Public-health and individual approaches to antiretroviral therapy: township South Africa and Switzerland compared

BACKGROUND: The provision of highly active antiretroviral therapy (HAART) in resource-limited settings follows a public health approach, which is characterised by a limited number of regimens and the standardisation of clinical and laboratory monitoring. In industrialized countries doctors prescribe from the full range of available antiretroviral drugs, supported by resistance testing and frequent laboratory monitoring. We compared virologic response, changes to first-line regimens, and mortality in HIV-infected patients starting HAART in South Africa and Switzerland. METHODS AND FINDINGS: We analysed data from the Swiss HIV Cohort Study and two HAART programmes in townships of Cape Town, South Africa. We included treatment-naïve patients aged 16 y or older who had started treatment with at least three drugs since 2001, and excluded intravenous drug users. Data from a total of 2,348 patients from South Africa and 1,016 patients from the Swiss HIV Cohort Study were analysed. Median baseline CD4+ T cell counts were 80 cells/mul in South Africa and 204 cells/mul in Switzerland. In South Africa, patients started with one of four first-line regimens, which was subsequently changed in 514 patients (22%). In Switzerland, 36 first-line regimens were used initially, and these were changed in 539 patients (53%). In most patients HIV-1 RNA was suppressed to 500 copies/ml or less within one year: 96% (95% confidence interval [CI] 95%-97%) in South Africa and 96% (94%-97%) in Switzerland, and 26% (22%-29%) and 27% (24%-31%), respectively, developed viral rebound within two years. Mortality was higher in South Africa than in Switzerland during the first months of HAART: adjusted hazard ratios were 5.90 (95% CI 1.81-19.2) during months 1-3 and 1.77 (0.90-3.50) during months 4-24. CONCLUSIONS: Compared to the highly individualised approach in Switzerland, programmatic HAART in South Africa resulted in similar virologic outcomes, with relatively few changes to initial regimens. Further innovation and resources are required in South Africa to both achieve more timely access to HAART and improve the prognosis of patients who start HAART with advanced disease.

The cyclotron production and nuclear imaging of bromine-77

In this investigation, bromine-77 was produced with a medical cyclotron and imaged with gamma cameras. Br-77 emits a 240 kev photon with a half life of 56 hours. The C-Br bond is stronger than the C-I bond and bromine is not collected in the thyroid. Bromine can be used to label many organic molecules by methods analogous to radioiodination. The only North American source of Br-77 in the 70's and 80's was Los Alamos National Laboratory, but it discontinued production in 1989. In this method, a p,3n reaction on Br-77 produces Kr-77 which decays with a 1.2 hour half life to Br-77. A cyclotron generated 40 MeV proton beam is incident on a nearly saturated NaBr or LiBr solution contained in a copper or titanium target. A cooling chamber through which helium gas is flowed separates the solution from the cyclotron beam line. Helium gas is also flowed through the solution to extract Kr-77 gas. The mixture flows through a nitrogen trap where Kr-77 freezes and is allowed to decay to Br-77. Eight production runs were performed, three with a copper target and five with a titanium target with yields of 40, 104, 180, 679, 1080, 685, 762 and 118 uCi respectively. Gamma ray spectroscopy has shown the product to be very pure, however corrosion has been a major obstacle, causing the premature retirement of the copper target. Phantom and in-vivo rat nuclear images, and an autoradiograph in a rat are presented. The quality of the nuclear scans is reasonable and the autoradiograph reveals high isotope uptake in the renal parenchyma, a more moderate but uniform uptake in pulmonary and hepatic tissue, and low soft tissue uptake. There is no isotope uptake in the brain or the gastric mucosa. ^

Offener Brief an A. Adler, Mitglied der Br. Rabbiner-Versammlung : als Antw. auf sein Sendschreiben an die 77 "sogenannten Rabbiner, die durch Verdächtigung d. Verläumdung zu gewinnen wären"

von ... [Raphael] K[irchhei]m

Ms. hebr. oct. 77 - Perush ha-Talmud min Masekhet Ḳ̣idushin

Vorbesitzer: Eljāqīm Carmoly; Abraham Merzbacher

Ms. Barth. 77 - De laudibus beatae Mariae virginis libri XII

Vorbesitzer: Dominikanerkloster Frankfurt am Main; Bartholomaeusstift Frankfurt am Main

Denkschrift gerichtet an Eine hohe National-Versammlung über die Gesetzes-Vorlagen No. 77, wegen Einführung und Erhöhung der Grundsteuer und über No. 57, wegen Erhöhung der Rübenzucker- und Maischsteuer

Boberach: Eine allgemeine Einkommen- und Vermögenssteuer soll anstelle der von der Regierung beabsichtigten Erhöhung der Grundsteuer aufgrund neuer Kataster und Abschaffung von Grundsteuerbefreiungen eingeführt, das gesamte Steuersystem gründlich überprüft werden. Die Fabrikation von Alkohol aus Kartoffeln darf nicht mit der Maischsteuer gefährdet werden. In der Anlage: Durchschnittliche Tagesbetriebskosten einer größeren preußischen Branntweinbrennerei

Identification of two Th1 cell epitopes on the Babesia bovis-encoded 77-kilodalton merozoite protein (Bb-1) by use of truncated recombinant fusion proteins

Previous studies have demonstrated the serologic and T-cell immunogenicity for cattle of a recombinant form of the apical complex-associated 77-kDa merozite protein of Babesia bovis, designated Bb-1. The present study characterizes the immunogenic epitopes of the Bb-1 protein. A series of recombinant truncated fusion proteins spanning the majority of the Bb-1 protein were expressed in Escherichia coli, and their reactivities with bovine peripheral blood mononuclear cells and T-cell clones derived from B. bovis-immune cattle and with rabbit antibodies were determined. Lymphocytes from two immune cattle were preferentially stimulated by the N-terminal half of the Bb-1 protein (amino acids 23 to 266, termed Bb-1A), localizing the T-cell epitopes to the Bb-1A portion of the molecule. CD4+ T-cell clones derived by stimulation with the intact Bb-1 fusion protein were used to identify two T-cell epitopes in the Bb-1A protein, consisting of amino acids SVVLLSAFSGN VWANEAEVSQVVK and FSDVDKTKSTEKT (residues 23 to 46 and 82 to 94). In contrast, rabbit antiserum raised against the intact fusion protein reacted only with the C-terminal half of the protein (amino acids 267 to 499, termed Bb-1B), which contained 28 tandem repeats of the tetrapeptide PAEK or PAET. Biological assays and Northern (RNA) blot analyses for cytokines revealed that following activation with concanavalin A, T-cell clones reactive against the two Bb-1A epitopes produced interleukin-2, gamma interferon, and tumor necrosis factors beta and alpha, but not interleukin-4, suggesting that the Bb-1 antigen preferentially stimulates the Th1 subset of CD4+ T cells in cattle. The studies described here report for the first time the characterization, by cytokine production, of the Th1 subset of bovine T cells and show that, as in mice, protozoal antigens can induce Th1 cells in ruminants. This first demonstration of B. bovis-encoded Th1 cell epitopes provides a rationale for incorporation of all or part of the Bb-1 protein into a recombinant vaccine.

Die Rechtsstellung der Reichspensionäre : (Artikel 33 (5), 3, 14, 19, 123 (1), 131, 134 Grundgesetz. § 77 des Gesetzes zu Art. 131 GG vom 11.5.51)

George Tzschirner

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 77 - Antwort auf die Briefe vom 18. Juni und 15. Juli 1800

u.a.: Deutschlandreise; Empfehlung eines Theaterstücks von Molière;

Na 1 Nachlass Max Horkheimer, 77 - Korrespondenzen u.a. mit Siegfried Kander (p. II 9, 223-402)

31 Briefe zwischen Siegfried Kander und Max Horkheimer, 1941-1949; 2 Briefe zwischen Harold H. Shaper und Max Horkheimer, 1945 siehe auch Siegfried Kander; 2 Briefe und Beilagen zwischen H. M. Kallen und Max Horkheimer, 1944; 17 Briefe und Beilage zwischen Erika Kickton und Max Horkheimer, 1946-1949; 9 Briefe zwischen Christa Kerti und Max Horkheimer, 1948-1949; 25 Briefe zwischen Else Klee-Hausmann und Max Horkheimer, 1947-1949; 18 Briefe und Beilage zwischen Philip Klein von The New York School of Social Work, American Jewish Committee und Max Horkheimer, 1944-1947; 2 Briefe zwischen Otto Klineberg und Max Horkheimer, 1949;

Ms. Praed. 77 - Postilla cum sermonibus dominicalibus

Vorbesitzer: Dominikanerkloster Frankfurt am Main;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 539 - Konzeptschreiben für den Kapellmeister der Frankfurter Oper Carl Wilhelm Ferdinand Guhr mit enthaltener Beschwerde über die schlechten Zustände in der Frankfurter Oper

veröffentlicht in: Arthur Hübscher (Hrsg), Arthur Schopenhauer Gesammelte Briefe, Bonn 1978, Nr.203