Persistent Diarrhea, Strongly Associated with HIV Infection in Kinshasa, Zaire

Ninety-eight (40%) of 243 acquired immune deficiency syndrome inpatients at Mama Yemo Hospital, Kinshasa, Zaire, presented with a history of diarrhea for at least 1 month. To determine the predictive value of persistent diarrhea for human immune deficiency virus (HIV) infection, 128 consecutive patients presenting at Mama Yemo Hospital with persistent diarrhea were tested for the presence of HIV antibodies. One-hundred seven (84%) of the 128 patients with diarrhea lasting at least 1 month were found to be HIV seropositive. HIV seropositive patients with persistent diarrhea more often had a generalized papular pruritic eruption (p = 0.02), a genital herpes simplex infection (p = 0.05), a history of herpes zoster (p = 0.08), and infection with cryptosporidia (p = 0.006) than HIV seronegative patients with persistent diarrhea. Bacterial enteric pathogens were found in 5 (7%) of the 76 seropositive and in none of the 14 seronegative patients in whom stool cultures were performed. Presently persistent diarrhea in adults in central Africa is strongly associated with HIV infection, but the pathophysiological mechanisms causing this diarrhea remain unclear.     

Value of the coronal plane in MRI of internal derangement of the knee

Sagittal images usually receive the most scrutiny in the magnetic resonance evaluation of meniscal and anterior cruciate ligament tears. We assessed the relative contribution of the coronal view. All knee magnetic resonance examinations performed over a 2-year period that had surgical confirmation were reviewed with respect to the presence of meniscal and anterior cruciate ligament tears. The appearance of an attenuated but uninterrupted anterior cruciate ligament was also evaluated. The coronal and sagittal plane images were evaluated separately. The study included 68 medial menisci, 67 lateral menisci, and 71 anterior cruciate ligaments. The coronal view is especially useful in the evaluation of the lateral meniscus. An anterior cruciate ligament that appears attennated but uninterrupted should be considered intact. The anterior cruciate ligament may be evaluated on the coronal view. The coronal view should be regarded as similar to the lateral chest radiograph, which supplements, but does not replace, the frontal chest radiograph.Presented at the Annual Meeting of the Radiological Society of North America, December 2, 1992, Chicago, Illinois     

GABA agonists enhance morphine and fentanyl antinociception in rabbit tooth pulp and mouse hot plate assays

Parallel experiments in the rabbit tooth pulp and mouse hot plate paradigms were performed to elucidate the effect of pretreatment with the GABA mimetic compound muscimol (M) and diazepam (DZ) on the antinociceptive effect of both morphine sulfate (MS) and fentanyl citrate (F). The ED₅₀ values for F in both rabbits and mice were lowered significantly (p ≤ 0.05) by pretreatment with either i.v. DZ or M in rabbits or i.p DZ or i.v. M in mice. There was a significant 7-fold shift of the F dose-response curve after pretreatment with M in rabbits and a 3-fold shift in mice compared to controls; a 10-fold shift after pretreatment with i.v. DZ in rabbits and a 2-fold shift after i.p DZ in mice. The ED₅₀ values for MS in both rabbits and mice were lowered significantly (p ≤ 0.05) by pretreatment with i.v. muscimol but not DZ (p ≤ 0.18). Similarly, pretreatment with i.v. M, in rabbits and mice, but not i.v DZ in rabbits or i.p DZ in mice, significantly shifted the dose-response curves of MS to the left compared to controls. DZ and M i.v. significantly prolonged the duration of antinociception (rabbit) of an ED₉₈ dose of MS and ED₉₀ dose of F. Time to 50% maximal possible antinociceptive effect (MPE) increased from 240 min for MS + vehicle to 425 min for MS + DZ, and over 450 min for MS + M. Time to 50% MPE increased from 25 min for F + vehicle to 38 min for F + DZ. Similar results were observed for F + M. DZ pretereatment enhances the antinociceptive potency of 2X ED₅₀ of F. In general, the average % MPE of F + DZ was twice tha tof F + vehicle over the first 20 min postopioid injection. A similar trend was noted following 2 × ED₅₀ pf MS, whereas scopolamine had no significant effect. These results suggest that GABA_A agonists, both direct M and indirect DZ enhance the antinociceptive effect of the opioids F and MS. since naloxone completely reversed this effect and scopolamine had no significant effect, this implies that GABA_A agonists enhance opioid antinociception by an opioid and not a cholinergic mechanism.     

Differential perception of institutional constraints in a residential school

This article explores the usefulness of a social-psychological approach for analyzing how restrictions are perceived in a particular type of total institution devoted to the socialization of adolescents. Using a cognitive perspective, it suggests that totality is not experienced as a monolithic phenomenon: The same residential school is experienced differently by students from different socio-cultural settings. Students from different backgrounds are aware of, disturbed by, and legitimize the institutional restrictions, both positional and personal, in different ways. The findings suggest that a cognitive approach can lead to a new and more fruitful conception of total institutions.     

Dopaminergic factors in human prolactin regulation: A pituitary model for the study of a neuroendocrine system in man

This study in normal male subjects further investigates the effects of dopaminergic-antidopaminergic interactions as manifested by the prolactin response to dopamine and neuroleptic drugs. Incremental doses of dopamine hydrochloride (4 g/min, 15 g/min, 60 g/min, 300 g/min) were infused fused at a constant rate over 90–120 min after a fixed dose of a neuroleptic drug (sufficient for about half of the maximal prolactin response) had been given IV. A dose of dopamine in the order of 15–60 g/min appeared to match the los of endogenous dopaminergic inhibition due to the antidopaminergic effect of the neuroleptic drug. The lactotrophic cells of the pituitary gland are suggested to serve as a model in man for the study of some basic neurohormonal mechanisms.     

Subjective image quality of digital panoramic radiographs displayed on monitor and printed on various hardcopy media

The subjective image quality of panoramic radiographs shown on a diagnostic computer monitor were compared with professional direct thermal prints and with common inkjet prints on different paper qualities. Indirect digital panoramic radiographs were obtained from 15 patients. The images were printed with a direct thermal printer in their original format. Afterwards, these were loaded in an imaging software programme (Microsoft Photo Editor) and assessed both on computer monitor and inkjet prints on transparency, glossy, satin and regular paper. Five observers assessed subjective image quality for different regions and anatomical landmarks on a 5-point rating scale. Data were statistically analysed and inter- and intra-observer performances were calculated. Best image quality was obtained with direct thermal prints, followed in descending order by panoramic images viewed on the monitor, inkjet prints on transparencies, glossy paper, satin paper and finally regular paper. The differences were significant except for monitor images versus direct thermal prints, inkjet-transparencies and inkjet-glossy images and inkjet-satin versus inkjet-glossy images. The subjective image quality of indirect digital panoramic images is different for images shown on the computer monitor and for printed images depending on both the printer and paper type used.The research was carried out at the Oral Imaging Centre, Katholieke Universiteit Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium     

Baseline assessment of collaborative tuberculosis/HIV activities in Kinshasa, the Democratic Republic of Congo

Ninety-two clinics were surveyed in 2005 as part of a baseline assessment of HIV activities in Tuberculosis (TB) clinics in Kinshasa, Democratic Republic of Congo. Some HIV activities were implemented in 58% of TB clinics. The majority of health had > or = 1 health care worker (HCW) trained in either HIV counseling or testing (71%). Fifty-three clinics offered counseling and testing to TB patients; twenty-two (42%) routinely offered HIV CT to all patients, while others used selective criteria. While most offered on-site counseling (92%) and testing (77%), not all 53 clinics had a HCW trained in counseling and only 31 had access to a counseling room. Cotrimoxazole prophylaxis was offered in 51% of clinics; antiretroviral treatment in 17%. Shortcomings in human resources, infrastructure and quality of services were revealed. Strengthening those clinics already implementing HIV activities could be prioritized to achieve the goals set forward by the Global Plan to Stop TB.