Performance of healthy braced participants during aerobic and anaerobic capacity tasks

Context:

Knee braces were introduced in sports approximately 30 years ago. However, the effects of a functional knee brace (FKB) on aerobic and anaerobic performance after fatigue are unknown.

Objective:

To investigate whether FKB use in noninjured participants hindered performance during aerobic (Léger beep test) and anaerobic (repeated high-intensity shuttle test [RHIST]) tasks.

Design:

Crossover study.

Setting:

Laboratory.

Patients or Other Participants:

Twenty-seven healthy male provincial and national basketball and field hockey athletes (age = 19.4 ± 3.0 years, range, 17–26 years; height = 182.6 ± 6.8 cm, range, 168–196 cm; mass = 80.0 ± 9.1 kg, range, 66–108 kg).

Interventions :

Each participant was provided a custom-fitted FKB and performed 5 nonbraced (NBR) testing sessions over 3 days, followed by 5 braced (BR) testing sessions over 3 days, for a total of 17.5 hours of testing per condition. During each testing session, participants performed 1 trial of the Léger beep test and 1 trial of the RHIST in each condition.

Main Outcome Measure(s):

Predicted maximal oxygen consumption (V˙o₂max) and time performance measures were recorded for each NBR and BR trial.

Results:

Initial performance levels were lower for BR than NBR for both the Léger beep test (BR = 44.3 mL/kg/min, NBR = 47.3 mL/kg/min; F_1,26 = 8.726; P = .007) and the RHIST (BR = 16.5 seconds, NBR = 16.2 seconds; F_1,26 = 13.98, P = .001). However, with continued FKB use, the aerobic performance measure remained higher for only the first 2 BR testing sessions (NBR = 46.9 mL/kg/min, BR = 42.4 mL/kg/min; F_3.0,79.8 = 4.95, P = .003). For the anaerobic test, no performance difference was noted between the testing conditions (NBR = 16.2 seconds, BR = 16.4 seconds; P = .7), whereas fatigue levels were lower during BR testing sessions (NBR = 33%, BR = 31%). After 14.0 hours of FKB use, performance levels were almost equal between the testing conditions (NBR = 47.6 mL/kg/min, BR = 46.1 mL/kg/min).

Conclusions:

We found an initial decrement in performance when the FKB was used during an aerobic or anaerobic task. However, after 14.0 hours of FKB use, accommodation to the FKB was possible.     

Two different fatigue protocols and lower extremity motion patterns during a stop-jump task

Context:

Altered neuromuscular control strategies during fatigue probably contribute to the increased incidence of non-contact anterior cruciate ligament injuries in female athletes.

Objective:

To determine biomechanical differences between 2 fatigue protocols (slow linear oxidative fatigue protocol [SLO-FP] and functional agility short-term fatigue protocol [FAST-FP]) when performing a running-stop-jump task.

Design:

Controlled laboratory study.

Setting:

Laboratory.

Patients or Other Participants:

A convenience sample of 15 female soccer players (age = 19.2 ±0.8 years, height = 1.67±0.05m, mass = 61.7 + 8.1 kg) without injury participated.

Intervention(s):

Five successful trials of a running–stop-jump task were obtained prefatigue and postfatigue during the 2 protocols. For the SLO-FP, a peak oxygen consumption (V˙o₂peak) test was conducted before the fatigue protocol. Five minutes after the conclusion of the V˙o₂peak test, participants started the fatigue protocol by performing a 30-minute interval run. The FAST-FP consisted of 4 sets of a functional circuit. Repeated 2 (fatigue protocol) × 2 (time) analyses of variance were conducted to assess differences between the 2 protocols and time (prefatigue, postfatigue).

Main Outcome Measure(s):

Kinematic and kinetic measures of the hip and knee were obtained at different times while participants performed both protocols during prefatigue and postfatigue.

Results:

Internal adduction moment at initial contact (IC) was greater during FAST-FP (0.064 ±0.09 Nm/kgm) than SLO-FP (0.024±0.06 Nm/kgm) (F_1,14 = 5.610, P=.03). At IC, participants had less hip flexion postfatigue (44.7°±8.1°) than prefatigue (50.1°±9.5°) (F_1,14 = 16.229, P=.001). At peak vertical ground reaction force, participants had less hip flexion postfatigue (44.7°±8.4°) than prefatigue (50.4°±10.3°) (F_1,14 = 17.026, P=.001). At peak vertical ground reaction force, participants had less knee flexion postfatigue (−35.9°±6.5°) than prefatigue (−38.8°±5.03°) (F_1,14 = 11.537, P=.001).

Conclusions:

Our results demonstrated a more erect landing posture due to a decrease in hip and knee flexion angles in the postfatigue condition. The changes were similar between protocols; however, the FAST-FP was a clinically applicable 5-minute protocol, whereas the SLO-FP lasted approximately 45 minutes.     

Zero prevalence of parasites associated with oral lesions of HIV infected and AIDS patients in South Western Uganda

Background

Despite paucity of information regarding oral lesions with parasitic etiology, parasitic diseases continue to be problematic among impoverished and immunocompromised individuals in developing countries.

Objective

To determine the prevalence of parasites in the oral lesions of Ugandan HIV infected and AIDS patients, in South Western Uganda.

Methods

Adult HIV/AIDS positive patients attending The AIDS Support Organization Clinics in South Western Uganda with oral lesions were recruited for this study. Standard parasitological methods (direct microscopy, saline and iodine wet preparations, Giemsa-Romanosky staining of smears and culture) were adopted in analysis of randomly collected six hundred and five samples (469 from females; 136 from males) for parasites.

Results

No ova, cyst, trophoziotes, lava or segment of parasites were seen in the oral lesions identified among the studied population.

Conclusion

Parasites were absent and therefore may not be implicated as etiologic microbial agents of observed oral lesions associated with HIV infected and AIDS patients living in South Western Uganda     

Ocular manifestations in paediatric HIV/AIDS patients in Mulago Hospital,Uganda

Background

In Uganda the prevalence of HIV averages 12% as was reported to the STD/AIDS control surveillance unit. In Uganda there are approximately 30,000 HIV infected infants per year. The burden of HIV disease is high in Uganda and patients present with ocular complications. However, there is paucity of information and knowledge concerning ocular manifestations in the paediatric HIV/AIDS population and how they may differ from those of adults.

Objectives

To describe the ocular manifestations of HIV/AIDS infection in an African paediatric population. Generally the study will record the external ocular manifestations seen but specifically to document the intra-ocular lesions, in particular the retinal changes associated with paediatric HIV/AIDS.

Design

A cross-sectional hospital based study.

Setting

The study was conducted at the Paediatric Infectious Disease Clinic at Upper Mulago Hospital, in Kampala, Uganda.

Patients

Patients are those with positive HIV sero status, with or without symptoms and signs of AIDS.Parents/caretakers of the children were interviewed to obtain the socio-demographic data of the patients and a general physical as well as an ophthalmic examination were conducted to document any ocular problems.

Results

A total of 158 HIV -infected children were examined. The overall rate of ophthalmic involvement was 35%. The most common finding was a non-purulent conjuctivitis, observed in 12% of the patients, followed by perivasculitis of the peripheral retinal vessels, in 12 % of patients and molluscum contagiosum.     

Eligibility for HIV/AIDS treatment among adults in a medical emergency setting at an urban hospital in Uganda

Background

Despite global effort to scale up access to antiretroviral therapy (ART), many people in need of HIV/AIDS care in Uganda have not been reached. HIV testing and ART are not widely offered as routine medical services and data on HIV/AIDS in emergency settings in Sub-Saharan Africa is limited.We determined the HIV prevalence and eligibility for ART in a medical emergency unit at Mulago hospital.

Methods

In a cross-sectional study, we interviewed 223 patients who were systematically selected from the patients'' register from October through December 2004. HIV testing was offered routinely and results were delivered within 30 minutes. We evaluated HIV infected patients for WHO clinical stage of disease and referred them for HIV/AIDS care.

Results

Out of 223 patients, 111 (50%) had HIV infection of whom 78 (70%) had WHO clinical stage 3 and 4 of disease thereby requiring ART. Overall, 84 out of 111 (76%) HIV positive patients had not received any specific HIV/AIDS care.

Conclusion

The burden of HIV infection in the medical emergency unit is high and majority of the patients who required ART had no prior HIV/AIDS care. We recommend scale up of HIV/AIDS care in acute care settings in order to increase access to ART.     

Attitude of Lesotho health care workers towards HIV/AIDS and impact of HIV/AIDS on the population structure

Background

The impact and management of HIV/AIDS in Lesotho in the context of disaster management was investigated.

Objectives

Lesotho health care workers'' perception on HIV/AIDS progression, whether HIV/AIDS was managed as a disaster, and the impact on the demographic profile was investigated.

Methods

The empirical investigation included a literature study, and primary and secondary data analyses. Questionnaires (n=116) determined health care workers'' perception of HIV/AIDS. Interviews with officers of Lesotho Disaster Management determined how HIV/AIDS was managed as a disaster. National population censuses and data from surveys were summarised to describe the impact of HIV/AIDS on the population structure.

Results

Respondents'' modal age group was 25 to 39 years, 28.4% viewed HIV/AIDS related deaths as very high and perceived that HIV/AIDS changed the age composition, sex and dependency ratio of the population. Although HIV/AIDS was declared a disaster, the Lesotho Disaster Management Authority only aided the National AIDS Commission. There was evidence that HIV/AIDS caused the population pyramid base to shrink, and an indentation in the active population.

Conclusion

Health care workers attributed HIV/AIDS to changing the demographic profile of Lesotho, also reflected in the population pyramid. Lesotho Disaster Management Authority played a supporting role in HIV/AIDS disaster management.     

A non-specific biomarker of disease activity in HIV/AIDS patients from resource-limited environments

Background

A general non-specific marker of disease activity that could alert the clinician and prompt further investigation would be of value in patients with HIV/AIDS, especially in resource limited environments.

Objective

To investigate the potential of neopterin as non-specific biomarker in patients with advanced HIV/AIDS.

Methods

Cross-sectional study in 105 HIV positive patients (75 on highly active antiretroviral treatment (HAART). Neopterin was assessed by enzyme linked immune-absorbent assay and cytokines by flow cytometry.

Results

Neopterin levels were significantly higher (p<0.001) for the total patient than for the control group. Significant correlations between neopterin and plasma indicators of inflammation showed neopterin to be a good indicator of active inflammatory status and of the effect of HAART on the immune system. Neopterin was superior to C-reactive protein and to individual cytokines as indicator of immune deficiency. Increased neopterin levels were associated with a decline in albumin, haemoglobin and the albumin/globulin ratio, and with increases in red cell distribution width.

Conclusions

Plasma neopterin is a good non-specific biomarker of disease activity in HIV/AIDS patients. It is a good indicator of inflammatory activity, perpetuation of inflammation-associated co-morbidities, degree of immune deficiency and has predictive value for underlying disease, and for monitoring the HAART response.     

Prevalence of cryptococcosis among HIV-infected patients in Yaounde, Cameroon

Background

Cryptococcus neoformans is encapsulated yeast which causes life-threatening infections in up to 40% of AIDS patients in Africa.

Objective

To investigate the prevalence of cryptococcosis among HIV infected patients in Yaounde.

Methods

In a hospital-based surveillance study of cryptococcosis, the colonization of Cerebrospinal Fluid (CSF), urine and blood sample by C. neoformans was evaluated by direct microscopic examination and culture techniques. Data obtained were then analyzed based on the medical records of the patients.

Results

Among the105 patients sampled for the study, the CD4 counts varied between 31 and 304 lymphocytes/mm³. Direct specimens examination (n= 294) in India ink preparations revealed polysaccharide capsule in 25 (8.5%) of the samples. Upon culture, 29 (9.86 %) samples were positive of C. neoformans (23 from the CSFs and 6 from the urine). All the positive samples were obtained from patients who were not on Antiretroviral Therapy (ART). Meningo-encephalitis symptoms were observed in 13 patients with C. neoformans in CSFs.

Conclusion

This study reveals that cryptococcosis is rife in AIDS patients in Yaounde. Therefore, to minimize the death toll, we recommend that its routine check should be integrated in the management of HIV/AIDS patients.     

The spectrum of liver diseases in HIV infected individuals at an HIV treatment clinic in Kampala, Uganda

Background

Liver diseases are common in patients with HIV due to viral hepatitis B and C co-infections, opportunistic infections or malignancies, antiretroviral drugs and drugs for opportunistic infections.

Objective

To describe the spectrum of liver diseases in HIV-infected patients attending an HIV clinic in Kampala, Uganda.

Method

Consecutive patients presenting with jaundice, right upper quadrant pain with fever or malaise, ascites and/or tender hepatomegaly were recruited and underwent investigations to evaluate the cause of their liver disease.

Results

Seventy-seven consecutive patients were recruited over an eleven month period. Of these, 23 (30%) had increased transaminases because of nevirapine (NVP) and/or isoniazid (INH) hepatotoxicity. Although 14 (61%) patients with drug-induced liver disease presented with jaundice, all recovered with drug discontinuation. Hepatitis B surface antigen was positive in 11 (15%) patients while anti-hepatitis C antibody was reactive in only 2 (3%). Probable granulomatous hepatitis due to tuberculosis was diagnosed in 7 (9%) patients and all responded to anti-TB therapy. Other diagnoses included alcoholic liver disease, AIDS cholangiopathy, hepatocellular carcinoma, schistosomiasis, haemangioma and hepatic adenoma. Twelve (16%) patients died during follow-up of which 7 (9%) died because of liver disease.

Conclusion

Drug history, liver enzyme studies, ultrasound, and hepatitis B and C investigations identified the probable etiology in 60 (78%) of 77 patients with HIV infection presenting with symptoms and/or signs of liver disease.     

HIV/AIDS knowledge among undergraduate university students: implications for health education programs in Ghana

Background

Globally, the spread of HIV/AIDS remains on the rise especially among adolescents who are at increased risk of infection. Sexual behavioural change remains one of the most effective ways of preventing further transmission among this vulnerable group.

Objective

To evaluate HIV/AIDS knowledge among undergraduate students'' and how it can be used in HIV prevention strategies in Ghana.

Methods

A cross-sectional study was conducted using structured questionnaires among 324 conveniently selected students enrolled at a tertiary institution in Accra, Ghana.

Results

The mean age of the respondents was 23 years. Although the mean score of the participants'' responses to 12 HIV/AIDS knowledge questions was 7.7 of 12 points, there was an inconsistent level of AIDS knowledge with significant gender difference. While students could identify the transmission modes and preventive measure, they were less knowledgeable about the causative agent of AIDS. Majority of the students reported having received AIDS information from both print and electronic media, but few of them received such information from parents. Although over 90% of the students knew where to access VCT services, 45% of them have not had HIV test.

Conclusion

The data underscore the urgent need for HIV/AIDS-related health education and prevention efforts targeting university students as well as younger age groups in Ghana     

The effect of age on knowledge of HIV/AIDS and risk related behaviours among army personnel

Background

HIV/AIDS has been described as the fourth largest cause of death globally and leading cause of death in Africa^. HIV/AIDS has been a devastating inferno for nearly 30 years, and has particularly impacted countries in sub-Saharan Africa^. In most African countries, it has been reported that the HIV infection amongst the military has been shown to be about 2 to 5 times higher than their civilian counterparts.

Objective

To address the knowledge level of HIV/AIDS and risk-related behaviours in military personnel, a well-described high risk groups for HIV/AIDS.

Methods

A cross-sectional study among army personnel in 82 Division Nigerian Army Headquarters Enugu, which has a population of about 1777. A random sampling in all the departments of 82 Division Nigerian Army Headquarters was done using the ballot method to select the respondents. Approval for the study was obtained from the General Officer in Command (GOC) of the 82 Division Nigerian Army Headquarters Enugu.

Results

There were no significant differences between the risk related behavior variables when comparisons were made between those under 30 years, and those 30 years and above. Furthermore, more respondents under 30 years (48.0%) did not seek medical treatment when infected with another STI before having sex again as against 45% of those above 30 years. Most of the respondents (9.1%) under the age of 30 years believed that HIV/AIDS could be contracted through mosquito bites as against 2.8% of those above 30 years.

Conclusion

The knowledge level of HIV/AIDS among the army personnel was high, though misconceptions about transmission modes like getting HIV through the bites of mosquitoes and casual body contacts were noted, especially among those under 30 years of age.     

Collaboration between the national tuberculosis programme and a non governmental organisation in TB/HIV care at a district level: experience from Tanzania

Background

The increase in tuberculosis and HIV/AIDS patients in many countries in Africa including Tanzania, is outstripping the ability of public health services to cope. This calls for a closer collaboration between tuberculosis programmes and other stakeholders involved in HIV/AIDS care.

Objective

To determine the feasibility of establishing collaboration between the tuberculosis programme and an NGO in TB/HIV care at a district level in Tanzania.

Methods

Quantitative and qualitative study designs involving TB as well as HIV suspects and patients together with health workers, were conducted between December, 2001 and September, 2002.

Results

A total of 72 patients and 28 key informants were involved. The collaboration was in the following areas; voluntary counselling and testing for HIV, diagnosis and treatment of TB, referral and follow up of patients and suspects, home based care, psychological support and training. . Both the tuberculosis programme and NGO benefited from the collaboration. TB case detection among PLWA increased more than three folds and TB treatment was integrated in home based care of NGO. The main barriers identified in this study were; poor communication, poor referral system and lack of knowledge and skills among health staff.

Conclusion

The study has shown that it is possible for a tuberculosis programme and a non governmental organisation to collaborate in TB/HIV care. The study has also identified potential areas of collaboration and barriers that needed to be overcome in order to provide such comprehensive services at a district level.     

Sexual dysfunctions among people living with AIDS in Brazil

INTRODUCTION

Sexual dysfunction symptoms in patients with HIV have not been fully investigated in Brazil.

OBJECTIVES

To investigate the association between sexual dysfunction symptoms and AIDS among participants in the Brazilian Sex Life Study.

METHODS

The Brazilian Sex Life Study is a cross-sectional population study. The participants answered an anonymous self-responsive inquiry. It was applied to a population sample in 18 large Brazilian cities. Answers given by those who reported having AIDS (75) were compared with those who reported not having AIDS (control; 150). This was a case-control study nested in a cross-sectional population study.

RESULTS

In females, AIDS was associated with “sexual inactivity over the last 12 months” and “does not maintain sexual arousal until the end of the sex act” (P < 0.05) after adjusting for race and thyroid disease. Compared to the control group, men with AIDS had more difficulty becoming sexually aroused (they required more help from their partner to begin the sex act, they required longer foreplay than they wished, they reported losing sexual desire before the end of the sex act, and they required longer to ejaculate than they desired) (P < 0.05). After adjusting for sexual orientation, sex hormone deficiency, depression, and alcoholism, only “does not have sexual desire,” “have longer foreplay,” and dyspareunia were associated with AIDS.

DISCUSSION AND CONCLUSIONS

The results support the hypothesis that sexual dysfunctions are associated with AIDS. Men with AIDS need more time and stimulation to develop a sexual response, and a significant portion (37%) of women with AIDS reported sexual inactivity over the last 12 months.     

Family communication about HIV/AIDS and sexual behaviour among senior secondary school students in Accra,Ghana

Background

Sexually active adolescents in Ghana are increasingly at risk of HIV and other sexually transmitted infections. As a primary agent of socialization, the family can exert a strong influence on adolescent sexual behaviour. Therefore, to aid in the design and implementation of effective prevention programmes, it is important to understand the role of the family in influencing sexual behaviour among school-going adolescents.

Objectives

To evaluate the relationship between family communications about HIV/AIDS and sexual activity and condom use among school-going adolescents in Accra, Ghana.

Method

A sample of 894 students (56.9% girls, 43.1% boys; mean age = 17.4 years, SD = 1.40) at two senior secondary schools in Accra completed a modified version of the Youth Risk Behavior Survey (YRBS) questionnaire, a self-administered instrument developed by the Centers for Disease Control and Prevention. Analytical techniques utilized included logistic regression and chisquare.

Results

Twenty-five percent of the participants reported being sexually experienced, and 73.6% had talked about HIV/AIDS with parents or other family members. Of the sexually experienced students, 64.7% initiated first sexual intercourse by age 16; and 55.7% did not use a condom at last sexual intercourse. Bivariate analysis showed significant gender differences in sexual activity, condom use, and family communication about HIV/AIDS. Logistic regression analysis showed that student-family communication about HIV/AIDS was not associated with sexual activity. However, communication about HIV/AIDS between students and parents or other family members increased the odds of using a condom at last sexual intercourse.

Conclusions

The findings of this study suggest that prevention programmes that seek to educate Ghanaian school-going adolescents about sexual risk behaviour must strongly encourage communication about HIV/AIDS between students and family members.     

Clinical and immunological status of a newly diagnosed HIV positive population, in Marrakech, Morocco

Objective

To evaluate the clinical and the immune status of newly HIV diagnosed patients, in Marrakech city and its neighboring area, in Morocco.

Methods

We performed a retrospective study on 235 patients who have been previously confirmed for HIV infection, and underwent a CD4 T cells using flow cytometry (FacsCount, Becton Dickinson®).

Results

The mean age of patients was 34,3 ± 8,4 years (range: 14–55), with a male predominance (sex-ratio M/F=1.4). On basis of clinical data of the patients, 62% (n=146) of them were categorized as “category C”, 18.4% (n=43) as “category B”, and 19.6% (n=46) as “category A” according to CDC (Center for Disease Control) HIV classification. Among all of them, 60.4% (n=142) had less than 200 CD4T cells, 26% (n=61) had between 200 and 499 CD4T cells, and only 13.6% (n=32) showed a number of CD4T cells less or equal to 500/mm³.

Conclusion

The results of this study reflect a significant delay in the diagnosis of HIV infected patients. Therefore, this delay may compromise timely management of HIV infected individuals and enhances propagation of the epidemic in our country. These data confirm the need for intensifying prevention efforts among high-risk population. Moreover, continuing education in HIV/AIDS among healthcare providers should be reinforced.     

A sigmoidal fit for pressure-volume curves of idiopathic pulmonary fibrosis patients on mechanical ventilation: clinical implications

OBJECTIVE:

Respiratory pressure-volume curves fitted to exponential equations have been used to assess disease severity and prognosis in spontaneously breathing patients with idiopathic pulmonary fibrosis. Sigmoidal equations have been used to fit pressure-volume curves for mechanically ventilated patients but not for idiopathic pulmonary fibrosis patients. We compared a sigmoidal model and an exponential model to fit pressure-volume curves from mechanically ventilated patients with idiopathic pulmonary fibrosis.

METHODS:

Six idiopathic pulmonary fibrosis patients and five controls underwent inflation pressure-volume curves using the constant-flow technique during general anesthesia prior to open lung biopsy or thymectomy. We identified the lower and upper inflection points and fit the curves with an exponential equation, V = A-B.e^-k.P, and a sigmoid equation, V = a+b/(1+e^-(P-c)/d).

RESULTS:

The mean lower inflection point for idiopathic pulmonary fibrosis patients was significantly higher (10.5±5.7 cm H₂O) than that of controls (3.6±2.4 cm H₂O). The sigmoidal equation fit the pressure-volume curves of the fibrotic and control patients well, but the exponential equation fit the data well only when points below 50% of the inspiratory capacity were excluded.

CONCLUSION:

The elevated lower inflection point and the sigmoidal shape of the pressure-volume curves suggest that respiratory system compliance is decreased close to end-expiratory lung volume in idiopathic pulmonary fibrosis patients under general anesthesia and mechanical ventilation. The sigmoidal fit was superior to the exponential fit for inflation pressure-volume curves of anesthetized patients with idiopathic pulmonary fibrosis and could be useful for guiding mechanical ventilation during general anesthesia in this condition.     

Neuromuscular changes after aerobic exercise in people with anterior cruciate ligament-reconstructed knees

Context:

Anterior cruciate ligament (ACL) reconstructions are common, especially in young, active people. The lower extremity neuromuscular adaptations seen after aerobic exercise provide information about how previously injured patients perform and highlight deficits and, hence, areas for focused treatment. Little information is available about neuromuscular performance after aerobic exercise in people with ACL reconstructions.

Objective:

To compare dynamic balance, gluteus medius muscle activation, vertical jump height, and hip muscle strength after aerobic exercise in people with ACL-reconstructed knees.

Design:

Case-control study.

Setting:

Research laboratory.

Patients or Other Participants:

Of 34 recreationally active volunteers, 17 had a unilateral primary ACL reconstruction at least 2 years earlier and 17 were matched controls.

Intervention(s):

All participants performed 20 minutes of aerobic exercise on a treadmill.

Main Outcome Measure(s):

We recorded dynamic, single-legged balance electromyographic gluteus medius muscle activation, single-legged vertical jump height, and maximum isometric strength for hip abduction, extension, and external rotation preexercise and postexercise.

Results:

Participants with ACL reconstructions exhibited shorter reach distances during dynamic balance tasks, indicating poorer dynamic balance, and less gluteus medius muscle electromyographic activation. Reductions in hip abduction and extension strength after exercise were noted in all participants; however, those with ACL reconstructions displayed greater hip extensor strength loss after aerobic exercise than did the control group.

Conclusions:

Neuromuscular changes after aerobic exercise exist in both patients with ACL reconstructions and controls. The former group may experience greater deficits in hip extensor strength after aerobic exercise. Reduced reach distances in people with ACL reconstructions may represent a protective mechanism against excessive tibiofemoral rotation during dynamic balance. Clinicians should identify weaknesses in the resting state and after aerobic exercise in recreationally active patients and those with ACL reconstructions.     

The impact of HIV/AIDS stigma on HIV counseling and testing in a high HIV prevalence population in Uganda

Background

Despite its importance in HIV/AIDS prevention and treatment, HIV/AIDS Counseling and Testing (HCT) is low in sub-Saharan Africa, where the disease continues to be a serious public health problem. This has in part been attributed to HIV/AIDS related stigma.

Objective

To assess the level of HIV/AIDS related stigma and its impact on uptake of HCT in a high HIV prevalence population in Uganda.

Methods

The paper used cross-sectional data on 135 men and 185 women in reproductive ages. Data were analyzed using the Pearson''s chi-square statistic and the random intercept binary logistic regression model to identify significant predictors of uptake of HCT.

Results

The result shows that only 18.4% of the respondents, most of them men expressed highly stigmatizing attitudes against PLHA and 59%, men and women alike, received HCT. Uptake of HCT was higher among men (OR=1.89, p<0.01) and women (OR=4.48, p <0.001) who expressed least stigmatizing attitudes. Secondary/higher education, work in the informal sector and being ever married were significant predictors of uptake of HCT. Compared to men, women aged 25–34, 35+ and with one sexual partner were more likely to have received HCT.

Conclusions

The low level of stigma, older age, higher level of education, being ever married and monogamous sexual relationships are significant predictors of increased uptake of HCT.     

Likely stakeholders in the prevention of mother to child transmission of HIV/AIDS in Blantyre, Malawi

Objectives

To determine potential partners for pregnant women in the prevention of mother to child transmission of HIV and to determine pregnant women''s perceptions towards selected potential HIV prevention efforts

Design

Cross sectional, questionnaire-administered study

Setting

Ante-natal clinics of eleven public health centers and the major referral and university teaching hospital of Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi

Subjects

A total of 321 pregnant women attending ante-natal clinics

Results

Antenatal women in Blantyre, Malawi obtain health information on HIV/AIDS from the radio (96.3%), health workers (82.2%), religious gatherings (66.7%), friends (54.8%) and newspapers (39.3%). The majority intend to be accompanied by own mother and sister for delivery (52.4% and 15.4% respectively). Almost all (99%) planned to breast feed with 91.8% reporting an intended breastfeeding period of at least 6 months. About 97% of married women reported desire to tell spouse in case of HIV sero-positive results while only 65.1% had ever discussed about HIV with spouse, and only 5.2% had ever attended antenatal clinic with spouse. Whether woman had ever discussed about HIV/AIDS with spouse or not did not influence desire to disclose HIV status to spouse.

Conclusion

Close relatives, spouse and the media are important stakeholders in the health of pregnant women. Programs aimed at prevention of mother to child transmission of HIV should give serious consideration to these partners.     

Respiratory symptoms and ventilatory function tests in Nigerians with HIV infection

Background

The impact of the human immunodeficiency virus (HIV) infection on the respiratory system of Africans has been little studied. This study aimed to determine the pattern of respiratory symptoms and ventilatory functions in HIV infected Nigerians.

Methods

In this cross sectional study, Respiratory symptoms frequency, Forced vital capacity (FVC), Forced expiratory volume in one second (FEV₁), FEV₁/FVC ratio, Forced expiratory flow between 25% and 75% of FVC, were determined in 100 HIV positive subjects and compared with values in 100 HIV negative controls.

Results

HIV positive patients had significantly more respiratory symptoms and lower ventilatory function tests values compared to the matched controls (p<0.05). HIV patients with at least one respiratory symptom and those with CD4 count less than 200cells/µl had lower ventilatory function values than their counterparts. 32% of the HIV patients had restrictive ventilatory functional impairment. (p<0.05). Using regression analysis, factors like HIV status, CD4 count and presence of respiratory symptoms were found to be associated with impairment in ventilatory functions.

Conclusions

HIV infected patients had more frequent respiratory symptoms and lower ventilatory function values. Further lung function studies and CT scanning in HIV positive patients especially in those with respiratory symptoms are indicated.