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HICNet Medical News Digest Thu, 01 Dec 1994 Volume 07 :
Issue 58
Today's Topics:
[MMWR] Prevelance of Overweight Adolescents
Int'l Workshop on Information Processing in Cells and Tissues
Musculoskeltal Pain Emanating from Head & Neck - CE Course
AIDS Daily News Summary
+------------------------------------------------+
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----------------------------------------------------------------------
Date: Thu, 01 Dec 94 06:52:47 MST
From: mednews@stat.com (HICNet Medical News)
To: hicnews
Subject: [MMWR] Prevelance of Overweight Adolescents
Message-ID: <o3qNwc9w165w@stat.com>
Health Objectives for the Nation
Prevalence of Overweight Among Adolescents -- United States, 1988-
91
Among adults, overweight is associated with increased risk for
death, coronary heart disease, diabetes mellitus, gallbladder
disease, joint disease, and certain cancers (1), and overweight
during adolescence is associated with increased risk for overweight
as an adult (2). CDC's third National Health and Nutrition
Examination Survey (NHANES III) provides data to monitor changes in
the dietary, nutritional, and health status of the U.S. population
(3) and to track progress toward achieving the year 2000 national
health objectives, including those related to prevalence of
overweight (4). This report presents findings from NHANES III,
Phase 1 (1988-91), on the prevalence of overweight among U.S.
adolescents (ages 12-19 years).
NHANES III used a stratified multistage probability design to
obtain a sample of the civilian, noninstitutionalized U.S.
population aged greater than or equal to 2 months. The survey
comprised two 3-year nationally representative phases with
oversampling of children aged 2 months-5 years, persons aged
greater than or equal to 60 years, blacks, and persons of Mexican
descent (5). Height and weight were measured as part of a
standardized physical examination in a mobile examination center
(3). Body mass index (BMI, kg/m2) was used as a measure of weight
adjusted for height. For adolescents, overweight was defined in the
year 2000 national health objectives (objective 2.3) using BMI
cutoffs based on modified age- and sex-specific 85th percentile
values of the second National Health and Nutrition Examination
Survey (NHANES II) (1976-80) (4).
Of the 1849 persons aged 12-19 years selected for the survey,
1632 (88%) were interviewed; of those interviewed, 1519 (93%)
underwent a standardized physical examination. Of those examined,
1490 (98%) had complete data for height and weight, resulting in an
overall analytic response rate of 81% (1490/1849). Data were
weighted to account for survey design and nonresponse.
During 1988-91, the prevalence of overweight for persons aged
12-19 years was 21%, an increase of 6% since NHANES II (Table 1).
Sex-specific prevalence of overweight was 20% for males and 22% for
females.
Reported by: Div of Health Examination Statistics, National Center
for Health Statistics, CDC.
Editorial Note: One national health objective for the year 2000 is
that overweight prevalence not exceed 15% among adolescents aged
12-19 years (baseline: 15% for adolescents aged 12-19 years in
1976-80) (objective 2.3) (4). The findings in this report indicate
that, since NHANES II, the prevalence of overweight among
adolescents has increased; a similar increase was reported for
adults (6). Because both national surveys employed standardized
equipment and procedures to measure height and weight, the increase
during 1988-91 probably does not reflect changes in methodology.
There is no generally accepted definition of overweight for
adolescents (7). The definition used for the year 2000 national
health objective (i.e., the 85th percentile from NHANES II) (4) has
the advantage of comparability with the definition for adults.
However, because of changes in body composition with growth, weight
is a less reliable measure of fatness for children and adolescents
than for adults (8), and this definition may classify some
adolescents as overweight who do not have excess body fat. In
addition, some adolescents change overweight classification with
age; most overweight adults were not overweight children (2).
The increase in the prevalence of overweight among adolescents
and adults is most likely associated with dietary energy intake
exceeding caloric expenditure. Energy intake through food
consumption and energy expenditure through physical activity cannot
be measured as precisely as height and weight in population
surveys. Although high-fat and high-calorie foods are abundant and
readily available in the United States, survey data suggest that
dramatic increases in energy intake alone do not account for the
increased prevalence of overweight among adolescents (9). Declining
levels of physical activity also may account for these changes. For
example, levels of participation by high school students in
physical education declined from 1984 to 1990 (10); other factors
possibly associated with declines in physical activity include
concerns about personal safety and changing parental work habits.
Changes in diet and activity levels are necessary for the U.S.
population to reduce overweight; primary prevention of overweight
should begin in childhood. The findings in this report can assist
in tracking progress toward achieving public health goals aimed at
reducing overweight among adolescents and adults. Subsequent
analyses of NHANES III will be used to elucidate differences in
overweight prevalence by socioeconomic status and race/ethnicity,
identify population subgroups at risk for increased prevalence of
overweight, and examine the relation between overweight and other
health and nutrition variables.
References
1. Public Health Service. The Surgeon General's report on
nutrition and health, 1988. Washington, DC: US Department of Health
and Human Services, Public Health Service, 1988; DHHS publication
no. (PHS)88-50210.
2. Guo SS, Roche AF, Chumlea WC, Gardner JD, Siervogel RM. The
predictive value of childhood body mass index values for overweight
at age 35 y. Am J Clin Nutr 1994;59:810-9.
3. NCHS. Plan and operation of the Third National Health and
Nutrition Examination Survey, 1988-94. Hyattsville, Maryland: US
Department of Health and Human Services, Public Health Service,
CDC, 1994; DHHS publication no. (PHS)94-1308. (Vital and health
statistics; series 1, no. 32).
4. Public Health Service. Healthy people 2000: national health
promotion and disease prevention objectives--full report, with
commentary. Washington, DC: US Department of Health and Human
Services, Public Health Service, 1991; DHHS publication no.
(PHS)91-50212.
5. Ezzati TM, Massey JT, Waksberg J, Chu A, Maurer KR. Sample
design: Third National Health and Nutrition Examination Survey.
Hyattsville, Maryland: US Department of Health and Human Services,
Public Health Service, CDC, NCHS, 1992; DHHS publication no.
(PHS)92-1387. (Vital and health statistics; series 2, no. 113)
6. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing
prevalence of overweight among US adults. JAMA 1994;272:205-11.
7. Flegal KM. Defining obesity in children and adolescents:
epidemiologic approaches. Crit Rev Food Science Nutr 1993;33:307-
12.
8. Kuczmarski RJ. Trends in body composition for infants and
children in the U.S. Crit Rev Food Sci Nutr 1993;33:375-87.
9. McDowell MA, Briefel RR, Alaimo K, et al. Energy and
macronutrient intakes of persons ages 2 months and over in the
United States: Third National Health and Nutrition Examination
Survey, Phase 1, 1988-91. Hyattsville, Maryland: US Department of
Health and Human Services, Public Health Service, CDC, NCHS, 1994;
DHHS publication no. (PHS)94-1250. (Advance data no. 255)
10. Heath GW, Pratt M, Warren CW, Kann L. Physical activity
patterns in American high school students: results from the 1990
Youth Risk Behavior Survey. Arch Pediatr Adolesc Med 1994;148:1131-
6.
------------------------------
Date: Thu, 01 Dec 94 06:54:27 MST
From: mednews@stat.com (HICNet Medical News)
To: hicnews
Subject: Int'l Workshop on Information Processing in Cells and Tissues
Message-ID: <g6qNwc10w165w@stat.com>
+++++++++ Preliminary Announcement and Call for Papers ++++++++++++
============= Please Inform Interested Colleagues =================
INTERNATIONAL WORKSHOP ON INFORMATION PROCESSING IN CELLS AND TISSUES
Liverpool 6th - 8th September 1995
The purpose of this workshop is to bring together a multidisciplinary
group
of scientists working in the general area of modelling cells and
tissues.
A central theme will be the nature of biological information
and the ways it is processed in cells and tissues. We hope that
the workshop will draw together researchers from a range of
disciplines
including: Computer Science, Cell Biology, Mathematics,
Physiology, Biophysics, Experimental Medicine,
Biochemistry, Electronic Engineering and Biotechnology.
The workshop is intended to provide a forum to report research,
discuss
emerging topics and gain new insights into information processing
in biological and computational systems.
Subjects areas are likely to include but not be restricted to:
* Cellular information processing systems
* Enzyme networks, Gene networks, Metabolic channeling
* Second messenger systems
* Signal Transduction and Cellular Pattern Recognition
* Automata models
* Parallel Distributed Processing models
* Cellular Automata models
* Single Neuron Computation
* Biomolecular computing
* Inter-cellular communication, Multi-cellularity
* Information Processing in Developmental Systems
* Information Processing in Immune networks
* Endocrine-immune-nervous interactions
* Information processing in neural tissue systems
* Information processing in non-neural tissue systems
* Communication and gap-junctions
* Asynchronous processing, MIMD, SIMD and NIMD systems
* Cell and tissues oscillators
* Fractals and Chaos
* Emergent phenomena and self-organisation
Programme Committee
Georg Brabant Endocrinology (Hanover)
Michael Conrad Computer Science (Detroit)
Roy Cuthbertson Cell Biology (Liverpool)
Claus Emmeche Philosophy of Nature and Science Studies (Copenhagen)
Mike Holcombe Computer Science (Sheffield)
George Kampis Ethology and Philosophy of Science (Budapest)
Douglas Kell Biological Sciences (Aberystwyth)
Gareth Leng Physiology (Edinburgh)
Pedro Marijuan Electronics & Informatics (Zaragoza)
Koichiro Matsuno BioEngineering (Nagaoka)
Ray Paton Computer Science (Liverpool)
Hans-Paul Schwefel Computer Science (Dortmund)
Idan Segev Neurobiology (Jerusalem)
Gordon Shepherd Neurobiology (Yale)
Rene Thomas Molecular Biology (Brussels)
Chris Tofts Computer Science (Manchester)
John Tucker Computer Science (Swansea)
G Rickey Welch Biological Sciences (New Orleans)
Gershom Zajicek Experimental Medicine and Cancer Research (Jerusalem)
Organizing Committee
Ray Paton, Roy Cuthbertson Milke Holcombe and 'Trina Houghton
Submission Details
All authors must submit 4 copies of the full technical
paper by mail or delivery service to:
Ray Paton
Department of Computer Science
The University of Liverpool
Liverpool L69 3BX
UK
PLEASE DO NOT SUBMIT PAPERS BY FAX.
The paper should be in English, double-spaced in 12 point
using Times or similar font. The paper should be a maximum of
16 pages including the first page.
The first page must contain: title of the paper,
author's names including affiliations, complete mailing
address, telephone and FAX numbers, email address,
and a 250 word (maximum) abstract.
Important Dates
Submission deadline: Friday April 14th 1995
Acceptance Notification: Friday May 26th 1995
Deadline for final paper: Friday June 23rd 1995
Enquiries
Enquires should be addressed to Ray Paton at the above address or
FAX +44 51 794 3715 or
email tissues@csc.liv.ac.uk
------------------------------
Date: Thu, 01 Dec 94 06:55:55 MST
From: mednews@stat.com (HICNet Medical News)
To: hicnews
Subject: Musculoskeltal Pain Emanating from Head & Neck - CE Course
Message-ID: <w8qNwc11w165w@stat.com>
Continuing Medical Education Listing
8th International Symposium sponsored by Physical Medicine Research
Foundation "Musculoskeletal Pain Emanating from the Head and Neck:
Current Concepts in Diagnosis, Management and Cost Containment",
October 13 - 15, 1995; Banff, Alberta, Canada "A World Heritage Site"
Keynote Speakers: Emeritus Professor Patrick D. Wall FRS, DM, FRCP
(UK)
(Founder & Chief Editor of the Journal PAIN); James K. Taylor MB, ChB,
DTM,
PhD, FAFRM -Sci, (Australia), & Chris J. Main MA, MPhil, PhD, FBPsS,
(UK)
For program information please contact:
Physical Medicine Research Foundation, 207 West Hastings St.
Ste. 510, Vancouver, B.C., V6B 1H7 Canada
Tele: (604) 684-4148, Facsimile (604) 684-6247 or E-Mail
mwhite@unixg.ubc.ca
------------------------------
Date: Thu, 01 Dec 94 06:56:54 MST
From: mednews@stat.com (HICNet Medical News)
To: hicnews
Subject: AIDS Daily News Summary
Message-ID: <J0qNwc12w165w@stat.com>
AIDS Daily Summary
The Centers for Disease Control and Prevention (CDC) National AIDS
Clearinghouse makes available the following information as a public
service only. Providing this information does not constitute
endorsement
by the CDC, the CDC Clearinghouse, or any other organization.
Reproduction
of this text is encouraged; however, copies may not be sold, and the
CDC
Clearinghouse should be cited as the source of this information.
Copyright 1994, Information, Inc., Bethesda, MD
In this issue:
*********************************************************************
"German AIDS-Detecting Drug Recalled; Maker Says It Missed Virus
in One Case"
"Risperidone in HIV-Related Manic Psychosis"
"Nosocomial HIV-1 Transmission and Primary Prevention in Romania"
"Evaluating Interventions for Fear of Contagion"
"When All Else Fails"
"Medical Briefs: Sulfadiazine Available"
"Infections Related to Venous Access Devices in Patients with
AIDS"
"Alkaline Phosphatase Band-10 Fraction as a Possible Surrogate
·
Marker for Human Immunodeficiency Virus Type 1 Infection in
Children"
"AIDS Drugs Fail to Curb Dementia and Nerve Damage"
"Killer T Cells Reported as a Potential Gene Therapy for Viral
Diseases and Cancer"
"Autopsy Rates Among Patients Reported with AIDS"
"Only a Phone Call Away: Educating Health Care Professionals
About HIV/AIDS"
"Reduction of Maternal-Infant Transmission of Human
Immunodeficiency
Virus Type 1 with Zidovudine Treatment"
"A Controlled Trial of Intravenous Immune Globulin for the
Prevention
of Serious Bacterial Infections in Children Receiving Zidovudine
for Advanced Human Immunodeficiency Virus Infection"
"An AIDS-Like Condition Induced in Baboons by HIV-2"
"Synergy Between Basic Fibroblast Growth Factor and HIV-1 Tat
Protein in Induction of Kaposi's Sarcoma"
*********************************************************************
"German AIDS-Detecting Drug Recalled;
Maker Says It Missed Virus in One Case"
Boston Globe (10/24/94) P. 52
Hoechst, one of Germany's largest drug companies, has initiated a
recall of Enzygnost--a drug used for HIV testing--because it
missed HIV in one instance. Behring, the distributor of
Enzygnost and a subsidiary of Hoechst, began a worldwide recall
action to 35 countries on Oct. 15. German pharmaceutical
authorities have withdrawn the license for the drug. In Japan,
the Health and Welfare Ministry has requested more information so
it can decide whether people who previously tested negative with
Enzygnost should be tested again. It is believed that enough
Enzygnost to test 150,000 people has been distributed in
Japan--and 80 percent of that has already been used. Behring
spokesman Wolfgang Faust said that extensive retesting would not
be necessary--only one problem case has occurred since the drug
was introduced in 1991. The diagnostic failure was partially
explained by the gap between when a person is infected with HIV
and when it can be detected in the blood, up to 12 weeks. Faust
said that Behring has applied to license a new, improved AIDS
test drug and that Enzygnost had become obsolete.
"Risperidone in HIV-Related Manic Psychosis"
Lancet (10/08/94) Vol. 344, No. 8928, P. 1029
(Singh, A. N.; Catalan, J.)
Manic psychosis is fairly common among people in the advanced
stages of HIV. Singh and Catalan successfully administered
risperidone to four male psychotic AIDS patients with manic
symptoms. Following the Young mania rating scale, ratings in
three patients fell from 43 to 8, 35 to 14, and 30 to 3 within
seven to 10 days of receiving the drug. In contrast to the study
by Dwight et al concluding that risperidone may exacerbate manic
symptoms in patients with schizoaffective disorders, the
preliminary findings of Singh and Catalan indicate that
risperidone may be safe and effective in the treatment of
AIDS-related psychosis with manic symptoms.
"Nosocomial HIV-1 Transmission and Primary Prevention in Romania"
Lancet (10/08/94) Vol. 344, No. 8928, P. 1028
(Apetrei, C.; Buzdugan, I.; Mitroi, I. et al)
To establish the incidence and prevalence of patient-to-patient
HIV transmission among Romanian children, a study was conducted
in life-care institutions for orphans and abandoned children. A
total of 2,673 patients were tested for HIV in 23 different
homes. A high prevalence of HIV infection was found--in contrast
with the very low prevalence of HIV in adults in that region.
All mothers of children who tested HIV-positive that could be
could be tested were found HIV-seronegative. Children who were
HIV-positive or had AIDS were not separated from other patients,
but strict primary prevention measures were adopted in five of
the six orphanages where HIV was found. After testing every six
months, no new cases were found in the first five homes. The
sixth home, which houses 60 children, had 19 new children who
were diagnosed with HIV. Seroconversion after the first test for
HIV took place in six of the children, while the other 13 arrived
at the orphanage during the survey and were seropositive when
first tested. The study shows that primary prevention measures
are effective early even when a significant portion of the
population is HIV-seropositive and lives among those who are
uninfected.
"Evaluating Interventions for Fear of Contagion"
Journal of the Association of Nurses in AIDS Care
(9/94-10/94) Vol. 5, No. 5, P. 48
(Meisenhelder, Janice Bell; Rice, Louise)
Contact with AIDS patients is one educational strategy employed
to lessen fear of HIV contagion. To evaluate this type of
intervention among nurses, two continuing educational offerings
presented a panel of people living with HIV. The one-day program
was marked by a significant decrease in levels of fear. In the
six-week course, however, nurses' willingness to care for
patients with HIV remained unchanged between preprogram and
postprogram tests. The results provide evidence supporting the
idea that exposure to persons living with HIV decreases the fear
of contagion among nurses.
"When All Else Fails"
American Medical News (10/10/94) Vol. 37, No. 38, P. 13
(Pinkney, Deborah Shelton)
The American Medical Association is seeking $75,000 from the
Centers for Disease Control and Prevention to develop an HIV
prevention training program for doctors. The prototype
information kit contains an array of items--including pamphlets,
condoms, a demonstration model penis, a contract card for
recording negotiated behavior-change agreements, and a
wallet-size card to help patients monitor their progress. The
kit would also include pointers on how to talk to patients about
risky behavior, which is useful for doctors who are unsure how
they can help patients change behaviors that increase the risk of
becoming HIV-infected. "Physicians have trouble talking to
patients about sensitive subjects such as sexual practices and
drug use because they are not trained to," said Dr. James R.
Allen, AMA vice president for science, technology, and public
health. If the grant proposal is approved, the kit will be
tested in two states among 200 to 400 patients, and will expand
if proven effective. HIV prevention training is currently
available through 17 national AIDS Education and Training Centers
operated by the federal Health Resources and Services
Administration.
"Medical Briefs: Sulfadiazine Available"
Advocate (10/18/94) No. 666, P. 34
Sulfadiazine, manufactured and marketed by Eon Labs Manufacturing
Inc., is now available in the United States. Previously obtained
only through the Centers for Disease Control and Prevention, the
drug can be used for treatment of many infections, including
adjunctive therapy with pryimethamine for toxoplasmosis--an
infection of the brain that often causes brain inflammation and
dementia in AIDS patients. Sulfadiazine has been approved by the
Food and Drug Administration to be marketed through an
accelerated drug-review process.
"Infections Related to Venous Access Devices in Patients with AIDS"
Journal of the Association of Nurses in AIDS Care
(9/94-10/94) Vol. 5, No. 5, P. 43
(Settle, Jane T.; Neff-Smith, Martha; Wan, George J.)
A retrospective study of venous access devices (VADs) was
conducted in patients with AIDS to compare infection rates in
implanted external catheters and completely implanted ports.
VADs are often found in PWAs who need long-term administration of
medications and access for phlebotomy and dehydration. All 48
participants were diagnosed with AIDS and received a total of 54
VADs. While the 41 external catheters had an infection rate of
36.5 percent, the 13 ports had a 30.8 percent infection rate.
The authors hypothesize that lack of compliance with care of the
device is a significant factor in the development of VAD
infections.
"Alkaline Phosphatase Band-10 Fraction as a Possible
Surrogate Marker for Human Immunodeficiency Virus
Type 1 Infection in Children"
J.A.M.A. (10/19/94) Vol. 272, No. 15, P. 1152
A lymphocyte fraction of alkaline phosphatase (ALP band-10)
activity in serum may be useful in predicting HIV-1 in children
born to HIV-1 seropositive mothers. ALP band 10 in serum's
presence correlated with HIV-1 infection status. HIV-1
positively identified in 31 samples from 18 patients, ages 0.1 to
10 years, while the absence of infection was noted in the 14
samples from 9 patients who made up the controls and whose serum
samples did not show ALP band-10 activity. The ability of ALP
band 10 to predict HIV-1 infection in children as young as two
months may be useful as a surrogate marker for early
identification in babies born to HIV-infected mothers long before
maternal anti-HIV antibodies are approved.
"AIDS Drugs Fail to Curb Dementia and Nerve Damage"
New York Times (11/01/94) P. C3
(Altman, Lawrence K.)
A study of six AIDS-related neurological conditions found that
the incidence of infections that affect the brain and central
nervous system is increasing among HIV-infected patients.
Previous studies have found that AIDS drugs helped protect
against such damage. The increase was due in part to the
negative effects of drugs such as ddI (didanosine), ddC
(zalcitabine), and d4T (stavudine). The conditions include
toxoplasmosis, cryptococcal meningitis, and neuropathy. The six
conditions affected about 40 percent of the 2,641 HIV-infected
gay males who participated in the study. Dementia affected
almost 20 percent of the patients. There is a debate in the
scientific community as to whether there has been a decline in
the incidence of AIDS dementia. A Dutch study suggested that the
use of AZT led to a significant decrease in dementia, but others
disagreed, saying that the dementia only seemed to disappear
because it is frequently fatal quickly. Dr. Justin S. McArthur,
head of the research team and a neurologist at Johns Hopkins
School of Medicine, said that the data underscores the need for
the development of more effective AIDS drugs. He also said that
while the survival rate after the development of opportunistic
infections has increased, more people are living longer with
severely suppressed immune systems--the period of vulnerability
to neurological complications, especially opportunistic
infections of the brain.
"Killer T Cells Reported as a Potential Gene Therapy
for Viral Diseases and Cancer"
PRNewswire (11/01/94)
A team of researchers lead by Margo R. Roberts--director of cell
biology and immunology for Cell Genesys, Inc.--has developed
anti-HIV T cells that specifically and efficiently kill
HIV-infected cells in laboratory experiments. The findings,
which are reported in the Nov. 1 issue of the journal Blood,
describe the first successful laboratory experiments that
resulted in permanent genetic modification of killer T cells
specific for HIV. Killer T cells, or CD8+ lymphocytes--a
significant component of the immune system that is normally
responsible for eliminating virus-infected and tumor cells--were
engineered to produce the anti-HIV T cells. The National
Institutes of Health began the first human test of genetically
altered HIV-specific killer T cells in September in a Phase I/II
trial of anti-HIV T cell therapy for AIDS. Phase I safety
results are expected in late 1995. Previous studies have shown
that, in people with AIDS, the level of HIV-specific killer T
cells--which kill HIV-infected cells--decreases as they progress
to later phases of AIDS.
"Autopsy Rates Among Patients Reported with AIDS"
A.J.P.H. (10/94) Vol. 84, No. 10, P. 1695
(Schable, Barbara; Chu, Susan Y.)
Researchers studied autopsy rates of people in the United States
who died of AIDS to determine if there was a decline similar to
that found in the general population of the country. The general
autopsy rate in the United States from World War II to 1991
dropped from about 50 percent to 11 percent of deaths. Data was
taken from 16 states and local health departments whose combined
AIDS deaths account for 43 percent of all AIDS deaths nationwide.
The autopsy rate for people with AIDS fell from 57 percent in
1983 to 10 percent in 1991. While the autopsy rate for adults
with AIDS declined by 82 percent, the autopsy rate in pediatric
AIDS cases declined by 57 percent. Autopsies are more likely to
be performed on persons with AIDS whose mode of HIV exposure is
hard to determine. The authors attribute the substantial decline
in autopsy rates among AIDS patients to improved diagnostic
techniques, increased workload for pathologists, the cost of the
procedure, and safety issues. Critical evaluation of the decline
is suggested because of the usefulness of autopsies in confirming
diagnoses both antemortem and in death certificates.
"Only a Phone Call Away: Educating Health Care
Professionals About HIV/AIDS"
J.A.M.A. (10/26/94) Vol. 272, No. 16, P. 1242
(Sumaya, Ciro V.; Macher, Abe M.; Bowen, Stephen G. et al)
The Health Resources and Services Administration (HRSA) is now
educating and updating health care providers in the clinical
management of HIV and AIDS through two telephone services.
Established in 1992, the International State-of-the-Art HIV
Clinical Conference Call Series lets health care workers from
around the world discuss HIV care issues with panels of
internationally known clinical experts. Topics and questions to
be addressed during the quarterly conference calls are determined
by surveying thousands of primary care providers. Evaluations
show that the participants find the programs informative and the
topics timely. Also, the National HIV Telephone Consulting
Service--sponsored by organizations such as the Western AIDS
Education and Training Center and the National Institutes of
Health's Office of AIDS Research--is an on-line consulting
service for health care providers. Primary care providers with
HIV-related clinical management questions can call the 800 number
and speak to expert consultants. As of February 1994, the
program--based out of San Francisco General Hospital--had
received more than 4,100 phone calls and 4,600 questions covering
all aspects of HIV.
"Reduction of Maternal-Infant Transmission of Human
Immunodeficiency Virus Type 1 with Zidovudine Treatment"
N.E.J.M. (11/03/94) Vol. 331, No. 18, P. 1173
(Connor, Edward M.; Sperling, Rhoda S.; Gelber, Richard et al)
Young children become infected with HIV-1 principally through
maternal-infant transmission. The Pediatric AIDS Clinical Trials
Group conducted a multicenter study in the United States and
France to assess the efficacy and safety of zidovudine (AZT) in
reducing such transmissions. A total of 477 HIV-positive
pregnant women with CD4+ cell counts above 200 were enrolled.
Only 8.3 percent of the babies who received AZT tested positive
for HIV, while 25.5 percent of the infants in the placebo group
tested positive. The researchers found that administering AZT to
the pregnant mother throughout pregnancy, labor, and delivery and
giving it to the infant for six weeks reduced the risk of HIV
transmission by about two-thirds. The birth levels of hemoglobin
in infants in the AZT group were significantly lower than those
in the placebo group but, by 12 weeks, both groups had similar
levels.
"A Controlled Trial of Intravenous Immune Globulin for the
Prevention of Serious Bacterial Infections in Children Receiving
Zidovudine for Advanced Human Immunodeficiency Virus Infection"
N.E.J.M. (11/03/94) Vol. 331, No. 18, P. 1181
(Spector, Stephen A.; Gelber, Richard D.; McGrath, Nuala et al)
HIV-infected children frequently experience recurrent serious
bacterial infections. A study was conducted to determine the
efficacy of intravenous immune globulin in children with AIDS or
AIDS-related complex who were being treated with zidovudine
(AZT). The trial followed 255 children between the ages of 3
months and 12 years for approximately two years. Each child
received 180 mg of AZT orally four times a day. The estimated
two-year rate of serious bacterial infections was 16.9 percent
for the group that received intravenous immune globulin. The
rate for the placebo group was 24.3 percent. The researchers
concluded that, for children with advanced HIV who are receiving
AZT, intravenous immune globulin decreases the risk of serious
bacterial infections. The decrease was seen primarily among the
children who were not taking trimethoprim-sulfamethoxazole as
prophylaxis when entering the trial.
"An AIDS-Like Condition Induced in Baboons by HIV-2"
Science (10/28/94) Vol. 266, No. 5185, P. 642
(Barnett, Susan; Murthy, Krishna K.; Herndier, Brian G. et al)
A study was conducted in which six baboons were injected with the
UC2 strain of HIV-2. Each of the baboons seroconverted within
six weeks and five became persistently infected. Within 18 to 24
months after injection, three had CD4+ T cell loss. At necropsy,
one baboon showed extensive circulation of the virus with
follicular depletion in the lymph nodes, widespread fibromatosis
involving lymphoid and nonlymphoid tissues, and lymphotic
interstitial pneumonitis. Other baboons were injected with UC14
strain of HIV-2 and all have demonstrated persistent infection.
The results show that persistent infection can be acheived and
that some animals demonstrate AIDS-like symptoms. The baboons
provide a useful animal model for studying HIV and for evaluating
potential antiviral therapies.
"Synergy Between Basic Fibroblast Growth Factor and
HIV-1 Tat Protein in Induction of Kaposi's Sarcoma"
Nature (10/20/94) Vol. 371, No. 6499, P. 674
(Ensoli, Barbara; Gendelman, Rita; Markham, Phillip et al)
Angiogenic Kaposi's sarcoma-like lesions in mice were induced by
the combined operation of basic fibroblast growth factor (bFGF)
and HIV-1 Tat protein. The synergy is induced by Tat, which
increases endothelial cell growth and type-IV collagenase
expression in response to bFGF imitating extracellular matrix
proteins. The bFGF, extracellular Tat, and Tat receptors are
found in HIV-1-related Kaposi's sarcoma (KS). Their presence may
explain the higher incidence and aggressiveness of HIV-1-related
KS compared to the classical form of KS--which is rare and mild
and found in elderly men of Mediterranean origin--where only bFGF
is found.
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End of HICNet Medical News Digest V07 Issue #58
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Editor, HICNet Medical Newsletter
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