Medicine and Health Sciences Commons^™

Inflammatory And Coagulation Biomarkers And Mortality In Patients With Hiv Infection, Lewis H. Kuller, Russell Tracy, Waldo Belloso, Stephane De Wit, Fraser Drummond, H. Clifford Lane, Bruno Ledergerber, Jens Lundgren, Jacqueline Neuhaus, Daniel Nixon, Nicholas I. Paton, James D. Neaton

Internal Medicine Publications

Background

In the Strategies for Management of Anti-Retroviral Therapy trial, all-cause mortality was higher for participants randomized to intermittent, CD4-guided antiretroviral treatment (ART) (drug conservation [DC]) than continuous ART (viral suppression [VS]).

We hypothesized that increased HIV-RNA levels following ART interruption induced activation of tissue factor pathways, thrombosis, and fibrinolysis.

Methods and Findings

Stored samples were used to measure six biomarkers: high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), amyloid A, amyloid P, D-dimer, and prothrombin fragment 1+2. Two studies were conducted: (1) a nested case–control study for studying biomarker associations with mortality, and (2) a study to compare DC and …

Metformin For The Treatment Of The Polycystic Ovary Syndrome, John E. Nestler

Internal Medicine Publications

This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are presented. The article ends with the author’s clinical recommendations.

A 23-year-old woman with known polycystic ovary syndrome visits her family physician. She has taken oral contraceptive pills in the past but did not tolerate them and is not currently receiving any treatment. She has three or four menstrual …

Treatment Of Patients With The Hypereosinophilic Syndrome With Mepolizumab, Marc E. Rothenberg, Amy D. Klion, Florence E. Roufosse, Jean E. Kahn, Peter F. Weller, Hans-Uwe Simon, Lawrence B. Schwartz, Lanny J. Rosenwasser, Johannes Ring, Elaine F. Griffin, Ann E. Haig, Paul I. H. Frewer, Jacqueline M. Parkin, Gerald J. Gleich

Internal Medicine Publications

BACKGROUND

The hypereosinophilic syndrome is a group of diseases characterized by persistent blood eosinophilia, defined as more than 1500 cells per microliter with end-organ involvement and no recognized secondary cause. Although most patients have a response to corticosteroids, side effects are common and can lead to considerable morbidity.

METHODS

We conducted an international, randomized, double-blind, placebo-controlled trial evaluating the safety and efficacy of an anti–interleukin-5 monoclonal antibody, mepolizumab, in patients with the hypereosinophilic syndrome. Patients were negative for the FIP1L1–PDGFRA fusion gene and required prednisone monotherapy, 20 to 60 mg per day, to maintain a stable clinical status and a …