Intraocular pseudotumor in a patient with Aids. Block excision, differential diagnosis, histology

Summary Background: Intraocular pseudotumors are a rare event in Aids patients and often pose diagnostic problems. Case report: A 37-year-old patient who had had HIV seroconversion for 7 years was seen to developed progressively growing, multiple, disseminated, subretinal lesions OD > OS, accompanied by exudative retinal detachment and iritis. Since all etiological laboratory diagnostic efforts to detect an infectious, noninfectious and neoplastic systemic lesion failed, a diagnostic and curative therapeutic chorioretinal excisional biopsy specimen of the largest of the tumors (3 × 3 × 2 mm) was taken. The histological work-up demonstrated granulation tissue similar to an intracular pseudotumor without signs of infection, malignancy or reactive lymphoid hyperplasia. This finding resulted in systemic corticosteroid treatment with complete resolution of the lesions in both eyes and no recurrences. Conclusions: An invasive diagnostic procedure in patients suffering from lesions of unknown cause resulting in the institution of an appropriate medical treatment may be beneficial for the integrity and vision of the respective eye.      

Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006

PURPOSE: To characterize the population of HIV+ Brazilian patients with late introduction of antiretroviral therapy (ARVT), using information from the Laboratory Exam Control System. METHODS: The study analyzed 84,694 patients, representing all individuals in Brazil age 15 or over with an initial CD4+ T lymphocyte count requested between 2003 and 2006, and whose ARVT start date was later than their initial CD4+ T cell count. These patients were considered antiretroviral treatment naive. The initial CD4+ T cell distribution was analyzed according to sex, age, region and year. RESULTS: Most of the patients were between 15 and 49 years of age (91%); 56% were males; 76% were asymptomatic; 50% lived in the Southeastern region of the country, with an additional 20% in the South. Initial CD4+ counts for one-third of the patients were less than 200 cells/mm(3). When combined with the number of symptomatic individuals, 41% of the total group was in need of immediate ARVT. This group included 47% of the men and 53% of the patients aged 50 years and over. CONCLUSIONS: Despite universal access to ARVT in Brazil, results show that a high proportion of patients initiate ARVT at an advanced stage of disease, indicating the need to develop strategies to promote early diagnosis of HIV infection nationwide.     

Child Care Providers' Use of HIV/AIDS Information Resources: Links to Professional Background Variables and Feelings about Caring for an HIV-Infected Child

The purpose of this study was to examine child care providers' use of different types of HIV/AIDS information resources in relationship to professional background variables and their feelings about caring for an HIV-infected child. The providers' level of education, years in the child care field, and the age group for which they were responsible were significantly correlated with two print media resources (newspaper and magazine articles; pamphlets) and one institutional resource (child care educational workshops). One HIV/AIDS resource (TV and radio programming) was significantly correlated with providers' negative feelings about caring for an HIV-infected child. In addition, one information resource (direct contact with an HIV-infected individual) was significantly correlated with providers' positive feelings about caring for an HIV-infected child. Results are discussed in relationship to HIV/AIDS child care training issues.     

安康市男男性行为人群HIV感染状况及高危行为调查分析

目的分析安康市男男性行为人群（MSM）干预前后对艾滋病知识的认知及行为学变化,为控制艾滋病传播及有针对性地对MSM人群采取有效干预措施提供依据。方法依托民间组织,采用同伴或调查对象巨相推荐的方法招募调查对象,对调查对象进行问卷调查和血清学检测。结果共调查MSM195人,大专及以上学历70．8％。职业以学生和公司职员为主。寻找性伴的方式以互联网为主,占74．4％。艾滋病知识知晓率91．35％。最近6个月55．4％（108人）与同性发生过肛交性行为,其中59．3％（64人）每次都使用安全套;108人中14．8％（16人）与同性发生过商业性行为,68．8％每次都使用安全套。最近6个月13．8％与女性发生过性行为,59．3％每次都使用安全套。最近1年75．4％接受过安全套发放／艾滋病咨询,46．7％做过HIV检测,HIV确认阳性3例,感染率1．54％。结论安康市MSM人群危险因素主要与年龄小、互联网隐蔽性助推、安全套的使用率低有关。提示工作重点应放在利用网络进行宣传,促进安全性行为的形成,扩大HIV检测,以遏制艾滋病的传播和流行。     

艾滋病元素医学食疗中心

笔者自2003年至2006年用元素医学食疗法治疗40余例艾滋病获突破，其中完全治愈两人，一个5岁小女孩、一个是65岁老人。2006年5月40岁中年妇女，在进行Hiv病毒抗体检验开始转阴，病人为生活所迫外出打工终止食疗，于6月份再次进行Hiv病毒抗体检验又转变为阳性。笔者于是决定对即将痊愈艾滋病人集中食疗，效果非常有效，建立艾滋病元素医学食疗中心是个好办法。     

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

IntroductionThe elderly population is increasingly benefiting from recent technological advances. In this scenario, geolocation-based dating applications provide a viable alternative for finding partners in a practical and timely manner, but may be accompanied by certain risk behaviors for HIV infection. Although there are considerable number of users over 50 on these applications, no studies have addressed this problem. The aim of the present study was to analyze factors of vulnerability to HIV/Aids among the population of men who have sex with men (MSM) age 50 years or older who use dating apps.MethodsThis was a cross-sectional, population-survey-based, analytical study, conducted exclusively online with a sample of 412 MSM. The data was collected from the following apps: Grindr®, Hornet®, Scruff® and Daddy Hunter®.ResultsFactors associated with a higher chance of having HIV were: sexual relations with an HIV-infected partner (ORa = 5.53; 95%CI = 2.23–13.73); chemsex (ORa = 3.97; 95%CI = 1.72–8.92); and, above all, having an HIV-infected partner (ORa = 8.02; 95%CI = 2.01–32.01). The belief that apps increase protection against sexually transmitted infections (ORa = 0.43; 95%CI = 0.19–0.95) and not being familiar with post-exposure prophylaxis (ORa = 0.43; 95%CI = 0.19–0.95) were associated with decreased chances of having HIV.ConclusionsWe highlight some important factors that structure the vulnerability of the MSM surveyed in relation to HIV infection. The findings should be used to customize care for this population, which could bring them in more for health care services.     

产钳助产98例临床分析

目的：通过对产钳助产术的回顾性分析,探讨产钳术在处理第二产程头位难产中的安全性及重要作用,指导临床正确使用产钳术。方法：对我科2010年1月-2012年12月共行产钳助产术98例进行回顾性分析。结果：低中位产钳术与低位产钳术、出口产钳术相比较,阴道裂伤差异有统计学意义（P＜0．05）;低产钳术与出口产钳术相比较,阴道裂伤差异无统计学意义（P＞0．05）;三者在阴道血肿、宫颈裂伤、会阴Ⅱ度裂伤、产后出血方面及对新生儿损伤差异无统计学意义（P＞0．05）。结论：第二产程中正确使用产钳术能迅速结束分娩,低中位以下产钳是解决胎儿头位难产、缩短产妇第二产程的有效方法。     

HIV/Aids Related Knowledge of Inmates in Greek Prisons

Within the context of a national study on the prevalence of male inmates' HIV-risk behaviour, we present data regarding the HIV-related knowledge of a sub sample of inmates in terms of modes of HIV transmission, methods of HIV prevention and risks of HIV transmission within prison. The sample comprised a randomly selected group of 242 inmates from the Greek prison with the largest inmate population. Inmates appeared highly knowledgeable regarding transmission via sexual behaviour and the basic modes of reducing risk during sexual intercourse. Nevertheless, high levels of misconception regarding certain sexual practices and drug related issues were also apparent. Significant knowledge gaps regarding risk of HIV transmission in prison also appeared. There were no significant differences between injecting drug users (IDUs) and non-IDUs regarding their knowledge, except on items related to procedural aspects of drug using, with non-IDUs being less knowledgeable. Inmates perceived themselves as knowing 'a medium' amount of information about AIDS. The pattern of knowledge that emerged was that although inmates knew the basic facts about AIDS, they were still ignorant or had misconceptions in significant areas. Results are discussed in relation to similar patterns of HIV-related knowledge that have appeared in other European studies in prison populations and in Greek studies of the general population.     

江西省多部门联合开展防艾工作的做法及经验

文章阐述了江西省艾滋病疫情的背景及观状,分析总结了江西省多部门联合开展防艾工作的主要经验及成效,并提出了进一步的工作建议。     

The Experience and Management of Temporality in Five Cases of Dementia

How persons with dementia may experience time, temporal problems and temporal adaptations in their everyday lives is explored. The clinical implementation process and outcome of time aid interventions in five cases are also described. Data were collected through initial interviews with five participants, diagnosed with dementia, and with three spouses. Thereafter, time aids were chosen for intervention in each case. During the intervention, data were collected through fieldnotes and interviews, including evaluative interviews closing the interventions. The participants described experiences of temporal rhythms and extensions. Their temporal problems mainly concerned temporal relationships and coherence, and "knowing when" and "how long". They individually met the problems with strategies that aimed to overall decrease the effects of the temporal problems in general, as well as with direct and conscious attempts to address problems mainly concerning temporal orientation. When time aids were used, difficulty "knowing when" seemed to be most responsive to aids. However, the success of the time aid interventions was limited, as was the success of the spontaneously used strategies. Motivation and insight seemed to be important, as well as the participants' present and former attitudes to temporality. Possible implications for occupational therapy interventions are discussed, considering the clinical and piloting nature of the study.