Impact of beliefs about HIV treatment and peer condom norms on risky sexual behavior among gay and bisexual men

The association between perceptions about condom use among one's peers, beliefs about new HIV treatments, and HIV sexual risk behavior was examined in a large urban sample ( N = 454) of gay and bisexual men in the Southeast. Results partially confirmed the hypothesis that men who endorsed new HIV treatment beliefs would report lower norms for condom use and higher HIV sexual risk behaviors than men who failed to endorse HIV treatment beliefs but with casual, and not main, partners. Moreover, results confirmed the hypothesis that the association between HIV treatment beliefs and unprotected sex would be partially mediated by peer condom norms. Results suggest social interventions are needed to promote condom norms in the social context of new HIV treatments. © 2006 Wiley Periodicals, Inc.     

Incontinence and troublesome behaviors predict institutionalization in dementia.

Factors predicting the early institutionalization of demented patients were studied in 143 outpatients using univariate and multivariate life-table methods. Four types of factors were evaluated for prognostic value: severity of functional impairment, behavioral disorders, individual patient characteristics, and type of caregiver. After follow-up of 19 +/- 12 months, 51 patients had been institutionalized. Increased global severity of dementia, the presence of troublesome and disruptive behaviors, and incontinence increased the likelihood of institutionalization. The best predictors of institutionalization were paranoia, aggressive behavior, and incontinence. Neither individual patient characteristics (age, education, and gender) nor caregiver relationship to the patient (male spouse, female spouse, and male or female child) influenced institutionalization. Since troublesome behavioral disorders are potentially treatable aspects of dementia leading to institutionalization, their management should be a major focus of therapy in dementia.     

Acute suppurative parotitis in a patient on total parenteral nutrition

A report of a patient who developed acute suppurative parotitis while on total parenteral nutrition for small bowel fistula is presented. The importance of early detection of parotitis as a cause of fever is emphasized. Attention to oral hygiene and early resumption of oral intake, whenever possible, are to be encouraged.     

A study comparing biopharmaceutic characteristics of four once daily controlled release diltiazem preparations

Summary— In the present study we have compared the steady state biopharmaceutic characteristics of four diltiazem once daily controlled release capsules: Mono-Tildiem LP 300® (300 mg), Adizem® XL (300 mg)¹, Cardizem® (300 mg) and Dilacor® (240 mg). Sixteen healthy male volunteers (aged 22.9 ± 3.3 years, range 19–31 years) completed an open label, multiple oral dose, randomized, four-period crossover study without a washout period in between. The volunteers received each diltiazem formulation once daily for four days. Trough diltiazem and metabolites plasma concentrations were determined on days 3 and 4. The 24-h plasma concentration-time profiles were assessed after the dose on day 4 of each period. The following steady state pharmacokinetic parameters for diltiazem were calculated: the minimum plasma concentration (c_min), the maximum plasma concentration (c_max), the time to reach that concentration (t_max), the time interval during which the plasma concentration exceeds 50% of c_max (t₅₀), the area under the plasma concentration-time curve (AUC_72–96) and the peak-to-trough fluctuation (PTF). For the metabolites of diltiazem, N-mono-desmethyl-diltiazem (NDM) and desacetyldiltiazem (DAD), AUC_72–96 (AUC_NDM and AUC_DAD) and the ratio metabolite/parent compound were calculated. Steady state was achieved on day 3. Except one, all controlled release formulations have satisfactory controlled release properties allowing once daily administration. However, significant (P < 0.05) differences were found between the pharmacokinetic characteristics which do not allow exchange of the various formulations. Concentrations well below 50 ng·mL^-1 in the morning hours were observed for Dilacor® (240 mg) and Adizem® XL (300 mg), which could be a disadvantage of these formulations as it is well-known that ischaemic events occur at a higher rate during that part of the day. The plasma concentration profiles of NDM and DAD, the major circulating metabolites, parallel the plasma concentration profiles for the parent compound. From a clinical point of view, all treatments were well tolerated.     

Evaluation of a learning resource center for cancer patients

To address cancer out-patients' needs for information, a self-servelearning resource center was established at a nearby hotel.This facility provides numberous written and audio-visual cancerinformation materials for out-patients being treated at theUniversity of Texas M.D.Anderson Cancer Center Houston, Texas.Over a three month period, we conductred a consumer profileand assessed consumer satisfaction and use of the learning resuorcecenter. Data were gathered primarily through a self-administeredpatient/family satisfaction questionnaire and through monthlyadministrative records. The primary variables associated withuse of the learning resource center were educational level andhow long one had been a patient at the M.D.Anderson Cancer Center.Respondents who had used the learning resource center also indicateda stronger preference for receiving information about cancerthrough written materials than those who had not used the center.Users’ degree of satisfaction with the learning resourcecenter was generally high. The case study presented here offersrecommendations for the practitioner regarding the establishmentand evaluation of a learning resource center for cancer out-patientsand addresses these issues in a unique program setting.     

Spina Bifida: The Transition into Adulthood Begins in Infancy

Many concerns surround the preparation of a person with spina bifida for a successful transition into adult life and responsibilities. A model of intervention must be based on developmental concerns and timely issues from infancy through all stages of development to young-adult life. This article discusses, within a developmental framework, issues of transition in relation to physical, social, emotional, and educational/vocational needs; it also presents a conceptual framework for the transition into adulthood. Guidelines were developed by incorporating expected outcomes of people with spina bifida and using a philosophical framework that encompasses the achievement of a balance among dependence, independence, and interdependence. This model is based on developmental issues from infancy through all stages of development to young-adult life. Using this framework for care, the rehabilitation nurse can feel confident that the needs of clients with spina bifida and similar chronic conditions are being met.     

Ibotenic acid-induced lesions of the medial zona incerta decrease lordosis behavior in the female rat

To examine the role of the medial zona incerta (mZI) in female sexual behavior, ovariectomized estrogen- and progesterone-treated female rats were tested for sexual receptivity after bilateral injections of the selective neurotoxin ibotenic acid (3 micrograms/0.3 microliter) directly into the mZI. These injections produced a significant attenuation of lordosis behavior in highly receptive females when compared with saline-injected controls. This decrease in sexual receptivity was also reflected in a significant increase of rejections of male mount attempts. However, these lesions did not abolish the display of lordosis behavior. In addition, the frequency of hopping and darting was decreased in ibotenic acid-injected females when compared with controls. Consistent with previous studies, these lesions also produced a transient impairment of drinking behavior (hypodipsia) typical of rats with large electrolytic lesions of the mZI. This study demonstrates that mZI neurons play a role in mediating sexual receptivity in the female rat. Collectively, these results suggest that in addition to the projection from the ventromedial nucleus of the hypothalamus to the midbrain central gray, the functional integrity of the mZI is of crucial importance for the expression of sexual receptivity in the female rat.