Eighty‐four HCV/HIV‐coinfected and 252‐matched HCV‐monoinfected liver transplant recipients were included in a prospective multicenter study. Thirty‐six (43%) HCV/HIV‐coinfected and 75 (30%) ...HCV‐monoinfected patients died, with a survival rate at 5 years of 54% (95% CI, 42–64) and 71% (95% CI, 66 to 77; p = 0.008), respectively. When both groups were considered together, HIV infection was an independent predictor of mortality (HR, 2.202; 95% CI, 1.420–3.413 p < 0.001). Multivariate analysis of only the HCV/HIV‐coinfected recipients, revealed HCV genotype 1 (HR, 2.98; 95% CI, 1.32–6.76), donor risk index (HR, 9.48; 95% CI, 2.75–32.73) and negative plasma HCV RNA (HR, 0.14; 95% CI, 0.03–0.62) to be associated with mortality. When this analysis was restricted to pretransplant variables, we identified three independent factors (HCV genotype 1, pretransplant MELD score and centers with <1 liver transplantation/year in HIV‐infected patients) that allowed us to identify a subset of 60 (71%) patients with a similar 5‐year prognosis (69%95% CI, 54–80) to that of HCV‐monoinfected recipients. In conclusion, 5‐year survival in HCV/HIV‐coinfected liver recipients was lower than in HCV‐monoinfected recipients, although an important subset with a favorable prognosis was identified in the former.
Taken as a whole, HCV/HIV‐coinfected liver transplant recipients have lower posttransplant survival than matched HCV‐monoinfected liver transplant recipients, although an important subset of coinfected patients with survival similar to that of HCV‐monoinfected patients can be identified retrospectively.
This work summarizes the results of a series of comprehensive studies on particulate matter (PM) carried out in Spain from 1999 to 2001. Monitoring sites were selected in accordance with different ...climatic and geographic conditions as well as anthropogenic influences, varying from rural background to urban curb-side sites. Measurements were carried out with gravimetric high-volume samplers and with automatic devices for different PM grain sizes, focusing on PM10 and PM2.5. A simultaneous meteorology study was performed to assess the influence of air masses and to detect long-range transport processes, especially African dust outbreaks, affecting the PM levels in the Iberian Peninsula and the Canary Islands. Mean values, chemical compositions and source apportionment analyses were obtained and discussed as a function of the different monitoring sites and during PM episodes.
After two years of operation, the High-Altitude Water Cherenkov (HAWC) Observatory has analyzed the TeV cosmic-ray sky over an energy range between 2.0 and 72.8 TeV. Like other detectors in the ...northern and southern hemispheres, HAWC observes an energy-dependent anisotropy in the arrival direction distribution of cosmic rays. This anisotropy is dominated by a dipole moment with phase in R.A. 40° and amplitude that slowly rises in relative intensity from 8 × 10−4 at 2 TeV to 14 × 10−4 around 30 TeV, above which the dipole decreases in strength. A significant large-scale (>60° in angular extent) signal is also observed in the quadrupole and octupole moments, and significant small-scale features are also present, with locations and shapes consistent with previous observations. Compared to previous measurements in this energy range, the HAWC cosmic-ray sky maps improve on the energy resolution and fit precision of the anisotropy. These data can be used in an effort to better constrain local cosmic-ray accelerators and the intervening magnetic fields.
We present a search of very high energy gamma-ray emission from the Northern
$\textit{Fermi}$ Bubble region using data collected with the High Altitude
Water Cherenkov (HAWC) gamma-ray observatory. ...The size of the data set is 290
days. No significant excess is observed in the Northern $\textit{Fermi}$ Bubble
region, hence upper limits above $1\,\text{TeV}$ are calculated. The upper
limits are between $3\times 10^{-7}\,\text{GeV}\, \text{cm}^{-2}\,
\text{s}^{-1}\,\text{sr}^{-1}$ and $4\times
10^{-8}\,\text{GeV}\,\text{cm}^{-2}\,\text{s}^{-1}\,\text{sr}^{-1}$. The upper
limits disfavor a proton injection spectrum that extends beyond
$100\,\text{TeV}$ without being suppressed. They also disfavor a hadronic
injection spectrum derived from neutrino measurements.
Rapid drug desensitization has enabled first-line therapies in patients with drug hypersensitivity reactions to chemotherapeutic drugs including monoclonal antibodies. Desensitization is a safe and ...highly effective procedure, not only for IgE-mediated reactions, but also for those mediated by non-IgE mechanisms. The likelihood of breakthrough reactions during desensitization is low, and most are mild; in fact, moderate-to-severe reactions are infrequent. In this document, 16 allergy departments belonging to the Spanish research network ARADyAL present a review of the available scientific evidence and provide general guidelines for the diagnosis and management of drug hypersensitivity reactions to chemotherapeutic drugs and monoclonal antibodies. Emphasis is placed on the desensitization procedure.
Two hundred twenty-one isolates of Acinetobacter baumannii and 15 of Acinetobacter genospecies 3 (AG3) were consecutively collected in a 30-day period during the nationwide project GEIH-Ab2000. ...Nosocomial acquisition (P = 0.01), intensive care unit admission (P = 0.02), and antibiotic pressure (P = 0.03) were observed to be lower in the AG3 group. AG3 isolates were more frequently implied in wound infections (P = 0.05), while A. baumannii tended to be recovered from respiratory samples (P = 0.08). To our knowledge, this is the first report analyzing the clinical differences among Acinetobacter genospecies, with our findings suggesting that clinical features of AG3 may not be equivalent to those traditionally described for A. baumannii.
The aim of this work was to produce insulin-loaded microspheres allowing the preservation of peptide stability during both particle processing and insulin release. Our strategy was to combine the ...concepts of using surfactants to improve insulin stability while optimising overall microsphere characteristics such as size, morphology, peptide loading and release. Bovine insulin was encapsulated within poly(lactide-co-glycolide) (PLGA 50:50, Resomer RG504H) microspheres by the multiple emulsion–solvent evaporation technique. Microspheres were prepared by adding to the primary emulsion three non-ionic surfactants, poloxamer 188, polysorbate 20 and sorbitan monooleate 80, at different concentrations (1.5 and 3.0% w/v). The presence of surfactants was found to decrease the mean diameter and to affect the morphology of the microspheres. Insulin encapsulation efficiency was reduced in the presence of surfactants and especially for sorbitan monooleate 80, in a concentration-dependent mode. The influence of the surfactants on the interactions between insulin and PLGA together with the primary emulsion stability were found to be the major determinants of insulin encapsulation. The release of insulin from microspheres was biphasic, showing an initial burst effect followed by a near zero-order release for all the batches prepared. The initial burst was related to the presence of insulin molecules located onto or near to the microsphere surface. In the presence of surfactants, a faster insulin release with respect to microspheres encapsulating insulin alone was observed. Insulin stability within microspheres after processing, storage and release was evaluated by reversed phase- and size-exclusion-HPLC. The analysis of microsphere content after processing and 6 months of storage showed that insulin did not undergo any chemical modification within microspheres. On the contrary, during the period of sustained release insulin was transformed in a high-molecular weight product, the amount of which was related to the surfactant used. In conclusion, polysorbate 20 at 3% w/v concentration was the most effective in giving regular shaped particles with both good insulin loading and slow release, and limiting insulin modification within microspheres.
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