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Background Human immunodeficiency virus (HIV) and antiretroviral therapy (ART) confer cardiovascular disease (CVD) risk in adults with HIV. Few studies have assessed endothelial dysfunction (ED), an early marker of subclinical CVD risk, in youth living with perinatally acquired HIV (YLPHIV). Methods Using peripheral arterial tonometry, we compared ED in YLPHIV and age-matched youth without HIV. A reactive hyperemic index ≤1.35 was defined as ED. Eligible participants included those aged 9–14 years and on ART ≥6 months at enrollment. Results Overall, 431 YLPHIV and 93 youth without HIV with a median age of 14.1 versus 13.9 years, respectively, were included. YLPHIV had a lower BMI z score (BMIZ; −0.2 vs 0.4; P  < .01) but higher rates of hypercholesterolemia (10% vs 1%; P  = .01) than youth without HIV. Among YLPHIV, mean log viral load (VL) was 4.83 copies/mL with 21.7% having a CD4 count <500 cell/mm3; median duration on ART was 9.8 years with 38% initiating at <2 years of age. YLPHIV had higher rates of ED than youth without HIV (50% vs 34%; P  = .01); this relationship persisted after adjusting for age, sex, BMIZ, elevated BP, and hypercholesterolemia (RR, 1.43; P  = .02). Among YLPHIV, CD4 count >500 cell/mm3 (RR, 1.04; P  = .76), VL (RR, 1.01; P  = .78), and current ART class (protease inhibitor based vs nonnucleoside inhibitor based: relative risk, 0.90; P  = .186) were not associated with ED after adjustment. Conclusions Even after adjusting for physiologic differences, YLPHIV appear to be at increased risk of ED compared with age-matched youth without HIV. These findings have important implications for the life course of YLPHIV who may be at increased risk of premature CVD and complications. [ABSTRACT FROM AUTHOR]

Glaucoma is a sight-threatening condition. A general practitioner (GP) should be able to diagnose glaucoma, know about the different management options, and refer appropriately. The aim of this paper is to provide a background to glaucoma, and describe the assessment and management of glaucoma patients. The role of the GP in the management of glaucoma and in creating awareness of glaucoma is put into perspective. [ABSTRACT FROM AUTHOR]

Introduction: Preeclampsia is associated with arterial stiffness and endothelial dysfunction. Objectives: The aim of the study was to compare vascular function of pregnant women with preeclampsia and normotensives by non-invasive techniques. Methods: This was a comparative study where participants were recruited from Mthatha General Hospital complex Antenatal clinics. Fifty four (54) normotensive and 21 preeclamptic women were recruited into the study. Arterial stiffness was assessed using applanation tonometry with SphygmoCor device; central aortic pressures and peripheral and central augmentation index (Alx) and carotid-femoral pulse wave velocity were then calculated. Endothelial function was assessed by EndoPAT 2000 device; pneumatic probes were fitted to the index fingers; after baseline recordings a blood pressure cuff was inflated on the non-dominant arm then released after 5min to induce flow mediated reactive hyperemia; the ratio of the readings before and after occlusion was then used to calculate the score for endothelial function; the reactive hyperaemia index (RHI) Results: RHI was significantly higher; p <0.001 among preeclamptic women compared to normotensives (1.76±0.5 vs 1.45±0.22) indicating good endothelial function. Pulse wave velocity was significantly higher; p <0.001 in preeclamptic than normotensive women (6.7±1.5 vs 5.1±0.7) indicating arterial stiffness. Alx measured by the EndoPAT 2000 correlated with peripheral Alx (r =0.623, p <0.0001) and central Alx (r =0.60, p <0.0001) was measured by the SphygmoCor. This means that either of these parameters can be used to assess arterial stiffness. Conclusion: In this interim analysis, we have demonstrated that women with preeclampsia have increased pulse wave velocity and peripheral augmentation index suggesting vascular stiffness. Low RHI values indicate endothelial dysfunction in the general population; however our results showed a higher value in preeclampsia than in normal pregnancy. Could there be other factors responsible for RHI in pregnancy? [Copyright &y& Elsevier]