Performance of patients with early HIV-1 infection on the Stroop Task.

HIV-seropositive and seronegative control subjects performed a standard paper-and-pencil version and an experimental reaction time version of the Stroop Color-Word Naming Task. Results indicated that both symptomatic and asymptomatic HIV-positive subjects showed an exaggerated Stroop effect compared to controls, but this increase was only apparent on the RT version of the task. Analysis of components of the effect indicated that HIV-positive subjects showed increased inhibition compared to controls but normal facilitation. These results suggest that HIV-related cognitive slowing has an attentional component, most likely involving controlled processes. In addition, these results emphasize the utility and sensitivity of RT measures in the study of early HIV-1 infection.

Spatial attention in HIV-1 infection: a preliminary report.

In a preliminary study, 30 nondemented human immunodeficiency virus (HIV-1) seropositive subjects without acquired immunodeficiency syndrome and 14 seronegative controls performed a reaction time measure of spatial attention. Compared with controls, seropositive asymptomatic subjects showed normal facilitation of reaction time at short cue-target intervals when attention was precued, but symptomatic subjects were impaired. However, asymptomatic subjects showed no evidence of normal inhibition of attention at the cued location at longer cue-target intervals, suggesting possible subtler spatial attentional deficits in this group. Cognitive slowing in HIV-1 infection may have an attentional component, with possible involvement of both automatic and controlled processes.

Decision-making speed in HIV-1 infection: a preliminary report.

OBJECTIVES: To test the efficacy of reaction time measures derived from cognitive psychology as measures of subclinical cognitive slowing in individuals with HIV-1 infection. DESIGN: Cognitive slowing is the primary deficit in AIDS dementia. One measure of cognitive slowing is decision-making speed, the discrepancy between simple and choice reaction times, which represents an index of central information processing time. METHODS: Nineteen HIV-seropositive and 13 control subjects performed a detection and decision task in a reaction time procedure. All subjects were administered measures of simple and choice reaction time, a control measure of rate of verbal encoding, and measures of psychological distress. RESULTS: Compared with controls, both symptomatic and asymptomatic HIV-seropositive subjects had significantly longer decision times, but performed the control task of rate of encoding normally. Simple reaction times correlated significantly with depression scores, but choice reaction times were unrelated to psychological distress. CONCLUSIONS: The results support mental slowing as the initial cognitive disturbance of HIV-1 infection and emphasize potential use of reaction times as markers of central nervous system involvement in HIV-1 infection.

Intravenous or intramuscular teicoplanin once daily for skin and soft-tissue infections.

Teicoplanin is a new glycopeptide antibiotic with potent activity against gram-positive bacteria and pharmacokinetics that allow once daily administration. To study the efficacy and safety of teicoplanin for skin and soft-tissue infections, 75 patients received teicoplanin intravenously (38) or intramuscularly (37, of which 16 were outpatients). Of 62 clinically evaluable patients, 97 percent of teicoplanin iv and 93 percent of teicoplanin im patients were cured or improved. All teicoplanin iv patients and 64 percent of teicoplanin im patients were cured microbiologically at 24-48 hours posttherapy. Persistence of organisms frequently was associated with skin ulcers or abscess cavities and usually had no bearing on clinical outcome. Possible adverse clinical and laboratory reactions caused by teicoplanin occurred in 4 of 38 teicoplanin iv patients (11 percent) and in 8 of 37 teicoplanin im patients (22 percent). Reactions were mild and resolved with discontinuation of teicoplanin in most cases. In this study, teicoplanin appeared to be safe, efficacious, and convenient for both hospital staff and patients, and potentially cost-effective for the treatment of skin and soft-tissue infections. In particular, teicoplanin appears to be appropriate for outpatient parenteral therapy.

Perinephric abscess in renal transplant recipients: report of seven cases and review.

The experience of four kidney transplantation programs from 1975 to 1986 was reviewed to determine the prevalence and clinical characteristics of perinephric abscess in renal transplant recipients. Seven cases were found, with a prevalence of 0.3% in 1,945 patients seen over a 12-year period in one program. Current prevalence appears markedly less than in older studies. Despite immunosuppression, signs and symptoms of perinephric abscess were prominent and included fever, flank and abdominal pain and tenderness, and abdominal mass. Perinephric abscesses were diagnosed 2 weeks to 52 months after transplantation and were associated with lymphoceles in two patients. Abdominal ultrasound and computed tomography were useful in diagnosis. Staphylococci (36%) and aerobic gram-negative rods (32%) were the most common pathogens in our seven patients combined with patients identified in a review of the English-language literature. Also of note were the presence of anaerobes (28%) and Candida albicans (4%). Therapy was successful in all of our seven patients.