HICNet Medical News Digest Thu, 01 Dec 1994 Volume 07 : Issue 58 Today's Topics: [MMWR] Prevelance of Overweight Adolescents Int'l Workshop on Information Processing in Cells and Tissues Musculoskeltal Pain Emanating from Head & Neck - CE Course AIDS Daily News Summary +------------------------------------------------+ ! ! ! Health Info-Com Network ! ! Medical Newsletter ! +------------------------------------------------+ Editor: David Dodell, D.M.D. 10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA Telephone +1 (602) 860-1121 FAX +1 (602) 451-1165 Internet: mednews@stat.com Bitnet: ATW1H@ASUACAD Mosaic WWW *Asia/Pacific: http://biomed.nus.sg/MEDNEWS/welcome.html *Americas: http://cancer.med.upenn.edu:3000/ *Europe: http:/www.dmu.ac.uk/0/departments/pharmacy/archive/www/MEDNEWS/welcome .html Compilation Copyright 1994 by David Dodell, D.M.D. All rights Reserved. License is hereby granted to republish on electronic media for which no fees are charged, so long as the text of this copyright notice and license are attached intact to any and all republished portion or portions. The Health Info-Com Network Newsletter is distributed biweekly. Articles on a medical nature are welcomed. If you have an article, please contact the editor for information on how to submit it. If you are interested in joining the automated distribution system, please contact the editor. Associate Editors: E. Loren Buhle, Jr. Ph.D. Dept. of Radiation Oncology, Univ of Pennsylvania Tom Whalen, M.D., Robert Wood Johnson Medical School at Camden Douglas B. Hanson, Ph.D., Forsyth Dental Center, Boston, MA Lawrence Lee Miller, B.S. Biological Sciences, UCI Dr K C Lun, National University Hospital, Singapore W. Scott Erdley, MS, RN, SUNY@UB School of Nursing Jack E. Cross, B.S Health Care Admin, 882 Medical Trng Grp, USAF Albert Shar, Ph.D. CIO, Associate Prof, Univ of Penn School of Medicine Martin I. Herman, M.D., LeBonheur Children's Medical Center, Memphis TN Stephen Cristol, M.D. MPH, Dept of Ophthalmology, Emory Univ, Atlanta, GA Subscription Requests = mednews@stat.com anonymous ftp = vm1.nodak.edu; directory HICNEWS FAX Delivery = Contact Editor for information ---------------------------------------------------------------------- Date: Thu, 01 Dec 94 06:52:47 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: [MMWR] Prevelance of Overweight Adolescents Message-ID: Health Objectives for the Nation Prevalence of Overweight Among Adolescents -- United States, 1988- 91 Among adults, overweight is associated with increased risk for death, coronary heart disease, diabetes mellitus, gallbladder disease, joint disease, and certain cancers (1), and overweight during adolescence is associated with increased risk for overweight as an adult (2). CDC's third National Health and Nutrition Examination Survey (NHANES III) provides data to monitor changes in the dietary, nutritional, and health status of the U.S. population (3) and to track progress toward achieving the year 2000 national health objectives, including those related to prevalence of overweight (4). This report presents findings from NHANES III, Phase 1 (1988-91), on the prevalence of overweight among U.S. adolescents (ages 12-19 years). NHANES III used a stratified multistage probability design to obtain a sample of the civilian, noninstitutionalized U.S. population aged greater than or equal to 2 months. The survey comprised two 3-year nationally representative phases with oversampling of children aged 2 months-5 years, persons aged greater than or equal to 60 years, blacks, and persons of Mexican descent (5). Height and weight were measured as part of a standardized physical examination in a mobile examination center (3). Body mass index (BMI, kg/m2) was used as a measure of weight adjusted for height. For adolescents, overweight was defined in the year 2000 national health objectives (objective 2.3) using BMI cutoffs based on modified age- and sex-specific 85th percentile values of the second National Health and Nutrition Examination Survey (NHANES II) (1976-80) (4). Of the 1849 persons aged 12-19 years selected for the survey, 1632 (88%) were interviewed; of those interviewed, 1519 (93%) underwent a standardized physical examination. Of those examined, 1490 (98%) had complete data for height and weight, resulting in an overall analytic response rate of 81% (1490/1849). Data were weighted to account for survey design and nonresponse. During 1988-91, the prevalence of overweight for persons aged 12-19 years was 21%, an increase of 6% since NHANES II (Table 1). Sex-specific prevalence of overweight was 20% for males and 22% for females. Reported by: Div of Health Examination Statistics, National Center for Health Statistics, CDC. Editorial Note: One national health objective for the year 2000 is that overweight prevalence not exceed 15% among adolescents aged 12-19 years (baseline: 15% for adolescents aged 12-19 years in 1976-80) (objective 2.3) (4). The findings in this report indicate that, since NHANES II, the prevalence of overweight among adolescents has increased; a similar increase was reported for adults (6). Because both national surveys employed standardized equipment and procedures to measure height and weight, the increase during 1988-91 probably does not reflect changes in methodology. There is no generally accepted definition of overweight for adolescents (7). The definition used for the year 2000 national health objective (i.e., the 85th percentile from NHANES II) (4) has the advantage of comparability with the definition for adults. However, because of changes in body composition with growth, weight is a less reliable measure of fatness for children and adolescents than for adults (8), and this definition may classify some adolescents as overweight who do not have excess body fat. In addition, some adolescents change overweight classification with age; most overweight adults were not overweight children (2). The increase in the prevalence of overweight among adolescents and adults is most likely associated with dietary energy intake exceeding caloric expenditure. Energy intake through food consumption and energy expenditure through physical activity cannot be measured as precisely as height and weight in population surveys. Although high-fat and high-calorie foods are abundant and readily available in the United States, survey data suggest that dramatic increases in energy intake alone do not account for the increased prevalence of overweight among adolescents (9). Declining levels of physical activity also may account for these changes. For example, levels of participation by high school students in physical education declined from 1984 to 1990 (10); other factors possibly associated with declines in physical activity include concerns about personal safety and changing parental work habits. Changes in diet and activity levels are necessary for the U.S. population to reduce overweight; primary prevention of overweight should begin in childhood. The findings in this report can assist in tracking progress toward achieving public health goals aimed at reducing overweight among adolescents and adults. Subsequent analyses of NHANES III will be used to elucidate differences in overweight prevalence by socioeconomic status and race/ethnicity, identify population subgroups at risk for increased prevalence of overweight, and examine the relation between overweight and other health and nutrition variables. References 1. Public Health Service. The Surgeon General's report on nutrition and health, 1988. Washington, DC: US Department of Health and Human Services, Public Health Service, 1988; DHHS publication no. (PHS)88-50210. 2. Guo SS, Roche AF, Chumlea WC, Gardner JD, Siervogel RM. The predictive value of childhood body mass index values for overweight at age 35 y. Am J Clin Nutr 1994;59:810-9. 3. NCHS. Plan and operation of the Third National Health and Nutrition Examination Survey, 1988-94. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1994; DHHS publication no. (PHS)94-1308. (Vital and health statistics; series 1, no. 32). 4. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212. 5. Ezzati TM, Massey JT, Waksberg J, Chu A, Maurer KR. Sample design: Third National Health and Nutrition Examination Survey. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, NCHS, 1992; DHHS publication no. (PHS)92-1387. (Vital and health statistics; series 2, no. 113) 6. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults. JAMA 1994;272:205-11. 7. Flegal KM. Defining obesity in children and adolescents: epidemiologic approaches. Crit Rev Food Science Nutr 1993;33:307- 12. 8. Kuczmarski RJ. Trends in body composition for infants and children in the U.S. Crit Rev Food Sci Nutr 1993;33:375-87. 9. McDowell MA, Briefel RR, Alaimo K, et al. Energy and macronutrient intakes of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, Phase 1, 1988-91. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, NCHS, 1994; DHHS publication no. (PHS)94-1250. (Advance data no. 255) 10. Heath GW, Pratt M, Warren CW, Kann L. Physical activity patterns in American high school students: results from the 1990 Youth Risk Behavior Survey. Arch Pediatr Adolesc Med 1994;148:1131- 6. ------------------------------ Date: Thu, 01 Dec 94 06:54:27 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: Int'l Workshop on Information Processing in Cells and Tissues Message-ID: +++++++++ Preliminary Announcement and Call for Papers ++++++++++++ ============= Please Inform Interested Colleagues ================= INTERNATIONAL WORKSHOP ON INFORMATION PROCESSING IN CELLS AND TISSUES Liverpool 6th - 8th September 1995 The purpose of this workshop is to bring together a multidisciplinary group of scientists working in the general area of modelling cells and tissues. A central theme will be the nature of biological information and the ways it is processed in cells and tissues. We hope that the workshop will draw together researchers from a range of disciplines including: Computer Science, Cell Biology, Mathematics, Physiology, Biophysics, Experimental Medicine, Biochemistry, Electronic Engineering and Biotechnology. The workshop is intended to provide a forum to report research, discuss emerging topics and gain new insights into information processing in biological and computational systems. Subjects areas are likely to include but not be restricted to: * Cellular information processing systems * Enzyme networks, Gene networks, Metabolic channeling * Second messenger systems * Signal Transduction and Cellular Pattern Recognition * Automata models * Parallel Distributed Processing models * Cellular Automata models * Single Neuron Computation * Biomolecular computing * Inter-cellular communication, Multi-cellularity * Information Processing in Developmental Systems * Information Processing in Immune networks * Endocrine-immune-nervous interactions * Information processing in neural tissue systems * Information processing in non-neural tissue systems * Communication and gap-junctions * Asynchronous processing, MIMD, SIMD and NIMD systems * Cell and tissues oscillators * Fractals and Chaos * Emergent phenomena and self-organisation Programme Committee Georg Brabant Endocrinology (Hanover) Michael Conrad Computer Science (Detroit) Roy Cuthbertson Cell Biology (Liverpool) Claus Emmeche Philosophy of Nature and Science Studies (Copenhagen) Mike Holcombe Computer Science (Sheffield) George Kampis Ethology and Philosophy of Science (Budapest) Douglas Kell Biological Sciences (Aberystwyth) Gareth Leng Physiology (Edinburgh) Pedro Marijuan Electronics & Informatics (Zaragoza) Koichiro Matsuno BioEngineering (Nagaoka) Ray Paton Computer Science (Liverpool) Hans-Paul Schwefel Computer Science (Dortmund) Idan Segev Neurobiology (Jerusalem) Gordon Shepherd Neurobiology (Yale) Rene Thomas Molecular Biology (Brussels) Chris Tofts Computer Science (Manchester) John Tucker Computer Science (Swansea) G Rickey Welch Biological Sciences (New Orleans) Gershom Zajicek Experimental Medicine and Cancer Research (Jerusalem) Organizing Committee Ray Paton, Roy Cuthbertson Milke Holcombe and 'Trina Houghton Submission Details All authors must submit 4 copies of the full technical paper by mail or delivery service to: Ray Paton Department of Computer Science The University of Liverpool Liverpool L69 3BX UK PLEASE DO NOT SUBMIT PAPERS BY FAX. The paper should be in English, double-spaced in 12 point using Times or similar font. The paper should be a maximum of 16 pages including the first page. The first page must contain: title of the paper, author's names including affiliations, complete mailing address, telephone and FAX numbers, email address, and a 250 word (maximum) abstract. Important Dates Submission deadline: Friday April 14th 1995 Acceptance Notification: Friday May 26th 1995 Deadline for final paper: Friday June 23rd 1995 Enquiries Enquires should be addressed to Ray Paton at the above address or FAX +44 51 794 3715 or email tissues@csc.liv.ac.uk ------------------------------ Date: Thu, 01 Dec 94 06:55:55 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: Musculoskeltal Pain Emanating from Head & Neck - CE Course Message-ID: Continuing Medical Education Listing 8th International Symposium sponsored by Physical Medicine Research Foundation "Musculoskeletal Pain Emanating from the Head and Neck: Current Concepts in Diagnosis, Management and Cost Containment", October 13 - 15, 1995; Banff, Alberta, Canada "A World Heritage Site" Keynote Speakers: Emeritus Professor Patrick D. Wall FRS, DM, FRCP (UK) (Founder & Chief Editor of the Journal PAIN); James K. Taylor MB, ChB, DTM, PhD, FAFRM -Sci, (Australia), & Chris J. Main MA, MPhil, PhD, FBPsS, (UK) For program information please contact: Physical Medicine Research Foundation, 207 West Hastings St. Ste. 510, Vancouver, B.C., V6B 1H7 Canada Tele: (604) 684-4148, Facsimile (604) 684-6247 or E-Mail mwhite@unixg.ubc.ca ------------------------------ Date: Thu, 01 Dec 94 06:56:54 MST From: mednews@stat.com (HICNet Medical News) To: hicnews Subject: AIDS Daily News Summary Message-ID: AIDS Daily Summary The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1994, Information, Inc., Bethesda, MD In this issue: ********************************************************************* "German AIDS-Detecting Drug Recalled; Maker Says It Missed Virus in One Case" "Risperidone in HIV-Related Manic Psychosis" "Nosocomial HIV-1 Transmission and Primary Prevention in Romania" "Evaluating Interventions for Fear of Contagion" "When All Else Fails" "Medical Briefs: Sulfadiazine Available" "Infections Related to Venous Access Devices in Patients with AIDS" "Alkaline Phosphatase Band-10 Fraction as a Possible Surrogate úÿ Marker for Human Immunodeficiency Virus Type 1 Infection in Children" "AIDS Drugs Fail to Curb Dementia and Nerve Damage" "Killer T Cells Reported as a Potential Gene Therapy for Viral Diseases and Cancer" "Autopsy Rates Among Patients Reported with AIDS" "Only a Phone Call Away: Educating Health Care Professionals About HIV/AIDS" "Reduction of Maternal-Infant Transmission of Human Immunodeficiency Virus Type 1 with Zidovudine Treatment" "A Controlled Trial of Intravenous Immune Globulin for the Prevention of Serious Bacterial Infections in Children Receiving Zidovudine for Advanced Human Immunodeficiency Virus Infection" "An AIDS-Like Condition Induced in Baboons by HIV-2" "Synergy Between Basic Fibroblast Growth Factor and HIV-1 Tat Protein in Induction of Kaposi's Sarcoma" ********************************************************************* "German AIDS-Detecting Drug Recalled; Maker Says It Missed Virus in One Case" Boston Globe (10/24/94) P. 52 Hoechst, one of Germany's largest drug companies, has initiated a recall of Enzygnost--a drug used for HIV testing--because it missed HIV in one instance. Behring, the distributor of Enzygnost and a subsidiary of Hoechst, began a worldwide recall action to 35 countries on Oct. 15. German pharmaceutical authorities have withdrawn the license for the drug. In Japan, the Health and Welfare Ministry has requested more information so it can decide whether people who previously tested negative with Enzygnost should be tested again. It is believed that enough Enzygnost to test 150,000 people has been distributed in Japan--and 80 percent of that has already been used. Behring spokesman Wolfgang Faust said that extensive retesting would not be necessary--only one problem case has occurred since the drug was introduced in 1991. The diagnostic failure was partially explained by the gap between when a person is infected with HIV and when it can be detected in the blood, up to 12 weeks. Faust said that Behring has applied to license a new, improved AIDS test drug and that Enzygnost had become obsolete. "Risperidone in HIV-Related Manic Psychosis" Lancet (10/08/94) Vol. 344, No. 8928, P. 1029 (Singh, A. N.; Catalan, J.) Manic psychosis is fairly common among people in the advanced stages of HIV. Singh and Catalan successfully administered risperidone to four male psychotic AIDS patients with manic symptoms. Following the Young mania rating scale, ratings in three patients fell from 43 to 8, 35 to 14, and 30 to 3 within seven to 10 days of receiving the drug. In contrast to the study by Dwight et al concluding that risperidone may exacerbate manic symptoms in patients with schizoaffective disorders, the preliminary findings of Singh and Catalan indicate that risperidone may be safe and effective in the treatment of AIDS-related psychosis with manic symptoms. "Nosocomial HIV-1 Transmission and Primary Prevention in Romania" Lancet (10/08/94) Vol. 344, No. 8928, P. 1028 (Apetrei, C.; Buzdugan, I.; Mitroi, I. et al) To establish the incidence and prevalence of patient-to-patient HIV transmission among Romanian children, a study was conducted in life-care institutions for orphans and abandoned children. A total of 2,673 patients were tested for HIV in 23 different homes. A high prevalence of HIV infection was found--in contrast with the very low prevalence of HIV in adults in that region. All mothers of children who tested HIV-positive that could be could be tested were found HIV-seronegative. Children who were HIV-positive or had AIDS were not separated from other patients, but strict primary prevention measures were adopted in five of the six orphanages where HIV was found. After testing every six months, no new cases were found in the first five homes. The sixth home, which houses 60 children, had 19 new children who were diagnosed with HIV. Seroconversion after the first test for HIV took place in six of the children, while the other 13 arrived at the orphanage during the survey and were seropositive when first tested. The study shows that primary prevention measures are effective early even when a significant portion of the population is HIV-seropositive and lives among those who are uninfected. "Evaluating Interventions for Fear of Contagion" Journal of the Association of Nurses in AIDS Care (9/94-10/94) Vol. 5, No. 5, P. 48 (Meisenhelder, Janice Bell; Rice, Louise) Contact with AIDS patients is one educational strategy employed to lessen fear of HIV contagion. To evaluate this type of intervention among nurses, two continuing educational offerings presented a panel of people living with HIV. The one-day program was marked by a significant decrease in levels of fear. In the six-week course, however, nurses' willingness to care for patients with HIV remained unchanged between preprogram and postprogram tests. The results provide evidence supporting the idea that exposure to persons living with HIV decreases the fear of contagion among nurses. "When All Else Fails" American Medical News (10/10/94) Vol. 37, No. 38, P. 13 (Pinkney, Deborah Shelton) The American Medical Association is seeking $75,000 from the Centers for Disease Control and Prevention to develop an HIV prevention training program for doctors. The prototype information kit contains an array of items--including pamphlets, condoms, a demonstration model penis, a contract card for recording negotiated behavior-change agreements, and a wallet-size card to help patients monitor their progress. The kit would also include pointers on how to talk to patients about risky behavior, which is useful for doctors who are unsure how they can help patients change behaviors that increase the risk of becoming HIV-infected. "Physicians have trouble talking to patients about sensitive subjects such as sexual practices and drug use because they are not trained to," said Dr. James R. Allen, AMA vice president for science, technology, and public health. If the grant proposal is approved, the kit will be tested in two states among 200 to 400 patients, and will expand if proven effective. HIV prevention training is currently available through 17 national AIDS Education and Training Centers operated by the federal Health Resources and Services Administration. "Medical Briefs: Sulfadiazine Available" Advocate (10/18/94) No. 666, P. 34 Sulfadiazine, manufactured and marketed by Eon Labs Manufacturing Inc., is now available in the United States. Previously obtained only through the Centers for Disease Control and Prevention, the drug can be used for treatment of many infections, including adjunctive therapy with pryimethamine for toxoplasmosis--an infection of the brain that often causes brain inflammation and dementia in AIDS patients. Sulfadiazine has been approved by the Food and Drug Administration to be marketed through an accelerated drug-review process. "Infections Related to Venous Access Devices in Patients with AIDS" Journal of the Association of Nurses in AIDS Care (9/94-10/94) Vol. 5, No. 5, P. 43 (Settle, Jane T.; Neff-Smith, Martha; Wan, George J.) A retrospective study of venous access devices (VADs) was conducted in patients with AIDS to compare infection rates in implanted external catheters and completely implanted ports. VADs are often found in PWAs who need long-term administration of medications and access for phlebotomy and dehydration. All 48 participants were diagnosed with AIDS and received a total of 54 VADs. While the 41 external catheters had an infection rate of 36.5 percent, the 13 ports had a 30.8 percent infection rate. The authors hypothesize that lack of compliance with care of the device is a significant factor in the development of VAD infections. "Alkaline Phosphatase Band-10 Fraction as a Possible Surrogate Marker for Human Immunodeficiency Virus Type 1 Infection in Children" J.A.M.A. (10/19/94) Vol. 272, No. 15, P. 1152 A lymphocyte fraction of alkaline phosphatase (ALP band-10) activity in serum may be useful in predicting HIV-1 in children born to HIV-1 seropositive mothers. ALP band 10 in serum's presence correlated with HIV-1 infection status. HIV-1 positively identified in 31 samples from 18 patients, ages 0.1 to 10 years, while the absence of infection was noted in the 14 samples from 9 patients who made up the controls and whose serum samples did not show ALP band-10 activity. The ability of ALP band 10 to predict HIV-1 infection in children as young as two months may be useful as a surrogate marker for early identification in babies born to HIV-infected mothers long before maternal anti-HIV antibodies are approved. "AIDS Drugs Fail to Curb Dementia and Nerve Damage" New York Times (11/01/94) P. C3 (Altman, Lawrence K.) A study of six AIDS-related neurological conditions found that the incidence of infections that affect the brain and central nervous system is increasing among HIV-infected patients. Previous studies have found that AIDS drugs helped protect against such damage. The increase was due in part to the negative effects of drugs such as ddI (didanosine), ddC (zalcitabine), and d4T (stavudine). The conditions include toxoplasmosis, cryptococcal meningitis, and neuropathy. The six conditions affected about 40 percent of the 2,641 HIV-infected gay males who participated in the study. Dementia affected almost 20 percent of the patients. There is a debate in the scientific community as to whether there has been a decline in the incidence of AIDS dementia. A Dutch study suggested that the use of AZT led to a significant decrease in dementia, but others disagreed, saying that the dementia only seemed to disappear because it is frequently fatal quickly. Dr. Justin S. McArthur, head of the research team and a neurologist at Johns Hopkins School of Medicine, said that the data underscores the need for the development of more effective AIDS drugs. He also said that while the survival rate after the development of opportunistic infections has increased, more people are living longer with severely suppressed immune systems--the period of vulnerability to neurological complications, especially opportunistic infections of the brain. "Killer T Cells Reported as a Potential Gene Therapy for Viral Diseases and Cancer" PRNewswire (11/01/94) A team of researchers lead by Margo R. Roberts--director of cell biology and immunology for Cell Genesys, Inc.--has developed anti-HIV T cells that specifically and efficiently kill HIV-infected cells in laboratory experiments. The findings, which are reported in the Nov. 1 issue of the journal Blood, describe the first successful laboratory experiments that resulted in permanent genetic modification of killer T cells specific for HIV. Killer T cells, or CD8+ lymphocytes--a significant component of the immune system that is normally responsible for eliminating virus-infected and tumor cells--were engineered to produce the anti-HIV T cells. The National Institutes of Health began the first human test of genetically altered HIV-specific killer T cells in September in a Phase I/II trial of anti-HIV T cell therapy for AIDS. Phase I safety results are expected in late 1995. Previous studies have shown that, in people with AIDS, the level of HIV-specific killer T cells--which kill HIV-infected cells--decreases as they progress to later phases of AIDS. "Autopsy Rates Among Patients Reported with AIDS" A.J.P.H. (10/94) Vol. 84, No. 10, P. 1695 (Schable, Barbara; Chu, Susan Y.) Researchers studied autopsy rates of people in the United States who died of AIDS to determine if there was a decline similar to that found in the general population of the country. The general autopsy rate in the United States from World War II to 1991 dropped from about 50 percent to 11 percent of deaths. Data was taken from 16 states and local health departments whose combined AIDS deaths account for 43 percent of all AIDS deaths nationwide. The autopsy rate for people with AIDS fell from 57 percent in 1983 to 10 percent in 1991. While the autopsy rate for adults with AIDS declined by 82 percent, the autopsy rate in pediatric AIDS cases declined by 57 percent. Autopsies are more likely to be performed on persons with AIDS whose mode of HIV exposure is hard to determine. The authors attribute the substantial decline in autopsy rates among AIDS patients to improved diagnostic techniques, increased workload for pathologists, the cost of the procedure, and safety issues. Critical evaluation of the decline is suggested because of the usefulness of autopsies in confirming diagnoses both antemortem and in death certificates. "Only a Phone Call Away: Educating Health Care Professionals About HIV/AIDS" J.A.M.A. (10/26/94) Vol. 272, No. 16, P. 1242 (Sumaya, Ciro V.; Macher, Abe M.; Bowen, Stephen G. et al) The Health Resources and Services Administration (HRSA) is now educating and updating health care providers in the clinical management of HIV and AIDS through two telephone services. Established in 1992, the International State-of-the-Art HIV Clinical Conference Call Series lets health care workers from around the world discuss HIV care issues with panels of internationally known clinical experts. Topics and questions to be addressed during the quarterly conference calls are determined by surveying thousands of primary care providers. Evaluations show that the participants find the programs informative and the topics timely. Also, the National HIV Telephone Consulting Service--sponsored by organizations such as the Western AIDS Education and Training Center and the National Institutes of Health's Office of AIDS Research--is an on-line consulting service for health care providers. Primary care providers with HIV-related clinical management questions can call the 800 number and speak to expert consultants. As of February 1994, the program--based out of San Francisco General Hospital--had received more than 4,100 phone calls and 4,600 questions covering all aspects of HIV. "Reduction of Maternal-Infant Transmission of Human Immunodeficiency Virus Type 1 with Zidovudine Treatment" N.E.J.M. (11/03/94) Vol. 331, No. 18, P. 1173 (Connor, Edward M.; Sperling, Rhoda S.; Gelber, Richard et al) Young children become infected with HIV-1 principally through maternal-infant transmission. The Pediatric AIDS Clinical Trials Group conducted a multicenter study in the United States and France to assess the efficacy and safety of zidovudine (AZT) in reducing such transmissions. A total of 477 HIV-positive pregnant women with CD4+ cell counts above 200 were enrolled. Only 8.3 percent of the babies who received AZT tested positive for HIV, while 25.5 percent of the infants in the placebo group tested positive. The researchers found that administering AZT to the pregnant mother throughout pregnancy, labor, and delivery and giving it to the infant for six weeks reduced the risk of HIV transmission by about two-thirds. The birth levels of hemoglobin in infants in the AZT group were significantly lower than those in the placebo group but, by 12 weeks, both groups had similar levels. "A Controlled Trial of Intravenous Immune Globulin for the Prevention of Serious Bacterial Infections in Children Receiving Zidovudine for Advanced Human Immunodeficiency Virus Infection" N.E.J.M. (11/03/94) Vol. 331, No. 18, P. 1181 (Spector, Stephen A.; Gelber, Richard D.; McGrath, Nuala et al) HIV-infected children frequently experience recurrent serious bacterial infections. A study was conducted to determine the efficacy of intravenous immune globulin in children with AIDS or AIDS-related complex who were being treated with zidovudine (AZT). The trial followed 255 children between the ages of 3 months and 12 years for approximately two years. Each child received 180 mg of AZT orally four times a day. The estimated two-year rate of serious bacterial infections was 16.9 percent for the group that received intravenous immune globulin. The rate for the placebo group was 24.3 percent. The researchers concluded that, for children with advanced HIV who are receiving AZT, intravenous immune globulin decreases the risk of serious bacterial infections. The decrease was seen primarily among the children who were not taking trimethoprim-sulfamethoxazole as prophylaxis when entering the trial. "An AIDS-Like Condition Induced in Baboons by HIV-2" Science (10/28/94) Vol. 266, No. 5185, P. 642 (Barnett, Susan; Murthy, Krishna K.; Herndier, Brian G. et al) A study was conducted in which six baboons were injected with the UC2 strain of HIV-2. Each of the baboons seroconverted within six weeks and five became persistently infected. Within 18 to 24 months after injection, three had CD4+ T cell loss. At necropsy, one baboon showed extensive circulation of the virus with follicular depletion in the lymph nodes, widespread fibromatosis involving lymphoid and nonlymphoid tissues, and lymphotic interstitial pneumonitis. Other baboons were injected with UC14 strain of HIV-2 and all have demonstrated persistent infection. The results show that persistent infection can be acheived and that some animals demonstrate AIDS-like symptoms. The baboons provide a useful animal model for studying HIV and for evaluating potential antiviral therapies. "Synergy Between Basic Fibroblast Growth Factor and HIV-1 Tat Protein in Induction of Kaposi's Sarcoma" Nature (10/20/94) Vol. 371, No. 6499, P. 674 (Ensoli, Barbara; Gendelman, Rita; Markham, Phillip et al) Angiogenic Kaposi's sarcoma-like lesions in mice were induced by the combined operation of basic fibroblast growth factor (bFGF) and HIV-1 Tat protein. The synergy is induced by Tat, which increases endothelial cell growth and type-IV collagenase expression in response to bFGF imitating extracellular matrix proteins. The bFGF, extracellular Tat, and Tat receptors are found in HIV-1-related Kaposi's sarcoma (KS). Their presence may explain the higher incidence and aggressiveness of HIV-1-related KS compared to the classical form of KS--which is rare and mild and found in elderly men of Mediterranean origin--where only bFGF is found. ------------------------------ End of HICNet Medical News Digest V07 Issue #58 *********************************************** --- Editor, HICNet Medical Newsletter Internet: david@stat.com FAX: +1 (602) 451-1165 Bitnet : ATW1H@ASUACAD