Phase Locking the Spin Precession in a Storage Ring.

This Letter reports the successful use of feedback from a spin polarization measurement to the revolution frequency of a 0.97 GeV/c bunched and polarized deuteron beam in the Cooler Synchrotron (COSY) storage ring in order to control both the precession rate (≈121 kHz) and the phase of the horizontal polarization component. Real time synchronization with a radio frequency (rf) solenoid made possible the rotation of the polarization out of the horizontal plane, yielding a demonstration of the feedback method to manipulate the polarization. In particular, the rotation rate shows a sinusoidal function of the horizontal polarization phase (relative to the rf solenoid), which was controlled to within a 1 standard deviation range of σ=0.21 rad. The minimum possible adjustment was 3.7 mHz out of a revolution frequency of 753 kHz, which changes the precession rate by 26 mrad/s. Such a capability meets a requirement for the use of storage rings to look for an intrinsic electric dipole moment of charged particles.

Audio-computer-assisted survey interview and patient navigation to increase chronic viral hepatitis diagnosis and linkage to care in urban health clinics.

Intravenous drug use and sexual practices account for 60% of hepatitis C (HCV) and B (HBV) infection. Disclosing these activities can be embarrassing and reduce risk reporting, blood testing and diagnosis. In diagnosed patients, linkage to care remains a challenge. Audio-computer-assisted survey interview (Audio-CASI) was used to guide HCV and HBV infection testing in urban clinics. Risk reporting, blood testing and serology results were compared to historical controls. A patient navigator (PN) followed up blood test results and provided patients with positive serology linkage to care (LTC). Of 1932 patients surveyed, 574 (30%) were at risk for chronic viral hepatitis. A total of 254 (44.3%) patients were tested, 34 (13.5%) had serology warranting treatment evaluation, and 64% required HBV vaccination. Of 16 patients with infection, seven HCV and three HBV patients started treatment following patient LTC. Of 146 HBV-naïve patients, 70 completed vaccination. About 75% and 49% of HCV antibody and HBV surface antigen-positive patients were born between 1945 and 1965. Subsequently, automated HCV testing of patients born between 1945 and 1965 was built into our hospital electronic medical records. Average monthly HCV antibody testing increased from 245 (January-June) to 1187 (July-October). Patient navigator directed LTC for HCV antibody-positive patients was 61.6%. In conclusion, audio-CASI can identify patients at risk for HCV or HBV infection and those in need of HBV vaccination in urban medical clinics. Although blood testing once a patient is identified at risk for infection needs to increase, a PN is useful to provide LTC of newly diagnosed patients.

Computational framework for particle and spin simulations based on the stochastic Galerkin method.

An implementation of the polynomial chaos expansion is introduced as a fast solver of the equations of beam and spin motion of charged particles in electromagnetic fields. We show that, based on the stochastic Galerkin method, our computational framework substantially reduces the required number of tracking calculations compared to the widely used Monte Carlo method.

Sphingomonas paucimobilis bacteremia in an HIV and hepatitis C co-infected patient.

INTRODUCTION: Prompt diagnosis and treatment of blood stream infections in an immunocompromised host can result in a decrease in mortality with appropriate antibiotic coverage. Signs, symptoms, physical examination, cultures and sensitivity findings must be evaluated and interpreted together to accurately diagnose and manage the problem. CASE PRESENTATION: We present a case of Sphingomonas paucimobilis bacteremia in a patient with Human Immunodeficiency virus (HIV) and hepatitis C virus co-infection. CONCLUSION: To our knowledge, this is the first reported case of this organism in a patient with HIV co-infected with chronic hepatitis C virus.

Sphingobacterium multivorum: case report and literature review.

We describe the case of a 67-year-old African American woman with multiple medical problems who presented with septic shock resulting from Sphingobacterium multivorum bacteraemia. S. multivorum, a Gram-negative bacillus, is ubiquitous in nature and is rarely involved in human infections. However, it is intrinsically resistant to many commonly administered antibiotics and can be a life-threatening microorganism.

Long-Term Consequences of Hepatitis C Viral Clearance on the CD4 (+) T Cell Lymphocyte Course in HIV/HCV Coinfected Patients.

The long-term impact of pegylated-interferon plus ribavirin treatment outcome on CD4 T cell course in patients coinfected with human immunodeficiency virus and hepatitis C virus is largely unclear in the literature. The aim of this study was to investigate the impact of HCV-RNA clearance by standard anti-HCV therapy on long-term CD4 cells recovery in HIV/HCV patients on successful combined antiretroviral therapy. We retrospectively enrolled HIV/HCV-coinfected patients on HIV medications and treated for hepatitis C. CD4 + T cell counts were registered at baseline and after hepatitis C therapy. Multiple linear regression analysis was performed to identify independent predictors of CD4 + T cell change following the anti-HCV treatment outcome. Of the 116 patients enrolled, 54 (46.6%) reached a sustained virological response. During a follow-up of 24 months, the SVR group showed a mean annual increase in CD4 + T cell from baseline of 84 cells/ll at 1 year and of a further 38 cells/ll within the second year (P = 0.01, 0.001, resp.). An insignificant mean increase of 77 cells/ll occurred in the non-SVR group within month 24 (P = 0.06). Variables associated with greater CD4 gains were higher nadir, lower preinterferon CD4 counts, and lower body mass index (BMI).

A case of sustained virologic response of HCV with telaprevir-based therapy in a patient with HIV and end stage kidney disease.

Sustained virologic response rates for hepatitis C virus are difficult to achieve in patients infected with human immunodeficiency virus, especially if they have other poor predictors of response. Rates of sustained virologic response for hepatitis C virus genotype 1 in patients with end stage kidney disease are lower than patients with normal renal function. We present the first case report of a co-infected African American man with end stage kidney disease, who was haemodialysis dependant, and an interferon non-responder with advanced liver fibrosis, who achieved sustained virologic response on a telaprevir-based regimen.

Epidemiologic aspects of abnormal ankle brachial index in the HIV infected population.

AIM: HIV infection is strongly associated with accelerated vascular atherosclerosis and increased cardiovascular events. The prevalence of peripheral arterial disease (PAD) in HIV infected patients is not clearly defined and the results of different reports are contradicting. OBJECTIVE: To determine the prevalence of abnormal Ankle Brachial Index (ABI) and associated risk factors in HIV infected population. METHODS: The ABI was measured manually using 5.0 MHz handheld Doppler probe in 173 HIV infected patients. The cohort was categorized according to the ABI measurements as; normal group (ABI 0.9 to 1.3), peripheral arterial disease (PAD) group (ABI<0.9), and High ABI group (ABI>1.3). Several demographic, atherosclerosis risk factors and HIV infection parameters have been evaluated as potential risk factors. RESULTS: Median age of the cohort was 49 years (inter-quartile ranges [IQR]: 42.5 to 54); 63.4% were males. Abnormal ABI was found in 47(27.2%) patients; twenty four (13.9%) had PAD and 23(13.3%) had high ABI. Among the risk factors evaluated, we observed that PAD group is associated with diabetes (Relative risk [RR]: 4.19; 95% confidence interval [CL]: 2.13 to 8.27; P=0.0002) and age above 49 (Relative risk [RR]: 3.96; 95% confidence interval [CL]: 1.56 to 10.0; P=0.002). However, the High ABI group was significantly associated with male gender (RR: 3.94; 95% CI: 1.23 to 12.70; P=0.009). CONCLUSION: HIV infection is associated with increased prevalence of abnormal resting ABI.

Brain lesions in patients with acquired immunodeficiency syndrome.

Infections involving the brain have become a major complication in patients with acquired immunodeficiency syndrome. We have reviewed 48 cases of central nervous system lesions in patients with acquired immunodeficiency syndrome. and its related complex. All patients had computed tomographic scans with contrast performed; 31 of 48 were intravenous drug abusers. Computed tomographic abnormalities found included 21 patients with multiple ring-enhancing lesions, 13 with single ring-enhancing lesions, 11 with single hypodense lesions, and three with multiple hypodense lesions. Twenty-five patients had a positive serologic reaction for Toxoplasma. Sixteen patients had brain tissues examined. Of the 16 patients, six had cerebral Toxoplasma (one with concomitant Mycobacterium tuberculosis), and ten had diagnoses other than toxoplasmosis (three of whom had a positive serologic reaction for Toxoplasma). Two patients had M tuberculosis; one patient had Nocardia asteroides with Salmonella enteritidis. Of the remaining seven patients, three had encephalitis of unknown cause, two had inconclusive tissue diagnoses, one had progressive multifocal leukoencephalopathy, and one had vasculitis. In the population of intravenous drug users, brain lesions from diseases other than toxoplasmosis may be just as prevalent. Attempts to obtain a diagnosis from brain tissue is highly recommended to permit the design of effective and specific therapy for those diseases amenable to therapy.