Mosaic of the AIDS epidemics in Latin America and the Caribbean.

AIDS: In Latin America and the Caribbean, the AIDS pandemic is comprised of groupings of different epidemics, varying in transmission routes and in populations affected. Primary modes of HIV transmission in Latin America, the Caribbean, and South America are outlined, and vary from type of sexual contact to intravenous drug use, depending on the subregion. Overall, the epidemic is progressing into younger, more impoverished, and more rural populations. Efforts to stem the spread of the epidemic should meet the prevention needs of marginalized and impoverished populations and be consistent with the type and characteristics of the epidemics found at the country level. Timely surveillance is a key component in alleviating the epidemic. Strategies targeting at-risk populations should empower women, educate youth, and disseminate messages.^ieng

More than a tropical dream: South-South cooperation in HIV prevention.

AIDS: Latin American and Caribbean countries possess the capability and expertise to manage their own HIV/AIDS programs but still need help with financial capital and material resources for these programs to reach their potential. Latin American countries have been especially proactive in working with each other to share information and develop regional planning programs. The history of HIV program development in this region is briefly outlined. Countries are continuing to work together with each other and with the private sector to design and manage programs that prevent and/or treat HIV infection.^ieng

Umbilical cord fluoride serum levels may not reflect fetal fluoride status.

OBJECTIVE: To evaluate the reliability of fluoride levels in the umbilical cord as reflecting neonate fluoride status. DESIGN: Prospective study of fluoride levels of pregnant women at term and their neonates. SETTING: Delivery room and maternity unite of Hadassah Hospital Mount Scopus. PATIENTS: Fluoride serum levels were determined in the sera of 20 women with normal pregnancies at term, during delivery, in the corresponding mixed cord sera and neonatal sera at 24 hours after delivery. RESULTS: The mean maternal fluoride serum level was 0.0303 microgram/ml (SD 9.015), mean cord fluoride serum level 0.0183 microgram/ml (SD 0.012), and mean neonatal fluoride serum 0.0380 microgram/ml (SD 0.016). CONCLUSION: The significantly (p < 0.001) low mixed cord serum levels of fluoride as compared with neonatal and maternal serum levels may be explained by placental sequestration of fluoride. It is suggested that cord serum fluoride levels to not reflect fetal fluoride status.

Outcome of 51 patients with roentgenographically occult lung cancer detected by sputum cytologic testing: a community hospital program.

BACKGROUND: Lung cancer is the most common fatal malignant neoplasm of both men and women. It is usually caused by tobacco smoke. However, at present there is no systematic approach to early diagnosis. The diagnosis of lung cancer is usually made by standard chest roentgenograms and biopsy by bronchoscopy or surgery. Survival rates at 5 years have remained 10% to 15% for the past 30 years with this conventional approach to diagnosis. METHODS: Fifty-one men and women, aged 46 to 81 years (mean age, 64.2 years), with roentgenographically occult cancer were identified in one community hospital by means of sputum cytologic testing. Cancers were diagnosed by means of one or more standard light fiberoptic bronchoscopic procedures with biopsies. RESULTS: Forty-four squamous cell carcinomas, three adenocarcinomas, two large-cell carcinomas, and two undifferentiated carcinomas were found. Forty-five (86%) were stage 0 or 1. Surgical cure was attempted in 27 patients, and there were three actuarial cancer deaths at 5 years and a total of nine deaths. Additionally, 19 patients received attempts at curative radiation therapy for various reasons, which were usually poor pulmonary or cardiac function or advanced age. Of both the 27 patients who underwent surgery and the 19 who were treated with radiation therapy (total, 46), the actuarial results by the life-table method included nine lung cancer deaths in 5 years and 21 deaths from all causes, giving an actuarial survival, including deaths from all causes, of 55%. CONCLUSION: Roentgenographically occult lung cancer can be found by sputum cytologic testing followed by fiberoptic bronchoscopy and biopsy at a time when cure is more likely than when it is diagnosed by conventional roentgenographic techniques (ie, 55% survival vs 10% to 15% survival). Sputum cytologic testing should be used as a case-finding tool, particularly in heavy smokers and those with occupational risks. This diagnostic approach to earlier diagnosis and intervention can be successful in a small community hospital.

Respiratory failure and multiple fractures in vitamin D-dependent rickets.

A 20-month-old boy presented with multiple fractures and respiratory failure. He was found to have vitamin D-dependent rickets. The rickets did not improve with phosphate, calcium and calciferol. The rickets healed, however, with large doses of 1-alpha-hydroxycholecalciferol. The presentation is unusual and the response to therapy suggests metabolic heterogeneity in vitamin D-dependent rickets.

Low serum 24,25 dihydroxyvitamin D in Duchenne muscular dystrophy.

Levels of serum 24,25(OH)2D3 (0.69 +/- 0.17 ng/ml) were lower in DMD patients than in age-matched controls (2.13 +/- 0.15 ng/ml). Circulating levels of 1,25(OH)2D3 and 25(OH)D3 were within the accepted normal range. Bearing in mind the proposed pathophysiologic role of calcium in DMD and the influence of vitamin D metabolites on muscle ATP and protein synthesis, as well as on sarcoplasmic reticulum calcium transport and muscle mitochondrial calcium content, the above findings of low or deficient 24,25(OH)2D3 levels in DMD could be meaningful from the etiologic and therapeutic points of view.

Idiopathic apnoea of prematurity treated with doxapram and aminophylline.

Doxapram infusion was given to five preterm infants in whom therapeutic concentrations of theophylline had failed to control episodes of apnoea. Doxapram successfully controlled the apnoea, the arterial blood PCO2 value decreased significantly, and no side effects were reported.

SCLERA: an Astrometric Telescope for Experimental Relativity.

An f/100, 12.2-m focal length photoelectric telescope designed specifically for daytime astrometry of objects near the sun is now operative at its Tucson, Arizona, site. The design goal was to achieve accuracies of order 0.001 sec of arc in field position measurements of stars. To accomplish this, many features reducing systematic and random errors are employed, including Schupmann medial telescope optics, compensation for lateral color aberration, apodization for reduction of diffracted light, and use of an accurately measured solar diameter for calibrating the field.

Measurements of scattered light from mirrors and lenses.

The limitations arising from scattered light from lenses and mirrors in a program of daytime astrometry near the sun are discussed. Measurements were made of the angular distribution of the scattered radiance for (1) a coronagraphic lens, (2) a 2.54-cm thick coronagraph quality window, and (3) flat quartz mirrors. Results are also given for the optical elements after they have been exposed in a vacuum for 48h. The results indicate that the accuracy of a daytime astrometry program would be determined by the shot noise of the scattered light produced by the refracting elements and the sky, each producing equal contributions.