Prevalence of HIV infection in psychiatric patients attending a general hospital in Tamil Nadu,south India

An anonymous, unlinked study was conducted to detect antibodies to HIV-1 or HIV-2 infections in 1,160 consecutive, newly registered, adult psychiatric outpatients at a general hospital in South India to determine whether psychiatric patients presenting to general hospitals are a population at high risk for HIV infection and should be routinely screened. The seroprevalence of HIV infection (12/1160; 1.03%; 95% CI = 0.4-1.6%) did not approximate rates expected of a high-risk group compared to the national (0.7%) or regional community (1.8%) prevalence. It did not differ significantly from HIV seroprevalence in non-psychiatric patients (233/35450; 0.7%; 95% CI = 0.57-0.74%) who were systematically screened (relative risk = 1.57; 95% CI = 0.88-2.80) during the same period, but was greater than the seroprevalence in healthy blood donors (0.5%; p = 0.02; relative risk = 2.15 95% CI = 1.17-3.95). Non-psychiatric patients were also more likely to be HIV infected than blood donors (p = 0.02; relative risk = 1.37; 95% CI = 1.05-1.78). These findings have implications for HIV testing policies among psychiatric and non-psychiatric patients presenting to general hospitals in India.     

Results of clinical trials for locally advanced and metastatic nonsmall-cell lung cancer

Chemotherapy in nonsmall-cell lung cancer (NSCLC) is not just a reality but has resulted in important improvements in quality of life and survival for patients with locally advanced and metastatic NSCLC. For patients with stage IV NSCLC, platinum-based 2-drug combinations are superior to single-agent therapy and have a superior therapeutic index than 3-drug combinations. Concurrent chemoradiation has become the standard of care for patients with locally advanced NSCLC. The addition of consolidation chemotherapy following definitive chemoradiation appears to improve median survival. The era of molecularly targeted therapies for NSCLC is here. Early results with some of the targeted agents studied for the treatment of NSCLC have generated a great deal of excitement. In this article, we review the results of recent clinical trials in locally advanced and metastatic NSCLC.     

Tracheo-esophageal puncture (TEP) for voice rehabilitation in laryngectomised patients blom-singer® Vs Provox® Prosthesis: Our experience

Background: Stage III and IV cancers of larynx and hypopharynx often require total laryngectomy which leaves the patient with severe communication handicap. In such laryngectomised patients tracheo-esophageal puncture is the best way for voice rehabilitation using either Blom-Singer® prosthesis or Provox® indwelling valve.     

Peripheral CD4+/CD8+ T-lymphocyte counts estimated by an immunocapture method in the normal healthy south Indian adults and HIV seropositive individuals.

BACKGROUND: Flow cytometry is the standard method for the estimation of CD4/CD8 counts, but the high initial investment for this instrument and costly reagents make it unaffordable to most of the centers in a developing country like India. OBJECTIVES: To evaluate the feasibility of an alternate system for the estimation of CD4 and CD8 counts in normal south Indian adults and validate the usefulness of this assay to monitor the counts in HIV seropositive individuals. STUDY DESIGN: Forty-six normal healthy adults and 68 HIV seropositive individuals both belonging to south Indian linguistic groups were enrolled in this cross-sectional study. The HIV seropositive individuals included 54 HIV-1, 9 HIV-2 and 5 HIV 1&2 infected individuals serologically confirmed by one of the commercial Immunoblot kits. The Capcellia CD4/CD8 whole blood assay, an immuno-capture ELISA based kit from Sanofi DIAGNOSTICS Pasteur, (France) was used with a few modifications in the procedure to measure the CD4 and CD8 counts. RESULTS: The mean CD4 cell counts were 1048 (central 95 centile only), 746 and 424 for the normal healthy adults, asymptomatic HIV seropositives and symptomatic HIV patients, respectively, and the mean CD8 counts were 595, 889 and 732, respectively. Statistically significant differences were observed in the CD4 cell counts between HIV seronegative healthy adults and asymptomatic (P < 0.001) as well as asymptomatic and symptomatic (P < 0.05) HIV infected individuals. The mean CD4 counts of asymptomatic HIV-2 infected individuals was significantly higher than the counts of asymptomatic HIV-1 infected individuals (P < 0.05). CONCLUSIONS: This is an user friendly test and can be an alternate to flow cytometry for the estimation of peripheral T-lymphocyte subsets in developing countries. The assay system has certain limitations inherent to ELISA techniques.     

Joongpoongtang 05 (JP05) confers neuroprotection via anti-apoptotic activities in Neuro-2a cells during oxygen-glucose deprivation and reperfusion

To evaluate the anti-apoptotic effects of Joongpoongtang 05 (JP05), a mixture of plant extracts, on a Neuro-2a (N2a) cell model of oxygen and glucose deprivation (OGD)/reperfusion (OGDR), a neuroblastoma cell injury model was induced by OGDR. This model allowed us to investigate cerebral ischemic changes and the protective effects of JP05. JP05 treatment significantly enhanced cell viability and reduced the levels of lactate dehydrogenase, nitric oxide, reactive oxygen species and the oxidants/antioxidants balance in neuronal cells as compared to the untreated OGDR group. Here, JP05 reduced OGDR-induced expressions of heme oxygenase-1 and nitric oxide synthase, which may contribute to the neuroprotection. JP05 also partially reversed the effects of OGDR on NF-κB and activated Akt production. Our findings suggest that JP05 confers neuroprotective effects via anti-apoptotic property against OGDR-induced free radical injury in N2a cells.     

Perceptions of assertive community treatment in the UK and Lithuania

BACKGROUND: There is current uncertainty over the future of assertive community and outreach teams in view of recent evidence suggesting that they no longer reduce hospital admissions. Despite this, assertive teams remain popular among practitioners. AIMS: To examine the views of assertive community team members and other mental health professionals in London (UK) and Vilnius (Lithuania) to determine important differences in attitudes. METHOD: A questionnaire, involving the assessment of statements giving common opinions on assertive community teams, was given to 62 staff in Vilnius, Lithuania and West London, UK, 33 from assertive community or outreach teams and 29 from other mental health professionals. RESULTS: The results of the questionnaire showed that personnel in experienced assertive outreach teams in London believed that they gave more intensive care (p < 0.001), felt it of greater value to see patients in the community (p < 0.001) and were not just well-resourced community teams with low caseloads (p < 0.01) than did other groups, but they placed lower value on assertiveness (p = 0.04) and comprehensive care (p < 0.04). These differences were less marked in Lithuania where staff regarded home treatment as similar to clinic treatment and were more supportive of comprehensive care. CONCLUSION: The results suggest that in experienced community teams the notion of assertiveness has become less important in planned intensive community care and so the term ACT may be outmoded. However, for countries such as Lithuania, somewhat similar to the United States in 1972 when ACT began, the original principles are still appropriate and 'assertive' is a major component of their effectiveness.