Seroprevalence of HIV-1 and hepatitis B and C in prostitutes in Albuquerque, New Mexico.

A survey of persons soliciting sex in an area known to be frequented by prostitutes in Albuquerque, NM, included 43 females and 66 males. Seroprevalence rates found in this population-based study were as follows: human immunodeficiency virus type 1 (HIV-1), 3%; hepatitis B, 39%; hepatitis C, 45%. Increased age, intravenous drug use, and condom use were independent risk factors for hepatitis B. Female gender and intravenous drug use were independent risk factors for hepatitis C. Neither sharing injection equipment nor engaging in receptive anal intercourse was independently associated with hepatitis B or C.     

1p36 deletion syndrome: Review and mapping with further characterization of the phenotype,a new cohort of 86 patients

Chromosome 1p36 deletion syndrome (1p36DS) is one of the most common terminal deletion syndromes (incidence between 1/5000 and 1/10,000 live births in the American population), due to a heterozygous deletion of part of the short arm of chromosome 1. The 1p36DS is characterized by typical craniofacial features, developmental delay/intellectual disability, hypotonia, epilepsy, cardiomyopathy/congenital heart defect, brain abnormalities, hearing loss, eyes/vision problem, and short stature. The aim of our study was to (1) evaluate the incidence of the 1p36DS in the French population compared to 22q11.2 deletion syndrome and trisomy 21; (2) review the postnatal phenotype related to microarray data, compared to previously publish prenatal data. Thanks to a collaboration with the ACLF (Association des Cytogénéticiens de Langue Française), we have collected data of 86 patients constituting, to the best of our knowledge, the second-largest cohort of 1p36DS patients in the literature. We estimated an average of at least 10 cases per year in France. 1p36DS seems to be much less frequent than 22q11.2 deletion syndrome and trisomy 21. Patients presented mainly dysmorphism, microcephaly, developmental delay/intellectual disability, hypotonia, epilepsy, brain malformations, behavioral disorders, cardiomyopathy, or cardiovascular malformations and, pre and/or postnatal growth retardation. Cardiac abnormalities, brain malformations, and epilepsy were more frequent in distal deletions, whereas microcephaly was more common in proximal deletions. Mapping and genotype–phenotype correlation allowed us to identify four critical regions responsible for intellectual disability. This study highlights some phenotypic variability, according to the deletion position, and helps to refine the phenotype of 1p36DS, allowing improved management and follow-up of patients.     

Fear of aids: An assessment of knowledge and attitudes of medical,nursing, and medical technology students

The reluctance of students in health professions to care for AIDS patients is partially based on the perceived risk of transmission of HIV from patient contact. We hypothesize that fear of contagion is due to lack of knowledge and deep‐rooted attitudes and emotions existing even in areas of low HIV seroprevalence. We tested this hypothesis on medical, nursing, and medical technology students. Using a questionnaire that yielded four scales, results showed only 58% of students were knowledgeable, 81% were fearful of contagion, 57% were homophobic, and 8% had death anxiety. Lack of knowledge was correlated with fear of contagion (p < .05), whereas homophobia was weakly associated (p = .08). We conclude that this perceived risk of infection is a result of lack of knowledge, disbelief of the facts, and the interplay of personal values and emotions. Alternative educational methods are needed to increase students’ knowledge and to encourage students to examine their personal feelings and attitudes.     

The cognitive management of daily life activities in patients with mild to moderate Alzheimer's disease in a day care centre: A case report

The day care centre appears to be a structure especially well suited for the management of mild to moderate Alzheimer patients. It constitutes a place in which performance in everyday life activities can be explored, and optimisation strategies can be installed before they are used at home. Another objective of the day care centre might also be to provide caregivers with support and ease the burden that the daily care of a demented patient represents. Finally, it may also help to alleviate the patient's loneliness. In this perspective, we describe the general organisation of the recently-created day care centre at the University Hospital of Liège. We also present the assessment and intervention programme which was conducted in this day care centre in order to reduce the generalised apathy and depressed mood observed in a 70-year-old Alzheimer patient (AM). This programme aimed at restoring a leisure activity (knitting) at home by proposing several adaptations designed to minimise the impact of AM's cognitive deficits on knitting activity. While an aggravation of her memory deficits was observed, the intervention significantly decreased AM's apathy and depressed mood as well as her husband's burden.     

A case of intravascular large cell lymphoma with pulmonary invasion]

A 60-year-old man was admitted to our hospital because of dyspnea, cough, and fever two weeks after participating demolition work. Computed tomography of the chest showed multiple diffuse interstitial shadows. While fibrotic bronchoscopy and transbronchial lung biopsy showed alveolitis. We diagnosed hypersensitivity pneumonitis (HP) and treated with mPSL-pulse therapy then got better soon, and also chest abnormal shadow disappeared. Two month later he was admitted because of the same symptom. His chest CT-scans showed diffuse interstitial shadows and we diagnosed recurrence of HP. Treatment with mPSL pulse-therapy was not effective. Acute respiratory failure appeared and progressed daily. The patient died 3 weeks after admission. The final diagnosis of autopsy is angiotrophic large cell lymphoma, a very rare type of lymphoma (<1% of NHL). It is important to consider angiotrophic large cell lymphoma in the differential diagnosis of diffuse interstitial lung disease.     

A non-invasively determined surrogate of cardiac power ('circulatory power') at peak exercise is a powerful prognostic factor in chronic heart failure.

OBJECTIVES: This study was designed to assess the prognostic value of a new variable derived from a cardiopulmonary exercise test, the circulatory power, a surrogate of cardiac power, at peak exercise, in patients with chronic heart failure. BACKGROUND: Peak exercise cardiac power and stroke work are invasive parameters with recently proven prognostic value. It is unclear whether these variables have better prognostic value than peak oxygen uptake (VO(2)). METHODS: The study population comprised 175 patients with chronic heart failure (ejection fraction <45%) who underwent a cardiopulmonary exercise test. Circulatory power and circulatory stroke work were defined as the product of systolic arterial pressure and VO(2) and oxygen pulse, respectively. Prognostic value was assessed by survival curves (Kaplan-Meier method) and uni- and multivariate Cox analyses. RESULTS: With a mean follow-up of 25+/-10 months, ejection fraction, heart rate, systolic arterial pressure, peak VO(2), VCO(2), the anaerobic threshold, minute ventilation, the ventilatory equivalents of oxygen and carbon dioxide, the half times of VO(2) and VCO(2) recoveries, and the circulatory stroke work and power predicted outcome. Multivariate analysis demonstrated that the peak circulatory power (chi-square=19.9, P<0.001) (but not peak circulatory stroke work) was the only variable predictive of prognosis. CONCLUSION: The prognostic value of cardiopulmonary exercise tests in heart failure patients can be improved by assessing a new variable, the circulatory power - a surrogate of cardiac power - at peak exercise.