HIV Protective Strategies Among College Students in Durban; South Africa

There is growing concern about the high level of HIV infection among young people in South Africa. The aim of the study is to examine the HIV protective strategies used by college students with specific emphasis on variations by race group. The data for the study come from a self-administrated survey that was conducted with 3 000 college students in Durban in order to understand the strategies they use to protect themselves against the risk of HIV infection. Overall; students perceived a far greater risk of pregnancy than HIV infection. The results show that abstinence is the most common protective factor among Indian and White students. Among African students; there is great concern about HIV but abstinence is less common. Among sexually active men and women; the majority report having more than one sexual partner (with the exception of Indian females). Female students among all groups were more likely than male students to report that they were faithful to their partners. In Africans the contrast is stark: 25 for women versus 6 for men. Condoms are the most commonly used method by students but are not used in every sexual encounter. Consistent condom use was highest among Indian males (46) and lowest among White females (13.7). More effort needs to be directed at promoting correct and consistent condom use in order to avoid the negative consequences associated with unprotected sexual intercourse including unwanted pregnancy and HIV/AIDS

Delayed development of a biloma in an infant following hepatic injury / Desarrollo retardado de un biloma en un infante luego de un daño hepático

A case report is presented of an infant who developed a biloma over three months after major hepatic injury and after almost complete healing. A brief literature review is given to highlight unusual features of this case.

Se presenta el caso de un infante que desarrolló un biloma en tres meses, tras sufrir un serio daño hepático y luego de una curación casi completa. Se ofrece una breve revisión de la literatura a fin de destacar las características poco usuales de este caso.

A barium chemobezoar in an infant / Quimobezoar de bario en un neonato

A case report is presented of an infant who developed a large barium concretion proximal to a jejunal anastomosis. A brief literature review outlines the issues involved in the indications for, and choice of, contrast material for use in the precise radiological diagnosis of upper intestinal obstruction in infants.

Se presenta el reporte de un caso de un neonato que desarrolló una concreción grande de bario cercana a una anastomosis yeyunal. Una breve revisión de la literatura esboza los problemas involucrados en las indicaciones y selección del material de contraste para uso en un diagnóstico radiológico preciso de la obstrucción intestinal superior en los neonatos.

Lymphoscintigraphic evaluation of chronic lower limb oedema

Ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), venography, lymphoscinti-graphy (LS) and contrast lymphography are frequently utilized in the evaluation of lower limb oedema but no clinical data from the Caribbean have been published on the role of LS despite its well-recognized clinical application. The successful clinical application of CT, colour doppler sonography and MRI in differentiating the various causes of lower limb oedema is well understood. Lymphoscintigraphy has found less acceptability especially in the Caribbean where nuclear imaging techniques are only now currently being developed. This paper describes the initial experience with this technique in 15 patients over a five-year period and discusses its value when lower limb lymphoedema is suspected. Scintigrams were analyzed for visualization of lymph vessels and lymph nodes, dilatation of lymphatic vessels, collaterals and dermal back flow. Lymphoscintigrams were classified as normal (n = 5) or consistent with lymphoedema (n = 10). Failure to visualize lymphatic vessels occurred in two cases of suspected primary lymphoedema. In the remaining eight cases of secondary lymphoedema, a positive study based on altered lymphatic flow and anatomy was recorded. An alternative explanation was offered in three out of five cases in which a normal lymphoscintigram was obtained

The initial Trinidad experience with Cine MRI in clinical cardiology

We describe the initial Trinidad experience with Magnetic Resonance Imaging (MRI) and Cine MRI as a diagnostic tool in clinical cardiology. Six patients from the following categories were referred for Cine MRI evaluation: congenital heart disease, valvular heart disease, aortic diseases, cardiomyopathy and intracardiac mass. All patients underwent echocardiography. MRI and Cine MRI were performed on all patients using a Siemens Magnetom 1.0 Tesla MR system at MRI Trinidad and Tobago Ltd. Selected patients underwent Angiography and/or computed tomography (CT) scanning. Clinical data and images of the six patients evaluated are described. MRI and Cine MRI provided excellent anatomical and functional details of the heart and aorta in five patients with dissection of the aorta, aneurysm of the ascending aorta, suspected left ventricular apical thrombus, infiltrative cardiomyopathy and arrhythmogenic right ventricular dysplasia. Technical difficulty was experienced with one patient who had a congenital defect (common atrium). In this study, Cine MRI provided excellent images in all but one patient. This new noninvasive technique enhanced diagnostic capabilities and facilitated management in patients with certain cardiovascular diseases.

The role of labelled red blood cell scintigraphy in the detection of acute gastrointestinal bleeding

This paper describes the experience with 99m Technetium labelled red blood cell (99mTc RBC) scintigraphy in twenty-two patients presenting with acute gastrointestinal (GI) tract bleeding. Studies were positive in thirteen cases--eight from the lower GI tract and five from the upper. The data from surgical intervention were available in ten cases. Scintigraphy cannot diagnose the cause of GI bleeding, as it is a nonspecific study. Its usefulness lies in its ability to accurately diagnose the bleeding site, as was shown in this study where there was good surgical correlation. The simplicity, reproducibility and reliability of the technique, particularly when bleeding rates are low and intermittent, make it, in our view, the first line of investigation in any patient with suspected bleeding from the colon or upper GI tract if endoscopic evaluation is not possible in the latter. Its current under-utilisation in the Caribbean may be a reflection of the lack of nuclear imaging facilities.

Intrathoracic cystic hygroma in an infant with respiratory failure

A 6-month-old infant presenting initially with clinical signs of bronchiolitis developed acute symptoms of large airway obstruction and respiratory failure despite treatment for bronchiolitis. Endotracheal intubation and oxygen therapy resulted in immediate and dramatic improvement of respiratory failure. Plain chest radiograph, computerized tomography and surgical biopsy with subsequent histological examination established that the respiratory failure was due to a mediastinal cystic hygroma.