Decline in perinatal HIV transmission in New York State (1997-2000)

BACKGROUND: Perinatal HIV transmission has declined significantly in New York State (NYS) since implementation of a 3-part regimen of zidovudine prophylaxis in the antenatal, intrapartum, and newborn periods. This study describes the factors associated with perinatal transmission in NYS from 1997 to 2000, the first 4 years of NYS's comprehensive program in which all HIV-exposed newborns were identified through universal HIV testing of newborns. METHODS: This population-based observational study included all HIV-exposed newborns whose infection status was known and their mothers identified in NYS through the universal Newborn HIV Screening Program (NSP) from February 1997 to December 2000. Antepartum, intrapartum, newborn, and pediatric medical records of HIV-positive mothers/infants were reviewed for history of prenatal care, antiretroviral therapy (ART), and infant infection status. Risks associated with perinatal HIV transmission were examined. RESULTS: Perinatal HIV transmission declined significantly from 11.0% in 1997 to 3.7% in 2000 (P < 0.05). Prenatal ART was associated with a decline in perinatal HIV transmission both for monotherapy (5.8%, relative risk [RR] = 0.3, 95% confidence interval: 0.2%-0.5%) and combination therapy [2.4%, RR = 0.1, 95% confidence interval: 0.1%-0.2%) compared with no prenatal antiretroviral prophylaxis (P < 0.05). CONCLUSIONS: Public health policies to improve access to care for pregnant women and advances in clinical care, including receipt of appropriate preventive therapies, have contributed to declines in perinatal HIV transmission in NYS.     

Yohimbine bioavailability in humans

Summary Pharmacokinetic profiles were determined in seven healthy young male subjects following single oral and intravenous doses of 10 mg of yohimbine hydrochloride.The drug was rapidly eliminated (t_1/2 0.58 h orally and t_1/2 0.68 h intravenously). Following intravenous administration the data fit a two-compartment pharmacokinetic model, with a very rapid distribution phase (t_1/2a was approximately 6 min). Both the oral and the intravenous yohimbine clearance values were high but oral clearance values were much higher (mean 9.77 ml·min^–1·kg^–1 intravenous versus 55.9 ml·min^–1·kg^–1 oral). The oral bioavailability showed great variability, ranging from 7% to 87% (mean value was 33%).The imcomplete oral bioavailability of yohimbine may reflect either incomplete absorption from the gastrointestinal tract or an hepatic first pass effect. Although yohimbine is rapidly absorbed when given orally, the bioavailability is quite variable and considerable individualization of dosing may be necessary when the drug is used orally for clinical indications.Supported in part by NIH grant # MOIRR 0042     

Vineland Adaptive Behavior Scale Scores as a Function of Age and Initial IQ in 210 Autistic Children

Human growth modeling statistics were utilized to examine how Vineland Adaptive Behavior Scale (VABS) scores changed in individuals with autistic disorder as a function of both age and initial IQ. Results revealed that subjects improved with age in all domains. The rate of growth in Communication and Daily Living Skills was related to initial IQ while rate of growth in Social Skills was not. Results should provide hope for parents and further support for the importance of functional social-communication skills in the treatment of autism.     

Infantile spasms: the development of nonverbal communication after epilepsy surgery

The postoperative development of nonverbal communication was studied in 29 children, aged 18.2 (SD = 11.54) months, who underwent multilobar resection or hemispherectomy for intractable symptomatic infantile spasms (IS). Using the Early Social Communication Scale, the IS subjects had little, if any, social interaction, joint attention or behavior regulation before surgery. After a mean follow-up of 24 months, most of the children continued to have delayed nonverbal communication skills compared to normal children. Seizure-related, surgical and cognitive factors were unrelated to the postsurgical development of nonverbal communication. The children with right-sided surgery had a statistically significant increase in the use of social interaction but not in other gestural behaviors. Removal of the frontal lobe was not related to the nonverbal communication outcome. The study's findings suggest that impaired use of nonverbal communication might be a feature of surgically treated children with medically intractable IS. Copyright Copyright 1999 S. Karger AG, Basel     

Mothers' compliance with physicians' recommendations on infant feeding.

One hundred thirty-one mothers who were patients of ten physicians were surveyed to determine their compliance with physician-recommended infant feeding practices. For a direct, self-reported measure, the rate of non-compliance was nearly 30 per cent. A second measure, a "compliance score," was computed by comparing mothers' responses to specific questions about the feeding of their babies with their physcians' recommendations for normal, healthy infants. The mean noncompliance rate on this measure was 44 per cent. Differing response patterns regarding specific feeding practices were found for breast-feeding and bottle feeding mothers. To determine selected psychologic factors associated with compliance, health-related attitude and belief scales were originated and validated. Attitudes that "nutrition is important" and a "concern for health" were significantly correlated with the compliance score for breast-feeding mothers.     

儿科肝移植术前的血管影像学检查

背景/目的:术前通过血管影像学检查对拟行肝移植术的儿童进行评价存在很大的差异。采用二维多普勒超声扫描(US)、磁共振血管造影术(M R A)和常规血管造影术评价血管变化范围。作者通过比较术前的血管成像结果和术中所见,从而确定这些检查的精确度和有效性。方法:将37例接受尸体     

广州队列研究生物库中条形码技术应用与评价

目的建立大规模人群的分子流行病学队列研究生物库，确保快速、准确地识别每一份生物样本，并保持其活性，以便长时间跟踪研究。方法采用条形码识别技术对血液样品的采集、处理及存储、查询过程进行全程管理。结果创建成功以条形码自动识别技术为核心的新型运作管理模式，建立起10000人份的生物样品库。大型生物样本库实施条形码管理系统可缩短每份样品的处理时间，提高工作效率1．5倍。结论条形码技术的应用可有效地避免样品间的相互混淆，使实验室每一项工作准确、可靠、高效，实现医学研究工作全面信息化，提高基因队列研究的质量。