AIDS awareness in the conduct of radiologic procedures: guidelines to safe practice

The epidemic of the acquired immunodeficiency syndrome (AIDS) has affected all geographic regions of the United States. Indeed, it is likely that a majority of U.S. hospitals have cared for patients who are infected with the human immunodeficiency virus (HIV), the virus that causes AIDS. More than 46,000 individuals with HIV infection have fulfilled the strict diagnostic criteria for AIDS (1). All of these patients with AIDS have been seriously ill and have been hospitalized, often multiple times and for prolonged periods. Another, larger group patients with HIV infection has had another form of the disease, the so-called AIDS-related complex. Many of these patients have also spent time in hospitals. An even larger group of individuals has been infected with HIV but has remained asymptomatic to date. Some of these persons have been admitted to hospitals or have received outpatient diagnostic procedures for intercurrent medical or dental complaints that were unrelated to their asymptomatic HIV infection. At the time of their medical evaluation, some of these asymptomatic individuals were known to have a positive HIV antibody test. It is likely, however, that the serologic status of the majority of asymptomatically infected patients was unknown. Thus, by now a very large number of health-care personnel in the United States, including diagnostic radiology staff, have assisted in the care of HIV-infected patients.     

Practical and technical considerations in establishing an intraoperative radiation therapy program in the community practice

The Radiation Oncology Center in Sacramento, California, has developed a procedure for establishing an intraoperative radiation therapy facility in a community practice. The logistics pertaining to personnel, equipment, physical measurements, and quality assurance are presented. Particular emphasis is given to the most effective means of acquiring the large quantity of data needed to ensure a program of acceptable quality.     

HIV prevention programmes for female sex workers in Andhra Pradesh,India: outputs,cost and efficiency

Background  

Female sex workers and their clients play a prominent role in the HIV epidemic in India. Systematic data on the outputs, cost and efficiency for HIV prevention programmes for female sex workers in India are not readily available to understand programme functioning and guide efficient use of resources.     

Prevalence and correlates of abscesses among a cohort of injection drug users

Recent studies have indicated that injection-related infections such as abscesses and cellulitis account for the majority of emergency room visits and acute hospitalizations accrued by local injection drug users. The objective of this analysis was to examine the prevalence and correlates of developing an abscess among a cohort of injection drug users in Vancouver and to identify socio-demographic and drug use variables associated with abscesses at baseline. We examined abscesses among participants enrolled in a prospective cohort of injection drug users. Categorical variables were analyzed using the Pearson's chi-square test and continuous variables were analyzed using the Wilcoxon signed rank test. Among 1 585 baseline participants, 341 (21.5%) reported having an abscess in the last six months. In a logistic regression model that adjusted for all variables that were associated with having an abscess at p < 0.1 in univariate analyses, female gender [odds ratio (OR) = 1.7, [95%CI: 1.2 – 2.4]; p = 0.002), recent incarceration (OR = 1.7, [95%CI: 1.3 – 2.2]; p < 0.001), sex trade involvement (OR = 1.4 [95% CI: 1.0 – 2.0]; p = 0.03), frequent cocaine use (OR = 1.5 [95%CI: 1.2 – 2.0]; p = 0.002) and HIV serostatus (OR = 1.5, [95%CI: 1.2 – 2.0]; p = 0.003) were positively associated with having an abscess. Explanations for these associations require further study, and interventions are needed to address this highly prevalent concern.     

The Incidence Of Prescribing Errors In An Eye Hospital

Background  

Relatively little is known about the incidence of prescribing errors and there has been no work on this in a single specialty ophthalmic hospital. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors. This study is an attempt in, the setting of an eye hospital, to try to identify and attribute these medication errors.     

抗高血压药物与罹患癌症的风险:324168例参与随机临床试验病人的荟萃分析和试验序贯分析

长期以来,一直存在抗高血压药物是否有致癌作用的争议.自从在年龄>50岁的妇女中使用萝芙碱提取物造成乳腺癌发病率增加的报道后[1],这一争议已持续了30年.Sipahi和同事们最近的研究显示:血管紧张素受体拮抗剂(angiotensin receptor-blockers,ARB)有较高的致癌风险.这一发现再次引发了抗...     

Functional outcome and complications using the intramedullary hip screw for intertrochanteric fractures

We prospectively studied 110 consecutive patients with intertrochanteric hip fractures treated with the 130 degree angle, 10-mm short IMHS intramedullary hip screw (IMHS, Smith & Nephew, Richards, Memphis, TN). Surgery was performed within 36 hours from admission; all patients were mobilized immediately postoperatively. Fracture union, pre- and post-operative mobility status and complications were evaluated. Eighty patients were included in the postoperative evaluation for a mean followup of 14 (range, 9 to 25) months. Mortality was 19%. Union occurred in 79 fractures within 6 months from surgery; there was one case of screw cut-out and one case of deep venous thrombosis. Periprosthetic femoral shaft fractures were not observed. At the latest examination, the mean mobility score decreased from 8.4 +/- 1.6 to 7.1 +/- 2.1 (p = 0.0001); 26 patients (32%) fully achieved the preoperative mobility score and 54 patients (68%) achieved more than 90% of the preoperative mobility score. The IMHS intramedullary hip screw represents a reliable method for the treatment of patients with intertrochanteric hip fractures, and provides for early mobilization and rehabilitation of the patients with acceptable complications.