Surgical therapy for 101 patients with acquired immunodeficiency syndrome and symptomatic cholecystitis.

BACKGROUND: Hepatobiliary disease in patients with acquired immunodeficiency syndrome (AIDS) has been well documented. Cytomegalovirus and Cryptosporidium are the pathogens most frequently associated. Previous reports of cholecystectomies and AIDS have had conflicting results on morbidity and mortality. METHOD: Retrospective review of 101 patients with AIDS and symptomatic cholecystitis who underwent cholecystectomy from December 1989 to May 1995. RESULTS: All patients had symptoms characteristic of gallbladder disease, the most common being abdominal pain and fever. Thickening of the gallbladder was the most common diagnostic finding. Fifty-six patients underwent open cholecystectomy and 45 laparoscopic cholecystectomy. Pathologic examination revealed an abnormal gallbladder in all cases and gallstones in 29%. A specific pathogen or malignancy was identified as the etiologic agent in 44% of patients. Perioperative morbidity was similar (<5%) in both surgical groups. Perioperative mortality was 4% among all the patients treated. CONCLUSIONS: Both open and laparoscopic cholecystectomy improved the quality of life of these patients and should be considered as the treatment for persistent hepatobiliary symptoms in patients with AIDS.

Infants' ability to draw inferences about nonobvious object properties: evidence from exploratory play.

Generalizing knowledge about nonobvious object properties often involves inductive inference. For example, having discovered that a particular object can float, we may infer that other objects of similar appearance likewise float. In this research, exploratory play served as a window on early inductive capability. In the first study, 48 infants between 9 and 16 months explored pairs of novel toys in 2 test conditions: violated expectation (two similar toys were presented in sequence, the first toy produced an interesting nonobvious property, such as a distinctive sound or movement, while the second toy was invisibly altered such that it failed to produce the nonobvious property available in the first toy), and interest control (two similar-looking toys were presented in sequence, neither of which produced the interesting property). Infants quickly and persistently attempted to reproduce the interesting property when exploring the second toy of the violated expectation condition relative to the first toy of the interest control condition (a baseline estimate) or the second toy of the interest control condition (an estimate of simple disinterest). The second study, with 40 9-16-months-olds, confirmed these results and also indicated a degree of discrimination on infants' part: Infants seldom expected toys of radically different appearance to possess the same nonobvious property. The findings indicate that infants as young as 9 months can draw simple inferences about nonobvious object properties after only brief experience with just 1 exemplar.