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The persistence of HIV antigens may explain why T cell activation persists in HIV patients even when they take AIDS drugs. This was the conclusion of a study of 47 HIV patients before and after they began drug treatment.

Recent thymic emigrants can be identified by T cell receptor excision circles (TRECs) formed during T-cell receptor rearrangement. Decreasing numbers of TRECs have been observed with aging and in human immunodeficiency virus (HIV)-1 infected individuals, suggesting thymic impairment. Here, we show that in healthy individuals, declining thymic output will affect the TREC content only when accompanied by naive T-cell division. The rapid decline in TRECs observed during HIV-1 infection and the increase following HAART are better explained not by thymic impairment, but by changes in peripheral T-cell division rates. Our data indicate that TREC content in healthy individuals is only indirectly related to thymic output, and in HIV-1 infection is mainly affected by immune activation., Author(s): Mette D. Hazenberg [1]; Sigrid A. Otto [1]; James W.T. Cohen Stuart [2, 3]; Martie C.M. Verschuren [4]; Jan C.C. Borleffs [2]; Charles A.B. Boucher [3]; Roel A. Coutinho [...]

Ritanovir may inhibit the activity of HIV-1 and increase CD4 counts in infected individuals in the short-term, but may or may not improve overall patient condition. Eighty-four HIV infected people were randomly assigned to receive either ritanovir or a placebo for four weeks followed by ritanovir. Initially, different doses of ritanovir, which ranged from 300 milligrams per 12 hours (mg/12 hr) to 600 mg/12 hr, all significantly reduced the levels of HIV-1 RNA in blood plasma and increased CD4 counts. However, after 16 weeks these measures returned to their pretreatment levels in all but the group receiving 600 mg/12 hr. In this dosage group, after 32 weeks the median CD4 count was was still elevated and an average drop in viral RNA persisted. Side effects were common and included nausea and abnormal sensation in the mouth.

Trimethoprim-sulfamethoxazole may be more effective than aerosolized pentamidine for preventing Pneumocystis carinii pneumonia (PCP) in HIV-infected individuals. PCP is a common opportunistic infection among individuals infected with HIV. Among 213 HIV-infected patients with low levels of T-cells and no previous episodes of PCP, 71 were treated with 480 milligrams (mg) of trimethoprim-sulfamethoxazole per day, 71 were treated with 960 mg of trimethoprim-sulfamethoxazole per day and 71 were treated with 300 mg of aerosolized pentamidine once a month. None of the patients treated with trimethoprim-sulfamethoxazole developed a first episode of PCP during an average follow-up period of 264 days, compared with six (11%) of the patients treated with pentamidine. Patients in both trimethoprim-sulfamethoxazole treatment groups were more likely to experience severe side effects than those in the pentamidine group.

Background: Internationally, postgraduate medical education (PGME) has shifted to competency-based training. To evaluate the effects of this shift on the outcomes of PGME appropriate instruments are needed. Aim: To provide an inventory of tasks specialists perform in practice, which can be used as an instrument to evaluate the outcomes of PGME across disciplines. Methods: Following methodology from job analysis in human resource management, we used document analyses, observations, interviews and questionnaires. Two thousand seven hundred and twenty eight specialists were then asked to indicate how frequently they performed each task in the inventory, and to suggest additional tasks. Face and content validity was evaluated using interviews and the questionnaire. Tasks with similar content were combined in a total of 12 clusters. Internal consistency was evaluated by calculating Cronbach's alpha. Construct validity was determined by examining predefined differences in task performance between medical, surgical and supportive disciplines. Results: Seven hundred and six specialists (36%) returned the questionnaire. The resulting inventory of 91 tasks showed adequate face and content validity. Internal consistency of clusters of tasks was adequate. Significant differences in task performance between medical, surgical and supportive disciplines indicated construct validity. Conclusion: We established a comprehensive, generic and valid inventory of tasks of specialists which appears to be applicable across medical, surgical and supportive disciplines. [ABSTRACT FROM AUTHOR]

Background: Research on the correlation between personality and students' specialty choice is helpful in their career counselling process and in predicting the future distribution of the specialties in a country. Aims: This study is the first of its kind in the Arab world. The research questions were: (1) What is the influence of gender on the personality profiles of medical students? (2) What are the personality profiles of students categorized according to their preferred specialist choices? (3) What are the preferred career choices of students categorized according to the stage of their medical education? Method: A cross-sectional study was performed at King Khalid University Medical School including 590 students during the academic year 2010-2011. A long version of the Zuckerman-Kuhlman personality questionnaire measuring five personality factors was used. Students were also asked for their specialty interests. Students were asked by means of a written questionnaire. Results: Study response was 92.5%. Surgery was the single most popular specialty amongst both male and female students. Males had significantly higher scores on the 'impulsive sensation seeking' scale and students preferring a surgery specialty had the highest score on the 'impulsive sensation seeking', 'neuroticism-anxiety', 'aggression-hostility' and 'sociability' scales. Hospital-based, surgical and primary care specialties became more popular as students progressed through their undergraduate years. Conclusions: Different personality types have distinct preferences in medical students' choice of careers. Personality and specialty choice research can enhance career counselling of medical students and fresh graduates. This also has implications for predicting the specialty distribution of the future health careers. [ABSTRACT FROM AUTHOR]

Focuses on therapeutic drug monitoring of protease inhibitors as potential tool to optimize the treatment of HIV-infection. Description of the inhibitors; Analysis of pharmacokinetic-pharmacodynamic relationships saquivanir treatment; Effectiveness of plasma concentrations of saquivanir for treatment of the infection.