Search

Examining both cross-sectional and longitudinal data may give a better understanding of the HIV epidemic among intravenous drug users (IDUs). Cross-sectional data pertains to a representative study group, and longitudinal data is that obtained over a period of time. Researchers in Italy analyzed HIV rates among IDUs entering drug treatment centers in Milan, Rome and Naples from 1985 through 1991. HIV prevalence, the number of cases present at one point in time, and HIV incidence, the number of new cases occurring, both declined during that time period. Females had higher HIV prevalence and incidence rates than males. Milan had the highest annual HIV prevalence, followed by Rome; Naples had a very low rate throughout the study period. The HIV prevalence rate declined most significantly among IDUs younger than 25 years. Among those who had injected drugs more than 10 years, the HIV prevalence was higher, but HIV incidence lower, than among those with a shorter duration of drug use.

Introduction: Transthoracic echocardiography with bubble test is an accurate, reproducible, and safe technique to verify the location of the tip of the central venous catheter. The aim of this study is to confirm the effectiveness of this method for tip location in patients with atrial arrhythmia.Methods: Transthoracic echocardiography with bubble test was adopted as a method of tip location in patients with atrial arrhythmia requiring central venous catheter. If bubbles were evident in the right atrium in less than 2 s after simple saline injection, tip placement was assumed as correct. In cases of uncertain visualization of the bubble effect, the test was repeated injecting a saline–air mixture. Tip location was also assessed by post-procedural chest X-ray.Results: In 42 patients with no evident P-wave at the electrocardiography, we placed 34 centrally inserted central catheters and 8 peripherally inserted central catheters. Transthoracic echocardiography with bubble test detected two centrally inserted central catheter malpositions. In four patients with peripherally inserted central catheter, transthoracic echocardiography with bubble test was positive only when repeated with the saline–air mixture. When the transthoracic echocardiography was positive, the mean (±standard deviation) time for onset of the bubble effect was 0.89 ± 0.33 s in patients with centrally inserted central catheter and 1.1 ± 0.20 s in those with peripherally inserted central catheter; such time difference was not statistically significant (p > 0.05).Conclusion: Tip location of central venous catheter by transthoracic echocardiography with bubble test is feasible, safe, and accurate in patients with atrial arrhythmia. This method can also be applied in peripherally inserted central catheters; however, further studies may be needed to confirm its use in this type of catheters.

We developed an innovative and efficient, feeder-free culture method to genetically modify and expand peripheral blood-derived NK cells with high proliferative capacity, while preserving the responsiveness of their native activating receptors. Activated peripheral blood NK cells were efficiently transduced by a retroviral vector, carrying a second-generation CAR targeting CD19. CAR expression was demonstrated across the different NK-cell subsets. CAR.CD19-NK cells display higher antileukemic activity toward CD19+cell lines and primary blasts obtained from patients with B-cell precursor ALL compared with unmodified NK cells. In vivo animal model data showed that the antileukemia activity of CAR.CD19-NK cell is superimposable to that of CAR-T cells, with a lower xenograft toxicity profile. These data support the feasibility of generating feeder-free expanded, genetically modified peripheral blood NK cells for effective “off-the-shelf” immuno-gene-therapy, while their innate alloreactivity can be safely harnessed to potentiate allogeneic cell therapy.

Introduction:Cardiogenic shock (CS) pathophysiology may be well explained through the left ventricular pressure-volume (PV) loops.Hypothesis:We developed an innovative model-based algorithm to derive non-invasive left ventricular PV loops and we assessed its ability to provide information in CS patients.Methods:We conceived and implemented a simple, intuitive and practical model-based algorithm for the non-invasive left ventricular PV loop diagram visualization and analysis. This model is based on the quantitative numerical calculation of the product of two time-varying curves, namely the LV volume V(t) multiplied by the time varying LV elastance function, in order to obtain the time varying LV pressure curve, according to the well-known relation: P(t) = E(t) * V(t) [formula F1] [Seeman et al. 2019]. The algorithm works as follows: 1) Input parameters: HR, EDV, ESV, Estimated LV elastance value for healthy (control) and for pathologic subjects. 2) Picked qualitative illustrations exhibiting time-varying dynamics of:a. Normal LV Elastance b. Normal LV Volume 3) Digitized, appropriately scaled, and adapted to input, curves in step (2).4) P(t) obtained by applying formula (F1) in Excel spreadsheet.5) Construction of the PV Loop diagram in Excel spreadsheet.Results:To test the algorithm, non-invasive input parameters were collected in a patient with CS due to acute myocarditis and in a normal subject. In the CS patient, HR, ESV, EDV were 83bpm, 228 ml and 200 ml, respectively; while in the normal subject, they resulted as 86 bpm, 110 ml, and 45 ml, respectively. In the CS patient, the non-invasive derived PV diagram was significantly different from that assessed in the control subject and exhibited an abrupt reduction of ventricular contractility.Conclusions:This novel model-based algorithm provides reliable non-invasive left ventricular PV diagrams in CS patients.

Introduction:Cardiogenic Shock (CS) is a life-threatening condition characterized by low cardiac output, end-organ hypoperfusion and hypoxia. Inotropic pharmacological support is recommended to restore proper hemodynamic in these patients. Levosimendan is a calcium-sensitizer with unique features, since it exerts inotropic effects preventing myocardial oxygen consumption. In CS patients, its effects on in-hospital outcomes are not well known.Hypothesis:The aim of the study was to assess whether in CS patients, levosimendan administration on top of standard inotropic support could affect in-hospital outcomes.Methods:We retrospectively reviewed clinical data of 41 CS patients admitted to Cardiac Intensive Care Unit (CICU). We compared clinical course and outcomes, including length of stay (LOS), length of mechanical support (LMS) and in-hospital mortality, between CS patients receiving levosimendan on top of standard inotropic support (group 1) and not-receiving ones (group 2).Results:Overall, 41 patients [83% males, mean age 65.8 ± 13.01 years, mean left ventricular ejection fraction (LVEF) 26.75 ± 13.28%] with CS due to acute coronary syndrome (ACS) in 19 (46.34 %), acute decompensated heart failure (ADHF) in 21 (51.22 %) and myocarditis in 1 (2.44%) were included. Eleven (26.83%) patients received levosimendan on top of standard inotropic support (group 1) while 30 (73.17%) were not-receiving (group 2). Between the two groups, any difference was observed in baseline LVEF (p= 0.14), ACS and ADHF aetiologies (p=0.98, p=0.14). Mechanical support rate was similar between patients receiving and not receiving levosimedan (p=0.05), while LMS was higher in group 1 (p= 0.001). Both CICU and in-hospital LOS were longer in group 1 (p=0.0001, p= 0.004). Conversely, CICU and in-hospital mortality did not differ between the two groups (p=0.9, p=0.72).Conclusion:In CS patients, levosimendan administration on top of standard inotropic support did not improve in-hospital outcomes.

The authors comment on patent exhaustion cases in the U.S. and care that patent holders should take while licensing patents containing both method and product claims. Topics discussed include the U.S. Supreme Court's decision in the case Quanta Computer v. LG Electronics, in which LG Electronics filed a lawsuit against Quanta for infringing its method patents and defence of exhaustion was raised by Quanta. It also discusses the case Helferich Patent Licensing, LLC, v. New York Times Co.