Prevalence and predictors of skin disease in the Women's Interagency HIV Study (WIHS).

OBJECTIVE: We attempted to determine the prevalence and predictors of skin disease in a cohort of women with and at risk for HIV infection. METHODS: We analyzed baseline data from a multicenter longitudinal study of HIV infection in women. RESULTS: A total of 2018 HIV-infected women and 557 HIV-uninfected women were included in this analysis. Skin abnormalities were reported more frequently among HIV-infected than uninfected women (63% vs 44%, respectively; odds ratio [OR] 2.10; 95% confidence interval [95% CI], 1.74-2.54). Infected women were also more likely to have more than 2 skin diagnoses (OR, 3.27; 95% CI, 1.31-8.16). Folliculitis, seborrheic dermatitis, herpes zoster, and onychomycosis were more common among HIV-infected women (P < .05). Independent predictors of abnormal findings on skin examination in the infected women were African American race (OR, 1.38; 95% CI, 1.07-1.77), injection drug use (OR, 2.74; 95% CI, 2.11-3.57), CD4(+) count less than 50 (OR, 1.68; 95% CI, 1.17-2.42), and high viral loads (100,000-499,999 = OR, 1.77; 95% CI, 1.32-2.37; > 499,999 = OR, 2.15; 95% CI, 1.42-3.27). CONCLUSION: HIV infection was associated with a greater number of skin abnormalities and with specific dermatologic diagnoses. Skin abnormalities were also more common among women with CD4(+) cell depletion or higher viral load.

Serum tocopherols and lipids in patients with coronary artery disease.

Serum tocopherols and lipids levels in 40 coronary artery disease patients were statistically analysed in relation to those of the normal controls and an attempt was made to define the correlation between tocopherols and various lipids. Serum tocopherols levels were found to be significantly low in coronary artery disease patients as compared to those of the controls implicating an inverse relationship between coronary artery disease and serum level of tocopherols. Coronary artery disease population did not register any significant change in various blood lipids, except triglyceride fraction, as compared to that of the normal population. Serum tocopherols and lipids were also analysed in relation to age and sex. The preliminary data suggest that coronary artery disease patients have sub-optimal tocopherols level (0.58 +/- 0.26 mg/dl) as compared to that of the normal controls (0.81 +/- 0.34 mg/dl; p < 0.001), which may be an important risk and/or contributing factor for atherogenesis and coronary artery disease

Women and HIV. A review of current epidemiology, gynecologic manifestations, and perinatal transmission.

HIV is increasing rapidly in women, particularly due to heterosexual transmission. The manifestations of HIV in women differ in some respects from those in men, most obviously with respect to gynecologic manifestations. Candidiasis, anogenital human papillomavirus and neoplasia, and contraception and prevention of sexual transmission are all important issues. Reduction in perinatal transmission is a key focus in women, with a growing number of effective preventative interventions.

Effect of oral verapamil on ventricular irregularity in long-standing atrial fibrillation.

In patients with chronic atrial fibrillation (AF), symptoms and cardiac function may be improved by regularizing the ventricular rhythm, even though the AF persists. This study concerned effects of i.v. and oral verapamil (V) on ventricular regularity. A regularizing effect was observed in 5 out of 10 patients after 0.15 mg of V/kg b.wt.i.v., but in only one patient after 80 mg of V By mouth. V in a dose of 240 mg by mouth resulted in ventricular regularity in 6 out of 10 other patients, 320 mg in a further 2 and 400 mg in the remaining 2 patients. Six patients were given chronic oral therapy in progressively increasing doses. Although ventricular regularity and symptom relief were obtained, intolerable side-effects precluded the evaluation of subjective long-term effects of this therapy in all but one patient. Further investigations, particularly concerning the pharmacokinetic mechanisms of V, are needed before the treatment can be recommended for patients with chronic AF.

Verapamil-induced ventricular regularity in atrial fibrillation. Effects of exercise, isoproterenol, atropine and conversion to sinus rhythm.

The effects of physical exercise, isoproterenol and atropine upon the ventricular rate and regularity were studied in 12 patients with atrial fibrillation (AF) during verapamil-induced regular ventricular rhythm. Physical exercise, isoproterenol and atropine all caused a gradual loss of ventricular regularity during AF. Verapamil caused a reduction of exercise heart rate during AF and, to a minor extent, even during sinus rhythm. The regular ventricular rhythm induced by verapamil during AF is interpreted as a total AV-nodal block with nodal escape rhythm. Possible clinical benefits of this rhythm are discussed.

Effects of metoprolol on heart rate in patients with digitalis treated chronic atrial fibrillation.

Adequate control of ventricular rate in patients with chronic atrial fibrillation (AF) may not be achieved with digitalis alone. In the present study the additional effect of two different doses (50 mg and 50 +/- 50 mg) of oral metoprolol, a new selective beta-blocking agent, on ventricular rate in patients with longstanding AF has been studied. A decrease in the mean ventricular rate during rest and during exercise at various work loads was observed after both doses. The effect was more pronounced at the highest work load of 80 W, both after 50 mg (p less than 0.002) and after 50 +/- 50 mg (p less than 0.01) of the drug. A high initial heart rate at rest or during exercise was reduced more by the drug than a lower one. Exercise tolerance was reduced in 2 patients. These results suggest that patients with AF in whom satisfactory control of heart rate cannot be achieved with digitalis alone may benefit from addition of individualized metoprolol therapy.