0]. Similarly for LDL-cholesterol, changes of -0.4 mmol/L (-9%) and -0.1 mmol/L (-1%) were observed in the tenofovir disoproxil fumarate + emtricitabine and control groups, respectively, indicating a difference of -0.4 mmol/L (P = 0.031) [95% CI: -0.7 to -0.0]. The proportion of patients with LDL-cholesterol >4.1 mmol/L decreased from 48% at baseline to 26% at week 12 in the tenofovir disoproxil fumarate + emtricitabine group versus no change in the control group. No virological failure was observed during the study. CONCLUSIONS: Switching to tenofovir disoproxil fumarate + emtricitabine in dyslipidaemic HIV-infected patients improves triglycerides and LDL-cholesterol.
Subject(s)
Adenine/analogs & derivatives , Anti-HIV Agents/therapeutic use , Cholesterol, LDL/blood , Deoxycytidine/analogs & derivatives , HIV Infections/drug therapy , Nucleosides/therapeutic use , Organophosphonates/therapeutic use , Triglycerides/blood , Adenine/adverse effects , Adenine/therapeutic use , Adult , Anti-HIV Agents/adverse effects , Deoxycytidine/adverse effects , Deoxycytidine/therapeutic use , Emtricitabine , Female , Humans , Male , Middle Aged , Nucleosides/adverse effects , Organophosphonates/adverse effects , TenofovirABSTRACT
OBJECTIVE: The goal of the study was to assess the activity of a multidisciplinary structure for HIV infected patients, two years after the opening of the day hospital. DESIGN: A retrospective observational study of the Bobo Dioulasso day-hospital was made using the ESOPE (Epiconcept, France) software. RESULTS: In 2002, 147 patients were followed in the Bobo Dioulasso university hospital, 27 (or 18.5 %) of whom were treated with antiretrovirals. Between 2005, opening of the day-hospital, and 2007, the total number of patients increased by 20 %. The number of patients on antiretrovirals rose from 47 to 70 % in the same time. The rate of patients with waved antiretroviral costs rose from 6 to 53 %. Three hundred and eighty-six patients died between 2002 and 2007. 1450 patients were lost to follow-up between 20002 and 2007. CONCLUSIONS: Two years after its opening, the Bobo Dioulasso day-hospital manages one of the largest HIV cohort in sub-Saharan Africa and has become a reference structure in Burkina Faso. The analysis of this cohort was an opportunity to identify issues concerning HIV patient treatment in 2009.