Continuing clozapine treatment after a diagnosis of cardiomyopathy.

A patient in a medium secure psychiatric unit with a 19-year history of treatment-resistant schizophrenia and violence whose mental illness only responded to clozapine, was noted to have a sustained tachycardia. Echocardiography revealed mild biventricular cardiomyopathy. The patient was not significantly affected by this. Initial recommendation from Cardiology was to consider discontinuation of clozapine. It was decided, however, that the risk of worsening psychosis and resultant violence outweighed the risk of the patient's relatively mild cardiomyopathy. The patient was commenced on ramipril, and later bisoprolol. The patient no longer requires treatment in a medium secure unit and has remained on clozapine with follow-up from cardiology.

China and Thailand to start trials of AIDS vaccines.

PIP: China and Thailand will soon become the first developing countries in which trials of experimental AIDS vaccines are conducted. These trials will be mounted with western help and are based upon the MN and IIIB strains which are prevalent in North America, but not common in either Asian country. The integrity of this approach has been criticized by research groups. Researchers in China are working with United Biomedical, an American company, to begin a trial of a vaccine based on the MN strain. Despite not having presented results of safety tests on humans in the US, the Chinese government and United Biomedical are in agreement to start the trail within weeks. In Thailand, the national AIDS prevention committee met to discuss cooperation between the US army and the Thai army to test the experimental vaccine gp160 based upon the original strain of HIV, IIIB. The Thai government and the US army are ready to start, but await approval from the committee; a scientific subcommittee has been appointed to speed the process. The World Health Organization also plans to support a vaccine field trial in Thailand, Brazil, Uganda, and Rwanda.^ieng

Thailand tries again to tackle AIDS.

PIP: Concerned about the potential economic impact of AIDS, the Thai government has increased the budget for HIV prevention, promised to tighten restrictions against the sex industry, and will attempt to eradicate child prostitution. 1753 AIDS patients have been reported in Thailand since the mid 1980s. Further, HIV prevalence among army recruits has increased from .5% in 1989 to 3.2% in 1992. An alarming 20% of new recruits tested positive for HIV in the northern province of Prayou. Approximately 5 million foreigners visit Thailand annually. a 1991 survey of tourists, however, found that 4% of respondents chose not to visit some parts of the country in response to the anti-AIDS campaign. A government minister has proposed establishing a task force against organized trade in child sex and the tourist sex industry. Should protective age limits for children in developing countries become comparable to those adopted for children in Germany, new legislation there may allow German authorities to begin prosecuting nationals who travel abroad seeking sex.^ieng