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Study Shows Decreased Risk Of Death From Opportunistic Infections With Earlier Antiretroviral Treatment
HIV-positive people with opportunistic infections who receive earlier antiretroviral treatment lower their risk of death compared with people who delay treatment, according to a new study conducted by the Stanford University School of Medicine and published in PLoS One, the San Jose Mercury News reports. The findings could lead to changes in recommendations for antiretroviral treatment protocol, specifically for patients diagnosed with HIV at an advanced stage, the Mercury News reports. The study included 262 HIV-positive participants at 39 health care sites across the U.S., and 20 participants in South Africa. During the yearlong study, the researchers found that among the participants who were treated promptly after developing an opportunistic infection, 14% died or developed another infection. The researchers also found that 24% of participants who deferred treatment for an average of 45 days died or had a decrease in health outcomes. According to the Mercury News, the question of when to start HIV-positive people on antiretroviral treatment remains unclear because of issues such as the high cost of medicines, side effects, and drug interactions or resistance. Andrew Zolopa, head of Stanford University School of Medicine"s division of infectious diseases and lead investigator of the study, said that physicians often treat HIV-positive people for an "acute crisis, then follow up later with treatment for HIV." He continues, "But that answer is wrong. The study shows very clearly that there is no safety downside to doing this -- and the benefit is quite substantial, reducing death by 50%." "Even in San Francisco, one of the first epicenters of HIV in the United States, we still find that many people present late in the course of their illness with an opportunistic infection," Mitch Katz, director of San Francisco"s Department of Health who was not involved in the study, said. He added, "This study shows that it is lifesaving to treat those persons with antiretroviral drugs while they are still in the hospital." Katz said that the results could lead to changes in HIV/AIDS practices worldwide. The International AIDS Society, CDC and the British AIDS Society have developed guidelines recommending that early antiretroviral treatment be considered in patients with opportunistic infections, Zolopa said. In addition, NIH is considering an international study to examine earlier initiation of antiretroviral treatment involving more than 9,000 people from both developed and developing countries (Krieger, San Jose Mercury News, 5/15).
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Stem Cell Discovery May Bring Tissue Repair Closer
The goal of creating adult blood stem cells from human embryos to prepare a patient for tissue and organ transplant has been brought a step closer by research carried out at the MRC Molecular Haematology Unit at Oxford University.
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Gliomas Exploit Immune Cells Of The Brain For Rapid Expansion
Gliomas are among the most common and most malignant brain tumors. These tumors infiltrate normal brain tissue and grow very rapidly. As a result, surgery can never completely remove the tumor. Now, the neurosurgeons Dr. Darko S. Markovic (Helios Klinikum Berlin-Buch) and Dr. Michael Synowitz (Charit̩) as well as Dr. Rainer Glass and Professor Helmut Kettenmann (both Max Delbr̿ck Center for Molecular Medicine, MDC, Berlin-Buch), have been able to show that glioma cells exploit microglia, the immune cells of the brain, for their expansion (PNAS Early Edition)*.
Mental Health

Traumatic Brain Injury Caused By Exposure To Explosive Blast Presents Critical Challenge

Blast-induced traumatic brain injury (TBI) has reached critical levels in modern-day warfare. The current issue of Journal of Neurotrauma focuses on the intensive efforts to develop effective treatment strategies and model systems for studying the cause and effects of explosive blast TBI. This special issue of Journal of Neurotrauma, a peer-reviewed journal published by Mary Ann Liebert, Inc., is free online. A comprehensive and clearly presented overview of the field entitled "Explosive Blast Neurotrauma" was prepared by a group of authors led by Geoffrey Ling, program officer overseeing the U.S. Defense Advanced Research Projects Agency (DARPA) Preventing Violent Explosive Neurotrauma (PREVENT) blast research program, and colleagues from the Uniformed Services University of the Health Sciences (Bethesda, MD), Duke University Medical Center (Durham, NC), Inova Fairfax Hospital (Virginia), and Integrated Services Group, Inc. (Potomac, MD). Two very instructive examples of current research on blast-induced neurotrauma that describe animal model systems developed to study head injuries sustained during combat are presented in the article entitled, "Blast Overpressure in Rats: Recreating a Battlefield Injury in the Laboratory." Joseph Long and co-authors from Walter Reed Army Institute of Research (Silver Spring, MD), simulated blast effects, evaluated the physiological, neuropathological, and neurobehavioral consequences of airblast exposure, and studied the potential for using a Kevlar vest to prevent death and TBI. The advantages and limitations of using a pig model to study the causes and effects of explosive trauma to the brain is the subject of the article, "An Introductory Characterization of a Combat-Casualty-Care Relevant Swine Model of Closed Head Injury Resulting from Exposure to Explosive Blast," co-authored by a group of researchers from the military, academia, and the private sector, led by Richard Bauman, from Walter Reed Army Institute of Research, Polytrauma & Resuscitation. "We believe the articles in this issue will...provide new insights and stimulate new avenues of investigation into this crucial area of treating our warfighters, as well as the civilian population," write Guest Editors Patrick Kochanek, Richard Bauman, Joseph Long, C. Edward Dixon, and Larry Jenkins, from the University of Pittsburgh School of Medicine and Walter Reed Army Institute of Research, in their Introduction, "A Critical Problem Begging for New Insight and New Therapies." Amy Gleason Quarshie Mary Ann Liebert, Inc./Genetic Engineering News 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801-5215, USA


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