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Individual learning efforts can be shown to aggregate within firms and explain the structural limits of knowledge creation, and these limits are often rooted in the heuristic shortcuts and limits of individual and group cognition and communication. Benefits from organizational learning should be apparent and measurable, and, at a minimum, these positive outcomes for the firm may come in the form of more efficient or effective human resource allocation and may generate significant innovations and the improved distribution of physical or financial resources, thereby resulting in savings or increased financial returns from applying superior knowledge, compared with rivals. [ABSTRACT FROM AUTHOR]

Competing Interests: Competing interests: None declared.

We report a case of acute kidney injury due to primary renal diffuse large B-cell lymphoma, which developed after initiation of tenofovir-containing antiretroviral therapy in a 28-year-old HIV-positive man.

The best management strategy for HIV patients who fail to respond to first-line therapy for Pneumocystis jirovecii pneumonia is currently unclear. We identified all patients who were treated with trimetrexate and folinic acid who failed 7 or more days of cotrimoxazole, clindamycin-primaquine or dapsone-trimethoprim between 1996 and 2006. Trimetrexate was tolerated in 100% of cases with no treatment termination secondary to adverse drug reactions. Despite severe disease, 71% of patients were alive after 12 weeks.

Background: Loiasis is one of the significant filarial diseases for people living in West and Central Africa with wide endemic area but is not seen in China. As economy booms and international traveling increase, China faces more and more imported parasitic diseases that are not endemic locally. Loiasis is one of the parasitic diseases that enter China by travelers infected in Africa. The better understanding of the clinical and laboratory features of loa loa infection will facilitate the diagnosis and treatment of loiasis in China. Methods: The study targeted travelers who were infected with L. loa in endemic Africa regions and returned to Beijing between 2014 and 2023. Epidemiological, clinical, and biological data as well as treatment of these patients were collected. Results: Total 21 cases were identified as L. loa infection based on their typical clinical manifestations and parasite finding. All cases had a history of travel to Africa for more than 6 months, most of them are the construction workers dispatched to West Africa with outdoor activities. Calabar swelling (n = 19; 90.5%) and pruritus (n = 11; 52.4%) were among the most common clinical symptoms followed by muscle pain (n = 7; 33.3%) and skin rash (n = 2; 9.5%). The adult worms were observed in the eyelid or subconjunctiva (n = 2; 9.5%) and subcutaneous tissues (n = 2; 9.5%). Although all patients presented with a high eosinophil count (> 0.52 × 109/L), only two cases displayed microfilariae in fresh venous blood and positive for filarial antigen. A cut section of adult worm was observed through biopsy on a skin nodule surrounded by lymphocytes, plasma cells and eosinophils. All subjects were positive in PCR targeting L. loa ITS-1. The constructed phylogenetic tree based on the amplified ITS-1 sequences identified their genetical relation to the L. Loa from Africa. All patients treated with albendazole and diethylcarbamazine were recovered without relapse. Conclusion: This study provides useful information and guideline for physicians and researchers in non-endemic countries to diagnose and treat loiasis and L. loa infections acquired from endemic regions. [ABSTRACT FROM AUTHOR]

HIV can be successfully suppressed to undetectable levels by antiretroviral therapy (ART) in most people with HIV (PWH). However, a small proportion continues to have persistent low-level viremia (LLV) during ART. A presumed source of LLV is production or replication from viral reservoirs, which are maintained in the presence of ART. It is unknown whether the oral cavity can be considered an HIV reservoir. As periodontal inflammation is a common problem in PWH, we hypothesize that periodontal inflammation in the oral cavity activates (latently) infected cells and thus might be associated with LLV. We included 11 individuals with HIV LLV, and compared HIV-RNA levels in saliva and plasma at baseline and at week 24 after switch of ART. We compared the LLV-group at baseline with 11 age-matched controls with suppressed viremia. To investigate the severity of periodontitis we used Periodontal Inflamed Surface Areas (PISA) by measuring probing depth, gingival recession, bleeding on probing and clinical attachment level. Severity of periodontitis was classified according to the CDC-AAP case definition. Additional insights in periodontal inflammation were obtained by comparing immune activation markers and the presence of periodontal pathogens. In four individuals of the LLV group, residual levels of HIV-RNA were detected in saliva at baseline (N = 1) or at week 24 (N = 2) or both (N = 1). Of the four individuals with LLV, three had residual levels of HIV-RNA in saliva. All 22 individuals had moderate to severe periodontitis. PISA was not significantly different between cases with LLV and controls. Similarly, periodontal pathogens were frequently observed in both groups. Total activated HLA-DR+CD38+ CD4+ cells and CD8+ cells were significantly higher in the LLV group than in the control group (p = <0.01). No immune markers were associated with LLV. In conclusion, periodontal inflammation is an unlikely driver of HIV LLV compared to HIV suppressed individuals. [ABSTRACT FROM AUTHOR]

Eighteen patients with symptomatic HIV disease were enrolled into a phase I/II study of a microsphere formulation of the HIV protease inhibitor KNI-272, with doses escalated up to a maximum dose of 60 mg/kg/day. One patient developed reversible elevation in hepatic transaminase. The plasma half-life of the drug was very short, varying between 0.25 and 1.1 h. No consistent effect on plasma HIV RNA levels or CD4(+) lymphocyte counts was seen.

HIV-1 is characterised by extensive genetic variability encompassing at least 10 different phylogenetically related clades within the major group of HIV-1 subtypes. Most commercially available HIV-1 RNA plasma viral load assays have been optimised with clade B viruses and may yield misleadingly low RNA levels for nonclade B viruses that are increasingly found in Europe. In this study we compare the most recent versions of the Roche Amplicor HIV Monitor and the Chiron Quantiplex for ability to detect viraemia in a population of patients infected with a range of HIV-1 subtypes. EDTA-treated plasma was obtained from 206 patients. The Amplicor and Quantiplex assays were carried out in accordance with manufacturers' instructions. Results from 53/206 (25.7%) samples differed by >0.4 log between Amplicor 1.5 and Quantiplex 3.0. A >0.5 log and 1.0 log difference was detected between Amplicor 1.5 and Quantiplex 3.0 in 37/206 (17.9%) and 7/206 (3.4%) of samples, respectively. Overall, Amplicor 1.5 gave a median value of 0.22 log higher than Quantiplex 3.0. Discordant results were detected in 53 out of 206 (25.7%) samples. Of these 22 out of 123 (17.9%) samples were of UK origin, 18 out of 43 (41.9%) African, 1 out of 8 (12.5%) South American, 1 out of 6 (16.7%) North American, 4 out of 9 (44.4%) North European, 3 out of 11 (23.7%) South European and 3 out of 7 (42.3%) Asian samples, respectively. Serotyping revealed that discordant viral load results between Amplicor 1.5 and Quantiplex 3.0 occurred within samples from all subtypes (A-E). Despite the improvements made to both the Roche Amplicor and the Chiron Quantiplex assays discordant results were detected between the two assays in 25.7% of cases. In a substantial minority of patients there were major discrepancies between the two assays that were not explained by HIV subtype differences., (Copyright 2000 Wiley-Liss, Inc.)

Thirteen protease inhibitor-naive patients with HIV-1 infection, and 12 patients with a median of 58 months prior treatment with saquinavir (SQV) monotherapy, were treated with SQV (400 mg twice daily) and ritonavir (RIT, 500 mg twice daily) in a study designed to assess the effect of prior treatment with SQV monotherapy on the antiretroviral activity of RIT-SQV combination therapy. Median baseline viral load and CD4+ cell counts were 155,000 and 262,000 copies/ml and 333 and 225 cells/mm3 in the naive and experienced groups, respectively. Mean viral load changes at 24 weeks were -1.63 and -0.27 log copies/ml in the naive and SQV-experienced groups, respectively (intent-to-treat analysis). Baseline genotype by point mutation assay and sequencing in the SQV-experienced group was highly predictive of virological response. Eight of 11 SQV-experienced patients had evidence of phenotypic resistance to RIT at baseline, despite previous treatment with SQV only. There was strong correlation between phenotypic resistance to RIT and the presence of the L90M mutation. We conclude that prolonged prior treatment with saquinavir monotherapy may produce cross-resistance to ritonavir and reduce the subsequent response to ritonavir-saquinavir in combination. In this study, both phenotypic resistance to ritonavir and presence of the L90M mutation predicted the viral load response to ritonavir-saquinavir.

To assess differences between Africans and expatriates, we reviewed records of 100 patients with loiasis presenting to The Hospital for Tropical Diseases, London. Fifty-one were black Africans, and 49 were white expatriates. A history of Calabar swellings was more common amongst expatriates (P = 0.0001, OR 8.1), whilst eyeworm was reported more frequently in Africans (P = 0.0038, OR 4.2). Higher eosinophil levels (P < 0.0001) and filarial antibody levels, whether measured by immunofluorescence (P = 0.047) or ELISA (P < 0.0001) were present in the expatriates. Africans were more likely to have microfilaraemia (P < 0.0025, OR 7.3), and among microfilaraemic patients, Africans had denser microfilaraemia (P = 0.012). The sensitivity of microfilaremia as a screening test for loiasis was 75% in Africans and 29% in expatriates. The sensitivities of filarial antibody tests in Africans and expatriates were 81% and 100% for IFAT, and 28% and 93% for ELISA. Following treatment, 63% of patients were considered cured, 25% were lost to follow-up and 12% had a documented relapse. The differences between the two groups of patients could be caused by differences in the chronicity of loiasis, but other explanations are also discussed.

A retrospective review of all 248 liver biopsies performed in patients with HIV infection at two referral centres in London over a 12 year period revealed five cases of major bleeding following biopsy, with four deaths. The risk of major bleeding was 2.0%, and mortality was 1.6% following liver biopsy. The risk of bleeding as much higher than in published series of biopsies done in patients without HIV infection, owing in part to the high prevalence of thrombocytopaenia and clotting abnormalities in patients with HIV infection. HIV infection per se may also increase the risk of bleeding following liver biopsy.

Feigned HIV infection or acquired immunodeficiency syndrome (AIDS), in which people mimic infection with or disease due to HIV, accounted for 1.7% of admissions to our specialist HIV unit in Central London over a 5 year period. Of 12 patients with feigned HIV/AIDS, 11 were HIV antibody-negative, and one refused testing. Presenting histories were sometimes grandiose, unusually tragic, or unlikely in relation to the patients' healthy appearance, and often included admissions to other specialist HIV units. Substance abuse was suspected in over half of the patients described, a higher frequency than that observed in our HIV-infected patient population. The possibility of feigned HIV/AIDS should be remembered in persons with self-reported HIV infection. Recognition of this condition is important to avoid costly and potentially dangerous investigation and therapy.

A total of 48 adults were tested in 24 separate pairs either during the morning (10:00 A.M.) or evening (10:00 P.M.). One member of each pair was instructed to record (write) impressions and descriptions of 8 different art pieces (5 min. each). At the same time the other member of the pair sat in a comfortable chair within an acoustic chamber in another room and wrote an ongoing narrative. The evaluation and activity dimensions of the words that composed the narratives were scored by the Whissell Dictionary of Affect in Language. The increased global geomagnetic activity two days before the experiments was significantly associated (rhos about 0.60) with the use of more unpleasant words for people who sat in the quiet chamber only. Implications for the hypothesis of affective concordance between emotionally bonded human beings and its role in episodes of potentially veridical telepathic experiences are discussed.

Objective: To describe the association between acute choreoathetosis/ballismus and hypoglycemia related to pentamidine therapy in a patient with the acquired immunodeficiency syndrome., Design: A single case report., Measures: Clinical observation, laboratory analysis of blood and cerebrospinal fluid, and magnetic resonance imaging of brain., Results: No association was found apart from hypoglycemia. The abnormal movements and hypoglycemia did not recur following cessation of pentamidine., Conclusions: Hypoglycemia related to pentamidine therapy can cause neurologic disorders in patients with the acquired immunodeficiency syndrome.

Large numbers of people return to the UK each year (estimated at 2 million in 1990) from tropical areas where they may have been exposed to a variety of tropical infections. Some will seek medical help because of specific symptoms, whilst others who are asymptomatic will request screening investigations to reveal latent infections which might give rise to symptoms later in life. A third group will ask for help with retrospective diagnosis of illnesses suffered whilst abroad. People from all three groups may express concern about the risk of passing on infections to close contacts or may be worried about their fitness to return to the tropics. The precise value of screening for tropical illness is hard to quantify, as the chance of finding an important treatable illness in any one individual will depend on the level of risk of infection to which that individual has been exposed. In some groups of travellers such as refugees, screening is clearly worthwhile, whilst in others whose risk of serious infection is low, the benefit is likely to be small. Nevertheless a demand for screening after tropical travel exists, and it is important to be aware of how to investigate for asymptomatic disease in returned travellers who request screening.

Introduction: The board games is an educational technology that represents an appealing, active and playful pedagogical strategy and may be capable of motivating imprisoned women to learn about Sexually Transmitted Infections. Methods: A methodological study to develop and evaluate a board game, following these stages: 1. Integrative literature review to identify educational technologies on Sexually Transmitted Infections used by imprisoned women; 2. Development of the board game; and 3. Content validation performed by 23 evaluators and semantic evaluation carried out with 10 imprisoned women who were enrolled in a school located within a female prison unit in the city of Recife, state of Pernambuco, Brazil. Results: The board game consisted of the following: 01 board; 01 instructions manual; 05 pawns; 52 cards; and 01 dice. A global Content Validity Index of 0.966 was reached in the content validation process performed by health and education professionals. In the validation of the board game content regarding appearance, performed by designers/developers, most of the items obtained a Content Validity Coefficient below 0.85, which resulted in the need for adjustments and a new validation round with these professionals, in which Content Validity Coefficient = 0.917 was obtained. In the semantic evaluation, all the women stated that they improved their knowledge, increased their motivation to attend the class and would like to play the board game again. Conclusions: The "Previna" board game has been validated and can be considered an important pedagogical tool in the construction of knowledge in relation to the prevention, treatment and control of Sexually Transmitted Infections in the female prison context. The quality of this educational technology is directly related to its development based on an appropriate theoretical and methodological framework, in addition to satisfactory feedback from the target audience. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

The article provides guidelines on managing opportunistic infections in individuals living with HIV, focusing on the clinical investigation and management of pyrexia of unknown origin (PUO) in the context of contemporary antiretroviral therapy. Topics include causes and evaluation of PUO in people with lower CD4 counts, essential clinical evaluations and investigations, and recommendations fo diagnostic procedures such as 18F-fluorodeoxyglucose PET-CT, bone marrow examination, and liver biopsy.