Definitions of genital ulcer disease and variation in risk for prevalent human immunodeficiency virus infection.

OBJECTIVES: Although genital ulcer disease (GUD) has been associated with human immunodeficiency virus (HIV) infection in a number of studies, definitions of genital ulceration have varied. The authors hypothesized that the association of GUD with prevalent HIV infection may vary according to the definition of GUD that is used. METHODS: As part of a prospective cohort study, 863 patients were interviewed and examined who presented to a sexually transmitted disease (STD) clinic for new symptom evaluation and who agreed to HIV testing to determine demographic and behavioral risk associated with prevalent HIV infection. To determine the association between GUD and prevalent HIV, the following definitions of GUD were used: observed ulcers, history of syphilis, serologic evidence of syphilis, observed culture-proven genital herpes, and serologic evidence of herpes simplex virus type II (HSV-2) infection. RESULTS: Of 481 men and 382 women enrolled, prevalent HIV infection was detected in 12.5% and 5.2%, respectively. In multivariate analyses controlling for known HIV risk behaviors, prevalent HIV infection was associated with observed GUD (odds ratio [OR] = 2.0, 95% confidence intervals (CI) = 1.0-3.9), a history of syphilis (OR = 6.0, CI = 2.8-12.7), and serologic evidence of syphilis (OR = 3.7, CI = 1.9-7.0), but not with serologic evidence of HSV-2 (OR = 1.2, CI = 0.7-2.1), nor with observed HSV-2 culture-positive genital ulcerations (OR = 1.0, CI = 0.4-4.2). Factors contributing to different strengths of association between HIV infection and a history of syphilis or serologic evidence of syphilis included the presence of underdiagnosed syphilis infection in people with reactive serologic tests and the absence of serologic reactivity in people with a positive history. CONCLUSIONS: Although GUD is strongly associated with prevalent HIV, the strength of the association depends on the definition of GUD used. For accurate evaluation of people at risk for HIV, clinicians and researchers should use multiple definitions of GUD.

Cord blood hypertriglyceridaemia as an index of fetal stress: use of a simple screening test and results of further biochemical analysis.

In this preliminary study, 120 cord blood samples were subjected to a simple on-the-ward triglyceride screening procedure and 15 were designated as being high and another 15 randomly selected as controls. All the samples were then subjected to detailed biochemical analysis for fatty acid profiles and/or concentrations of free fatty acids, triglycerides (TG), phospholipids, cholesterol esters and glycerol. Eleven of the samples designated 'high' were associated with one or more of the following clinical conditions: family history of ischaemic heart disease, maternal starvation, fetal distress, light-for-dates babies and excessive weight gain during pregnancy. There was an association between high TG levels and high glycerol levels. The fatty acid pattern of the TG was altered when at abnormally high concentration, in particular oleic acid was increased relative to the others, and this was associated with an increase in cholesterol ester oleic acid. The possible mechanisms resulting in cord hypertriglyceridaemia are discussed.

Source of fetal-stored lipids during maternal starvation in rabbits.

The effect of 48 h maternal starvation on the composition of fetal rabbit brown and white adipose tissue was examined. Compared with fed control rabbits, adipose tissue triglyceride fatty acids took on a composition more like that of maternal plasma free fatty acids (FFA), whose concentration more than doubled after 48 h starvation. It is concluded that maternal FFA contribution to the fetal lipids increases during starvation and certain fetal acids, in particular linoleic acid, may in the fed state be derived from maternal lipids other than the FFA.

Quantitative recovery of free and esterified fatty acids from thin-layer plates coated with silica gel.

A method is described for the recovery of fatty acids from silica gel on thin-layer plates. The method is simple and rapid and depends on the conversion of silica gel to potassium silicate, using potassium hydroxide, followed by acidification in such a way that the silicic acid is kept in solution. Fatty acids are then extracted by shaking with solvent. Fatty acid recovery from free fatty acid, phospholipid, glyceride and cholesterol ester zones is more than 90% efficient. There is no oxidation or isomerization of unsaturated fatty acids.