Relations of stroke volume and cardiac output to body composition: the strong heart study.

BACKGROUND: Although cardiac output (CO) plays the vital role of delivering nutrients to body tissues, few data are available concerning the relations of stroke volume (SV) and CO to body composition in large population samples. METHODS AND RESULTS: Doppler and 2D echocardiography and bioelectric impedance in 2744 Strong Heart Study participants were used to calculate SV and CO and to relate them to fat-free body mass (FFM), adipose mass, and demographic variables. Both SV and CO were higher in men than women and in overweight than normal-weight individuals, but these differences were diminished or even reversed by normalization for FFM or body surface area. In both sexes, SV and CO were more strongly related to FFM than adipose mass, other body habitus measures, arterial pressure, diabetes, or age. In multivariate analyses using the average of Doppler and left ventricular SV to minimize measurement variability, FFM was the strongest correlate of SV and CO; other independent correlates were adipose mass, systolic pressure, diabetes, age, and use of digoxin and calcium channel and beta-blockers. CONCLUSIONS: In a population-based sample, SV and CO are more strongly related to FFM than other variables; increased FFM may be the primary determinant of increased SV and CO in obesity.

Infectious complications the year after autologous bone marrow transplantation or peripheral stem cell transplantation for treatment of breast cancer.

Few studies have examined the specific incidence of infections after autologous bone marrow transplantation (BMT) or peripheral stem cell transplantation (PSCT) for treatment of breast cancer. We reviewed the medical records of 127 consecutive patients who underwent autologous BMT or PSCT for breast cancer at the University of Pennsylvania Medical Center from 1 May 1991 through 31 March 1995 and through 1 year of follow-up. The mean duration of neutropenia after transplantation was 10 days. Initial infections included catheter-site cellulitis (in 20 patients [16%]), bacteremia (17 [13%]), Clostridium difficile colitis (13 [10%]), and urinary tract infection (in 10 [8%]); there was only 1 documented invasive fungal infection (1% of patients). The mortality from infection was 2%. Infections during the 1 year follow-up included upper respiratory infections (11 patients [10%]) and dermatomal zoster (9 [8%]); neither was significantly associated with death. This group of patients who underwent BMT or PSCT for breast cancer had a low rate of infectious morbidity and mortality. Viral and fungal infections were rare despite inconsistent prophylaxis.

The clinical manifestations and treatment of sexually transmitted diseases in human immunodeficiency virus-positive men.

Sexually transmitted diseases (STDs) occur commonly in sexually active human immunodeficiency virus (HIV)-positive men. STDs may have atypical presentations, can cause significant morbidity in persons with HIV infection, and may increase the risk of HIV transmission. Thus, the appropriate diagnosis and treatment of STDs in this population are extremely important. The clinical manifestations and treatment of several common STDs in HIV-positive men are reviewed. Further research is needed to define effective management and screening strategies for STDs in men with HIV infection.

Lasiodiplodia theobromae isolated from a subcutaneous abscess in a Cambodian immigrant to Australia.

A patient from Cambodia presented at a hospital in Melbourne with a persistent subcutaneous abscess of the right buttock. Septate fungal hyphae were seen in biopsy tissue. Lasiodiplodia theobromae was isolated and identified by the formation of pycnidia that produced typical conidia. The abscess was managed by drainage and debridement only. We briefly review the history and importance of the fungus as a wound parasite in tropical horticulture and its relatively rare occurrence in human infections. The significance of this fungus in Australian horticulture and its potential as an opportunistic human pathogen is noted. This paper records the first isolation of L. theobromae from a human lesion in Australia and the second isolation from a subcutaneous lesion worldwide.