In vitro susceptibility characteristics of Cryptococcus neoformans varieties from AIDS patients in Goiânia, Brazil

Sixty clinical isolates of Cryptococcus neoformans from AIDS from Goiânia, state of Goiás, Brazil, were characterized according to varieties, serotypes and tested for antifungal susceptibility. To differentiate the two varieties was used L-canavanine-glycine-bromothymol blue medium and to separate the serotypes was used slide agglutination test with Crypto Check Iatron. The Minimal Inhibitory Concentration (MIC) of fluconazole, itraconazole, and amphotericin B were determined by the National Committee for Clinical Laboratory Standards macrodilution method. Our results identified 56 isolates as C. neoformans var. neoformans serotype A and 4 isolates as C. neoformans var. gattii serotype B. MIC values for C. neoformans var. gattii were higher than C. neoformans var. neoformans. We verified that none isolate was resistant to itraconazole and to amphotericin B, but one C. neoformans var. neoformans and three C. neoformans var. gattii isolates were resistant to fluconazole. The presence of C. neoformans var. gattii fluconazole resistant indicates the importance of determining not only the variety of C. neoformans infecting the patients but also measuring the MIC of the isolate in order to properly orient treatment.

Cellular immune responses and disease control in acute AIDS-associated Kaposi's sarcoma.

Kaposi's sarcoma-associated herpesvirus (KSHV) specific T cell responses and KSHV viremia were analyzed in seven HIV-infected patients with active Kaposi's sarcoma lesions who initiated highly active antiretroviral therapy, and were compared between patients with improved Kaposi's sarcoma and those with progressive Kaposi's sarcoma requiring further systemic chemotherapy. Patients with controlled Kaposi's sarcoma disease demonstrated undetectable Kaposi's sarcoma viremia together with KSHV-specific CD8 T cells secreting interferon-gamma and tumor necrosis factor-alpha, whereas progressors showed increasing viremia with weak or no T-cell responses. These data point toward a potential role of KSHV-specific immunity in the control of AIDS-associated Kaposi's sarcoma.

Fidelidad al modelo especificado en el código generado automáticamente por la herramienta CASE Poseidon for UML

L'objectiu principal d'aquest treball és estudiar el grau de fidelitat al model especificat que manté el codi generat automàticament per l'eina CASE Poseidon Professional for UML. Concretament, estudiarem el codi que es genera en Java i SQL mitjançant un diagrama de classes determinat.

Improvement of the HIV/AIDS vaccine candidate NYVAC-C by deletion of the viral type I IFN inhibitor and/or acquisition of replication competence

Background: Recombinant viruses based on the attenuated vaccinia virus strain NYVAC are promising HIV vaccine candidates as phase I/II clinical trials have shown good safety and immunogenicity profiles. However, this NYVAC strain is non-replicating in most human cell lines and encodes viral inhibitors of the immune system. Methods: With the aim to increase the immune potency of the current NYVAC-C vector (expressing the codon optimized clade C HIV-1 genes encoding gp120 and Gag-Pol-Nef polyprotein), we have generated and characterized three NYVAC-C-based vectors by, 1) deletion of the viral type I IFN inhibitor gene (NYVAC-CdeltaB19R), 2) restoration of virus replication competence in human cells by re-inserting K1L and C7L host range genes (NYVAC-C-KC) and, 3) combination of both strategies (NYVACC- KC-deltaB19R). Results: Insertion of the KC fragment restored the replication competence of the viruses in human cells (HeLa cells and primary dermal fibroblasts and keratinocytes), increased the expression of HIV antigens by more than 3-fold compared to the non-replicating homologs, inhibited apoptosis induced by the parental NYVAC-C and retained attenuation in a newborn mouse model. In adult mice, replication-competent viruses showed a limited capacity to replicate in tissues surrounding the inoculation site (ovaries and lymph nodes). After infection of keratinocytes, PBMCs and dendritic cells these viruses induced differential modulation in specific host cell signal transduction pathways, triggering genes important in immune modulation. Conclusion: We have developed improved NYVAC-C-based vectors with enhanced HIV-1 antigen expression, with the ability to replicate in cultured human cells and partially in some tissues, with an induced expression of cellular genes relevant to immune system activation, and which trigger IFN-dependent and independent signalling pathways, while maintaining a safety phenotype. These new vectors are promising new HIV vaccine candidates. These studies were performed within the Poxvirus Tcell Vaccine Discovery Consortium (PTVDC) which is part of the CAVD program.

A Study of the Epidemiology of AIDS in Ireland and an Evaluation of an AIDS Education Programme in Second-level Schools

Second-level school students have been identified by the Minister for health as a priority group for education on AIDS. An education programme was accordingly initiated in 1988 in Community Care Area 1 in South county Dublin. This report evaluates this education intervention by means of pre- and post- intervention questionnaires. The questionnaire examined knowledge and attitudes of students relevant to AIDS. The results showed that the level of knowledge of students living in this area was high prior to intervention. The education programme succeeded in improving some aspects of knowledge and also influenced some attitudes of the students. A study of the epidemiology of Aids in Ireland reveals that the epidemic is at a relatively early stage with a consequent rapid doubling time of 9-10 months. In comparison with most developed countries Ireland has a high proportion of AIDS cases occurring among intravenous drug abusers and directly related to this a high number of HIV infected children. Examination of the literature reveals that behaviour change has occurred most noticeably among the homosexual/bisexual risk group. There is some evidence that the comprehensive programmes can achieve change in the behaviour of intravenous drug abusers. There are very few reports linking behaviour change among adolescents and young adults to education programmes. Much of the available literature relates to changes in knowledge and attitudes. International recommendations on the nature of the ideal health education intervention on AIDS are reviewed. The importance of a comprehensive health education programme which incorporates AIDS education and which commences early in youth is noted. The role of the community physician in relation to education programmes and other aspects of monitoring and management of the AIDS epidemic is discussed.This resource was contributed by The National Documentation Centre on Drug Use.

A Survey of Health Service Utilisation and Health Needs of a Population of Patient with HIV/ AIDS

This study described the demographic and medical characteristics of a population of patients with HIV/AIDS attending the department of Genito-Urinary Medicine (GUM) at a major Dublin hospital. The study population's utilisation of statutory and voluntary medical and social services at primary care level, satisfaction with services received and perceived need for services examined. The information obtained was used to make recommendations concerning the provision of care to patients with HIV/AIDS. The study was carried out between February and November 1994. Data was collected from a consecutive sample of eighty inpatients using n interviewer-administered questionnaire which contained both closed and open questions. The first forty patients interviewed were reviewed six months following the initial interview to document changes in physical condition and uptake of medical services over that time period. Data for the second part of the study was obtained by review of the patients' medical case notes and interview with the individual hospital medical social worker assigned to each patient. Over ninety percent of respondents were from the Greater Dublin Area. Almost three quarters were intravenous drug users (IVDUs), and the majority of these patients came from south inner city Dublin. The methodology was biased towards sampling patients with advanced disease and 73% had CDC Stage 4 disease. Twenty percent required some assistance with the activities of daily living when first interviewed. Most were reliant on informal carers. Social and physical dependency increased substantially over the six month period of the follow-up study of forty patients. Financial difficulties were identified as a particular area of need. Only ten percent of those interviewed were in current employment and over 80% were dependent on statutory payments. There is a need for greater co-ordination between the providers of services to patients HIV/AIDS and an improved system of data collection regarding patients' uptake of services and unmet needs is required to assist in future service planning.This resource was contributed by The National Documentation Centre on Drug Use.

HIV & AIDS education and prevention plan 2008-2012. Mid-term review.

In 2008 a 4-year plan for HIV and AIDS Education and Prevention in Ireland was published. The plan aimed to contribute to a reduction in new infections of HIV and AIDS through education and prevention measures. It also aimed to guide and inform the development of policy and services in the statutory and non-statutory sectors with responsibility in this regard. This report is produced as a response to a letter from the Secretariat of the National AIDS Strategy Committee (NASC). The letter requested “feedback from the Education and Prevention Sub-Committee on prevention activities currently in place and on progress to date on the Education and Prevention Action Plan (2008-2012).” In addition, action 2 under Action Area 5: Monitoring and evaluation states that “a mid-term review of the implementation of this action plan should be published”. We note from the HPSC data that there has been a slight decrease in the overall number of new HIV infections however; there has been a huge concern over the large increase in new diagnoses in men who have sex with men (MSM). Although we cannot provide the evidence for the reason for this increase, it is stipulated that there has been a huge increase in the education and prevention programmes targeted at MSM and the report will show the evidence of that increase (Action Area 3: Preventing new infections: population group MSM). There is a presumption that because of increased awareness, access and confidence of MSM and improved treatment that there are more MSM being tested and more diagnoses. This report presents an update on the progress of the implementation of the actions in the HIV and AIDS Education and Prevention Plan 2008-2012.This resource was contributed by The National Documentation Centre on Drug Use.

Implementación y entrenamiento de un modelo clasificatorio de red neural sobre la base de datos IGBADAT para la clasificación de las rocas basálticas de acuerdo a las clases del sistema de clasificación tradicional de Yoder and Tiller.

Aquest treball vol implementar un projecte de mineria de dades en l'àrea de la petrologia ígnia, especialitat englobada dins la geologia clàssica.

Estudio del modelo de representación XML/RDF

Aquest estudi té com a objectiu introduir el lector en dues tecnologies complementàries, XML i RDF. L'estudi mostra els inicis dels llenguatges de marcatge i explica perquè van ser concebuts.

Histopathological study of Schistosoma mansoni infection in the murine model using the PC (Pará) and LILA (Maranhão) strains

Experimental models of Schistosoma mansoni infections in mammals have contributed greatly in understanding the pathology and pathogenesis of human infection. The absence of earlier reviews regarding specific strains of the Amazon region prompted research, which the main objective was to describe histopathological lesions in different phases of schistosomiasis in a murine model using PC (Pará) and LILA (Maranhão) S. mansoni strains. One hundred and eighty young female albino swiss mice (Mus musculus) were used and were randomly divided into five groups (PC-01, PC-02, LILA-01, LILA-02, and controls), according to the number of cercariae injected and the strain adopted. Animals were sacrificed in predetermined periods (35, 56, 112, 156, and 180 days) in an attempt to follow the evolution of the disease in the histological sections of their tissues at different phases of infection. Our findings were compatible with the data already described by others authors using different strains of S. mansoni, making it possible to identify some peculiarities, which are discussed in this work. In conclusion, the strains of parasite used did not modify the histopathological findings in the tissues of infected mice in any significant way when compared with the results of other studies using different strains.

Molecular diversity of serial Cryptococcus neoformans isolates from AIDS patients in the city of São Paulo, Brazil

Despite highly active anti-retroviral therapy, cryptococcal meningoencephalitis is the second most prevalent neurological disease in Brazilian AIDS patients, being frequently a defining condition with several episodes. As knowledge of Cryptococcus neoformans isolates in the same episode is critical for understanding why some patients develop several episodes, we investigated the genotype characteristics of C. neoformans isolates in two different situations. By pulsed field gel electrophoresis and random amplifield polymorphic DNA analysis, 54 isolates from 12 patients with AIDS and cryptococcosis were analyzed. Group 1 comprised 39 isolates from nine patients with a single episode and hospitalization. Group 2 comprised 15 isolates from three patients with two episodes and hospitalizations. Except for three patients from group 1 probably infected with a single C. neoformans isolate, the other nine patients probably were infected with multiple isolates selected in different collection periods, or the infecting isolate might have underwent mutation to adapt and survive the host immune system and/or the antifungal therapy. However, the three patients from group 2 presented genetic diversity among isolates collected in both hospitalizations, possibly having hosted the initial isolate in both periods. These data, emphasize that Cryptococcus diversity in infection can contribute to strategies of treatment and prevention of cryptococcosis.

A deterministic model to assess the impact of AIDS interventions in countries with generalized HIV epidemic. An application to Botswana

General introductionThe Human Immunodeficiency/Acquired Immunodeficiency Syndrome (HIV/AIDS) epidemic, despite recent encouraging announcements by the World Health Organization (WHO) is still today one of the world's major health care challenges.The present work lies in the field of health care management, in particular, we aim to evaluate the behavioural and non-behavioural interventions against HIV/AIDS in developing countries through a deterministic simulation model, both in human and economic terms. We will focus on assessing the effectiveness of the antiretroviral therapies (ART) in heterosexual populations living in lesser developed countries where the epidemic has generalized (formerly defined by the WHO as type II countries). The model is calibrated using Botswana as a case study, however our model can be adapted to other countries with similar transmission dynamics.The first part of this thesis consists of reviewing the main mathematical concepts describing the transmission of infectious agents in general but with a focus on human immunodeficiency virus (HIV) transmission. We also review deterministic models assessing HIV interventions with a focus on models aimed at African countries. This review helps us to recognize the need for a generic model and allows us to define a typical structure of such a generic deterministic model.The second part describes the main feed-back loops underlying the dynamics of HIV transmission. These loops represent the foundation of our model. This part also provides a detailed description of the model, including the various infected and non-infected population groups, the type of sexual relationships, the infection matrices, important factors impacting HIV transmission such as condom use, other sexually transmitted diseases (STD) and male circumcision. We also included in the model a dynamic life expectancy calculator which, to our knowledge, is a unique feature allowing more realistic cost-efficiency calculations. Various intervention scenarios are evaluated using the model, each of them including ART in combination with other interventions, namely: circumcision, campaigns aimed at behavioral change (Abstain, Be faithful or use Condoms also named ABC campaigns), and treatment of other STD. A cost efficiency analysis (CEA) is performed for each scenario. The CEA consists of measuring the cost per disability-adjusted life year (DALY) averted. This part also describes the model calibration and validation, including a sensitivity analysis.The third part reports the results and discusses the model limitations. In particular, we argue that the combination of ART and ABC campaigns and ART and treatment of other STDs are the most cost-efficient interventions through 2020. The main model limitations include modeling the complexity of sexual relationships, omission of international migration and ignoring variability in infectiousness according to the AIDS stage.The fourth part reviews the major contributions of the thesis and discusses model generalizability and flexibility. Finally, we conclude that by selecting the adequate interventions mix, policy makers can significantly reduce the adult prevalence in Botswana in the coming twenty years providing the country and its donors can bear the cost involved.Part I: Context and literature reviewIn this section, after a brief introduction to the general literature we focus in section two on the key mathematical concepts describing the transmission of infectious agents in general with a focus on HIV transmission. Section three provides a description of HIV policy models, with a focus on deterministic models. This leads us in section four to envision the need for a generic deterministic HIV policy model and briefly describe the structure of such a generic model applicable to countries with generalized HIV/AIDS epidemic, also defined as pattern II countries by the WHO.

El impacto de las TIC en la empresa turística : el caso de Cataluña

En aquest article s'aporten proves de l'impacte positiu que té l'aplicació de les tecnologies de la informació i la comunicació (TIC) en l'empresa turística catalana. La transcendència que en els darrers anys ha adquirit el mercat turístic català en el context europeu el converteix en un laboratori d'anàlisi idoni per al sector. Els resultats obtinguts posen de manifest que l'ús d'aquestes tecnologies s'acompanya d'un major grau d'internacionalització de l'empresa, el desenvolupament de canvis organitzatius i la implantació de noves estratègies competitives, cosa que dóna lloc a un model de negoci allunyat de les concepcions tradicionals del sector. A més, l'ús estratègic de les TIC afavoreix l'ús de mà d'obra més qualificada, un servei més personalitzat i una major proximitat a proveïdors i distribuïdors. Tanmateix, és en el procés d'innovació empresarial on l'impacte positiu de les TIC és percep més, atès que el seu ús ha contribuït a superar alguns dels obstacles existents, a interioritzar el procés en el si de l'empresa i a fer més partícips els mateixos treballadors, i això ha donat com a resultat una àmplia diversitat d'innovacions de tota mena (de producte, de procés i organitzatives). La participació en xarxes de cooperació, el fet de tenir treballadors amb un nivell educatiu elevat i l'aplicació intensiva de les TIC han estat elements indispensables en aquest procés innovador. Finalment, gràcies a l'ús de les TIC i el seu impacte en la innovació, però també al canvi organitzatiu dins l'empresa, s'han millorat els registres de productivitat, amb la qual cosa s'afavoreix una major competitivitat en un context canviant i de forta pressió de l'entorn.