I am looking for a new form to be used in our clinic. I am a Registered Dietitian and assess muscle mass daily along with body fat, ECT, phase angle etc. I am wondering what other clinics do to report this information to the physicians or if they do. Are there any assessment forms I can purchase or create to display the necessary information?   thanks  Amy

Subject:   Re: BIA Report Form
Date: Wed, 31 Oct 2001 17:41:59 -0500
From:  HIV Nutrition Discussion List 
CC:   Cade Fields-Gardner 

Hello Amy,

Other than the forms produced upon doing a BIA, I am not aware that there are any other BIA assessment forms to relay information to physicians. Cade Fields-Gardner, who I have sent a copy of this message to, is the 'BIA guru' and may be able to lead you to some resources. I'll also post your query in our nutrition and HIV discussion area to see if anyone else has any thoughts on this topic.
Sharon Ann Meyer

To whom it may concern:
I am a senior high school student in Ontario, Canada and I am doing a science fair project regarding the effects of blue green algae on the HIV virus.  I read an article entitled, "Algae for HIV:  Blue, Green or Red?" located on the Healing Well Web Site.

I was wondering if you would be able to send me any additional information regarding this topic.  This is greatly appreciated! Thank you in advance, Lynn 
 

Hello Lynn,
I do NOT recommend the use of this product. Visit  these web sites for more information:
Health Canada - Warnings/Advisories - Toxins may be present in blue-green algae
Canadian Resource #1
Canadian Resource #2
Canadian Resource #3
Sharon Ann Meyer

Hello Sharon,
I stumbled across your article on Red and green algae while surfing the web. I have suffered....and I do mean suffered from canker sores for many years and just started taking the Red marine algae.  I am on my 2nd bottle.  And yes you are right....it is very costly but Thank you Jesus, it works!!!!!I am concerned however about your reference to RMA producing deadly neurotoxins, as well as possibly decreasing our calcium content.   I would like more information on the negative aspects of RMA.  Can you help? May God bless you for your work in the health care field.  Shirley J. Dillard
 

Subject: Re: Red marine algae (was Blue Green Algae)
Date: Tue, 12 Nov 2002 19:36:50 -0500
From: HIV Nutrition Discussion List - Sharon Ann Meyer

Hello Shirley,
The mention of neurotoxins I assume was:
"A prospective user notes that in early 1994, a study warned of the dangers of using Blue- Green Algae (Spirulina) because it “was said to produce deadly neurotoxins”.  “Toxins were first noticed in the Mid-West where migrating geese would drink from ponds with Blue-Green Algae blooms and promptly be dead within hours with tremors and halted heart and respiratory function.”  This source stated that studies identified three of the neurotoxins that BGA can produce." The reference used was:
 White R. Blue-Green Algae (Spirulina).  World Wide Web: Critpath (accessed 2 Nov 1996). Of course, that was years ago and the reference is no longer there.

The reference to calcium, "Consuming too much micro- algae can be harmful because “too much nucleic acid can raise the uric acid level in the body, causing calcium depletion, kidney stones, and gout." is Farfield K.  Red, Blue or Green, Which Algae Is For You? World Wide Web: Quake
(accessed 28 Sept 1996). Again not there any longer.

I suggest you try to research side effects of RMA by using PubMed and the Google site above for more recent information.

Lysine is also taken by many people for cold sores, see PubMed. It does seem to work for the people I know.

Yes, check below and check the HIV Nutrition News Update for September 28, 2001 at the Archive. It reports that cryptosporidium infection through swimming pools is still a concern. 

Hi, Does anyone know if you can get crypto infection through  swimming pools?

Thanks  Adam

"Parasite Scare in the Hat" - Calgary Sun (08.28.01)

A second swimming pool in Medicine Hat was closed yesterday as cases of cryptosporidium infection continued to climb in the southern Alberta city. The number of confirmed cases rose to 16, said Bruce van Mulligen, regional manager of environmental health services with the Palliser Health Authority. At least two of the affected people were hospitalized. Another 21 people are showing symptoms of the disease but have not been tested. The parasite can cause diarrhea, fever, nausea and malaise in healthy people but can be life-threatening to those whose immune systems are weakened by AIDS or cancer.
 

"Parasitic Disease May Be Spreading, Tazewell County Official Says" - Associated Press (08.16.01)

Health officials in Tazewell County, Ill., are warning that cryptosporidiosis, a parasitic disease that can be fatal to people with compromised immune systems, might have spread to swimming pools throughout the area. There have been eight confirmed cases of the disease, which is spread by a microscopic parasite in the feces of humans and animals. The county is asking the managers of public swimming pools to superchlorinate them to 20 parts per million for eight hours. The original source of 
contamination has not been identified. The confirmed cases all have links to the Splashdown water park, although there is no direct evidence the park's pool was infected. When cryptosporidium parvum protozoa invaded Milwaukee's water supply in 1993, it made 400,000 people sick and killed 100. The 
fatalities were mainly AIDS patients, along with some elderly persons and babies.

Can you direct me to the website of the "buyers club" to purchase DNCB. Mike
 

Hello Mike,
While I do NOT recommend DNCB you may be able to get it from one of these Buyer's Clubs.
 

Hi, Does anyone have a guide or some information on drinking  water? Thanks 
James
 

Check out Guidance For People With Severely Weakened Immune Systems.

Here is an excerpt from the AIDS Digest on exercise and lipodystrophy:

"HIV Lipodystrophy With Exercise Works Best"
AIDS Alert (10/00) Vol. 15, No. 10, P. 126
A study from Nicholaos Bellos of Bellos Southwest Infectious Disease of Dallas shows that steroids, exercise, and diet changes are useful treatments for AIDS-related lipodystrophy.  Patients who follow a regimen to fight fat redistribution can be helped by these treatments, according to Bellos.  Interim data from his study found that the patients following this regimen experienced up to a 15 percent increase in lean body mass.  Lipodystrophy is not to be confused with AIDS wasting, which reduces fat mass. Weight loss along with fat redistribution is a sign of lipodystrophy, which repositions fat in the abdomen and face. Bellos' study was an extension of a previous one from the University of California at Berkeley, published last year in the Journal of the American Medical Association.  Patients treated with oxandrolone, an anabolic medication, showed an increase in lean body mass; however, their body fat did not change.  Bellos' approach for treatment includes a dietitian's analysis and photographs to monitor appearance, along with a strict exercise program.

Cheers, Samson Stikes
 

HIV FITNESS NEWSLETTER
Issue #6 -- June 15, 2001
Copyright 2000 Timothy M. Brewi, All Rights Reserved.

You received this newsletter either because (1) you are a subscriber, or (2) someone forwarded it to you. The HIV Fitness Newsletter reported on developments in the study of fitness for people living with HIV. The newsletter also announced new information and features added to HIV Fitness Guidelines. Feel free to forward this newsletter to anyone who might be interested in it!

3/4/04 Editors Note: Sadly, Tim Brewi, BA, DTR passed away. We will always be grateful for his many contributions to the field of HIV Fitness. 

==================================================

CONTENTS
1.  Q-&-A: What Can Be Done About Skinny Legs?
2.  Q-&-A: Skinny Legs and Glutamine
3.  Nutrition and Athletic Performance -- Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine

==================================================

1.  WHAT CAN BE DONE ABOUT SKINNY LEGS?
QUESTION:

I have extremely skinny legs and don't know what to do.

ANSWER:
by Timothy M. Brewi, BA, DTR

[Editor-&-#8217;s Note: We cannot give personal advice over the internet.  But we can provide general information for educational purposes. The most important point we can make is that you must obtain your doctor's approval before undertaking any physical activity or fitness program.]

I give a fitness class at a local AIDS service organization, and I'm asked this question a lot. Here are some thoughts I have...

If you've ALWAYS had skinny legs or arms, the cause could be genetics, diet, or exercise.
Genetics: You might just be built that way. Diet: You tend to be an under-eater and not get enough calories. Exercise: You're not doing heavy enough work to stimulate muscle growth.

If your legs and arms have become skinnier since HIV, the cause could be wasting, lipodystrophy, or both. Wasting: You're losing muscle mass due to hypermetabolism (high calorie burn), malnutrition (poor nutrient digestion/ utilization), or hypogonadism (insufficient testosterone production) 
Lipodystrophy: You're losing fat (but not muscle) in your legs and arms, making them appear skinnier.

Both wasting and lipodystrophy lead to serious medical consequences. They're not just "looks" issues. Here are 3 things you could do about it...

1. Medical: Wasting is caused by infections. Not only do you have an HIV infection, but you could also have other infections. Your doctor needs to determine possible medical causes and treat accordingly. Treatment might include androgen therapy. As for lipodystrophy, the causes are not known for sure and good remedies have not been established. It's awful to be in a position where lipodystrophy might be caused by the medications that are saving you from HIV/AIDS! I would say the first most important thing to do is review your situation with yourdoctor carefully.

2. Diet: Get yourself to a dietitian! I feel there are just too many serious nutritional consequences in HIV infection to manage your nutritional care without professional guidance. There are many nutrients that should be evaluated and possibly supplemented in your diet. Have your doctor refer you to a dietitian, or find a dietitian specializing in HIV through your local AIDS service organization.

3. Fitness: If your medical and nutritional needs have been fully addressed and YOUR DOCTOR APPROVES YOU FOR FITNESS ACTIVITIES, then have a qualified fitness professional design an exercise plan for you. Many of my clients come to me either overtrained or undertrained. Overtraining is doing too much exercise and results in slow muscle loss. Undertraining is doing to little exercise and results in little or no muscle gain. Most people are overtrained in some muscles and undertrained in others.

One muscle that is commonly undertrained is the heart. The heart is trained with aerobic exercise. But many guys have the mistaken belief that aerobic exercise burns off muscle mass. This could be TRUE if you're not getting adequate medical or nutrition care. As I said above, you must first ensure that your medical and nutritional needs have been fully addressed, or else exercise can be counterproductive and result in muscle loss. But if your doctor has approved you for fitness activities and you have consistently good nutritional intake, then aerobic exercise is a GREAT tool for increasing muscle mass in the legs! Not to mention that it's great for your heart and all the organs served by the blood supply.

As for weightlifting, most people seem to know they should use heavy weights. But your training sessions should be brief -- or you risk overtraining. And anytime you train a given muscle, you should not train it again until after you've had at least 3 nights of sound sleep. This is because most muscle growth occurs at night while you're sleeping (not nights when you have insomnia). If you don't get enough rest between training sessions, you will most certainly become overtrained.

Sorry, I don't know anything about you, so I can't give a more specific answer. These are just some of the basic points I check in my clients. I hope it helps you in some way!

==================================================
2.  SKINNY LEGS, GLUTAMINE, AND CARNITINE
QUESTION:

Read you comments (above) regarding "Skinny Legs" and was wondering if you agree with the general consensus that 40 grams daily of glutamine is beneficial?  Are you aware of any negative side effects using this supplement?  Also, I've been told that glutamine is the same thing as carnitine.  Is that true?

ANSWER:
By Timothy M. Brewi, BA, DTR

[Editor-&-#8217;s Note: We cannot give personal advice over the internet.  But we can provide general information for educational purposes. The most important point we can make is that you must obtain your doctor's approval before undertaking any physical activity or fitness program.]

No, carnitine and glutamine are not the same.

Carnitine is a substance which the body makes from the amino acids lysine and methionine.  It helps transport fat into mitochondria, where fat is burned for energy.

Glutamine is a nonessential amino acid which the body makes from protein- rich foods.  It's the most abundant amino acid in muscle and blood. It's also used as fuel by certain cells in the gut and by lymphocytes and macrophages.

I certainly wouldn't say there's a general consensus on the amount of glutamine to take.  There's considerable controversy about its uses and benefits, and very little data on its longterm effects.

The claims about glutamine seem to fall into three main categories:
    (1) Glutamine can help treat diarrhea;
    (2) Glutamine can boost the immune system; and
    (3) Glutamine can help build muscle mass.

In all three cases, however, I wouldn't consider glutamine the sole line of defense. Diarrhea, immune deficiency, and muscle wasting are potentially life-threatening conditions requiring full medical attention.  Glutamine would be, at best, an adjunct to medical care.  In any given case, the amount of glutamine to take has not been established and is often discovered by trial and error.

For example, consider the following...

In one study of the effects of glutamine on immune response after strenuous exercise, the researchers used nine doses of 100 mg glutamine per kilogram of body weight (visit web site above for more)...

The CRIA Update, the Community Research Initiative on AIDS' quarterly treatment newsletter fall issue will look at the roles of nutrition and exercise in the treatment of HIV disease. 

The goal is to take a look at the data overall to see what we know, what we're guessing about, and the limitations in our understanding due to the lack of adequate research. According to my research very few have been. Obviously this doesn't mean we should discount the results of uncontrolled studies, but it's important to acknowledge their limitations.

The CRIA Update past issues are at the website. The newsletter is distributed free of charge to
individuals and AIDS service organizations throughout the US. Our readership includes people living with HIV, clinicians, service providers and researchers.
James Learned
Director of Treatment Education; Editor, CRIA Update
Community Research Initiative on AIDS
230 West 38th Street, 17th Floor
New York, NY 10018

CRIA is an independent, non-profit community-based AIDS research and education organization committed to improving the length and quality of life for people living with HIV/AIDS through clinical research and treatment education.
 

Just as an FYI:

Resistance exercise training reduces hypertriglyceridemia in HIV-infected men treated with antiviral therapy.Yarasheski KE,  Tebas P,  Stanerson B, Claxton S,  Marin D,  Bae K,  Kennedy M,  Tantisiriwat W,  Powderly WG.J Appl Physiol. 2001 Jan;90(1):133-8. 

Hypertriglyceridemia, peripheral insulin resistance, and trunk adiposity are metabolic complications recently recognized in people infected with human immunodeficiency virus (HIV) and treated with highly active antiretroviral therapy (HAART). These complications may respond favorably to exercise 
training. Using a paired design, we determined whether 16 wk of weight-lifting exercise increased muscle mass and strength and decreased fasting serum triglycerides and adipose tissue mass in 18 HIV-infected men. 

The resistance exercise regimen consisted of three upper and four lower body exercises done for 1-1.5 h/day, 4 days/wk for 64 sessions. Dual-energy X-ray absorptiometry indicated that exercise training increased whole body lean mass 1.4 kg (P = 0.005) but did not reduce adipose tissue mass (P = NS). 
Axial proton-magnetic resonance imaging indicated that thigh muscle cross-sectional area increased 5-7 cm(2) (P < 0.005). Muscle strength increased 23-38% (P < 0.0001) on all exercises. Fasting serum triglycerides were decreased at the end of training (281-204 mg/dl; P = 0.02). These findings imply that resistance exercise training-induced muscle hypertrophy may promote triglyceride clearance from the circulation of hypertriglyceridemic HIV-infected men treated with antiviral therapy. 

Good reply Tim. I'd add:If you have osteoporosis, ask your health care provider if twisting motions and impact activities are harmful.
 

Re: Subject: Appropriate exercise during wasting
Date: 10/12/00 5:13:24 AM Pacific Daylight Time
From: HIV Nutrition Discussion List -Timothy M. Brewi 

Stewart,
You've hit upon one of the central issues of fitness in HIV.  I'll share with you some information I have.  I'll also forward this message to some of my colleagues working on various aspects of nutrition and exercise in HIV.  I'm sure they'll have further information they'd be happy to share with you.

[See <snip> below for Stewart's orginal message to Tim.]

First, the client must be under the care of a physician and taking all her medications as prescribed.  I myself do not provide fitness counseling or advise physical activity to an HIV client unless I have received a written note from their physician stating that exercise is safe and recommended for them.  This assures me that the complex medical aspects of HIV are being attended and that the lead member of the healthcare team -- the physician -- approves of physical activity for the client.  For example, a dramatic rise in viral load or drop in CD4 t-cell count would warn against physical activity until these signs have been adequately addressed by the physician.

Second, the client should be visiting a registered dietitian on a regular basis to address the complex nutritional aspects of HIV. [What is the UK equivalent of an RD?]  If the client is not eating well -- whether for physical, emotional, financial, or other reasons -- the client should not be exercising.

Third, the client should obtain a body composition analysis that includes measurement of body cell mass (BCM), fat mass, and hydration status.  Body composition can be measured by bioelectrical impedence analysis (BIA), dual-energy x-ray absorptiometry (DeXA), or hydrostatic weighing.  BIA is the least expensive, most convenient method.  In the States, BIA is often provided by RDs working with the HIV population.  The client should have their body composition analyzed on a regular basis (perhaps every three months) to monitor changes in muscle and fat mass.

Fourth, you should understand that wasting has a multi-factorial etiology. It can be caused by any combination of malnutrition (inadequate food intake), malabsorption (poor digestion/absorption of nutrients), hypermetabolism (abnormally high energy usage due to infection), hormonal derangement (e.g. hypogonadism), and other factors.

Since physical activity increases calorie expenditure and nutrient usage, exercise would exacerbate wasting caused by malnutrition, malaborsorption, and hypermetabolism.  This is one of the reasons medical care and nutrition care are prerequisites to fitness counseling and physical activity.  But since exercise, when applied appropriately, provides a powerful anabolic stimulus to the body, physical activity may be used successfully as an adjunct to medical and nutritional intervention for wasting.  Given these conflicting factors, monitoring body composition is key in designing a safe and effective fitness program.  You must monitor the client closely and be prepared to quickly change or stop the program, depending on the client's ever-changing physiological response to exercise.

Fifth, the client's self perceptions are important...  Does she feel good exercising?  Is she enjoying increased stamina?  Does she look forward with relish to her daily activities?  Is she motivated to continue?

In some cases, we might need to slow down an overly enthusiastic client who would drive herself to exhaustion in a zest to achieve.

Please don't take this message as a complete account of fitness counseling for HIV clients.  The field is complex and changing.  Please use this message as some indication of the topics you might look into more closely.

Take care! -- Tim  :)
Timothy M. Brewi, BA, DTR, CPT

Subject: Appropriate exercise during wasting
Date: 10/12/00 4:55:47 AM Pacific Daylight Time
From: HIV Nutrition Discussion List -SHarrison

Hello, I came across your website while searching for information to pass to a patient of mine who is seeking advice on appropriate exercise to build muscle bulk.  My main concern is that if I set her off on a resistance program aimed at increasing her muscle tissue the cause of the wasting will prevent any benefit, indeed the breaking down of tissue during exercise may not be replaced and I am concerned there may be a net negative effect. 

I admit to almost complete ignorance on this issue and would appreciate any advice or direction to other appropriate sources of information.
Thanks in anticipation.
S. Harrison
Physiotherapist
UK

HIV ReSources has added another electronic message list for people interested in HIV/AIDS and nutrition-related issues. The HIV Nutrition News Update is a free weekly review of news related to nutrition and HIV/AIDS. Previous issues of the update are available through the HIV ReSources web site at the HIV ReSources Free Weekly Electronic Update List and the Archive.

Recently there was a poster from the Retrovirus conference in Chicago about a drug-herb interaction. They said garlic decreases saquinavir blood levels. Can you tell me any more about the interaction of garlic and drugs? Also, do other herbs affect the drugs I am taking? Thanks 
John
 

This is such a timely topic as there are so many things we need to know about the interaction of drugs and supplements.  Yes, studies have shown that garlic can decrease Saquinavir concentrations. In addition to the Herb Drug Interaction Handbook by Sharon Herr, RD, mentioned below, there are a number of herbs mentioned in Zaneta Pronsky's book HIV Medications-Food Interactions Handbook. 

As far as garlic, there are other drug interactions as well. In our current issue of the HIV ReSource Review Issue 28 -  Sharon Herr, RD, discusses the many interactions between herbs and drugs Herb Drug Interaction Handbook - Herb-Drug Interactions. Here is an excerpt on garlic:
"Garlic (Allium sativum): Interactions with garlic generally only occur when it is taken in supplements or large quantities of garlic cloves. Garlic consumed in cooking is generally not of sufficient quantity to cause interactions with drugs unless there is a preexisting bleeding problem. Garlic's potential to lower serum lipids may be additive (research on this effect varies). When garlic supplements or large quantity of cloves are consumed while taking lipid lowering drugs such as atrovastatin (Lipitor), fenofibrate (Lipidil), fluvastatin (Lescol), gemfibrozil (Lopid), Pravastatin (Pravachol), and simvastatin (Zocor), or niacin (Niaspan) lipid levels may be lowered further. (41,148) A recently approved drug Baycol (cervistatin), a lipid lowering drug in the above class, will exhibit the same effect. High intake of garlic has the potential to inhibit the uptake of iodine by the thyroid gland, so caution should be used with concurrent thyroid replacement therapy. (35,103,106) Garlic has the potential to increase bleeding (see Table 3) and lower glucose (see Table 2). See the Sept/Oct 1998 Review issue for more information on garlic."
 

Forwarding this for Ellen.
Hi,  my name is ellen  i am l doing a research on garlic  anybody knows formula for garlic any formula and how  to grow it? I just need a molecular formula on garlic, if you know  by any chance thank you  my e-mail

Subject: Re: Garlic
Date: Fri, 18 Apr 2003 18:29:39 -0400
From: HIV Nutrition Discussion List - Sharon Ann Meyer

Hello Ellen,
Try the ARS Web Site with Dr. Duke's information on herbs for the molecular formula.
 

"The power of HIV to shut down normal genes and activate others is impressive, and begins immediately. Only 30 minutes after exposure to HIV, more than 500 genes were shut down in the infected cells." Read on...

Source: University Of California, San Diego School Of Medicine
Date Posted:   Thursday, June 28, 2001
Web Address: Science Daily

HIV-&-#39;S DEADLY ASSAULT ON IMMUNE CELLS CHRONICLED IN STEP-BY- STEP ACCOUNT OF VIRAL INVASION

Using sophisticated post-genomic technology, a team of researchers has looked deep within the body’s immune cells and recorded the molecular events triggered by invasion of the human immunodeficiency virus (HIV), creating a detailed account of the devastating progression of cellular injury following HIV infection.

HIV kills critical immune cells called CD4+ T cells, eventually leading to full-scale destruction of the immune system and AIDS. The precise choreography and mechanisms by which HIV causes CD4+ T cells to die has not been detailed until now.

This first-ever sequential record of the multiple steps leading to immune cell death due to HIV infection was created by simultaneously monitoring nearly 7,000 genes at eight points in time over 72 hours, using microarray gene chip technology and a software program designed by UCSD bioinformatics specialists.

The results, published in the July 2001 issue of Genome Research, demonstrate in detail how efficiently HIV commits its cellular coup d'etat, rapidly taking over the cell's DNA machinery and inserting its own viral blueprints for destruction, suppressing vital survival and repair functions, and inducing the cell to kill itself. 

"Better understanding of the steps involved in HIV destruction of immune system cells opens the door to new investigations of methods to potentially block or prevent HIV infection," said Jacques Corbeil, Ph.D., assistant professor of medicine at the University of California, San Diego (UCSD) School of Medicine and the paper's first author.

This study of the specific genetic events in the CD4+ T cell, from infection to cell death, involved medical researchers, bioengineers, and bioinformatics experts from UCSD; the San Diego Supercomputer Center at UCSD; the Veterans Affairs (VA) San Diego Healthcare System, and Affymetrix, the company that develops GeneChips® probe arrays to measure whether individual genes are dormant or active.

Their findings show that HIV suppresses genes vital to immune cell maintenance and repair, while activating a cell-death process called apoptosis.

The scientists utilized UCSD-developed software called 2HAPI (High-density Array Pattern Interpreter, version 2) to analyze the expression of nearly 7,000 genes, the largest number ever studied by HIV researchers.

“With this technology, our ability to study HIV has moved from observing clinical manifestations of HIV, to studying the molecular machinery of the cell as the virus changes and effects the cell’s living process,” said Daniel Masys, M.D., Director of Biomedical Informatics at UCSD School of Medicine and co-inventor of the HAPI software. This web-based microarray analysis tool was developed by members of the UCSD Center for AIDS Research Genomics core, the San Diego Supercomputer Center, and the UCSD Cancer Center, and is available.

To track gene activity in the infected cells, the team used Affymetrix GeneChips®, silicon chips coated with DNA fragments representing known sequences of genes. Simply stated, when these chips are exposed to specially labeled cells, the DNA seeks and binds to active genes within the cell, providing a snapshot of gene expression within the cell at a specific point in time. The chips produce vast amounts of data indicating which genes are activated, which must then be interpreted using computer analysis.

For this study, an HIV infected CD4+T cell line was monitored following infection at several time intervals, from 30 minutes to 72 hours after exposure. For each interval, 10 million infected cells were applied to the microarray gene chips.  A control sample of healthy cells was analyzed at the same intervals for comparison.

The 2HAPI software provides automated linkage of data produced by microarray gene chip technology regarding simultaneous expression  of thousands of genes, to published information about the expressed genes and gene clusters, allowing investigators to analyze and interpret the relevant gene activity.

The resulting data show how effectively HIV invades and overpowers the host cell's DNA, integrating its own infectious DNA into the host's cellular machinery, poisoning genes and altering the cellular energy source, quashing the cell’s DNA repair mechanism, and setting in motion the cell-suicide process of apoptosis.

Within hours of entering the immune cell, HIV suppresses genes that regulate and maintain a constant and healthy internal environment. The virus cripples enzymes essential for function of the mitochondria,cellular structures that serve as the source of energy needed to sustain life and growth. And, HIV suppresses the genes that ordinarily repair altered cellular DNA, rendering the cell incapable of mending HIV-induced damage as it occurs.

The power of HIV to shut down normal genes and activate others is impressive, and begins immediately. Only 30 minutes after exposure to HIV, more than 500 genes were shut down in the infected cells. Conversely, nearly 200 genes were uniquely activated in the infected cells compared with normal cells. These included genes associated with cellular defense against  invasion, and "suicide" genes that normally remain dormant until switched on as part of the normal cycle of cell death.

By shutting down important genes, and activating others programmed to kill the cell, HIV proves to be a swift and deadly predator. Within three days of infection, the HIV-exposed cells had only half the 1,400 active genes normally found within the healthy cell.

“Now that we have the ability to see the specific genes that are modulated by HIV, we’re probing further to find the promoter regions of these genes where activation begins or is suppressed,” Corbeil says. “We want to determine how they are expressed as well as the length of time the genes are turned on or off.”

The research was supported by the National Institute of Allergy and Infectious Diseases, the Center for AIDS Research Genomics Core laboratory, the University wide AIDS Research program, the San Diego Veterans Medical Research Foundation, and the San Diego VA Healthcare System.

In addition to Corbeil, authors of the Genome Research paper included Masys; Thomas Gingeras, Ph.D., Affymetrix; UCSD Department of Medicine researchers Davide Genini, Ph.D., Steffney Rought, Ph.D.,Lorenzo Leoni, Ph.D., Pinyi Du, B.S., and Mark Ferguson, B.S.; UCSD Department of Pathology researchers Dennis Sheeter, B.S. and John B. Welsh, M.D., Ph.D.; Lynn Fink, B.S., San Diego Supercomputer Center; Roman Sasik, Ph.D.,UCSD Department of Physics; Affymetrix researchers David Huang, B.S. and Jorg Drenkow, B.S.;and Douglas D. Richman, M.D., UCSDDepartments of Medicine and Pathology, San Diego VA Medical Center and Veterans Medical Research Foundation.
 

Hello, my name is Dave J. B., I have contracted HIV and I wish to start an Organization to promote the Prevention and Protection from HIV/AIDS across Canada. I have started an online solution. This site is for everyone HIV+ or HIV- (kids, heterosexual, gay, lesbian, bi, transexual) who are interested in HIV+ Prevention and information. I have also created a web site for HIV+ heterosexuals only which has services such as online chat and links to other organizations for help in their area. I am in the works of making the complicated setups simular to HeteroPOZ.org for the other communities too (gay, bi, etc). I have programmed and set up these servers without any funding or income other than my monthly disability cheques. I do without proper food and shelter in order to maintain the costs.

 We must educate more, and be willing to give out these details (pamplets, etc) without having to goto a HIV/AIDS organizations (not everyone feels comfortable enough to go into one of these offices). I am doing my best to spread the HIV- word, yet everything costs money. I would love to promote and organize a HIV Prevention Convention and a cross Canada HIV Prevention Tour where we hand out pamplets/info/condoms to everyone. Even give out needle cleaning kits. Promote the giving away of sponsored condoms at public events/bars!

Please, can you tell me what I must do to become a Not-For-Profit Organization in Toronto, Ontario, Canada. Is there a free way to obtain this title? 

I look forward to hearing your comments, and seeing a public commitment for the fight to save hundreds of thousands of lives. 
 

Does anyone know about the nutritional / herbal preparation from Uganda known as Mariandina?  I've spent over an hour on the Internet looking for published research or any other information other than what the producers of the product have written, but have come up with nothing. See below for the original message. 

From the ingredient list it is quite a mishmash of vitamins and herbal preparations, which is a tad bit scary as to how they will interact with each other - it isn't like the mishmash of ingredients in natural foods becuase humans aren't quite as good at it!    I like a lot of what the creator of the product says about the importance of nutrition and the reliance on local foods and medicines that are prepared in a low- processed manner.  But I can't speak for the product.   It is expensive considering all the fruits, vegetables, legumes, nuts, whole grains and herbs that we have here in Africa - but getting people to lean of a diet focused on these isn't as easy as telling them to pop 3 pills 3 times a day (although this later is completely unsustainable!).

I think it would be helpful if you have helpful information to add that you post your responses to this entire mailing (by pressing reply to all) so that we can all benefit.   Please feel free to pass this request on to your other contacts!
Thank you, Stacia M. Nordin, RD
HIV/AIDS Crisis Corps Coordinator
Providing 6-month Volunteer experts for HIV/AIDS care and prevention programs
Lilongwe, Malawi, Africa
~~~~~~~~~~~~~~~~~~~~~~~~~~~~

----- Original Message -----
From: HIV Nutrition Discussion List - Css
Sent: Monday, May 20, 2002 6:27 PM
Subject: Mariandina - affordable/successful treatment for AIDS patients

Dear Sir / Madam,

Mariandina - affordable/successful treatment for AIDS patients

My name is Christine Kas and I am writing to see if we can work with you and eventually other docters and clinics to evaluate a nutritional supplement called Mariandina which has proved very successful with AIDS / HIV sufferers to date. 

Though there is still no total cure for infection by the HIV virus, there is treatment that will ensure that one can lead a normal life, free of AIDS symptoms. Professor Charles Ssali, a Ugandan researcher, has successfully treated many infected people, using the range of Nutritional supplements called Mariandina. Now the product is being promoted to a wider audience. See the Mariandina web site listed above for further information.

I would like to bring you and the Professor Ssali to work with some AIDS victims so that you can see the impact of the product and then see how we can market it.

The product is made from various vitamins and supplements and has no toxic products. As with the regulations all the ingredients are listed on the bottle. The product is made in the UK.

Please do get in touch, we look forward to working together.

Best Regards
Christine Kas=
The Mariandina Team (UK)

yah hi i am doing a report on aids and i need to have some spcific scienitfic act and i cant seem to find it. all i can find is how to treat it and prevention not what it is and how it efects the t-cells in your body i want to know about the virus.

ttttttttthhhhhhhhhhhaaaaaaaannnnnnnnnkkkkkkkkkk   you

Why don't you try AIDSInfo. There is also the Florida AIDS Hotline and the Centers for Disease Control. 

Good luck
 

Looking for feedback regarding our new HIV+AIDS sites. Also hope you will link to us, submit for web awards or just let us know what you think about our little network and possible ways to improve.

HIV/AIDS Search Engine. Please volunteer to add your favorite HIV/AIDS related site(s) to help OUR network grow. Free Submission! 

Simple HIV+ Personals for all sexual preferences (heterosexual, gay, bisexual, transgender or just friendships) in North America. Easily submit your personal today! 

Post a message to this Forum and reply will also be sent to your email. Volunteer nurses come by to answer medical Q-&-A.

Hetero POZ Community- Support and resources for HIV+ Heterosexuals. Chat and meeting too.

Thanks. Founder Dave Brown

PS: Could someone send us a list of HIV+ testing locations in Canada and/or USA? Both anonymous and clinics are appreciated. Feel free to send us email about your HIV/AIDS websites or let us know how you can help. Please let your friends or local organization know about us.
 

Hello,
I just received a sample of the supplement NutriVir and with it was a page taken from the HIV ReSource Review-volume 4 issue 1, July/August 1999.  It is titled Clinician Experience, NutriVir- by Donna Tinnerello.

Can you tell me where I can get more information about NutriVir?  I took one of the two samples I have today and would like to be able to pass on any more info I can get to my peers. 

I just finished a training course for HIV Peer Educator and I will be going out to the community to teach others about HIV/AIDS prevention and treatment.  One of the things we do is give out info concerning HIV/AIDS and Hepatitis C, so I would like to be able to know where I can tell others to look up info about this supplement.

Any consideration given to this matter will be greatly appreciated.

Thank You, Linda 

Hello Linda,
Congratulations on finishing the training course for HIV Peer Educator. Visit the link here to find additional information on NutriVir. 

Hello
You can find more information from Nutrivir's website. The are a smaller company out of Ithaca, New York. There is information about insurance reimbursement for the supplement, the "noteworthy" ingredients in Nutrivir like Whey protein -&- L-glutamine, recommended dosage, product ordering, as well as other links. 

Julie Engberg, RD
San Francisco
 

FYI-- The FDA is notifying pharmacists and other healthcare professionals about an urgent class I recall of injectable colchicine and other injectable pharmaceuticals distributed by Phyne Pharmaceuticals of Scottsdale, Arizona. The products listed are varied and range from drugs to substances such as Ascorbic Acid, Vitamin B-12, (L) Glutathione, Human Chorionic Gonadotropin, Iron, and others.

Phyne has issued a recall due to the lack of Current Good Manufacturing Practice (CGMP)compliance at its contract manufacturing site in Rathdrum, ID (Amram, Inc).  The lack of CGMP's includes, but is not limited to, the lack of assurance of sterility in these injectable products and super-potency of its Colchicine product labeled as .5 mg/mL, but actually formulated at 5 mg/mL.  It is important that you
immediately examine your drug supplies for any of these products and if found, discontinue dispensing or use and return them to Phyne Pharmaceuticals.  If you have further distributed any of these products, immediately contact your accounts and advise them of the recall situation. Please  refer to the complete recall notice for the full list of these recalled products.

Subject: Solgar Vitamin And Herb Company Recalls Solgar's Digestive Aid 100's Dietary Supplements Because Of Possible Salmonella Contamination
Date:    Monday, April 30, 2001 12:34 PM
From: HIV Nutrition Discussion List - Sharon Ann Meyer

(NOTE: This FDA Talk Paper was released on Friday, April 27, 2001, and is being re-sent to accomodate a technical request. No changes have occurred from the original text).

Consumer Inquiries: 888-INFO-FDA

Solgar Vitamin And Herb Company Recalls Solgar's Digestive Aid 100's Dietary Supplements Because Of Possible Salmonella Contamination

Solgar Vitamin and Herb Company of Leonia, New Jersey, is recalling 754 bottles of Solgar's Digestive Aid 100's dietary supplements, because they have the potential to be contaminated with Salmonella, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

Solgar Bottles of Solgar's Digestive Aid 100's were distributed from March 30, 2001, to April 20, 2001, to retail stores nationwide and in some foreign countries, including the United Kingdom, France and Israel. The product comes in brown bottles with yellow labels that have an orange stripe on the bottom. The bottles being recalled are marked with lot numbers 31993 or 30957 that are printed above the expiration date on the bottle neck.   The label reads in part, "Solgar Digestive Aid - Dietary
Supplement - 100 Tablets - Sugar and Starch free."

No illnesses from this product have been reported to date. The recall was the result of a routine sampling program by American Laboratories Inc., of Omaha, Nebraska, which detected Salmonella in the raw material, pepsin, that was used in Solgar's dietary supplement.  FDA's investigation of the situation continues.

Consumers who purchased this product are urged to not consume it and should instead destroy it or return it to the place of purchase for a full refund. Consumers with questions may contact the company at 201/944-2311.
 

If you would like to meet HIV positive people from Russia, to take new friends, please send information about your self to the Russian magazine “Steps” (Shagi).
Please remember to include your contact information (e-mail address).

I started yesterday on Serostim injections,  Can anyone give me  any info at all like side effects if any and what should I expect and when.--Thanks Mike
 

Hi Mike,
These two web sites offer a lot of information on Serostim but are two different points of view:
Medibolics
Serono

My husband is classified as AIDS and he has had two AIDS episodes.  He's doing very well on the cocktail.  I've recently read a disturbing article in Newsweek as to the long term effects of the cocktail, such as terminal liver damage.  Will this new research on HIV be of any help to those who already have AIDS and do you know of any more research on long-terms effect of the HIV and what to watch for?  Thanks for your help
 

Other long-term effects of the cocktail are diabetes, heart disease and osteoporosis (bone loss). If he has not already done so, your hubby may find that a visit with a nutritionist could be helpful in helping to maybe lessen the risk of the above diseases.

I don't know if this research will lead to help for people already HIV+ but hopefully it may. There's lots of research on the above at Medscape.com You can enter the subjects you'd like to know about in the search engine to read some of the articles. The site requires registration but you can enter a fake name if you want, as some people do, along with a fake email address from hotmail.com or yahoo.com. That is if you don't like to use your own name. Another good site is AEGIS. 

hi..I just wanted to know if someone can get AIDS from coming in contact with vomit from an infected person..for example, if the vomit gets on your hands, where you have cuts...

Hi, 
I do not know for sure but I would err on the side of caution and if this has happened get tested. I am not aware of a transmission case due to vomit but it is a body fluid and since we know HIV is in blood, sperm, vaginal fluids and saliva I wouldn't take any  chances. 

Take Care

FYI:
FDA WARNS CONSUMERS ABOUT VIVA BRAND IMPORTED CANTALOUPE
The FDA is advising consumers of an outbreak of foodborne illness associated with cantaloupe from two Mexican companies, S.P.R. De  R.I. Legumbrera San Luis and S.P.R. De R.I. Los Arroyos, and imported by Shipley Sales Service of Nogales, Arizona. This outbreak of Salmonella poona has involved numerous illnesses and two deaths in Arizona, California, Connecticut, Georgia, Hawaii, 
Massachusetts, Minnesota, Missouri, New Mexico, Nevada, New York, Oregon, Tennessee and Washington state.

Salmonella poona is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella poona often experience fever, diarrhea, nausea, vomiting and abdominal pain.

In rare circumstances, infection can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.

The cantaloupe was sold in retail stores and restaurants and possibly served in health care facilities. Fresh cantaloupe has a shelf life of 14-18 days.

As a result of this investigation, FDA has taken steps to prevent the importation of any other contaminated cantaloupe. FDA is detaining all cantaloupe imported by Shipley Sales Service from S.P.R. De R.I. Legumbrera San Luis and S.P.R. De R.I. Los Arroyos. FDA, States and other government agencies are continuing to investigate this matter. Retailers, restaurants and food service operations should determine if any of their existing stock of cantaloupe was purchased or sold under the Viva brand name, and if so, remove from sale. Any cantaloupe bearing this brand name should not be consumed.

Although Viva is the only brand associated with this outbreak, FDA continues to recommend that consumers take the following steps with cantaloupe and other produce to reduce the risk of foodborne illness. This supports advice given by the state of California.

*       Purchase produce that is not bruised or damaged. If buying fresh cut produce, be sure it is refrigerated or surrounded by ice.

*       After purchase, put produce that needs refrigeration away promptly. (Fresh whole produce such as bananas and potatoes do not need refrigeration.) Fresh produce should be refrigerated within two hours of peeling or cutting. Leftover cut produce should be discarded if left at room temperature for more than two hours.

*       Wash hands often. Hands should be washed with hot soapy water before and after handling fresh produce, or raw meat, poultry, or seafood, as well as after using the bathroom, changing diapers, or handling pets.

*       Wash all fresh fruits and vegetables with cool tap water immediately before eating. Don't use soap or detergents. Scrub firm produce, such as melons and cucumbers, with a clean produce brush. Cut away any bruised or damaged areas before eating.

*       Wash surfaces often. Cutting boards, dishes, utensils, and counter tops should be washed with hot soapy water and sanitized after coming in contact with fresh produce, or raw meat, poultry, or seafood. Sanitize after use with a solution of  1 teaspoon of chlorine bleach in one quart of water.

*       Don't cross contaminate. Use clean cutting boards and utensils when handling fresh produce. If possible, use one clean cutting board for fresh produce and a separate one for raw meat, poultry, and seafood. During food preparation, wash cutting boards, utensils or dishes that have come into contact with fresh produce, raw meat, poultry, or seafood. Do not consume ice that has come in contact with fresh produce or other raw products.

*       Use a cooler with ice or use ice gel packs when transporting or storing perishable food outdoors, including cut fresh fruits and vegetables. ####
 

Check out "GUIDANCE FOR PEOPLE WITH SEVERELY WEAKENED IMMUNE SYSTEMS"
 

Here's some information on a supplement recall for products used in many fitness centers. For the full talk paper visit the FDA web site.

FDA Talk Papers are prepared by the Press Office to guide FDA personnel in responding with consistency and accuracy to questions from the public on subjects of current interest. Talk Papers are subject to change as more information becomes available.

T00-64    Print Media: 301-827-6242
November 21, 2000   Broadcast Media: 301-827-3434
Consumer Inquiries: 888-INFO-FDA
FDA WARNS AGAINST CONSUMING DIETARY SUPPLEMENTS CONTAINING TIRATRICOL

The Food and Drug Administration is again warning consumers of products marketed as dietary supplements that contain tiratricol, also known as triiodothyroacetic acid or TRIAC, a potent thyroid hormone that may cause serious health consequences including heart attacks and strokes. Despite four recalls over the past seven months, various products that contain tiratricol may still have reached consumers. FDA urges all consumers to stop using such products immediately.

On November 11, 1999, FDA warned the public against consuming Triax Metabolic Accelerator, a dietary supplement for weight loss by Syntrax Innovations, Inc., Cape Giradeau, Mo. Since this action, several other firms have recalled similar products containing tiratricol. Distribution of these products has been primarily through retail sales to health food stores, fitness centers, and gymnasiums. There have been four additional such recalls.
 

Just forwarding this on zinc for you. 

April 11, 2001
NUTRITION NEWS FOCUS
"Nutrition news is important.  We help you understand it!"

Today's Topic: New Zinc Recommendation

Zinc is a cofactor for many enzymes in the body and is vital for normal gene function.  Zinc is found in red meat, some seafood and whole grains, and in fortified breakfast cereals.  The new RDA was set at 11 milligrams for men and 8 milligrams for women. It is recommended that vegetarians get one and a half times those amounts because plant sources are not as well absorbed.

Just like iron, human milk does not contain enough zinc for older infants, so babies over six months require supplemented food or formula to provide adequate zinc.  The upper limit for zinc was set at 40 milligrams daily, primarily based on interference with copper absorption at high levels of intake.

HERE'S WHAT YOU NEED TO KNOW: Zinc is one of the nutrients that
many American do not get in sufficient quantity. Despite this, there is concern about use of zinc lozenges for treating colds.  Following directions on these supplements can provide over 100 milligrams daily.  While this is not intended for long-term use, there still may be adverse effects including lowering of HDL-cholesterol and temporary suppression of the immune system, just the opposite of what you want when fighting off a cold.

*****************************************************************
Please recommend Nutrition News Focus to your family and friends.
DISCLAIMER: The information in Nutrition News Focus is intended only to help you understand the Nutrition News.  We do not recommend any treatment, food or supplement.  It is not intended to replace the advice of a physician.  If you read something in this newsletter that in any way contradicts what your physician tells you, TAKE YOUR PHYSICIAN'S ADVICE, NOT OURS.
Copyright 2001 Nutrition News Focus Inc.
 

In our HIV ReSource Review (Issue 16- abstract)  literature review of zinc we noted that: 

"Zinc status can be assessed by measuring static indices (serum/plasma, red or white blood cells, urine or hair), or functional indices such as isotope turnover tests. (33) Although most clinicians measure zinc in plasma or blood cells these parameters do not appear to be reliable and sensitive predictors of zinc status. (5, 43) Plasma zinc concentrations are influenced by conditions such as infection, stress, hypoalbuminemia, hormonal state, drugs that alter binding to plasma proteins, oral contraceptives,
nutritional deficiency and food intake. (5, 33, 122) Experimental as well as clinical studies indicate that systemic infections, which produce an acute phase response, cause the plasma zinc concentration to fall. (123) In addition, plasma zinc concentrations do not reflect recent changes in dietary zinc. (33) A fairly common test, hair zinc, affected by age and other factors, is not of value in clinical practice. (33, 124) It's important to realize that patients with normal plasma or serum zinc may still be deficient
in zinc. 

Researchers have noted a correlation between zinc levels and albumin in PLWHIV. (11, 125) Some note that zinc deficiency should be assessed independently of albumin. (11, 126) The measurement of serum metallothionein may be useful in diagnosing zinc deficiency but it is affected by protein status. (33, 43, 127) Australian scientists caution that true deficiency can be diagnosed only after serum or plasma levels are adjusted for serum albumin and total protein concentrations. (11) Amelioration of symptoms in response to increased zinc intake confirms severe clinical zinc deficiency. (24) Beck and colleagues noted that increases in absolute lymphocyte count, CD4/CD8 T-cell ratio and other immune system parameters after zinc treatment may offer a useful diagnostic criterion for zinc deficiency. (113) One of the best lab indicators of zinc levels, which may be used in the future, is alkaline phosphatase activity because it's deprived of its zinc quite readily. (25, 52, 128, 129) For now, a more accurate assessment of zinc status may be realized through a combination of measurements. (33)". 

References 
5. Raiten D. Nutrition And HIV Infection. A Review And Evaluation Of The Extent Of Knowledge Of The Relationship Between Nutrition And HIV Infection. Bethesda, MD: Life Sciences Research Office, Federation of American Societies for Experimental Biology; 1990.

11. Malcolm JA, Sutherland DC. When Do Low Serum Levels Of Trace Metals Represent A True Deficiency State? Int Conf AIDS (9th). 1993 Jun 6-11;9(1):527 (abstract no. PO-B36-2353). 

24. Cousins RJ, Hempe JM. Zinc. In: Brown ML, ed. Present Knowledge in Nutrition, Sixth Edition. Washington, D.C: International Life Sciences Institute- Nutrition Foundation; 1990:251-260.

25. Cohen RD, Braunstein NS. Vitasearch Reference Guide To Vitamins And Minerals. Newmarket, NH; 1996. 

33. McBean LD. Zinc In Human Nutrition. Second edition. National Cattlemen's Beef Assoc: Chicago, IL; 1997. No. 17-214 49715. 

43. Sullivan VK, Burnett FR, Cousins RJ. Metallothionein Expression Is Increased In Monocytes And Erythrocytes Of Young Men During Zinc Supplementation. J Nutr 1998; 128(4): 707-713. Downloaded 5 April 1998.

113. Beck FW, Kaplan J, Fine N, Handschu W, Prasad AS. Decreased Expression Of CD73 (ecto-5'-nucleotidase) In The CD8+ Subset Is Associated With Zinc Deficiency In Human Patients. J Lab Clin Med. 1997;130(2):147-56.

52. Myers C. HIV & Zinc and Copper revisited. CATIE Resource Centre holding; March 1997. Accessed 4 June 1998.

122. Donovan UM, Gibson RS. Iron And Zinc Status Of Young Women Aged 14 To 19 Years Consuming Vegetarian And Omnivorous Diets. J Am Coll Nutr. 1995;14(5):463-72. 

123. Brown KH. Effect Of Infections On Plasma Zinc Concentration And Implications For Zinc Status Assessment In Low-Income Countries. Am J Clin Nutr. 1998 Aug;68(2 Suppl):425S-429S. 

124. Barrett S. Commercial Hair Analysis: A Cardinal Sign of Quackery. QuackWatch Home Page. Accessed 19 Nov 1998.

125. Heise W, Nehm K, L'Age M, Averdunk R, Gunther T. Concentrations Of Magnesium, Zinc And Copper In Serum Of Patients With Acquired Immuno-Deficiency Syndrome. J Clin Chem Clin Biochem. 1989;27(8):515-7.

126. Koch J, Neal EA, Schlott MJ, Garcia-Shelton YL, et al. Serum Zinc And Protein Levels: Lack Of A Correlation In Hospitalized Patients With AIDS. Nutrition. 1996;12(7-8):511-4. 

127. Sullivan VK, Cousins RJ. Competitive Reverse Transcriptase-Polymerase Chain Reaction Shows That Dietary Zinc Supplementation In Humans Increases Monocyte Metallothionein mRNA Levels. J Nutr. 1997; 127:694-698. Downloaded 17 Jan 1998. 

128. Faure H, Favier A, Tripier M, Arnaud J. Determination Of The Major Zinc Fractions In Human Serum By Ultrafiltration. Biol Trace Elem Res. 1990;24(1):25-37. 

129. Lin TH, Cheng SY. Determination Of Zinc Fractions In Human Blood And Seminal Plasma By Ultrafiltration And Atomic Absorption Spectrophotometry. Biol Trace Elem Res. 1996;51(3):267-76.