NO metabolites and nNOS immunoreactive neurons innervating the lo

NO metabolites and nNOS immunoreactive neurons innervating the lower lip were also increased in the TG. Intra-TG administration of nNOS substrate induced the mechanical allodynia. The present findings suggest that NO released from TG neurons regulates the excitability of TG neurons innervating the whisker pad skin, and the enhancement of TG neuronal excitability may underlie ectopic mechanical allodynia.”
“Objective: The excision of laryngeal papillomas poses a great challenge for both LY2874455 the anesthesiologist and the surgeon. The narrowness of the airways and the great variability of the pathological lesions necessitate close collaboration between the surgical and anesthesia

teams to provide optimal operating conditions and ensure adequate ventilation and oxygenation. Our aim was to explore perioperative anesthesia management in pediatric patients during the excision of laryngeal

papillomas with a suspension laryngoscope.

Methods: Fifty-eight pediatric patients suffering from laryngeal papillomas were included in this retrospective study. These patients had degrees of laryngeal obstruction from I to III and underwent suspension laryngoscopic surgery to excise laryngeal papillomas between January 2007 and December 2010. The American Society of Anesthesiologists (ASA) physical status of the patients ranged from I to III. Anesthesia was induced by intravenous administration. Once the child was unconscious, a 2% lidocaine aerosol solution was sprayed over the laryngeal area directly under the laryngoscope. For patients to tolerate suspension VE821 laryngoscopy, it is necessary to maintain spontaneous breathing and ensure adequate anesthesia depth. The airway was secured, and sufficient ventilation was established throughout a tracheal tube (ID 2.5 or A 1331852 3.0) which was placed close to glottis and connected to Jackson Rees system. Hemodynamic parameters and pulse oxygen saturation (SpO(2)) were closely monitored, and adverse events were recorded.

Results: Most of the patients 89% (52/58) were hemodynamically stable during

the perioperative period. Laryngospasm and laryngeal edema occurred in several children during emergence from the anesthesia. Tracheal intubations were performed in six patients (10.3%). Tracheotomies were performed in two patients. One patient had to be sent to the ICU for comprehensive therapy.

Conclusion: The most important consideration for anesthesia during suspension laryngoscopy is (1) the maintenance of adequate ventilation, (2) to permit surgical exposure, and (3) to maintain suitable depth of anesthesia which relaxes the vocal band, avoids laryngeal spasms (reflex closure), reduces cardiovascular reaction and wakes up quickly after operation. Any factors that aggravate laryngeal obstruction and dyspnea should be avoided. (C) 2011 Elsevier Ireland Ltd. All rights reserved.”
“For overproduction of recombinant proteins both eukaryotic and prokaryotic expression systems are used.

Methods: Solvent casting method was used to prepare

patch

Methods: Solvent casting method was used to prepare

patches using polymethyl methacrylate (PMMA) and Eudragit E100 (EE100) polymers, dimethylsulfoxide (DMSO) penetration enhancer, dibutylphthalate (DBP) plasticizer and Tween 80 surfactant. A 2(3) factorial design was used based on three variables (PMMA, EE100, DMSO). at two levels Second order polynomial equations indicating interplay of ingredients were obtained by factorial design using SigmaTech software for 1, 4, 8 and 20 h release data. so the design was extended to central composite design (CCD). The target formulation was obtained from contour plots and evaluated for various physicochemical parameters. including in-vitro dissolution studies.

Results: Curvature effect was observed in F1 to buy ERK inhibitor F8 formulations, highlighting the interplay of ingredients. The interaction term (X2X3) see more exhibited highest Sum of Squares SS ratio at 1, 4, and 8 h data with positive coefficients indicating interaction; and so extended to CCD. From contour plots target formulation, F19, was identified

and evaluated. The release data, were subjected to kinetic analysis, which followed Higuchi (diffusion) model (R-2 = 0.9886).

Conclusion: F19 yielded release profile nearer to the theoretical predictions with R-2 of 0.9888 and followed Higuchi kinetics. Thus, a diffusion-mediated carvedilol matrix patch was successfully developed.”
“This study investigated the predictors of chronic valvular disease in children with rheumatic carditis. The short- to mid-term follow-up records of 88 patients (mean age, 10.68 +/- A 2.5 years) with chronic

rheumatic heart disease were reviewed. The mean follow-up period was 2.95 +/- A 1.4 years. Valvular involvement completely improved for 24 of the patients (27%) during the follow-up period. The multivariate logistic regression analysis found initial left ventricular dilation to be a significant independent risk factor associated with the persistence of either valvular involvement or mitral regurgitation. Furthermore, persistence of mitral regurgitation was found to be strongly correlated Volasertib ic50 with cardiac murmur at admission. No significant correlation was detected between age, gender, severity of valvular involvements at initial evaluation, and chronic valvular disease. The majority of patients with rheumatic carditis had normal left ventricular systolic function. However, a significant proportion of patients had left ventricular dilation, reported in the medical literature to be associated with the severity of valve involvement. This study found no relation between initial severity of valve involvements and chronic valvular disease. For this reason, increased left ventricular end-diastolic diameter may be secondary to myocardial involvement independent of valvular regurgitation. The findings in this study also suggest that subclinic carditis had a better outcome than clinically evident carditis.

At the beginning of leaf dehydration,

At the beginning of leaf dehydration,

EGFR phosphorylation moderate light accelerated the leaf water-loss rate and then lowered the maximal light-trapping efficiency of P-680. Upon further dehydration under moderate light or dehydration under high light, light accelerated the water-loss rate and also directly decreased the maximal light-trapping efficiency of P-680. The more significant decrease in the exchange capacity of plastoquinones at the Q(B) site was mainly attributed to the faster water-loss rate under moderate light than in the dark. Under high light, irradiation also directly lowered the capacity. The reoxidation of PQH(2) in the dehydrated leaves was enhanced by the light irradiation. The rapidly decreased contents of P-700 + plastocyanin were mainly attributed to the faster water-loss Target Selective Inhibitor Library rate under light conditions in contrast with that in the dark. The different effects of light irradiations on the photosynthetic electron transport chain might be involved in the acclimation of apple tree leaves to dehydration. (C) 2012 Elsevier Masson SAS. All rights reserved.”
“Ten Aureobasidium isolates were collected from bathroom surfaces in Thailand. They were identified as Aureobasidium pullulans. Cell extracts from all isolates were tested for antifungal activities against four selected Aspergillus species using a paper disc

diffusion and conidial germination inhibition assay. BM1, KT1, HKW1 and HKW2 extracts inhibited Aspergillus terreus, whereas KT1 and BM1 extracts also inhibited Aspergillus fumigatus. BM1 extract alone inhibited Aspergillus flavus. From TLC analysis, an antifungal compound with an identical Rf to that of aureobasidin A was found in all extracts. Antifungal tests of TLC-separated compounds

supported the paper disc diffusion and conidial germination inhibition assays.”
“The functional relevance of NOS3 and ACE genetic variations to endothelial cell function is largely unstudied. Here we tested the functional relevance of the NOS3 (Glu298Asp) polymorphism and ACE (I/D) polymorphism in endothelial cells in vitro. Our hypothesis was that these genetic polymorphisms alter endothelial cell sensitivity to glucose and 3-nitrotyrosine (3NT). Genotyped HUVECs were incubated with glucose, free 3NT or a combination of these two toxicants. Significant differences INCB028050 datasheet in glucose-induced cell death and free 3NT-induced cell death were observed among the NOS3 genotypes. Combined glucose/3NT caused increased toxicity among the NOS3 genotypes. No differences were observed among the ACE genotypes in their responses to glucose/3NT. These data demonstrate that the NOS3 genotype may be an important predictor of, or be mechanistically involved in, endothelial vulnerability, whereas the ACE I/D genotype is apparently less important. Thus this NOS3 genetic variation may play a role in vulnerability to endothelium-dependent diabetic vascular complications.

uCTX-II may have a role as a prognostic marker following ACLR and

uCTX-II may have a role as a prognostic marker following ACLR and warrants further investigation. (C) 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.”
“Purpose: The aim of this cross-sectional study was to investigate concentrations Dihydrotestosterone order of cartilage and bone markers, and

pro-inflammatory cytokines in synovial fluid (SF) collected at different time-points from acutely injured knees with hemarthrosis and to compare these with SF concentrations of knees of age and gender-matched healthy reference subjects.

Methods: SF was aspirated from the acutely injured knee of 111 individuals (mean age 27 years, span 13-64 years, 22% women). Concentrations of sulfated glycosaminoglycan (sGAG) were measured by Alcian blue precipitation

whereas cartilage ARCS, bone biomarkers [osteocalcin (OCL), secreted protein acidic and rich in cysteine (SPARC) and osteopontin (OPN)] and pro-inflammatory cytokines [interleukin (IL)-1 beta, IL-6, IL-8 and tumor necrosis factor (TNF)-alpha] were analyzed using electrochemiluminescence. Samples were also analyzed with regard to time between injury and aspiration [same day (n = 29), 1 day (n = 31), 2-3 days (n = 19), 4-7 days (n = 20) and 8-23 days (n = 12)].

Results: SF concentrations of ARCS (P < 0.001), SPARC (P < 0.001), OPN (P < 0.001), and all cytokines (P < 0.001), but not sGAG (P = 0.06) or OCL (P = 0.992), were significantly higher in injured knees compared to knees PCI-34051 of reference subjects. The cartilage markers sGAG and

ARCS were significantly higher in knees aspirated later than 1 day after injury, whereas concentrations of SPARC and OPN and all cytokines were higher in knees aspirated the same day as the injury and at all time-points thereafter.

Conclusions: Our results suggest that an acute knee injury is associated with an instant local biochemical response to the trauma, which may affect cartilage and bone as well as the inflammatory activity. (C) 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.”
“SETTING: In the 1960s, treatment for latent tuberculosis infection (LTBI) with isoniazid proved to be so effective, safe, and inexpensive that research into alternative treatments virtually ceased. Now that multidrug-resistant tuberculosis (MDR-TB) is widespread, Stattic no data are available to guide the management of persons exposed to MDR-TB (contacts).

METHODS: We surveyed National TB Program directors and MDR-TB program managers about current practices for managing MDR-TB contacts in countries with an MDR-TB prevalence of >2% in new patients and those with programs for managing MDR-TB.

RESULTS: Of 35 countries that met the survey criteria, 25 (71%) responded; 24 of these (96%) have a guideline for managing TB contacts. Of these, 19 (76%) usually or always evaluated contacts and treated LTBI.

0001) SF-36 scores varied by indicators of clinical severity, wi

0001). SF-36 scores varied by indicators of clinical severity, with greater impairment observed for more severe degrees of clinical activity (all p < 0.0001). FACIT-Fatigue scores correlated significantly with SF-36 scores (r = 0.42 to 0.74; all p < 0.0001) and varied by clinical severity (p < 0.05 to p < 0.0001).

Conclusions: The SF-36 is a reliable, valid, and responsive measure of health-related quality of life and the FACIT-Fatigue is a brief and psychometrically sound measure of the effects of fatigue on patients with AS. These PROs may be useful in evaluating effectiveness

of new treatments for AS.”
“Until recently, the last common ancestor of African apes and humans was presumed to resemble living chimpanzees and bonobos. This was frequently extended to their locomotor pattern leading to the presumption that knuckle-walking www.selleckchem.com/products/pd-0332991-palbociclib-isethionate.html HIF-1 pathway was a likely ancestral pattern, requiring bipedality to have emerged as a modification of their bent-hip-bent-knee gait

used during erect walking. Research on the development and anatomy of the vertebral column, coupled with new revelations from the fossil record (in particular, Ardipithecus ramidus), now demonstrate that these presumptions have been in error. Reassessment of the potential pathway to early hominid bipedality now reveals an entirely novel sequence of likely morphological events leading to the emergence of upright walking.”
“The risk of recurrent ischemic stroke after presumed perinatal stroke and the risk factors for such recurrence are rarely reported. Here, we present an adolescent with a history of presumed perinatal stroke who presented with arterial ischemic stroke recurrence AZD5363 at the age of 15 years. Hereditary thrombophilia screening performed at the time of his stroke recurrence demonstrated protein S deficiency.

No evidence-based consensus guidelines on thrombophilia screening in children with presumed perinatal stroke exist, nor has the role of secondary prophylaxis been addressed. There is a risk of stroke recurrence after presumed perinatal stroke, and routine thrombophilia screening may identify those children who are at higher risk for recurrence and who might therefore benefit from secondary prophylaxis. Clear guidelines should be developed to standardize investigations and management of children with presumed perinatal ischemic stroke.”
“The case of a 32-year-old Caucasian female with multi-drug resistant HIV-1 subtype B infection treated with a salvage regimen including maraviroc, raltegravir, etravirine and unboosted saquinavir who started atovaquone/ proguanil prophylaxis, is reported. The potential interactions between atovaquone/proguanil and these anti-retroviral drugs are investigated. Pharmacokinetic analyses documented a marked increase in etravirine and saquinavir plasma concentrations (+55% and +274%, respectively), but not in raltegravir and maraviroc plasma concentrations.

(C) 2011 Wiley Periodicals, Inc J Appl Polym Sci 120: 3109-3117,

(C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 120: 3109-3117, 2011″
“We report on molecular beam epitaxial growth of AlInSb/GaInSb metamorphic selleckchem high-electron-mobility-transistor structures for low power, high frequency applications on 4 in. GaAs substrates. The structures consist of a Ga(0.4)In(0.6)Sb channel embedded in Al(0.4)In(0.6)Sb barrier layers which are grown on top of an insulating metamorphic buffer, which is based on the linear exchange

of Ga versus In and a subsequent exchange of As versus Sb. Precise control of group V fluxes and substrate temperature in the Al(0.4)In(0.6)As(1-x)Sb(x) buffer is essential to achieve high quality device structures. Good morphological properties were achieved demonstrated by the

appearance of crosshatching and root mean square roughness values of 2.0 nm. Buffer isolation is found to be > 100 k Omega/square for optimized growth conditions. Hall measurements learn more at room temperature reveal electron densities of 2.8 x 10(12) cm(-2) in the channel at mobility values of 21.000 cm(2)/V s for single-sided Te volume doping and 5.4 x 10(12) cm(-2) and 17.000 cm(2)/V s for double-sided Te delta-doping, respectively. (C) 2011 American Institute of Physics. [doi:10.1063/1.3544041]“
“How can clinical epileptologists and computational neuroscientists learn to function together within the confines of interdisciplinary teams to develop new and more effective treatment strategies for epilepsy?

Here we introduce epileptologists to the way modelers think about epilepsy as a dynamic disease. Not only is there terminology to be learned, but also it is necessary to identify those areas where clinical input might be expected to have the greatest impact. It is concluded that both groups have major roles to play in educating, evaluating, and shaping the direction of the efforts of each other. (C) 2010 Elsevier Inc. All rights reserved.”
“Two new alternating copolymers based on dithienyl benzotriazole segment and phenylene vinyl unit were synthesized by Heck cross coupling method. The polymers exhibited broad absorption bands (from 300 nm to 752 nm for P1, and from 300 nm to 654 nm for P2) in the UV-visible region BIRB 796 MAPK inhibitor with optical bandgap ranging between 1.6 and 1.9 eV and proper electronic energy levels measured by cyclic voltammetry. The photovoltaic properties of the polymers as electron donors with 6.6-phenyl C61-butyric acid methyl ester as the electron acceptor in a bulk heterojunction structures were reported. Preliminary results showed moderate power conversion efficiency of 0.36% and 0.4%, respectively, under the illumination of AM 1.5, 100 mW/cm 2 with a device structure of ITO/PEDOT : PSS/polymer : PC(60)BM (1 : 3)/Ca/Al. Furthermore, the side chain effect on properties has also been investigated. (C) 2010 Wiley Periodicals, Inc.

65 +/- 2 10% versus 14 59 +/- 1 93%, p = 0 08, and 4 45 +/- 0 15

65 +/- 2.10% versus 14.59 +/- 1.93%, p = 0.08, and 4.45 +/- 0.15 versus 4.46 +/- 0.15 mm, p = 0.3, respectively). Nitrite concentration reduced from 6.50 +/- 0.21 to 2.57 +/- 0.18 A mu mol/l (p < 0.001), ESR from 40.90 A +/- 6.00 to 11.50 A +/- 1.38 mm in the first hour (p < 0.001), and CRP level from 29.08 A +/- 4.11 to 2.69 A +/- 0.43 mg/dl (p < 0.001). BASDAI and BASFI scores were significantly reduced from 5.40 A +/- 1.14 to 1.40 A +/- 0.70 (p < 0.05)

and 5.05 A +/- 1.76 to 0.20 A +/- 0.63 (p < 0.05), respectively. The study suggests that in ankylosing spondylitis, endothelial dysfunction is a part of the disease process and infliximab improves both endothelial dysfunction Inhibitor Library high throughput and

inflammatory MLN2238 disease activity.”
“Background: Allocation of graft in liver transplantation (LT) depends mainly on Model for End Stage Liver Disease (MELD) score. We studied the prognostic ability of three metabolic liver function tests in 560 cirrhotic patients listed for transplantation, in comparison with MELD and Child-Turcotte-Pugh (CTP) scores.

Methods: Indocyanine green retention rate (ICG), aminopyrine breath test (ABT), and galactose elimination capacity were performed at the time of listing in addition to standard biological parameters. Seventy-three patients died on waiting list, 438 were transplanted, and 73 died after LT. Cox regression analysis and receiver operating characteristic curves with c-statistics were calculated after stratification according to CTP and MELD score.

Results: For the mortality before transplantation, c-statistics showed that ICG and ABT had a slightly better prognostic ability

(0.73 and 0.68, respectively) than MELD score (0.66), and similar to CTP score (0.70). ABT’s prognostic ability remained significant once the MELD score (below and above 20) had already been taken into account. Only ICG had a prognostic ability to predict the survival after LT, even after stratification according to MELD and CTP score.

Conclusions: Our results strongly support that ABT and ICG may be useful in the DZNeP ranking of the patients in LT list, adding prognosis information in association with MELD score.”
“The magnetization process in field annealed amorphous ribbons has been investigated from dc to 10 MHz. Loss and permeability measurements, carried out both on single strips and ring samples by means of a broadband fluxmetric setup, have been associated with observations of the domain wall dynamics by high-speed stroboscopic Kerr apparatus. Transverse anisotropy Co-based ribbons exhibit a combination of rotational and domain wall processes, the latter being observed to progressively damp with frequency and coming to a halt on approaching the megahertz range.

The optical emission features were studied via temperature and ex

The optical emission features were studied via temperature and excitation laser power dependent photoluminescence. Based on the photoluminescence and transmission electron microscopy observations, photoluminescence spectral features can be attributed to a bi-modal height distribution in certain samples. In order

to extend the optical emission to room temperature, the sample with 5 ML of InAs and an 8 nm spacer layer was subjected to post-growth rapid thermal annealing at different temperatures. The emission wavelength was tunable from 1.63 to 1.72 mu m at room temperature. (C) 2011 American Institute of Physics. [doi:10.1063/1.3598082]“
“A case of pulmonary blastomycosis in a pediatric patient diagnosed by gastric lavage is described. Use of gastric lavage averted the need for more invasive diagnostic techniques selleck chemicals including bronchoscopy. Further study is required to define the sensitivity of gastric lavage for recovery of Blastomyces dermatitidis from pediatric patients

with pulmonary blastomycosis.”
“Renal autotransplantation is a safe and effective procedure see more to reconstruct the urinary tract. The current indications for autotransplantation include renal vascular disease, severe ureteral damage, tumours of the kidney and ureter, complex nephrolithiasis and retroperitoneal fibrosis. We report a rare case where we had to perform renal autotransplantation along with hybrid surgery for aortic aneurysm repair. To our knowledge, this is the first case report of AZD1152 in vivo its kind for this specific condition. Copyright (c) 2012 S. Karger AG, Basel”
“Hydrothermal ZnO wafers implanted at room temperature with 60 keV Sn+ ions are examined by means of photoluminescence (PL), atomic force spectroscopy (AFM), and X-ray diffractometry techniques. The PL intensity significantly decreases in the wafers implanted to doses of 4.1 x 10(13) ions/cm(2) and higher. The AFM measurements indicate that surface roughness variation is not the cause of the significant decrease in PL intensity. Furthermore, the PL deep level (DL) band peak blueshifts after illuminating

the implanted samples with the He-Cd laser 325 nm line; meanwhile, the DL band intensity first increases and then decreases with illumination time. These abnormal behaviors of the DL band are discussed. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3598068]“
“We report herpes simplex encephalitis (HSE) in a toddler after a subtotal hemispherectomy for seizures related to HSE 16 months earlier. Herpes simplex virus reactivation in the cerebrospinal fluid shortly after treatment of HSE has been described, but is extremely rare in other situations. HSE reactivation is a potential complication of epilepsy surgery after HSE in children.”
“In this case report, we describe a severe arterial bleeding during transurethral resection of bladder cancer where routine endoscopic methods failed to stop the hemorrhage.

001) Regression analysis revealed that external locus of control

001). Regression analysis revealed that external locus of control and coping by accepting Ilomastat cost responsibility accounted for 67% of the variance in parenting stress. Other styles of coping, child behaviour problems and the amount of time since diagnosis were not found to be predictive of levels of parenting stress.

Conclusions: There was a high prevalence of parenting stress in caregivers of children with a brain tumour. An external locus of control and coping by accepting responsibility increased the likelihood of elevated

levels of stress. Results emphasised the importance of ongoing support for parents of children with brain tumours. Intervention might helpfully be centred on strategies to increase parents’ internal locus of control. Copyright (C) 2012 John Wiley & Sons, Ltd.”
“Background: Malaria in pregnancy is associated with increased risks of maternal and foetal complications. Currently, intermittent

preventive treatment (IPT) of malaria during pregnancy with sulphadoxine-pyrimethamine (SP) is recommended by the WHO as part of a package of interventions also including insecticide-treated nets and effective case management. However, with increasing resistance to SP, the effectiveness of SP-IPT has been questioned. A randomized controlled trial (RCT) selleck inhibitor to investigate the relative efficacy of an alternative strategy of intermittent screening and treatment (IST), which involves a rapid diagnostic test for malaria at scheduled ANC visits and treatment of women only BAY 80-6946 if positive, versus SP-IPT has been conducted in Ashanti region, Ghana. This paper reports on a complementary study investigating the acceptability of the different strategies to women enrolled in the trial.

Methods:

Data were collected through twelve focus group discussions with women selected at random from the different arms of the RCT, exploring their experiences and perceptions about antenatal care and their involvement in the trial. Content analysis was used to identify relevant themes to structure the results.

Results: Five main themes emerged from participants’ experiences of ANC and the RCT that would influence their acceptability of malaria prevention strategies during pregnancy: health benefits; drugs received; tests received; other services received; and health worker attitude. Their own health and that of their baby were strong motivations for attending ANC, and reported favourably as an outcome of being in the RCT. Women were not always clear on the biomedical function of drugs or blood tests but generally accepted them due to strong trust in the health staff. Home visits by staff and free ITNs as part of the trial were appreciated. Politeness and patience of health staff was a very strong positive factor.

Conclusions: Overall, both intermittent screening and treatment and intermittent preventive treatment appeared equally acceptable to pregnant women as strategies for the control of malaria in pregnancy.

Using lifetime risk estimates 50 8% of screen detected prostate c

Using lifetime risk estimates 50.8% of screen detected prostate cancer was calculated to be clinically insignificant and the 49.2% largest tumor volume of 325 prostatectomy specimens was used to determine the threshold tumor volume for insignificant prostate cancer. Because stage and grade represent the strongest determinants of cancer aggressiveness, we also calculated the Nec-1s solubility dmso tumor volume threshold

for insignificant cancer after the selection of patients with organ confined prostate cancer without Gleason pattern 4/5. The analyses were performed for total tumor volume and for index tumor volume.

Results: The minimum threshold tumor volume of the index tumor and total tumor was 0.55 and 0.70 ml, respectively. After accounting for tumor stage and grade we obtained a threshold volume for the index tumor and total tumor of 1.3 and 2.5 ml, respectively.

Conclusions: We confirmed the original BTSA1 manufacturer value of the index tumor volume threshold of 0.5 ml for insignificant prostate cancer, and we demonstrated that clinically insignificant prostate cancer may include index Gleason score 6, pT2 tumors with volumes up to at least 1.3 ml. These results

suggest a reconsideration of current methods and nomograms used for pretreatment risk assessment.”
“Background

The dual epidemic of human immunodeficiency virus (HIV) and tuberculosis is a major cause of sickness and death in sub-Saharan Africa. We conducted a double-blind, randomized, placebo-controlled trial of preexposure isoniazid prophylaxis see more against tuberculosis in HIV-infected children and uninfected children exposed to HIV during the perinatal period.

Methods

We randomly assigned 548 HIV-infected and 804 HIV-uninfected infants (91 to 120 days of age) to isoniazid (10 to 20 mg per kilogram of body weight per day) or matching placebo for 96 weeks. All patients received bacille Calmette-Guerin (BCG) vaccination against tuberculosis within 30 days after birth. HIV-infected children had access to

antiretroviral therapy. The primary outcome measures were tuberculosis disease and death in HIV-infected children and latent tuberculosis infection, tuberculosis disease, and death in HIV-uninfected children within 96 to 108 weeks after randomization.

Results

Antiretroviral therapy was initiated in 98.9% of HIV-infected children during the study. Among HIV-infected children, protocol-defined tuberculosis or death occurred in 52 children (19.0%) in the isoniazid group and 53 (19.3%) in the placebo group (P = 0.93). Among HIV-uninfected children, there was no significant difference in the combined incidence of tuberculosis infection, tuberculosis disease, or death between the isoniazid group (39 children, 10%) and the placebo group (45 children, 11%; P = 0.44).