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A letter to the editor is presented in response to the article "Histoplasmosis in a child with JRA on low-dose methotrexate," by Hunstad and colleagues in a 2006 issue of "Rheumatology."

Focuses on cortical spreading depression (CSD) and migraine. Analysis of antimigraine compounds and their effects on CSD.

Background: Although the use of highly active antiretroviral therapy in HIV positive individuals has proved to be effective in suppressing the virus to below detection limits of commonly used assays, virological failure associated with drug resistance is still a major challenge in some settings. The prevalence and effect of pre-treatment resistance associated variants on virological outcomes may also be underestimated because of reliance on conventional population sequencing data which excludes minority species. We investigated long term virological outcomes and the prevalence and pattern of pre-treatment minority drug resistance mutations in individuals initiating HAART at a local HIV clinic. Methods: Patient's records of viral load results and CD4 cell counts from routine treatment monitoring were used and additional pre-treatment blood samples for Sanger sequencing were obtained. A selection of pretreatment samples from individuals who experienced virological failure were evaluated for minority resistance associated mutations to 1 % prevalence and compared to individuals who achieved viral suppression. Results: At least one viral load result after 6 months or more of treatment was available for 65 out of 78 individuals followed for up to 33 months. Twenty (30.8 %) of the 65 individuals had detectable viremia and eight (12.3 %) of them had virological failure (viral load > 1000 RNA copies/ml) after at least 6 months of HAART. Viral suppression, achieved by month 8 to month 13, was followed by low level viremia in 10.8 % of patients and virological failure in one patient after month 20. There was potentially reduced activity to Emtricitabine or Tenofovir in three out of the eight cases in which minority drug resistance associated variants were investigated but detectable viremia occurred in one of these cases while the activity of Efavirenz was generally reduced in all the eight cases. Conclusions: Early viral suppression was followed by low level viremia for some patients which may be an indication of failure to sustain viral suppression over time. The low level viremia may also be representing early stages of resistance development. The mutation patterns detected in the minority variants showed potential reduced drug sensitivity which highlights their potential to dominate after treatment initiation. [ABSTRACT FROM AUTHOR]

Objectives. Clinical care and therapeutic trials in idiopathic inflammatory myopathies (IIM) require accurate and consistent assessment of cutaneous involvement. The Cutaneous Assessment Tool (CAT) was designed to measure skin activity and damage in IIM. We describe the development and inter-rater reliability of the CAT, and the frequency of lesions endorsed in a large population of juvenile IIM patients. [ABSTRACT FROM PUBLISHER]

Analysis of ultraviolet (UV) observations with the FAUST shuttle-borne telescope toward the Antennae and NGC 6752 celestial regions resulted in the detection of 46 and 221 candidate sources respectively, for a signal-to-noise ratio of 8. We discuss the source detection process and the identification of UV sources with optical counterparts. Using correlations with existing catalogues, we present reliable identifications for approximately 60 per cent of the sources. We find that most identified objects are B, A and F stars. The remaining identified objects are galaxies, a white dwarf in a binary system, and two K-type stars. Nearly all of the remaining unidentified objects have assigned optical counterparts but, lacking additional information, we give these only as best estimates. With help from new diagnostic diagrams, we suggest that these unclassified objects are main-sequence (or giant) stars within the local spiral arm or halo; or other hot evolved objects within the local spiral arm. We discuss the nature of the objects found and compare our results with those predicted from spectral and Galactic models. [ABSTRACT FROM AUTHOR]

We analyse a UV observation with FAUST in the direction of the North Galactic Pole. The region includes a cirrus cloud (G251.2+73.3) and a dark globule, and the FAUST image contains 75 UV sources. We discuss the UV source detection and their identification with optical counterparts. We use, for the first time, low-resolution spectral information as the primary means of identifying possible optical counterparts. This is complemented, and sometimes modified, by optical information available from existing data bases. The results are interpreted with the help of maps of the distribution of far-infrared emission and of the neutral hydrogen gas. We discuss the types of objects found, the degree of matching with the predictions of our UV Galaxy model, and the general behaviour of the Galactic UV extinction in this Milky Way part. We compare the UV results for this region with similar observations in the same neighbourhood, which are less affected by dust, and attempt to explain the peculiar distribution of UV magnitudes as a result of a peculiar distribution of foreground dust, which does not follow the accepted dust-to-gas relation. [ABSTRACT FROM AUTHOR]