Patients with AIDS-defining cancers are not universally screened for HIV: a 10-year retrospective analysis of HIV-testing practices in a Swiss university hospital.

OBJECTIVES: Kaposi's sarcoma (KS), invasive cervical carcinoma (ICC) and non-Hodgkin lymphoma (NHL) have been listed as AIDS-defining cancers (ADCs) by the Centers for Disease Control and Prevention since 1993. Despite this, HIV screening is not universally mentioned in ADC treatment guidelines. We examined screening practices at a tertiary centre serving a population where HIV seroprevalence is 0.4%. METHODS: Patients with KS, ICC, NHL and Hodgkin lymphoma (HL), treated at Lausanne University Hospital between January 2002 and July 2012, were studied retrospectively. HIV testing was considered part of the oncology work-up if performed between 90 days before and 90 days after the cancer diagnosis date. RESULTS: A total of 880 patients were examined: 10 with KS, 58 with ICC, 672 with NHL and 140 with HL. HIV testing rates were 100, 11, 60 and 59%, and HIV seroprevalence was 60, 1.7, 3.4 and 5%, respectively. Thirty-seven patients (4.2%) were HIV-positive, of whom eight (22%) were diagnosed at oncology work-up. All newly diagnosed patients had CD4 counts < 200 cells/µL and six (75%) had presented to a physician 12-236 weeks previously with conditions warranting HIV testing. CONCLUSIONS: In our institution, only patients with KS were universally screened. Screening rates for other cancers ranged from 11 to 60%. HIV seroprevalence was at least fourfold higher than the population average. As HIV-positive status impacts on cancer patient medical management, HIV screening should be included in oncology guidelines. Further, we recommend that opt-out screening should be adopted in all patients with ADCs and HL.

[The diagnosis of brain cholesteatomas]. / Diagnostika kholesteatom golovnogo mozga.

The authors analyse the results of radiological examination of 65 patients with cholesteatomas of the brain and the value of the main neuroradiological methods in the diagnosis of the disease. The specific features of the CT-picture of these tumors are discussed. The article describes cases of atypical CT isodensity cholesteatomas and cholesteatomas of increased density as well as cases in which a vascular network of the tumor capsule was demonstrated by angiography. The indices of the contrast range of brain cholesteatomas are analysed. The algorithm of radiodiagnosis of cerebral cholesteatomas is elaborated on the basis of the results of the study.

[Changes in the space-time organization of the bioelectrical activity of the human brain on completing the solution of a mental task]. / Izmenenie prostranstvenno-vremennoi organizatsii bioélektricheskoi aktivnosti mozga cheloveka po okonchanii resheniia myslitel'noi zadachi.

Changes in spatial-temporal organization of human bioelectrical brain activity were studied following formal completion of the process of solution of mental tasks of various complexity. It was shown that in the first seconds after the response, desynchronization took place of cortical potentials, identical to the one observed in the process of solution; at frequencies of alpha- and beta-2-rhythms, predominant decrease took place of parameters of spatial-temporal biopotentials conjunction as compared to the level of calm alertness. Dynamics of recovery of calm alertness EEG characteristics is determined by subjective complexity for the subject of previous activity and by the degree of his confidence in the correctness of the obtained result. The latter is determined by individual-typological properties of the subject.

[Mathematical model of normal tissue involvement in gamma teletherapy]. / Matematicheskaia model' porazheniia normal'nykh tkanei pri distantsionnoi gamma-terapii.

A model of normal tissue injury as a result of exposure to ionizing radiation is based on an assumption that the degree of tissue injury is determined by the degree of destruction by certain critical cells. The dependence of the number of lethal injuries on a single dose is expressed by a trinomial - linear and quadratic parts and a constant, obtained as a result of the processing of experimental data. Quantitative correlations have been obtained for the skin and brain. They have been tested using clinical and experimental material. The results of the testing point out to the absence of time dependence on a single up to 6-week irradiation courses. Correlation with an irradiation field has been obtained for the skin. A conclusion has been made as to, first, time lag blurring time dependence within a certain range of courses, second, the presence of a component of true regeneration of which the degree depends on the volume irradiated. Proceeding from such an understanding of injury-regeneration processes a conclusion has been made that the concept of isoefficacy of irradiation courses is conditional. Volume-time fractionation is a promising direction in the development of radiation therapy.