Mass media involvement in education and information about HIV/AIDS

AIDS is the first international mass media disease. Throughout the world, most people have learned more about AIDS from radio, television and the press than from personal contacts with health professionals. Mass media AIDS materials influence behavior most when they are designed and developed for different segments of the audience, with the specific needs and concerns of those segments in mind. In the past mass media evoked fear, anxiety and other negative emotional responses to AIDS and didn't proposed practical and realistic ways of action. The journalists made frequently distinctions between innocent victims of HIV, that are infants and recipients of infected blood or blood products through health care, and other "guilty" infected people such as gays, sex workers or african people. Mass media can change behavior and if journalists accept their responsibility in presenting the news, the publicity about AIDS may have a great and positive impact in HIV/AIDS.     

Special Issue: 50th Anniversary of ABME

Annals of Biomedical Engineering -     

An investigation of cranial motion through a review of biomechanically based skull deformation literature

ObjectivesThere is ongoing debate over the existence of cranial motion resulting from manual manipulation during Cranial Osteopathy (CO). The purpose of this study was to review and summarize the literature regarding cranial mobility and human cranial stiffness in order to evaluate the validity of cranial movement in humans due to manual manipulation.MethodsIn Part I, the literature was reviewed to determine the existence and extent of cranial motion in animals and humans. In Part II, the literature was reviewed to determine the stiffness of the human cranium. In Part III, a biomechanical analysis was performed to determine the amount of force necessary to cause cranial deflections reported in the studies identified in Part I, using published skull stiffness values reported in the studies identified in Part II.ResultsSkull deflection across the cranial sutures of animals ranged from 0 μm to 910 μm. Cranial vault deflection in living humans was reported to range from 0.78 μm to 3.72 μm. Reported human skull stiffness values ranged from 390 N/mm to 6430 N/mm depending on the region of the skull and the method of loading. Based on the range of skull stiffness values, it was determined that an applied force between 0.44 N and 23.2 N would be required to cause 0.78 μm of deflection, and between 2.09 N and 111 N would be required to cause 3.72 μm of deflection.ConclusionExternally applied forces and increases in intracranial pressure can result in measurable cranial motion across the cranial sutures in adolescent and adult mammalian animal species, and measurable changes in cranial vault diameter in post-mortem and living adult humans. However, the amount of cranial motion may vary by subject, the region of the head to which forces are applied, and the method of force application. Given that the forces required to generate reported cranial deflections in living humans are within the range of forces likely to be used during CO, it is reasonable that small amounts of cranial deflection can occur as a result of the forces applied to the skull during CO.     

Infections of prosthetic heart valves and cardiac pacemakers

Prosthetic valve endocarditis may be considered present when two fo the following criteria are met: (1) two or more blood cultures are positive with the same organism in the absence of extracardiac infections, (2) evidence of bacterial endocarditis by histology or cultures is obtained from surgical or autopsy specimens, and/or (3) a clinical picture compatible with endocarditis (fever, new or changing regurgitant murmur, splenomegaly, hematuria, or evidence of peripheral emboli) is present. The overall incidence of PVE ranges from 0.98 to 4.4 per cent. Early and late PVE (that is endocarditis developing less than 60 and 60 or more days following valve implantation, respectively) accounts for 18 to 36 per cent and 64 to 82 per cent of infections, respectively. The overall mortality is 53 per cent and is higher in patients with early versus late PVE. Coagulase-negative staphylococci are responsible for a higher percentage of early (43 per cent) than late (28 per cent) infections. Streptococci are more common in late (27 per cent) than in early (3 per cent) PVE, while diphtheroids are most common in early PVE. The diagnosis of PVE may be difficult to establish, especially in patients with postoperative bacteremias who have other potential sources of extracardiac infections. Antimicrobial therapy is generally based on the susceptibility of the offending pathogen. With respect to the use of synergistic combinations, results are controversial, and most available data are derived from patients with native-valve endocarditis. Surgery remains an important aspect of treatment, and the mortality among patients who undergo early surgical intervention, particularly if their illness is complicated, is less than in those who are treated only with antibiotics. Indications for surgery include: (1) moderate-severe refractory congestive heart failure, (2) persistent bacteremia or fungemia, (3) multiple emboli, (4) myocardial abscesses, (5) relapsing PVE, and possibly (6) patients with clinical evidence of PVE and negative blood cultures and persistent fever despite 1 week or more of appropriate antibiotics. Pacemaker infections occur in less than 6 per cent of patients who undergo pacemaker insertion. These infections generally result from wound contamination at the time of surgery, and 75 per cent of infections are due to staphylococci. Staphylococcus aureus causes most infections occurring within 2 weeks after surgery, while S. epidermidis causes most later infections. The need to remove infected pacemakers is controversial.     

A huge low-grade fibromyxoid sarcoma of small bowel mesentery simulating hyper immune splenomegaly syndrome: a case report and review of literature

Introduction

Low-grade fibromyxoid sarcoma (LGFMS) is a rare non epithelial tumour. It usually arises from the smooth muscles of the extremities. It is, however, occasionally reported to arise from other regions of the body.

Case report

We report the case of a 32 year old man who complained of a progressive abdominal swelling of 4 months duration. There was associated abdominal discomfort and weight loss. Abdominal examination revealed a non-tender intra abdominal mass filling the abdomen completely. Abdominal ultrasound suggested a massive splenomegaly. Abdomina Computerized Tomography (CT) scan was not done due to financial constraints. At laparotomy, a large, pearl-coloured mass was found within the mesentery of the proximal jejunum, with dilated, tortuous vessels. It was resected along with the overlying 60cm of jejunum. It weighed 7.5kg. Histology and immunohistochemistry confirmed the diagnosis of lowgrade fibromyxoid sarcoma. Post-operative period was uneventful and there were no features of recurrent after 2 year of follow up.

Conclusion

LGFMS may cause a diagnostic dilemma, especially in a third world setting where preoperative diagnosis is hampered by lack of facilities and poverty. A high index of suspicion is needed for preoperative diagnosis, which is necessary for proper planning of the operation.